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Charania NA, Tonumaipe'a D, Barbarich-Unasa TW, Iusitini L, Davis G, Pacheco G, Wilson D. Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand. Hum Vaccin Immunother 2024; 20:2301626. [PMID: 38205779 DOI: 10.1080/21645515.2023.2301626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. "We go with the norm" reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants' acceptance of routine vaccines before the pandemic. "Everything became difficult" explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. "It needed to have an ethnic-specific approach" highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. "People are now finding their voice" expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
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Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Daysha Tonumaipe'a
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Te Wai Barbarich-Unasa
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Georgina Davis
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Gail Pacheco
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Wilson
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
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Achterbergh RCA, McGovern I, Haag M. Co-Administration of Influenza and COVID-19 Vaccines: Policy Review and Vaccination Coverage Trends in the European Union, UK, US, and Canada between 2019 and 2023. Vaccines (Basel) 2024; 12:216. [PMID: 38400199 PMCID: PMC10891656 DOI: 10.3390/vaccines12020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Recommending co-administration of influenza and COVID-19 vaccines has emerged as a strategy to enhance vaccination coverage. This study describes the policy on co-administration and uptake of influenza and COVID-19 vaccination in Europe, the United Kingdom, the United States, and Canada between 2019 and 2023. We collected co-administration policy data from governmental websites, national health organizations, and newspapers. Influenza vaccination coverage among persons ≥65 years and COVID-19 vaccination coverage rates among persons ≥60 years or the general population were collected using national databases, the ECDC database, or ourworldindata.org between 2019 and 2023. Descriptive analyses were used. We collected data from 30/32 (94%) countries on vaccination policy in seasons 2021-2022 and 2022-2023, with most countries (25/30 to 30/30) having policies recommending co-administration. For influenza vaccination coverage, we collected data from 29/32 (91%, 2019-2020), 28/32 (88%, 2020-2021), 27/32 (84%, 2021-2022), and 6/32 (19%, 2022-2023) countries. COVID-19 vaccination was collected from 32/32 (2020-2021), 31/32 (97%, 2021-2022), and 24/32 (75%, 2022-2023) countries. Influenza vaccination coverage increased from 2019-2020 to 2021-2022. COVID-19 vaccination coverage was higher among countries with higher influenza vaccination coverage. By 2022-2023, all countries included implemented a policy supporting co-administration. A positive correlation existed between higher influenza vaccination coverage and higher COVID-19 vaccination rates.
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Affiliation(s)
| | - Ian McGovern
- Center for Outcomes Research and Epidemiology, CSL Seqirus, Waltham, MA 02451, USA;
| | - Mendel Haag
- Center for Outcomes Research and Epidemiology, CSL Seqirus, 1105 BJ Amsterdam, The Netherlands
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Powelson J, Kalepa J, Kachule H, Nkhonjera K, Matemba C, Chisema M, Chumachapera T, Lawrence E. Using community-based, participatory qualitative research to identify determinants of routine vaccination drop-out for children under 2 in Lilongwe and Mzimba North Districts, Malawi. BMJ Open 2024; 14:e080797. [PMID: 38307530 PMCID: PMC10836352 DOI: 10.1136/bmjopen-2023-080797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/08/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVE In recent years, full childhood routine immunisation coverage has fallen by 5% to levels not seen since 2008; between 2019 and 2021, 67 million children were undervaccinated. We aimed to identify and describe the determinants of vaccination drop-out from the perspectives of caregivers and health workers in Malawi. DESIGN We used a community-based participatory research approach to collect data through photo elicitation, short message service exchanges, in-depth interviews and observations. We used a team-based approach for thematic analysis, guided by the Behavioural and Social Drivers of Vaccination framework. SETTING The study was conducted in Lilongwe and Mzimba North Districts in Malawi, representing urban and rural settings, respectively. PARTICIPANTS Participants included caregivers of partially vaccinated (n=38) and fully vaccinated (n=12) children between 25 and 34 months and Community Health Workers (n=20) who deliver vaccines. Caregiver participants were identified through health facility vaccination registers and with the assistance of community health volunteers. RESULTS We identified five principal drivers of routine vaccination drop-out: (1) poor caregiver knowledge of the vaccine schedule and how many vaccines are needed for full vaccination; (2) caregivers' fear of repercussions after not following vaccination guidelines; (3) rumours and concerns if vaccines are repeated or new ones are introduced; (4) high opportunity cost of health facility visits, exacerbated by wait times, stockouts and missed opportunities and (5) limited family support and vaccination burden placed largely on mothers. Key differences between rural and urban settings related to practices around health cards and vaccine wastage, wait times, migrant and tenant communities, and social support systems. CONCLUSIONS Immunisation interventions should be tailored to address drivers of drop-out in the community, the health facility and beyond. Service quality, timeliness and reliability need to be improved, and tailored messaging and education are needed, especially in response to COVID-19-related misinformation and introductions of new, routine vaccines.
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Fadl N, Abdelmoneim SA, Gebreal A, Youssef N, Ghazy RM. Routine childhood immunization in Sub-Saharan Africa: addressing parental vaccine hesitancy. Public Health 2024; 226:66-73. [PMID: 38007843 DOI: 10.1016/j.puhe.2023.10.049] [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: 06/15/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES Parental vaccine hesitancy (VH) is a major barrier to childhood vaccination. We aimed to identify the determinants of parental VH towards routine childhood immunization in 12 Sub-Saharan African countries. STUDY DESIGN A cross-sectional study was conducted from November 1 to December 15, 2022. METHODS Parents of children aged 19 months to 6 years and residing in the Sub-Saharan Africa were included. An anonymous online survey and face-to-face interviews were conducted. The Parent Attitude about Childhood Vaccine Scale was used to identify vaccine-hesitant parents. Multivariate regression and mediating analysis were performed. RESULTS Across the 5032 participants, 21.2% were hesitant towards routine childhood immunization. Urban residents (adjusted odds ratio [AOR] = 1.32, 95% confidence interval [CI]: 1.10-1.58), non-first-born children (AOR = 1.54, 95% CI: 1.19-1.98), and chronically ill children (AOR = 2.00, 95% CI: 1.69-2.37) increased the likelihood of parental VH. Mothers with higher education, attending at least one antenatal care (ANC) visit (AOR = 0.25, 95% CI: 0.19-0.32), and had a healthcare facility-based delivery (AOR = 0.55, 95% CI: 0.44-0.70) decreased the odds of parental VH. Parental VH mediated the effect of ANC and mothers' age on vaccination uptake. ANC increased the odds of vaccination uptake (odds ratio [OR] = 12.49, 95% CI: 9.68-16.13). Parental VH mediated the association between ANC and vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.12, 95% CI: 0.10-0.14). Each additional year of the mother's age decreased the odds of vaccination uptake (OR = 0.95, 95% CI: 0.95-0.96). The indirect effect of mother's age on vaccination through parental VH decreased the odds of vaccination uptake (OR = 0.45, 95% CI: 0.44-0.45). Parental VH continued to be a mediator of the combined effect of mother's age and ANC on vaccination uptake, decreasing the likelihood of vaccination uptake (OR = 0.0017, 95% CI: 0.00166-0.00168). CONCLUSIONS Context-specific interventions are needed to address parental VH and improve vaccine acceptance and coverage.
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Affiliation(s)
- N Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
| | - S A Abdelmoneim
- Clinical Research Administration, Directorate of Health Affairs, Egyptian Ministry of Health, Alexandria, Egypt.
| | - A Gebreal
- Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - N Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Saudi Arabia.
| | - R M Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
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Ghazy RM, Elkhadry SW, Abdel-Rahman S, Taha SHN, Youssef N, Elshabrawy A, Ibrahim SA, Al Awaidy S, Al-Ahdal T, Padhi BK, Fadl N. External validation of the parental attitude about childhood vaccination scale. Front Public Health 2023; 11:1146792. [PMID: 37261239 PMCID: PMC10228384 DOI: 10.3389/fpubh.2023.1146792] [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: 01/17/2023] [Accepted: 04/14/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Internal validation techniques alone do not guarantee the value of a model. This study aims to investigate the external validity of the Parental Attitude toward Childhood Vaccination (PACV) scale for assessing parents' attitude toward seasonal influenza vaccination. Methods Using a snowball sampling approach, an anonymous online questionnaire was distributed in two languages (English and Arabic) across seven countries. To assess the internal validity of the model, the machine learning technique of "resampling methods" was used to repeatedly select various samples collected from Egypt and refit the model for each sample. The binary logistic regression model was used to identify the main determinants of parental intention to vaccinate their children against seasonal influenza. We adopted the original model developed and used its predictors to determine parents' intention to vaccinate their children in Libya, Lebanon, Syria, Iraq, Palestine, and Sudan. The area under the curve (AUC) indicated the model's ability to distinguish events from non-events. We visually compared the observed and predicted probabilities of parents' intention to vaccinate their children using a calibration plot. Results A total of 430 parents were recruited from Egypt to internally validate the model, and responses from 2095 parents in the other six countries were used to externally validate the model. Multivariate regression analysis showed that the PACV score, child age (adolescence), and Coronavirus disease 2019 (COVID-19) vaccination in children were significantly associated with the intention to receive the vaccination. The AUC of the developed model was 0.845. Most of the predicted points were close to the diagonal line, demonstrating better calibration (the prediction error was 16.82%). The sensitivity and specificity of the externally validated model were 89.64 and 37.89%, respectively (AUC = 0.769). Conclusion The PACV showed similar calibration and discrimination across the six countries. It is transportable and can be used to assess attitudes towards influenza vaccination among parents in different countries using either the Arabic or English version of the scale.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Sally Waheed Elkhadry
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Suzan Abdel-Rahman
- Biostatistics and Demography Department, Faculty of Graduate Studies for Statistical Research, Cairo University, Giza, Egypt
| | - Sarah Hamed N. Taha
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdelhamid Elshabrawy
- Biostatistics and Demography Department, Faculty of Graduate Studies for Statistical Research, Cairo University, Giza, Egypt
| | - Sarah Assem Ibrahim
- Biostatistics and Demography Department, Faculty of Graduate Studies for Statistical Research, Cairo University, Giza, Egypt
| | | | - Tareq Al-Ahdal
- Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Bijaya Kumar Padhi
- Community Medicine and School of Public Health Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Alimoradi Z, Lin CY, Pakpour AH. Worldwide Estimation of Parental Acceptance of COVID-19 Vaccine for Their Children: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11030533. [PMID: 36992117 DOI: 10.3390/vaccines11030533] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023] Open
Abstract
Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents’ and guardians’ willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents’ acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents’ or guardians’ willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18–70) years and that of their children was 8.45 (range: 0–18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52–62%, I2: 99.92%, τ2: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents’ COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents’ knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3415613911, Iran
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3415613911, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden
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Ghazy RM, Sallam M, Fadl N, Bouraad E, Youssef N, Ghoneim OSA. Attitude of Parents of Children with Cerebral Palsy Towards COVID-19 Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031909. [PMID: 36767281 PMCID: PMC9915268 DOI: 10.3390/ijerph20031909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 05/26/2023]
Abstract
Children with cerebral palsy (CP) are at a greater risk of respiratory complications from coronavirus disease 2019 (COVID-19). Therefore, this study aimed to assess COVID-19 vaccine hesitancy (VH) among parents of CP children in Egypt, using the Arabic version of the Parental Attitude about Childhood Vaccination (PACV) questionnaire. This cross-sectional survey study was conducted at the outpatient clinics of two hospitals in Cairo, Egypt. Parents of children with CP were recruited using a simple random sampling technique. A total of 321 parents were enrolled; more than half of them were mothers of the children (61.37%); and the majority were Egyptians (87.23%) and living in urban areas (84.42%). Nearly 70% of the parents were hesitant to administer the COVID-19 vaccine to their children. A multiple linear regression model revealed that the PACV mean scores were lower among the following categories: (1) parents who could pay back loans, compared to those who could not pay back loans and who reported insufficient income (β = -2.39, p = 0.030); (2) non-Egyptian parents (β = -1.54, p = 0.002); (3) those who were fully vaccinated against COVID-19 themselves or had the intention to receive the complete COVID-19 vaccination (β = -6.28, p < 0.001); (4) those who had the intention to give the COVID-19 vaccination to their children (β = -3.04, p < 0.001); and (5) parents whose children received routine vaccines (β = -2.86, p < 0.045). After adjusting for other covariates, the parental COVID-19 vaccine status (β = -6.28, p < 0.001) and parents who experienced a COVID-19-related death in the family (β = -1.75, p < 0.001) showed significantly lower mean PACV scores. However, higher mean PACV scores were reported among parents who had a COVID-19 infection (β = 2.77, p < 0.001) or who were not sure (β = 2.94, p < 0.001). Our findings suggest the need to increase COVID-19 vaccine acceptance among parents of vulnerable children to reduce the negative consequences of COVID-19.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Etwal Bouraad
- Department of Epidemiology and Population Health, American University of Beirut, Beirut 961, Lebanon
- School of Pharmacy, Lebanese International University, Beirut 961, Lebanon
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Omnya Samy A. Ghoneim
- Department of Physical Therapy for Pediatrics and Pediatric Surgery, Faculty of Physical Therapy, Badr University in Cairo, Cairo 11829, Egypt
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Elkhadry SW, Salem TAEH, Elshabrawy A, Goda SS, Bahwashy HAA, Youssef N, Hussein M, Ghazy RM. COVID-19 Vaccine Hesitancy among Parents of Children with Chronic Liver Diseases. Vaccines (Basel) 2022; 10:vaccines10122094. [PMID: 36560504 PMCID: PMC9783335 DOI: 10.3390/vaccines10122094] [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: 11/22/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Children with chronic medical conditions are more susceptible to developing a serious negative outcome from corona virus disease 2019 (COVID-19) than healthy children. This study investigated the extent of COVID-19 vaccine hesitancy (VH) and its predictors in parents of children with chronic liver disease (CLD) in Egypt. Methods: A cross-sectional study was conducted at the National Liver Institute from September to October 2022, using a random sampling method. Data were collected using the validated Arabic version of parents’ attitudes about childhood vaccines (PACV) scale. Structural equation modeling (SEM) and discriminant analysis were used to identify direct and indirect determinants of VH. Results: Of the 173 participating parents, 81.5% hesitated to vaccinate their child. Relevant characteristics for hesitancy included being the mother of the child (88.2%), younger than 40 years (92.9%), illiterate (92%), unemployed (88.8%), without health insurance (87.8%), unvaccinated against COVID-19 (97.2%), refused to complete vaccinations (85.7%), and not having chronic disease (85.7%) (p < 0.05). Previous COVID-19 infection of children motivated vaccination (p < 0.0001). Median total PACV, attitude, and trust scores were significantly higher in the hesitant group than the vaccinated group (p = 0.023). SEM suggests that child age and family size have a direct effect, while education level, and income have indirect effects on parents’ hesitancy. The model showed acceptable goodness of fit (GFI = 0.994, CFI = 1, RMSEA < 0.0001). A 92.9% corrected classification of the discriminator VH variables was determined using the discriminant analysis model (safety and efficacy, attitude and trust, child age, and family size). Conclusions: Many socioeconomic factors significantly affect parents’ attitudes toward their child’s vaccination. Thus, increasing parents’ awareness of the importance of childhood vaccination, especially among this risky group, may enhance their decision-making ability regarding vaccinating their children.
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Affiliation(s)
- Sally Waheed Elkhadry
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
- Correspondence: (S.W.E.); (R.M.G.); Tel.: +200-100-366-0120 (R.M.G.)
| | - Tahany Abd El Hameed Salem
- Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | - Abdelhamid Elshabrawy
- Department of Bio Statistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo 12556, Egypt
| | - Shymaa Sami Goda
- Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | - Howyda Ali Al Bahwashy
- Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Menoufia 32511, Egypt
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Mai Hussein
- Alexandria Clinical Research Administration, Health Affairs Directorate, Ministry of Health and Population, Alexandria 21554, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
- Correspondence: (S.W.E.); (R.M.G.); Tel.: +200-100-366-0120 (R.M.G.)
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Napolitano F, Miraglia del Giudice G, Angelillo S, Fattore I, Licata F, Pelullo CP, Di Giuseppe G. Hesitancy towards Childhood Vaccinations among Parents of Children with Underlying Chronic Medical Conditions in Italy. Vaccines (Basel) 2022; 10:vaccines10081254. [PMID: 36016141 PMCID: PMC9416633 DOI: 10.3390/vaccines10081254] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 02/04/2023] Open
Abstract
Background: This study was designed to evaluate vaccination hesitancy and behaviors among parents of children with chronic conditions. Methods: This cross-sectional study was conducted from June to December 2021 in three public hospitals in southern Italy. Data were collected using a face-to-face interview of parents of children up to 17 years of age with at least one chronic condition. Results: Of the 532 parents approached, 444 agreed to participate, with a response rate of 83.4%. Almost half of parents (43%) knew that children with chronic diseases are at greater risk of complications from VPDs, and 21.6% knew all the vaccinations available in Italy. Additionally, 55.9% felt that vaccine-preventable diseases (VPDs) are very dangerous for their children, and 28.7% were very worried about the side effects of vaccines. The result of the Parent Attitudes about Childhood Vaccine (PACV) score indicated that 23.2% of parents were hesitant about vaccinations. Parental vaccine hesitancy was significantly more common among parents who had female children, among those who did not know the recommended vaccinations, among those who had a higher concern of potential side effects of the vaccines, among those who believed that the administration of the vaccinations was not useful, and among who received information on recommended vaccination from the internet, social and mass media. Conclusions: Important efforts by policy makers and healthcare providers must be implemented to counter vaccine hesitancy among parents.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | | | - Silvia Angelillo
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, 88100 Catanzaro, Italy
| | - Italo Fattore
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesca Licata
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, 88100 Catanzaro, Italy
| | - Concetta Paola Pelullo
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-081-5667708
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