1
|
Noor Mohamad NA, Omar J. Cervical cancer in Malaysia. J Obstet Gynaecol Res 2024. [PMID: 39030916 DOI: 10.1111/jog.16031] [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: 04/30/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
Cervical cancer is preventable due to effective screening to detect pre-malignant lesion, and vaccination against its causative organism namely human papillomavirus (HPV). This review article described current situation of cervical cancer in Malaysia. There is decreasing cervical cancer incidence in the country, with age-standardized rate of 10.3, versus 14.1 and 7.5 per 100 000 for worldwide and high-income countries, respectively. School-based HPV vaccination is part of national immunization since 2010, with yearly coverage rate of 83%-91%. The figure declined during coronavirus disease-19 pandemic due to scarce vaccine supply and movement-control order, resulting in about 500 000 students missing their course, with catch-up program currently onboard. Opportunistic cervical screening program started in 1960s with cervical smear cytology, which is succeeded by HPV DNA screening since 2020. Cervical cytology remains indispensable screening method in healthcare facility without access to HPV test kit, and used to triage high-risk HPV positive with abnormal cytology that require urgent colposcopy. Computed tomography is the main imaging modality to assess local and distal extent of cervical cancer. Primary surgical treatment for early-stage cancer is performed by trained gynecologic oncologist, with long waiting list for radiation therapy in locally advanced disease due to limited available public facility. There is restricted access to targeted therapy due to high treatment cost. In conclusion, Malaysia is heading toward cervical cancer elimination through rigorous investment in primary and secondary prevention, and increase in public engagement with the support of government policy enforcement.
Collapse
Affiliation(s)
- Noor Azura Noor Mohamad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Jamil Omar
- Department of Gynecologic Oncology, National Cancer Institute, Putrajaya, Malaysia
- Ministry of Health, Putrajaya, Malaysia
| |
Collapse
|
2
|
Yagi A, Ueda Y, Oka E, Nakagawa S, Kimura T. Human Papillomavirus Vaccination by Birth Fiscal Year in Japan. JAMA Netw Open 2024; 7:e2422513. [PMID: 39012629 PMCID: PMC11252895 DOI: 10.1001/jamanetworkopen.2024.22513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/14/2024] [Indexed: 07/17/2024] Open
Abstract
Importance The Ministry of Health, Labour, and Welfare (MHLW) of Japan aggregates human papillomavirus (HPV) vaccination data across Japan for each fiscal year (FY) by age at vaccination. Birth FY (BFY)-specific vaccination coverage remains unknown. Objective To calculate the BFY-specific vaccination coverage for each FY and the cumulative first-dose coverage for each BFY in Japan, to understand the generation-specific vaccination coverage, and to estimate the cumulative first-dose coverage of each BFY that would be achieved by FY 2028 vs World Health Organization (WHO) targets. Design, Setting, and Participants In this cross-sectional study, MHLW-published national age-specific HPV vaccination numbers and demographic data for female individuals were used to calculate the BFY-specific first-dose coverage for each FY and the BFY-specific cumulative first-dose coverage. It was assumed that the BFYs 2007 to 2012 vaccination coverage in FY 2023 to 2028 would remain the same as the vaccination coverage of the same grade in FY 2022 to estimate the cumulative first-dose coverage that would be achieved by FY 2028. Data analysis was performed from December 2023 to January 2024. Exposure Two MHLW policy changes were the government's suspension of proactive recommendation for HPV vaccination in June 2013 and the government's resumption of proactive recommendation for HPV vaccination in April 2022. Main Outcomes and Measures The primary outcome was generation-specific vaccination coverage among female individuals born in BFYs 1994 to 2010 in FYs 2010 to 2022, calculated using reconfigured published data. Results In this study of vaccination data for 9 414 620 female individuals, the generation-specific vaccination coverage was 71.96% for the vaccination generation (BFYs 1994-1999), 4.62% for the vaccine-suspension generation (BFYs 2000-2003), 16.16% for the generation that received information individually (BFYs 2004-2009), and 2.83% for the vaccine-resumed generation (BFY 2010). HPV routine vaccination coverage was extremely low in BFYs 2000 to 2010 (0.84%-25.21%) vs BFYs 1994 to 1999 (53.31%-79.47%). The cumulative first-dose coverage that was estimated to be achieved in the vaccine-resumed generation by FY 2028 plateaued at 43.16%. Conclusions and Relevance Even after the resumption of MHLW's proactive recommendations, HPV vaccination coverage has only minimally recovered in Japan. The cumulative first-dose coverage that was estimated to be achieved in the vaccine-resumed generation by FY 2028 is below the WHO target. These findings reveal that stronger cervical cancer control measures are required, particularly for the vaccine-resumed generation, which will plateau at approximately one-half the WHO target values.
Collapse
Affiliation(s)
- Asami Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Emiko Oka
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Nakagawa
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
3
|
Pouvrasseau A, Jeannot E. Vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland: protocol for an online national study. Front Public Health 2023; 11:1302676. [PMID: 38155889 PMCID: PMC10754524 DOI: 10.3389/fpubh.2023.1302676] [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: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Vaccine hesitancy is a persistent challenge in public health, exacerbated by the proliferation of anti-vaccine sentiments facilitated by social networks. The COVID-19 pandemic has underscored the importance of addressing vaccine hesitancy, designated by the WHO as a top global health threat. This study explores vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland-a cohort crucial to public health given their future roles as healthcare professionals-with a particular emphasis on the HPV vaccine, which exhibits lower confidence levels compared to other vaccines. Methods This study will employ an online questionnaire distributed to nursing and midwifery undergraduate students from various healthcare universities. The questionnaire will collect data on vaccine hesitancy (general confidence in vaccines and specifically in the HPV vaccine), HPV vaccine coverage, socio-demographics, likelihood to recommend vaccines to patients, perception of vaccination education and interest in complementary medicine. Conclusion The study's findings will contribute to our understanding of vaccine hesitancy among nursing and midwifery undergraduate students, providing insights that can inform targeted interventions and education strategies to bolster vaccine confidence among future healthcare professionals, thereby enhancing public health efforts.
Collapse
Affiliation(s)
- Audrey Pouvrasseau
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Emilien Jeannot
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Center for Excessive Gambling, Addiction Medicine (Service), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| |
Collapse
|
4
|
Oh SH, Lee CJ, Park A. Trust Matters: The Effects of Social Media Use on the Public's Health Policy Support Through (mis)beliefs in the Context of HPV Vaccination. HEALTH COMMUNICATION 2023; 38:2628-2639. [PMID: 35850554 DOI: 10.1080/10410236.2022.2096985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examines whether social media exposure is associated with the public's beliefs and misbeliefs about human papillomavirus (HPV) vaccination and how those (mis)beliefs are associated with the public's support for HPV vaccination-related policies. This study also explores whether trust in HPV vaccination-related regulatory organizations moderates the associations between social media exposure and public policy support through (mis)beliefs. We found that social media exposure was positively associated with misbeliefs about HPV vaccination. The findings also indicated that while beliefs about benefits were positively associated with policy support for HPV vaccination, misbeliefs were negatively associated with this support. More interestingly, our analysis revealed that the negative association of HPV-related misbeliefs with vaccination policy support was larger for those who had low levels of trust, compared to their high-trust counterparts.
Collapse
Affiliation(s)
- Sang-Hwa Oh
- Department of Advertising, College of Media, University of Illinois at Urbana-Champaign
| | - Chul-Joo Lee
- Department of Communication, Seoul National University
| | - Andrew Park
- Department of Communication, Seoul National University
| |
Collapse
|
5
|
Afsharinia B, Gurtoo A. Role of leadership and incentive-based programs in addressing vaccine hesitancy in India. Vaccine X 2023; 15:100346. [PMID: 37577213 PMCID: PMC10413069 DOI: 10.1016/j.jvacx.2023.100346] [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: 10/11/2022] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/15/2023] Open
Abstract
The current study goes beyond the popular 5Cs model of vaccine hesitancy to explore perceived social norms, role of leadership and the role of incentive-based intervention for improving the likelihood of vaccination, in a population-representative sample of adults in India (N = 1129). We investigated differences in socio-demographic status, perceived descriptive norms like vaccine behaviours, beliefs, experience and perceived injunctive norms like community and political leadership within the context of the COVID-19 pandemic are related to vaccination. Further, we examined the role of incentive-based intervention as a potentially salient predictor of adults' vaccine uptake. The study is based on a cross-sectional survey conducted in July-November 2021, which included questions about impacts of pandemic collected by phone call interview from adults' beneficiaries of Government free food schemes, across 11 states in India. The data include 81 % vaccinated and 19 % vaccine hesitant participants, with a higher proportion of business or self-employed (53.1 %) as vaccine hesitant. We performed the t-test to assess the variation between vaccinated and vaccine hesitant adults, and Exploratory Factor Analysis to uncover the underlying dimension of vaccine hesitancy. Subsequently, Binary Logistic Regression model probed the factors associated with likelihood of vaccination uptake. In contrast to the prevailing evidence, results demonstrated community and political leadership has significant negative impact on vaccination (p-value < 0.06, 95 % CI, 0.57-1.01). Incentive-based intervention offer a vital leverage to enhance positive attitude towards vaccination (p-value < 0.05, 95 % CI, 1.01-1.80). The results thus broadly highlight the limited role of political and community leaders in leveraging their influence on vaccination, the role of timely, accurate information, applications of telemedicine as an important tool to provide healthcare and the need for optimal design of incentive-based vaccination programs recommended by trusted sources.
Collapse
Affiliation(s)
- Bita Afsharinia
- Senior Research Scholar, Department of Management Studies, Indian Institute of Science, Bangalore 560012, India
| | - Anjula Gurtoo
- Senior Research Scholar, Department of Management Studies, Indian Institute of Science, Bangalore 560012, India
| |
Collapse
|
6
|
Campbell H, Paterson P, Letley L, Saliba V, Mounier-Jack S, Yarwood J. Vaccination, information and parental confidence in the digital age in England. Vaccine X 2023; 14:100345. [PMID: 37533872 PMCID: PMC10393542 DOI: 10.1016/j.jvacx.2023.100345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
Background Immunisation programmes have led to substantial reductions in vaccine-preventable infectious diseases globally. A variety of factors have been shown to impact parental confidence and uptake of childhood vaccines, from concerns about vaccine safety to a lack of perceived need. Determinants of vaccine decision making include information, risk perceptions, and modifying factors such as attitude, identity, norms, habit and barriers. With the rise of the internet and social media, there has been a vast increase in information available about vaccines, not all scientifically-based and well-informed. Methods 285 locations in England were randomly selected to survey a nationally representative sample of the English population. 1735 primary care givers of children aged between 2 months and <5 years old from England were randomly selected and surveyed via face-to-face interviews between January and March 2019. Results A much higher percentage of parents surveyed trust health care workers, the NHS, pharmacists and government for advice about immunisation, in comparison to media, the internet and social media. Most parents use official sources to obtain information on vaccines including parents who use the internet. The small proportion of parents who reported having seen negative information about vaccines were more likely to find it on the internet. Parents who felt they did not have enough information were more likely to have delayed or refused a vaccine for their child. Interpretation This study showed that for parents of young children in England, vaccination continues to be the social norm but this can rapidly change and clear, consistent messaging from trusted sources continues to be important. Although a proportion do seek vaccine information on the internet, the majority use official sources. Representative attitudinal surveys continue to be key in identifying any emerging threats to parental vaccine confidence.
Collapse
Affiliation(s)
- H. Campbell
- Department of Immunisation and Countermeasures, UK Health Security Agency, UK
| | - P. Paterson
- Department of Infectious Disease Epidemiology, London School of Hygiene, & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - L. Letley
- Department of Immunisation and Countermeasures, UK Health Security Agency, UK
| | - V. Saliba
- Department of Immunisation and Countermeasures, UK Health Security Agency, UK
| | - S. Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - J. Yarwood
- Department of Immunisation and Countermeasures, UK Health Security Agency, UK
| |
Collapse
|
7
|
Kong J, Liang C, Fu D, Wang L, Yan X, Li S, Zhang H. Reliability and validity evaluation of the chinese revision of the attitude towards adult vaccination scale. BMC Public Health 2023; 23:883. [PMID: 37173680 PMCID: PMC10176303 DOI: 10.1186/s12889-023-15684-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Although vaccination is one of the critical interventions to address global health issues, inadequate vaccination rates has become an international challenge. Vaccine hesitancy is the key to affecting inadequate vaccination rates. According to the WHO SAGE working group's definition, vaccine hesitancy refers to delaying or refusing vaccination and has been ranked as one of the top 10 health threats. There has yet to be a scale that evaluates vaccination attitudes among Chinese adults. However, an attitude quantity, the adult vaccination attitude scale, has been developed to assess adult vaccination attitudes and reasons for vaccine hesitancy. OBJECTIVE The Adult Attitudes to Vaccination Scale (ATAVAC) was initially developed by Professor Zoi Tsimtsiou et al. This study aimed to analyze the structure of the Chinese version of the ATAVAC and explore the relationship between adult vaccination attitudes, e-health literacy, and medical distrust. METHODS After obtaining author permission for the initial scales, the study was translated using the Brislin back-translation method. 693 adults were enrolled to the study. To validate this hypothesis, participants finished the socio-demographic questionnaire, the Chinese version of the ATAVAC, the electronic Health Literacy Scale (e-HEALS) and the Medical Mistrust Index (MMI). The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying structure of the factors of the Chinese version of the Adult Vaccination Attitude Scale and to measure its reliability and validity. RESULTS The Cronbach's alpha coefficient for the Chinese version of the ATAVAC was 0.885, with Cronbach's alpha coefficients ranging from 0.850 to 0.958 for each dimension. The content validity index was 0.90, and the retest reliability was 0.943. The exploratory factor analysis (EFA) supported the 3-factor structure of the translation instrument, and the scale had good discriminant validity. The confirmatory factor analysis (CFA) revealed a degree of freedom of 1.219, a model fit index (GFI) of 0.979, a normative fit index (NFI) of 0.991, a Tucker-Lewis index (TLI) of 0.998, a comparability index (CFI) of 0.998 and a root mean square error of approximation (RMSEA) of 0.026. CONCLUSION The results show that the Chinese version of the ATAVAC has demonstrated good reliability and validity. Hence, it can be used as an effective tool to assess vaccination attitudes among Chinese adults.
Collapse
Affiliation(s)
- Jie Kong
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, Jinzhou, 121001, China
| | - Chunguang Liang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, Jinzhou, 121001, China.
| | - Dongmei Fu
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, Jinzhou, 121001, China
| | - Liying Wang
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, Jinzhou, 121001, China
| | - Xiangru Yan
- School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road, Jinzhou, 121001, China
| | - Sisi Li
- School of Medicine, Panjin Vocational and Technical College, Panjin, China
| | - Hui Zhang
- School of Medicine, Wuhan College of Arts and Science, Wuhan, China
| |
Collapse
|
8
|
Lelliott M, Sahker E, Poudyal H. A Review of Parental Vaccine Hesitancy for Human Papillomavirus in Japan. J Clin Med 2023; 12:jcm12052004. [PMID: 36902790 PMCID: PMC10003921 DOI: 10.3390/jcm12052004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Globally, Japan has the lowest rate of vaccine confidence. The persistent parental vaccine hesitancy has been attributed to safety and efficacy concerns and is primarily driven by the negative experience with human papillomavirus (HPV) vaccines. This literature review aimed to identify factors associated with HPV vaccine uptake and potential strategies to reduce vaccine hesitancy among Japanese parents. Articles published in English or Japanese between January 1998 and October 2022 that examined Japanese parental factors for HPV vaccine uptake were identified from PubMed, Web of Science, and Ichushi-Web. In total, 17 articles met the inclusion criteria. Four key themes which affected HPV vaccine hesitancy and acceptance were identified: perceptions of risk and benefits, trust and recommendation, information and knowledge, and sociodemographic characteristics. While governmental and healthcare provider recommendations are important factors, efforts to improve parental confidence in the HPV vaccine are required. Future interventions to counteract HPV vaccine hesitancy should actively disseminate information on vaccine safety and effectiveness, along with information on the severity and susceptibility of HPV infection.
Collapse
Affiliation(s)
- Madoka Lelliott
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto 606-8501, Japan
| | - Ethan Sahker
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto 606-8501, Japan
- Population Health and Policy Research Unit, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Hemant Poudyal
- Population Health and Policy Research Unit, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Correspondence:
| |
Collapse
|
9
|
Mlakar J, Oštrbenk Valenčak A, Kežar J, Beseničar-Pregelj L, Poljak M. Assessment of Acceptability and Determinants of Uptake and Schedule Completion of Human Papillomavirus (HPV) Vaccine by 25 to 45 Years Old Women in Slovenia. Vaccines (Basel) 2023; 11:vaccines11020423. [PMID: 36851300 PMCID: PMC9964155 DOI: 10.3390/vaccines11020423] [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: 01/16/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
HPV immunization programs are mainly focused on girls and boys, but adult women and men could also benefit from vaccination. A multinational CoheaHr-WP4 study investigated the acceptability of HPV vaccination among 25-45 years old women. A total of 607 women from Slovenia participated in the study, and 49.6% (301/607) agreed with HPV vaccination, with a significant difference (p < 0.0001) between the two centers. Non-vaccinated women had a higher education (p = 0.0068) and were more frequently in a committed relationship or married (p = 0.01). The most trusted source of medical and vaccination information was healthcare providers (55.2%). The main reasons for vaccine acceptance were protection against HPV-related disease (93.4%), severity of preventable diseases (82.7%), HPV vaccine safety (66.8%), free HPV vaccine availability (62.8%), and the existence of vaccination recommendations (55.5%). The main reasons for refusing vaccination were the need for additional vaccine-related information (31.4%) and vaccine safety concerns (29.4%). To increase vaccine coverage, information about the benefits and safety of HPV vaccination must be widely disseminated to all health professionals and the general public. We are convinced that the knowledge obtained in this study can be reliably applied to other countries in the region that lack such information and have a very high cervical cancer burden.
Collapse
Affiliation(s)
- Jana Mlakar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia
| | - Anja Oštrbenk Valenčak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia
| | - Jožefa Kežar
- Litija Community Health Center, Partizanska pot 8a, SI-1270 Litija, Slovenia
| | | | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia
- Correspondence:
| |
Collapse
|
10
|
Wang Q, Qu Z, Tu S, Chen X, Hou Z. The whole-of-society approach of mass COVID-19 vaccination in China: a qualitative study. Health Res Policy Syst 2022; 20:142. [PMID: 36585666 PMCID: PMC9802023 DOI: 10.1186/s12961-022-00947-7] [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: 08/19/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Many countries have an inefficient vaccination system, which hinders global exit from the COVID-19 pandemic. It is vital to summarize COVID-19 vaccination practices in countries with high vaccination coverage and provide implications for other countries. This study aimed to investigate China's COVID-19 vaccination system and to summarize its implementation experience from a health system perspective. METHODS We conducted key informant interviews in five representative cities of China in late 2021. Guided by the health systems framework proposed by WHO, we developed our interview guidelines which included seven building blocks-leadership and governance, health workforce, vaccination service delivery, vaccination mobilization and communication, financing, access to vaccines, and information systems. Semi-structured interviews and COVID-19 vaccination policy documents were collected and coded using a thematic analysis approach. RESULTS A total of 61 participants (nine vaccination programme directors of the local Center for Disease Control and Prevention, four government staff and 48 vaccination service workers) were interviewed. We found that China adopted a whole-of-society approach with adequate government engagement and linked health and non-health sectors to promote COVID-19 vaccination. Key measures included the collaboration of multiple systems and departments from a governance perspective, allocating sufficient health workers and resources, large-scale vaccination mobilization and communication, expansion of vaccine financing channels, localized production and digital information systems. With the vaccination system strengthening, the two-doses vaccination coverage reached 89.5% for the total population but relatively lower coverage for older adults as of July 2022. CONCLUSIONS Our study highlights the importance of a government-led whole-of-society approach to promote mass vaccination. The low vaccination coverage among older adults should be paid the greatest attention to. The experiences and lessons from China may serve as a reference for other countries.
Collapse
Affiliation(s)
- Qian Wang
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Zhiqiang Qu
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyi Tu
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xi Chen
- grid.47100.320000000419368710Department of Health Policy and Management, Yale School of Public Health, City of New Haven, United States of America ,grid.47100.320000000419368710Department of Economics, Yale University, City of New Haven, United States of America
| | - Zhiyuan Hou
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| |
Collapse
|
11
|
McGrath E. Emergence of Vaccine-Preventable Diseases: The Perfect Storm of Hesitancy, Refusal, a Pandemic, and War. Pediatr Ann 2022; 51:e426-e430. [PMID: 36343179 DOI: 10.3928/19382359-20220913-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The landscape of pediatric vaccination has changed dramatically due to changing attitudes toward immunizations and recent world events. The rise of vaccine hesitancy and refusal related to the concurrent rise of social media and anti-vaccination messages with misinformation campaigns have led to populations of children being unimmunized or under-immunized. These populations have been left vulnerable to the rapid spread of vaccine-preventable infection. Additionally, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the clinical syndrome known as coronavirus disease 2019 (COVID-19) resulted in the emergence of a worldwide pandemic. Control measures to mitigate the spread of COVID-19 resulted in numerous reports of children missing routine vaccines along with the stopping of many public health immunization programs. Finally, armed conflicts and war have led to large family migrations from their homelands to various countries and regions leading to increased risk for missed maternal and child immunization as well as difficulty in keeping vaccination records. [Pediatr Ann. 2022;51(11):e426-e430.].
Collapse
|
12
|
Long S, Wu J, Wang S, Zhao Y, Wang J, Zhao S, Niu Q, Jin H. Changes of factors associated with vaccine hesitancy in Chinese residents: A qualitative study. Front Public Health 2022; 10:929407. [PMID: 36203693 PMCID: PMC9530596 DOI: 10.3389/fpubh.2022.929407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/24/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction There is an urgent need to address vaccine hesitancy to achieve booster vaccination. This study aimed to reveal the factors associated with vaccine hesitancy (including COVID-19 vaccine) among Chinese residents, address modifications of the factors since the previous year, and propose vaccination rate improvement measures. Materials and methods This qualitative return visit study was performed between January and mid-February 2022, following the last interview conducted between February and March 2021. According to an outline designed in advance, 60 Chinese residents from 12 provinces participated in semi-structured interviews. Results Vaccine safety was the biggest concern raised by respondents, followed by self-immunity and vaccine effectiveness, eliciting concern since the interview last year. Notably, online media accounted for a more significant portion of suggestion sources than before, and fear of pain was a novel factor affecting vaccine hesitancy. Moreover, unlike other areas, those from provinces with a per capita gross domestic product of 3-5 (RMB 10,000) reported less concern about vaccine price and effectiveness. They tended to seek advice via online media less and were greatly influenced by vaccination policies. Conclusions Influential factors of vaccine hesitancy among Chinese residents are changing dynamically. Monitoring these trends is essential for public health measures and higher vaccination levels.
Collapse
Affiliation(s)
- Sigui Long
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jingying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shile Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yaqi Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jianli Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shuangyu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Qing Niu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China,*Correspondence: Qing Niu
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China,Hui Jin
| |
Collapse
|
13
|
Sides E, Jones LF, Kamal A, Thomas A, Syeda R, Kaissi A, Lecky DM, Patel M, Nellums L, Greenway J, Campos-Matos I, Shukla R, Brown CS, Pareek M, Sollars L, Pawson E, McNulty C. Attitudes towards coronavirus (COVID-19) vaccine and sources of information across diverse ethnic groups in the UK: a qualitative study from June to October 2020. BMJ Open 2022; 12:e060992. [PMID: 36581971 PMCID: PMC9437733 DOI: 10.1136/bmjopen-2022-060992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Across diverse ethnic groups in the UK, explore attitudes and intentions towards COVID-19 vaccination and sources of COVID-19 information. DESIGN Remote qualitative interviews and focus groups (FGs) conducted June-October 2020 before UK COVID-19 vaccine approval. Data were transcribed and analysed through inductive thematic analysis and mapped to the Theoretical Domains Framework. SETTING England and Wales. PARTICIPANTS 100 participants from 19 self-identified ethnic groups. RESULTS Mistrust and doubt were reported across ethnic groups. Many participants shared concerns about perceived lack of information about COVID-19 vaccine safety and efficacy. There were differences within each ethnic group, with factors such as occupation and perceived health status influencing intention to accept a vaccine once made available. Across ethnic groups, participants believed that public contact occupations, older adults and vulnerable groups should be prioritised for vaccination. Perceived risk, social influences, occupation, age, comorbidities and engagement with healthcare influenced participants' intentions to accept vaccination once available. All Jewish FG participants intended to accept, while all Traveller FG participants indicated they probably would not.Facilitators to COVID-19 vaccine uptake across ethnic groups included: desire to return to normality and protect health and well-being; perceived higher risk of infection; evidence of vaccine safety and efficacy; vaccine availability and accessibility.COVID-19 information sources were influenced by social factors and included: friends and family; media and news outlets; research literature; and culture and religion. Participants across most different ethnic groups were concerned about misinformation or had negative attitudes towards the media. CONCLUSIONS During vaccination rollout, including boosters, commissioners and providers should provide accurate information, authentic community outreach and use appropriate channels to disseminate information and counter misinformation. Adopting a context-specific approach to vaccine resources, interventions and policies and empowering communities has potential to increase trust in the programme.
Collapse
Affiliation(s)
- Eirwen Sides
- Primary Care and Interventions Unit, UKHSA South West, Bristol, UK
| | - Leah Ffion Jones
- Primary Care and Interventions Unit, UKHSA South West, Bristol, UK
| | - Atiya Kamal
- Psychology, Birmingham City University, Birmingham, UK
| | - Amy Thomas
- Primary Care and Interventions Unit, UKHSA South West, Bristol, UK
| | - Rowshonara Syeda
- Prevention Strategy & Innovation Team, UK Department of Health and Social Care, London, UK
| | - Awatif Kaissi
- Primary Care and Interventions Unit, UKHSA South West, Bristol, UK
| | - Donna M Lecky
- Primary Care and Interventions Unit, UKHSA South West, Bristol, UK
| | - Mahendra Patel
- School of Pharmacy and Medical Sciences (Faculty of Life Sciences), University of Bradford, Bradford, UK
| | - Laura Nellums
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | | | | | | | - Colin S Brown
- Bacteria Reference Department, National Infection Service, UKHSA, London, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | | | - Emma Pawson
- UK Department of Health and Social Care, London, UK
| | - Cliodna McNulty
- Primary Care and Interventions Unit, UKHSA South West, Bristol, UK
| |
Collapse
|
14
|
Albatineh AN, Dalvand P, Aslani M, Saritas S, Baghi V, Ghanei Gheshlagh R. Prevalence and factors associated with COVID-19 vaccine acceptance among the general population in Asadabad, Iran: a cross-sectional study. Trop Med Health 2022; 50:59. [PMID: 36038885 PMCID: PMC9424066 DOI: 10.1186/s41182-022-00453-0] [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: 06/12/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Vaccination can be an essential protective measure against Coronavirus disease 2019 (COVID-19) if well received by the public. Various factors affect the acceptance or refusal of vaccines. Several waves of COVID-19 caused much death in Iran. This study aimed to evaluate the acceptance of the COVID-19 vaccine in the general population of Asadabad in 2021. Methods In this cross-sectional study, 650 people from the general population of Asadabad with a mean age of 34.6 (SD = 15.1) years were selected and included. In addition to socio-economic and demographic data, data were collected using the COVID-19 fear scale. Univariate and multiple logistic regression models were used to investigate the relationship between the tendency to get the COVID-19 vaccine (the dependent variable) and other variables. Results About 42.3% of participants were reluctant to receive the available COVID-19 vaccines. After adjusting for several covariates, there was a significant relationship between willingness to get vaccinated and family history of COVID-19 infection (AOR = 1.86, 95% CI 1.06–3.27, p = 0.032), trust in healthcare workers (AOR = 2.07, 95% CI 1.13–3.79, p = 0.019), trust in existing vaccines (AOR = 3.94, 95% CI 2.15–7.23, p < 0.001), encouraging family members to get vaccinated (AOR = 7.6, 95% CI 4.12–14.01, p < 0.0001). Also, people infected with COVID-19 are less likely to accept vaccination (AOR = 0.55, 95% CI 0.33–0.93, p = 0.025). Also, a unit increase in the score of fear of getting the COVID-19 virus increased the odds of getting the COVID-19 vaccine by 6% (AOR = 1.06, 95% CI 1.02–1.10, p = 0.002). Conclusion The culture and context of different societies can affect the acceptance or refusal of the COVID-19 vaccine. Based on these characteristics and providing extensive education to the people, the health authorities in each community should build trust and better communicate all health information to clear any fear and remove all obstacles to increase willingness to get COVID-19 vaccination.
Collapse
Affiliation(s)
- Ahmed Najeeb Albatineh
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Pegah Dalvand
- Department of Mathematics, Shahrood University of Technology, Shahrood, Iran
| | - Marzieh Aslani
- Department of Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Serdar Saritas
- Department of Surgical Nursing, Faculty of Nursing, Inonu University, Campus 44280, Malatya, Turkey
| | - Vajiheh Baghi
- Be'sat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Ghanei Gheshlagh
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| |
Collapse
|
15
|
Affiliation(s)
- Heidi J Larson
- From the Institute for Health Metrics and Evaluation, University of Washington, Seattle (H.J.L., E.G., C.J.L.M.); and the Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London (H.J.L.)
| | - Emmanuela Gakidou
- From the Institute for Health Metrics and Evaluation, University of Washington, Seattle (H.J.L., E.G., C.J.L.M.); and the Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London (H.J.L.)
| | - Christopher J L Murray
- From the Institute for Health Metrics and Evaluation, University of Washington, Seattle (H.J.L., E.G., C.J.L.M.); and the Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London (H.J.L.)
| |
Collapse
|
16
|
Casey RM, Adrien N, Badiane O, Diallo A, Loko Roka J, Brennan T, Doshi R, Garon J, Loharikar A. National introduction of HPV vaccination in Senegal-Successes, challenges, and lessons learned. Vaccine 2022; 40 Suppl 1:A10-A16. [PMID: 34593269 PMCID: PMC10662429 DOI: 10.1016/j.vaccine.2021.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/22/2021] [Accepted: 08/12/2021] [Indexed: 11/23/2022]
Abstract
Following successful school-based demonstration programs in 2014-2016, the human papillomavirus (HPV) vaccine was introduced nationwide in Senegal for 9-year-old girls in 2018, using a routine service delivery strategy at health facilities, schools, and other outreach sites. We reviewed the HPV vaccine introduction in Senegal to understand the successes, challenges, and lessons learned. Focusing on three key domains (program decision-making, planning, and implementation), we conducted ten semi-structured interviews during 2019-2020 with purposively selected national-level stakeholders (government, expert advisory committee, key technical and implementation partners) and comprehensive desk reviews of country documents on HPV vaccine introduction. Due to the global HPV vaccine shortage, the introduction was limited to a single-age cohort; therefore, 9-year-old girls were chosen. This strategy enabled Senegal to potentially reach more girls in primary education because school enrolment rates decline thereafter. Vaccination through routine delivery platforms (i.e., health facility, school-based, and community outreach) was perceived to be more cost-effective than a campaign approach. High-level political commitment and collaborations between immunization and education partners were frequently cited by key informants as reasons for a successful vaccine introduction. All key informants reported that the health care worker (HCW) strike, rumors, and vaccine hesitancy negatively impacted the introduction. Other challenges noted included insufficient information on attitudes towards HPV vaccination among HCWs, teachers, and community members. Senegal successfully introduced HPV vaccine into the national immunization schedule, using a routine delivery strategy. Strong leadership and a multi-sectoral approach likely contributed to this success. To build sustainability of the HPV vaccination program in the future, it is important to improve the understanding and engagement among all stakeholders, including HCWs and community members, and to strengthen and innovate communication and crisis management strategies. To better understand the efficiency and effectiveness of Senegal's vaccination strategy, additional assessments of the operational costs and coverage achieved are needed.
Collapse
Affiliation(s)
- Rebecca M Casey
- CDC Foundation, Atlanta, GA, USA; Centers for Disease Control and Prevention, Atlanta, USA.
| | | | | | - Aliou Diallo
- World Health Organization, Senegal Country Office, Dakar, Senegal
| | | | | | - Reena Doshi
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Julie Garon
- Centers for Disease Control and Prevention, Atlanta, USA
| | | |
Collapse
|
17
|
Vaccination—A Step Closer to Universal Health Coverage. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01322-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
18
|
Huynh G, Nguyen HTN, Van Tran K, Le An P, Tran TD. Determinants of COVID-19 vaccine hesitancy among parents in Ho Chi Minh City, Vietnam. Postgrad Med 2022; 134:303-308. [DOI: 10.1080/00325481.2022.2044142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Giao Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Han Thi Ngoc Nguyen
- Infection Control Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Khanh Van Tran
- Department of Scientific Research, District 2 Hospital, Ho Chi Minh City, Vietnam
| | - Pham Le An
- Family Medicine Training Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tuan Diep Tran
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| |
Collapse
|
19
|
Parental childhood vaccine hesitancy and predicting uptake of vaccinations: a systematic review. Prim Health Care Res Dev 2022; 23:e68. [PMID: 36330835 PMCID: PMC9641700 DOI: 10.1017/s1463423622000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim: This review aims are to (1) identify relevant quantitative research on parental childhood vaccine hesitancy with vaccine uptake and vaccination intention being relevant outcomes and (2) map the gaps in knowledge on vaccine hesitancy to develop suggestions for further research and to guide interventions in this field. Background: Vaccine hesitancy recognises a continuum between vaccine acceptance and vaccine refusal, de-polarising past anti-vaccine, and pro-vaccine categorisations of individuals and groups. Vaccine hesitancy poses a serious challenge to international efforts to lessen the burden of vaccine-preventable diseases. Potential vaccination barriers must be identified to inform initiatives aimed at increasing vaccine awareness, acceptance, and uptake. Methods: Five databases were searched for peer-reviewed articles published between 1998 and 2020 in the fields of medicine, nursing, public health, biological sciences, and social sciences. Across these datasets, a comprehensive search technique was used to identify multiple variables of public trust, confidence, and hesitancy about vaccines. Using PRISMA guidelines, 34 papers were included so long as they focused on childhood immunisations, employed multivariate analysis, and were published during the time frame. Significant challenges to vaccine uptake or intention were identified in these studies. Barriers to vaccination for the target populations were grouped using conceptual frameworks based on the Protection Motivation Theory and the World Health Organization’s Strategic Advisory Group of Experts on Immunization Working Group model and explored using the 5C psychological antecedents of vaccination. Findings: Although several characteristics were shown to relate to vaccine hesitancy, they do not allow for a thorough classification or proof of their individual and comparative level of influence. Understudied themes were also discovered during the review. Lack of confidence, complacency, constraints, calculation, and collective responsibility have all been highlighted as barriers to vaccination uptake among parents to different degrees.
Collapse
|
20
|
Cervical Cancer Protection in Japan: Where Are We? Vaccines (Basel) 2021; 9:vaccines9111263. [PMID: 34835194 PMCID: PMC8619953 DOI: 10.3390/vaccines9111263] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
In Japan, government subsidies for human papillomavirus (HPV) vaccination of girls aged 13–16 commenced in 2010. By early 2013, vaccination had become a widely accepted national immunization program. However, in June of 2013, the Ministry of Health, Labor, and Welfare (MHLW), the government’s lead agency, suspended its recommendation for vaccination in response to reports of adverse vaccine events. The rate of HPV vaccination quickly dropped from 70% to almost zero, where it has lingered for eight years. In 2020, a new 9-valent HPV vaccine was licensed in Japan. The momentum seemed to be building for the resumption of HPV vaccinations, yet Japanese mothers remain widely hesitant about vaccinating their daughters, despite the well-proven safety and efficacy of the HPV vaccines. The Japanese government and our educational and medical institutions must work harder as a team to inform our parents and their children about the life-saving benefits of the HPV vaccine, and at the same time, we must respond to all their concerns and questions. The vaccine hesitancy of unvaccinated women born in 2000 and thereafter is a natural consequence of the suspension of the government‘s recommendation. We must also take every possible measure to reduce the significant risk for cervical cancer these women have.
Collapse
|
21
|
Vujovich-Dunn C, Skinner SR, Brotherton J, Wand H, Sisnowski J, Lorch R, Veitch M, Sheppeard V, Effler P, Gidding H, Venn A, Davies C, Hocking J, Whop LJ, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson CA, Lane N, Kaldor J, Guy R. School-Level Variation in Coverage of Co-Administered dTpa and HPV Dose 1 in Three Australian States. Vaccines (Basel) 2021; 9:vaccines9101202. [PMID: 34696310 PMCID: PMC8537995 DOI: 10.3390/vaccines9101202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/14/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Australian adolescents are routinely offered HPV and dTpa (diphtheria, tetanus, pertussis) vaccines simultaneously in the secondary school vaccination program. We identified schools where HPV initiation was lower than dTpa coverage and associated school-level factors across three states. METHODS HPV vaccination initiation rates and dTpa vaccination coverage in 2016 were calculated using vaccine databases and school enrolment data. A multivariate analysis assessed sociodemographic and school-level factors associated with HPV initiation being >5% absolute lower than dTpa coverage. RESULTS Of 1280 schools included, the median school-level HPV initiation rate was 85% (interquartile range (IQR):75-90%) and the median dTpa coverage was 86% (IQR:75-92%). Nearly a quarter (24%) of all schools had HPV vaccination initiation >5% lower than dTpa coverage and 11 % had >10% difference. School-level factors independently associated with >5% difference were remote schools (aOR:3.5, 95% CI = 1.7-7.2) and schools in major cities (aOR:1.8, 95% CI = 1.0-3.0), small schools (aOR:3.3, 95% CI = 2.3-5.7), higher socioeconomic advantage (aOR:1.7, 95% CI = 1.1-2.6), and lower proportions of Language-background-other-than-English (aOR:1.9, 95% CI = 1.2-3.0). CONCLUSION The results identified a quarter of schools had lower HPV than dTpa initiation coverage, which may indicate HPV vaccine hesitancy, and the difference was more likely in socioeconomically advantaged schools. As hesitancy is context specific, it is important to understand the potential drivers of hesitancy and future research needs to understand the reasons driving differential uptake.
Collapse
Affiliation(s)
- Cassandra Vujovich-Dunn
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
- Correspondence: ; Tel.: +61-2-9348-0033
| | - Susan Rachel Skinner
- Children’s Hospital Westmead, Sydney Children’s Hospitals Network, Sydney 2145, Australia; (S.R.S.); (C.D.)
- Faculty of Medicine and Health, University of Sydney, Specialty of Child and Adolescent Health, Sydney 2006, Australia
| | - Julia Brotherton
- Population Health, VCS Foundation Ltd., East Melbourne, Melbourne 3053, Australia;
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne 3010, Australia;
| | - Handan Wand
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| | - Jana Sisnowski
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
- National Centre for Epidemiology & Population Health, Australian National University, Canberra 0200, Australia;
| | - Rebecca Lorch
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| | - Mark Veitch
- Department of Health and Human Services, Tasmanian Government, Hobart 7001, Australia; (M.V.); (N.L.)
| | - Vicky Sheppeard
- Communicable Diseases Branch, Health Protection NSW, St Leonards, Sydney 2065, Australia;
- School of Public Health, University of Sydney, Camperdown, Sydney 2006, Australia;
| | - Paul Effler
- Department of Health, Communicable Disease Control Directorate, East Perth 6000, Australia; (P.E.); (C.A.T.)
| | - Heather Gidding
- School of Population Health, University of New Souh Wales, Sydney 2052, Australia;
- Norther Clinical School of Sydney, University of Sydney, Camperdown, Sydney 2006, Australia
- Women and Babies Research, Kollin Intstitye, Northern Sydney Local Health District, St Leaonards, Sydney 2064, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, Sydney 2145, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian 7000, Australia;
| | - Cristyn Davies
- Children’s Hospital Westmead, Sydney Children’s Hospitals Network, Sydney 2145, Australia; (S.R.S.); (C.D.)
- Faculty of Medicine and Health, University of Sydney, Specialty of Child and Adolescent Health, Sydney 2006, Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne 3010, Australia;
| | - Lisa J. Whop
- National Centre for Epidemiology & Population Health, Australian National University, Canberra 0200, Australia;
- Menzies School of Health Research, Charles Darwin University, Brisbane 4000, Australia
| | - Julie Leask
- Faculty of Medicine and Health, Sydney Nursing School, University of Sydney, Camperdown, Sydney 2006, Australia;
| | - Karen Canfell
- Cancer Research Division, Cancer Council, Brisbane 2011, Australia;
| | - Lena Sanci
- Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Melbourne 3010, Australia; (L.S.); (M.T.-S.)
| | - Megan Smith
- School of Public Health, University of Sydney, Camperdown, Sydney 2006, Australia;
- Cancer Research Division, Cancer Council, Brisbane 2011, Australia;
| | - Melissa Kang
- Westmead Clinical School, University of Sydney, Sydney 2006, Australia;
| | - Meredith Temple-Smith
- Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Melbourne 3010, Australia; (L.S.); (M.T.-S.)
| | - Michael Kidd
- Southgate Institute for Health, Flinders University, Adelaide 5042, Australia;
| | - Sharyn Burns
- School of Population Health, Curtin University, Perth 6102, Australia;
| | - Linda Selvey
- School of Public Health, University of Queensland, Brisbane 4072, Australia;
| | - Dennis Meijer
- Immunisation Unit, Health Protection NSW, St Leonards, Sydney 2065, Australia; (D.M.); (S.E.)
| | - Sonya Ennis
- Immunisation Unit, Health Protection NSW, St Leonards, Sydney 2065, Australia; (D.M.); (S.E.)
| | - Chloe A. Thomson
- Department of Health, Communicable Disease Control Directorate, East Perth 6000, Australia; (P.E.); (C.A.T.)
| | - Nikole Lane
- Department of Health and Human Services, Tasmanian Government, Hobart 7001, Australia; (M.V.); (N.L.)
| | - John Kaldor
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| | - Rebecca Guy
- The Kirby Institute, University of New South Wales, Kensington, Sydney 2052, Australia; (H.W.); (J.S.); (R.L.); (J.K.); (R.G.)
| |
Collapse
|
22
|
Babicki M, Pokorna-Kałwak D, Doniec Z, Mastalerz-Migas A. Attitudes of Parents with Regard to Vaccination of Children against COVID-19 in Poland. A Nationwide Online Survey. Vaccines (Basel) 2021; 9:vaccines9101192. [PMID: 34696300 PMCID: PMC8539339 DOI: 10.3390/vaccines9101192] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 01/22/2023] Open
Abstract
Within a few months, the scientific world achieved a great success, developing effective and safe vaccines against COVID-19. Many countries with full access to vaccines have introduced recommendations for the vaccination of not only people who are at risk of developing severe COVID-19, i.e., the elderly and chronically ill, but all members of society, including children aged 12 and above as the currently registered preparations can be used above the said age. However, the use of COVID-19 vaccines in children arouses strong emotions, with their sense being frequently questioned. The aim of the paper was to assess the attitudes of Polish parents with regard to vaccinations against COVID-19 administered to their children. The study was conducted with the use of the authors' original questionnaire, which was distributed online. The questionnaire was completed 4732 times, and 4432 surveys were qualified for the final analysis. The vast majority of the respondents were women (77.6%), people aged 36-44 (40.3%), with higher education (86.2%) and people living in the city with more than 250,000 inhabitants (48%). The mean age of the study group was 37.5 ± 6.61 years. Out of the studied group, 28.2% of parents are healthcare professionals. The study was conducted prior to the EMA's decision that permitted the use of BNT162b2 in children. Results: The vast majority of the respondents were mothers, who showed significantly more favorable attitudes toward the vaccinations than fathers. Forty-four percent of parents want to vaccinate their children as soon as possible, while every fourth parent does not want to vaccinate their child at all. Main concerns about the vaccines include concerns that the preparation has not been adequately tested and that it is ineffective, as well as the lack of information concerning potential complications in the future. The main sources of information on childhood vaccinations are the media, including the Internet and television. Vaccination of the pediatric population against COVID-19 raises many emotions and doubts in parents and it is also debated by experts. The decision to vaccinate should rest on child's parents. Both the individual benefits of protection against COVID-19 and the population benefits of pandemic control must be considered. There is a need for ongoing monitoring of the safety of administering COVID-19 vaccinations in children, as well as for evaluating their effectiveness and benefits in reducing individual risk of severe course of COVID-19 and complications after this disease, and for evaluating the population benefits of vaccines in children.
Collapse
Affiliation(s)
- Mateusz Babicki
- Department of Family Medicine Wroclaw Medical University, Syrokomli 1, 51-141 Wroclaw, Poland; (D.P.-K.); (A.M.-M.)
- Correspondence: ; Tel.: +48-71-325-51-26
| | - Dagmara Pokorna-Kałwak
- Department of Family Medicine Wroclaw Medical University, Syrokomli 1, 51-141 Wroclaw, Poland; (D.P.-K.); (A.M.-M.)
| | - Zbigniew Doniec
- Department of Pediatric Pneumonology and Allergology Institute of Tuberculosis and Lung Diseases Regional Branch, 34-700 Rabka Zdrój, Poland;
- Medical Institute, Podhale State College of Applied Sciences, 34-400 Nowy Targ, Poland
| | - Agnieszka Mastalerz-Migas
- Department of Family Medicine Wroclaw Medical University, Syrokomli 1, 51-141 Wroclaw, Poland; (D.P.-K.); (A.M.-M.)
| |
Collapse
|
23
|
Hwang SE, Kim WH, Heo J. Socio-demographic, psychological, and experiential predictors of COVID-19 vaccine hesitancy in South Korea, October-December 2020. Hum Vaccin Immunother 2021; 18:1-8. [PMID: 34614382 PMCID: PMC8920123 DOI: 10.1080/21645515.2021.1983389] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Vaccine hesitancy is the primary barrier to controlling the COVID-19 pandemic in South Korea. We used logistic multivariate regression modeling to investigate (1) the prevalence and reasons for COVID-19 vaccine hesitancy, (2) sub-groups that had higher rates of vaccine hesitancy, and (3) vaccine hesitancy predictors. We used a national survey of representatively sampled households (n = 13,021 adults) from October to December 2020. A self-report questionnaire asked about vaccination intention and reasons for hesitancy and gathered data on socio-demographic, demographic, psychological, and experiential factors. Our study indicated that 39.8% of the participants answered that they hesitated or refused to be vaccinated. The most common reason for vaccine hesitancy was a lack of confidence in the COVID-19 vaccine (77.9%). Less or no fear of COVID-19 (OR = 2.08, 95% CI = 1.92–2.26; OR = 1.79, 95% CI = 1.54–2.08), unstable job status (OR = 1.42, 95% CI = 1.18–1.70), decreased family income (OR = 1.40, 95% CI = 1.21–1.61), and worsening health status (OR = 1.38, 95% CI = 1.13–1.68) were predictors of vaccine hesitancy. Younger age, no religious affiliation, political conservatism, and lower family income were also significantly associated with vaccine hesitancy. Effective health communication and policies need to consider the target subgroup population and predictors of vaccine hesitancy to attain herd immunity at an early stage.
Collapse
Affiliation(s)
- Seo Eun Hwang
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.,Department of Medicine, Seoul National University Graduate School of Medicine, Seoul, Republic of Korea
| | - Woong-Han Kim
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongho Heo
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Quality of Life Group, National Assembly Futures Institute, Seoul, Republic of Korea
| |
Collapse
|
24
|
Odone A, Gianfredi V, Sorbello S, Capraro M, Frascella B, Vigezzi GP, Signorelli C. The Use of Digital Technologies to Support Vaccination Programmes in Europe: State of the Art and Best Practices from Experts' Interviews. Vaccines (Basel) 2021; 9:1126. [PMID: 34696234 PMCID: PMC8538238 DOI: 10.3390/vaccines9101126] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/22/2022] Open
Abstract
Digitalisation offers great potential to improve vaccine uptake, supporting the need for effective life-course immunisation services. We conducted semi-structured in-depth interviews with public health experts from 10 Western European countries (Germany, Greece, Italy, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, and the United Kingdom) to assess the current level of digitalisation in immunisation programmes and retrieve data on interventions and best practices. Interviews were performed using an ad hoc questionnaire, piloted on a sample of national experts. We report a mixed level of digital technologies deployment within vaccination services across Europe: Some countries are currently developing eHealth strategies, while others have already put in place robust programmes. Institutional websites, educational videos, and electronic immunisation records are the most frequently adopted digital tools. Webinars and dashboards represent valuable resources to train and support healthcare professionals in immunisation services organisation. Text messages, email-based communication, and smartphone apps use is scattered across Europe. The main reported barrier to the implementation of digital-based programmes is the lack of resources and shared standards. Our study offers a comprehensive picture of the European context and shows the need for robust collaboration between states and international institutions to share best practices and inform the planning of digital intervention models with the aim of countering vaccine hesitancy and increasing vaccine uptake.
Collapse
Affiliation(s)
- Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Vincenza Gianfredi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Sebastiano Sorbello
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Michele Capraro
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Beatrice Frascella
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Giacomo Pietro Vigezzi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| |
Collapse
|
25
|
Tomaszewski T, Morales A, Lourentzou I, Caskey R, Liu B, Schwartz A, Chin J. Identifying False Human Papillomavirus (HPV) Vaccine Information and Corresponding Risk Perceptions From Twitter: Advanced Predictive Models. J Med Internet Res 2021; 23:e30451. [PMID: 34499043 PMCID: PMC8461539 DOI: 10.2196/30451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/04/2021] [Indexed: 01/27/2023] Open
Abstract
Background The vaccination uptake rates of the human papillomavirus (HPV) vaccine remain low despite the fact that the effectiveness of HPV vaccines has been established for more than a decade. Vaccine hesitancy is in part due to false information about HPV vaccines on social media. Combating false HPV vaccine information is a reasonable step to addressing vaccine hesitancy. Objective Given the substantial harm of false HPV vaccine information, there is an urgent need to identify false social media messages before it goes viral. The goal of the study is to develop a systematic and generalizable approach to identifying false HPV vaccine information on social media. Methods This study used machine learning and natural language processing to develop a series of classification models and causality mining methods to identify and examine true and false HPV vaccine–related information on Twitter. Results We found that the convolutional neural network model outperformed all other models in identifying tweets containing false HPV vaccine–related information (F score=91.95). We also developed completely unsupervised causality mining models to identify HPV vaccine candidate effects for capturing risk perceptions of HPV vaccines. Furthermore, we found that false information contained mostly loss-framed messages focusing on the potential risk of vaccines covering a variety of topics using more diverse vocabulary, while true information contained both gain- and loss-framed messages focusing on the effectiveness of vaccines covering fewer topics using relatively limited vocabulary. Conclusions Our research demonstrated the feasibility and effectiveness of using predictive models to identify false HPV vaccine information and its risk perceptions on social media.
Collapse
Affiliation(s)
- Tre Tomaszewski
- School of Information Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Alex Morales
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Ismini Lourentzou
- Department of Computer Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Rachel Caskey
- College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Bing Liu
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL, United States
| | - Alan Schwartz
- Department of Medical Education, University of Illinois at Chicago, Chicago, IL, United States
| | - Jessie Chin
- School of Information Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| |
Collapse
|
26
|
HPV vaccine acceptance in West Africa: A systematic literature review. Vaccine 2021; 39:5277-5284. [PMID: 34366143 DOI: 10.1016/j.vaccine.2021.06.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 11/24/2022]
Abstract
Human papillomavirus (HPV) infections are mostly sexually transmitted and cause the greatest share of infection-associated cancers. Each year more than half a million women are diagnosed with cervical cancer and the mortality rate in West Africa is over ten times higher than that of Northern Europe. HPV vaccines are highly effective at preventing various strains of the infection. However, vaccine hesitancy and access issues have led to low HPV vaccine acceptance in certain countries. A search strategy was developed in PubMed and included an extensive list of keywords and related MeSH/subject headings to capture the many dimensions and expressions of vaccine access, confidence, trust and hesitancy related to HPV vaccination in West Africa. Thirty-five articles were included by full text. Most studies were conducted in Nigeria. Three were conducted in Mali, and one each in Côte d'Ivoire, Ghana and Senegal. The main concerns relating to the vaccine were inadequate information, cost and safety concerns. Several studies also mentioned fertility and promiscuity concerns. Despite over half of West African countries introducing an HPV vaccine pilot project, there is a scarcity of literature on HPV vaccine acceptance in the region. It is important to understand how cultural and gender dynamics in different settings can influence peoples' vaccination decisions. This can be done through in-depth local ethnographies, taking the views of all community members and influencers into account, and complemented by in-depth individual interviews and focus groups.
Collapse
|
27
|
Wang J, Zhang Y, Long S, Fu X, Zhang X, Zhao S, Xiu S, Wang X, Lu B, Jin H. Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study. Vaccines (Basel) 2021; 9:vaccines9070772. [PMID: 34358188 PMCID: PMC8310190 DOI: 10.3390/vaccines9070772] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/23/2021] [Accepted: 07/05/2021] [Indexed: 12/21/2022] Open
Abstract
Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. However, the impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain unclear. This study was an online survey performed in Eastern, Central, and Western China between February 2021 and March 2021 using proportional sampling (n = 7381). Adults aged ≥ 18 years were included, especially younger people (aged < 65). Vaccine hesitancy was assessed using the 3C model and relative scales; logistic regression was used to explore the factors affecting vaccination uptake; structural equation modeling was used to evaluate the correlations between variables. Overall, 67.6% and 24.7% of adults reported vaccine hesitancy toward the non-EPI and COVID-19 vaccines, respectively. Participants (66.3%) reported taking the vaccine mainly based on recommendations from medical staff. Vaccine-hesitant participants (60.5%) reported a fear of side effects as the deciding factor in vaccine rejection. Vaccine hesitancy interacted negatively with confidence (β = −0.349, p < 0.001) and convenience (β = −0.232, p < 0.001), and positively with complacence (β = 0.838, p < 0.001). Nonmedical personnel, adults who had previously received the influenza vaccine, and older people had lower vaccine hesitancy than their counterparts. Most Chinese adults have non-EPI but not COVID-19 vaccine hesitancy. Vaccine safety remains a concern.
Collapse
Affiliation(s)
- Jianli Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
| | - Yan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
| | - Sigui Long
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
| | - Xin Fu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
| | - Xiaoxuan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
| | - Shuangyu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
| | - Shixin Xiu
- Wuxi Center for Disease Control and Prevention, Wuxi 214023, China; (S.X.); (X.W.); (B.L.)
| | - Xuwen Wang
- Wuxi Center for Disease Control and Prevention, Wuxi 214023, China; (S.X.); (X.W.); (B.L.)
| | - Bing Lu
- Wuxi Center for Disease Control and Prevention, Wuxi 214023, China; (S.X.); (X.W.); (B.L.)
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (J.W.); (Y.Z.); (S.L.); (X.F.); (X.Z.); (S.Z.)
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing 210009, China
- Correspondence: ; Tel.: +86-025-8327-2572; Fax: +86-825-83272561
| |
Collapse
|
28
|
Colón-López V, Rivera-Figueroa V, Arroyo-Morales GO, Medina-Laabes DT, Soto-Abreu R, Rivera-Encarnación M, Díaz-Miranda OL, Ortiz AP, Wells KB, Vázquez-Otero C, Hull PC. Content analysis of digital media coverage of the human papillomavirus vaccine school-entry requirement policy in Puerto Rico. BMC Public Health 2021; 21:1286. [PMID: 34210308 PMCID: PMC8248762 DOI: 10.1186/s12889-021-11311-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11–12 years old. Evidence suggests that the content of media coverage may impact people’s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR. Methods A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach. Results The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy's implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal. Conclusions Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.
Collapse
Affiliation(s)
- Vivian Colón-López
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico. .,Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Vilnery Rivera-Figueroa
- Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
| | - Glizette O Arroyo-Morales
- Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
| | - Diana T Medina-Laabes
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Roxana Soto-Abreu
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Manuel Rivera-Encarnación
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Olga L Díaz-Miranda
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Ana P Ortiz
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico.,Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 70184, San Juan, 00936-8184, Puerto Rico
| | - Katelyn B Wells
- Association of Immunization Managers, 620 Hungerford Dr. Suite 29, Rockville, MD, 20850, USA
| | - Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health Dana-Farber Cancer Institute, NCI Postdoctoral Fellow, 450 Brookline Ave., LW 633, Boston, MA, 02215, USA
| | - Pamela C Hull
- Department of Behavioral Science, College of Medicine, Markey Cancer Center, University of Kentucky, 2365 Harrodsburg Rd, Suite A230, Lexington, KY, 40504-3381, USA
| |
Collapse
|
29
|
Ilogu LC, Lugovska O, Vojtek I, Prugnola A, Callegaro A, Mazzilli S, Van Damme P. The intent of students to vaccinate is influenced by cultural factors, peer network, and knowledge about vaccines. Hum Vaccin Immunother 2021; 18:1938492. [PMID: 34191678 PMCID: PMC8920151 DOI: 10.1080/21645515.2021.1938492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Young adults are the future vaccine decision-makers as parents or health-care professionals. To understand their attitudes and behaviors toward vaccination, we conducted a cross-sectional survey of 2079 students attending the University of Antwerp, Belgium and the University of Pisa, Italy. Principal component analysis was used to investigate associations between survey responses and the intent to vaccinate. Vaccination knowledge, attitudes, and behaviors among university students in Italy and Belgium were high. However, only one-half of respondents displayed an intent to vaccinate. High levels of knowledge, positive attitudes, and confidence in vaccines were positively associated with age, higher level of study, being a medical student, a recent vaccination experience, and not knowing trusted persons who did not believe in vaccines. Country of origin was highly correlated with the survey responses and was clustered with lifestyle, family, and data source variables, suggesting a strong modifying effect of culture and family attitudes on how vaccines are perceived in this age-group. Recent meningococcal vaccination campaigns and public discussions around mandatory vaccination in Italy may have influenced these results. We show that the intent to vaccinate was correlated with two main clusters of variables linked to culture (country, family, lifestyle), and to scholarship (knowledge, attitudes, data source) that together influence the behavior of students with respect to vaccination. Our study reinforces previous findings that knowledge about vaccines is key to shaping attitudes and behaviors, but also shows that cultural and lifestyle factors are another platform that could be leveraged in promoting vaccination among young people.
Collapse
Affiliation(s)
- Laura Chinenye Ilogu
- Département Biologie, Faculté des Sciences et Techniques, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Olga Lugovska
- Département Biologie, Faculté des Sciences et Techniques, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | | | | | - Sara Mazzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | |
Collapse
|
30
|
Garon JR, Mukavhi A, Rupfutse M, Bright S, Brennan T, Manangazira P, An Q, Loharikar A. Multiple cohort HPV vaccination in Zimbabwe: 2018-2019 program feasibility, awareness, and acceptability among health, education, and community stakeholders. Vaccine 2021; 40 Suppl 1:A30-A37. [PMID: 34144852 PMCID: PMC10367138 DOI: 10.1016/j.vaccine.2021.05.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/27/2021] [Accepted: 05/22/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Zimbabwe introduced human papillomavirus (HPV) vaccine nationally in May 2018, targeting multiple cohorts (girls aged 10-14 years) through a school-based vaccination campaign. One year later, the second dose was administered to the multiple cohorts concurrently with the first dose given to a new single cohort of girls in grade 5. We conducted cross-sectional surveys among health workers, school personnel, and community members to assess feasibility of implementation, training, social mobilization, and community acceptability. METHODS Thirty districts were selected proportional to the volume of the HPV vaccine doses delivered in 2018; two health facilities were randomly selected within each district. One health worker, school health coordinator, village health worker, and community leader were surveyed at each selected health facility and surrounding area during January-February 2020, using standard questionnaires. Descriptive analysis was completed across groups. RESULTS There were 221 interviews completed. Over 60% of health workers reported having enough staff to carry out vaccination sessions in schools while maintaining routine vaccination services in health facilities. All school health coordinators felt the HPV vaccine should be delivered in schools in the future. Knowledge of the correct target cohort eligibility decreased from 91% in 2018 to 50% in 2020 among health workers. Understanding of HPV infection and use of HPV vaccine for cervical cancer prevention was above 90% for all respondents. Forty-two percent of respondents reported hearing rumors about the HPV vaccine, primarily regarding infertility and safety. CONCLUSIONS Findings demonstrate the presence of highly knowledgeable staff at health facilities and schools, strong community acceptance, and a school-based HPV program considered feasible to implement in Zimbabwe. However, misunderstandings regarding target eligibility and rumors persist, which can impact vaccine uptake and coverage. Continued social mobilization efforts to maintain community demand and training on eligibility were recommended. Integration, partnerships, and resource mobilization are also needed to ensure program sustainability.
Collapse
Affiliation(s)
- Julie R Garon
- CDC Foundation, USA; Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, USA.
| | | | | | - Shakia Bright
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, USA
| | | | - Portia Manangazira
- Epidemiology and Disease Control, Zimbabwe Ministry of Health and Child Care, Zimbabwe
| | - Qian An
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, USA
| | - Anagha Loharikar
- Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, USA
| |
Collapse
|
31
|
Vannice KS, Hills SL, Schwartz LM, Barrett AD, Heffelfinger J, Hombach J, Letson GW, Solomon T, Marfin AA. The future of Japanese encephalitis vaccination: expert recommendations for achieving and maintaining optimal JE control. NPJ Vaccines 2021; 6:82. [PMID: 34131150 PMCID: PMC8206071 DOI: 10.1038/s41541-021-00338-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 04/15/2021] [Indexed: 02/05/2023] Open
Abstract
Vaccines against Japanese encephalitis (JE) have been available for decades. Currently, most JE-endemic countries have vaccination programs for their at-risk populations. Even so, JE remains the leading recognized cause of viral encephalitis in Asia. In 2018, the U.S. Centers for Disease Control and Prevention and PATH co-convened a group of independent experts to review JE prevention and control successes, identify remaining scientific and operational issues that need to be addressed, discuss opportunities to further strengthen JE vaccination programs, and identify strategies and solutions to ensure sustainability of JE control during the next decade. This paper summarizes the key discussion points and recommendations to sustain and expand JE control.
Collapse
Affiliation(s)
| | - Susan L Hills
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | | | - Alan D Barrett
- Sealy Institute for Vaccine Sciences, Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Joachim Hombach
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | | | - Tom Solomon
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, and Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | | |
Collapse
|
32
|
Sherman SM, Smith LE, Sim J, Amlôt R, Cutts M, Dasch H, Rubin GJ, Sevdalis N. COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccin Immunother 2021; 17:1612-1621. [PMID: 33242386 PMCID: PMC8115754 DOI: 10.1080/21645515.2020.1846397] [Citation(s) in RCA: 422] [Impact Index Per Article: 140.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/08/2020] [Accepted: 10/29/2020] [Indexed: 01/21/2023] Open
Abstract
To investigate factors associated with intention to be vaccinated against COVID-19 we conducted a cross-sectional survey of 1,500 UK adults, recruited from an existing online research panel. Data were collected between 14th and 17th July 2020. We used linear regression analyses to investigate associations between intention to be vaccinated for COVID-19 "when a vaccine becomes available to you" and sociodemographic factors, previous influenza vaccination, general vaccine attitudes and beliefs, attitudes and beliefs about COVID-19, and attitudes and beliefs about a COVID-19 vaccination. 64% of participants reported being very likely to be vaccinated against COVID-19, 27% were unsure, and 9% reported being very unlikely to be vaccinated. Personal and clinical characteristics, previous influenza vaccination, general vaccination beliefs, and beliefs and attitudes about COVID-19 and a COVID-19 vaccination explained 76% of the variance in vaccination intention. Intention to be vaccinated was associated with more positive general COVID-19 vaccination beliefs and attitudes, weaker beliefs that the vaccination would cause side effects or be unsafe, greater perceived information sufficiency to make an informed decision about COVID-19 vaccination, greater perceived risk of COVID-19 to others (but not risk to oneself), older age, and having been vaccinated for influenza last winter (2019/20). Despite uncertainty around the details of a COVID-19 vaccination, most participants reported intending to be vaccinated for COVID-19. Actual uptake may be lower. Vaccination intention reflects general vaccine beliefs and attitudes. Campaigns and messaging about a COVID-19 vaccination could consider emphasizing the risk of COVID-19 to others and necessity for everyone to be vaccinated.
Collapse
Affiliation(s)
- Susan M. Sherman
- School of Psychology, Keele University, Newcastle-under-Lyme, UK
| | - Louise E. Smith
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - Julius Sim
- School of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Emergency Response Department Science and Technology, Public Health England, Behavioural Science Team, Wiltshire, UK
| | - Megan Cutts
- School of Psychology, Keele University, Newcastle-under-Lyme, UK
| | - Hannah Dasch
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Implementation Science, King’s College London, London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - Nick Sevdalis
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Implementation Science, King’s College London, London, UK
| |
Collapse
|
33
|
Prieto Santamaría L, Tuñas JM, Fernández Peces-Barba D, Jaramillo A, Cotarelo M, Menasalvas E, Conejo Fernández A, Arce A, Gil de Miguel A, Rodríguez González A. Influenza and Measles-MMR: two case study of the trend and impact of vaccine-related Twitter posts in Spanish during 2015-2018. Hum Vaccin Immunother 2021; 18:1-16. [PMID: 33662222 PMCID: PMC9128558 DOI: 10.1080/21645515.2021.1877597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Social media, and in particularly Twitter, can be a resource of enormous value to retrieve information about the opinion of general population to vaccines. The increasing popularity of this social media has allowed to use its content to have a clear picture of their users on this topic. In this paper, we perform a study about vaccine-related messages published in Spanish during 2015-2018. More specifically, the paper has focused on two specific diseases: influenza and measles (and MMR as its vaccine). By also including an analysis about the sentiment expressed on the published tweets, we have been able to identify the type of messages that are published on Twitter with respect these two pathologies and their vaccines. Results showed that in contrary on popular opinions, most of the messages published are non-negative. On the other hand, the analysis showed that some messages attracted a huge attention and provoked peaks in the number of published tweets, explaining some changes in the observed trends.
Collapse
Affiliation(s)
- Lucia Prieto Santamaría
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain.,Escuela Técnica Superior de Ingenieros Informáticos, Universidad Politécnica de Madrid, Boadilla del Monte, Spain
| | - Juan Manuel Tuñas
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
| | | | | | - Manuel Cotarelo
- Global Medical and Scientific Affairs, MSD España, Madrid, Spain
| | - Ernestina Menasalvas
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain.,Escuela Técnica Superior de Ingenieros Informáticos, Universidad Politécnica de Madrid, Boadilla del Monte, Spain
| | | | | | - Angel Gil de Miguel
- Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | - Alejandro Rodríguez González
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain.,Escuela Técnica Superior de Ingenieros Informáticos, Universidad Politécnica de Madrid, Boadilla del Monte, Spain
| |
Collapse
|
34
|
Suzuki S, Hayata E, Hoshi SI, Sekizawa A, Sagara Y, Tanaka M, Kinoshita K, Kitamura T. Current status of cervical cytology during pregnancy in Japan. PLoS One 2021; 16:e0245282. [PMID: 33411854 PMCID: PMC7790376 DOI: 10.1371/journal.pone.0245282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/24/2020] [Indexed: 11/18/2022] Open
Abstract
In Japan, uterine cancer screening during pregnancy is subsidized by public funds. We examined the current status of the results of cervical cytology conducted during pregnancy in Japan. We requested 2,293 obstetrical facilities to provide information on cervical cytology in pregnant women who delivered between October 2018 and March 2019. A total of 1,292 obstetrical facilities responded, with valid information on a total of 238,743 women. The implementation rate of cervical cytology during pregnancy was 86.8% in Japan. The prevalence of abnormal cervical cytology during pregnancy was 3.3% in total and 4.9% using a spatula/brush with liquid-based cytology (LBC). The prevalence of positive high-risk human papillomavirus (HPV) in teenagers with atypical squamous cells of undetermined significance (ASC-US) was significantly higher than women of other ages (p < 0.01). Because HPV vaccine coverage has dropped to less than 1% in Japan, a further study with various conditions will be needed to improve the accuracy of cervical cancer screening during pregnancy.
Collapse
Affiliation(s)
- Shunji Suzuki
- Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
- * E-mail:
| | - Eijiro Hayata
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | - Shin-ichi Hoshi
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | - Akihiko Sekizawa
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | - Yoko Sagara
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | - Masanobu Tanaka
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | | | | |
Collapse
|
35
|
Wagner AL, Huang Z, Ren J, Laffoon M, Ji M, Pinckney LC, Sun X, Prosser LA, Boulton ML, Zikmund-Fisher BJ. Vaccine Hesitancy and Concerns About Vaccine Safety and Effectiveness in Shanghai, China. Am J Prev Med 2021; 60:S77-S86. [PMID: 33189502 PMCID: PMC7877188 DOI: 10.1016/j.amepre.2020.09.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Rapidly urbanizing communities in middle-income countries could be sources of vaccine hesitancy, and may create hot spots of low vaccination coverage. This study characterizes vaccine hesitancy in Shanghai and identifies disparities in vaccine safety and efficacy concerns by residency status-a marker for recent migration into the city. METHODS Parents of children aged ≤18 years from immunization clinics in Shanghai were enrolled in summer 2019, with the data analyzed during winter 2019-2020. The paper questionnaire used the Parental Attitudes towards Childhood Vaccines scale, which included questions about vaccine safety and efficacy concerns. The primary independent variable was residency-whether an individual was a Shanghai local or a recent migrant (i.e., non-local). Linear regression models assessed the relationship between residency and vaccine safety and efficacy concerns. RESULTS Among 1,021 participants, 65.4% had local residency, and the remainder were urban non-locals (13.1%) or rural non-locals (21.5%). A majority of parents expressed concerns about vaccine side effects (73.8%), vaccine safety (63.9%), and vaccine effectiveness (52.4%). Compared with locals, rural non-locals were more concerned about vaccine side effects (β=0.26, 95% CI=0.07, 0.46), vaccine safety (β=0.42, 95% CI=0.19, 0.65), and vaccine effectiveness (β=0.37, 95% CI=0.16, 0.58). CONCLUSIONS Differences in vaccine hesitancy by residency could lead to geographical and sociodemographic disparities in vaccination coverage and outbreaks of vaccine-preventable disease. SUPPLEMENT INFORMATION This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
Collapse
Affiliation(s)
- Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China
| | - Jia Ren
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China
| | - Megan Laffoon
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Mengdi Ji
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Leah C Pinckney
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Xiaodong Sun
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China
| | - Lisa A Prosser
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan
| | - Matthew L Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, Ann Arbor, Michigan
| | - Brian J Zikmund-Fisher
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| |
Collapse
|
36
|
Okuhara T, Ishikawa H, Ueno H, Okada H, Kiuchi T. Examining Long-Term Effects of Human Papillomavirus Vaccine Recommendation Messages: A 4-Month Follow-Up Survey of a Randomized Controlled Study in Japan. Healthcare (Basel) 2020; 8:healthcare8040549. [PMID: 33321946 PMCID: PMC7763459 DOI: 10.3390/healthcare8040549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
We previously conducted a randomized controlled study to examine persuasive messages recommending HPV vaccination to mothers with daughters in Japan. That study showed that the three types of intervention message used (statistical information only, a patient’s narrative in addition to statistical information, and a mother’s narrative in addition to statistical information) all significantly improved mothers’ intention to have their daughter(s) receive the HPV vaccine, in comparison with mothers who received no messaging. The present study is a follow-up survey to assess the long-term effect of the intervention. Four months after the initial study, in January 2018, participants in the previous study were contacted and queried about their current intention to have their daughter(s) receive the HPV vaccine. Statistical analysis was conducted using the paired t-test and analysis of variance. A total of 978 mothers participated in the current survey. Vaccination intention 4 months after intervention had decreased to a level that did not differ significantly from the level prior to intervention in all three intervention conditions. The amount of change in vaccination intention 4 months after intervention did not differ significantly among the three intervention groups (p = 0.871). A single exposure to messaging was insufficient to produce a persistent intervention effect.
Collapse
Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
- Correspondence: ; Tel.: +81-3-5800-6549
| | - Hirono Ishikawa
- School of Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan;
| | - Haruka Ueno
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| |
Collapse
|
37
|
Bell S, Clarke R, Mounier-Jack S, Walker JL, Paterson P. Parents' and guardians' views on the acceptability of a future COVID-19 vaccine: A multi-methods study in England. Vaccine 2020; 38:7789-7798. [PMID: 33109389 PMCID: PMC7569401 DOI: 10.1016/j.vaccine.2020.10.027] [Citation(s) in RCA: 320] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The availability of a COVID-19 vaccine has been heralded as key to controlling the COVID-19 pandemic. COVID-19 vaccination programme success will rely on public willingness to be vaccinated. METHODS We used a multi-methods approach - involving an online cross-sectional survey and semi-structured interviews - to investigate parents' and guardians' views on the acceptability of a future COVID-19 vaccine. 1252 parents and guardians (aged 16 + years) who reported living in England with a child aged 18 months or under completed the survey. Nineteen survey participants were interviewed. FINDINGS Most survey participants reported they would likely accept a COVID-19 vaccine for themselves (Definitely 55.8%; Unsure but leaning towards yes 34.3%) and their child/children (Definitely 48.2%; Unsure but leaning towards yes 40.9%). Less than 4% of survey participants reported that they would definitely not accept a COVID-19 vaccine. Survey participants were more likely to accept a COVID-19 vaccine for themselves than their child/children. Participants that self-reported as Black, Asian, Chinese, Mixed or Other ethnicity were almost 3 times more likely to reject a COVID-19 vaccine for themselves and their children than White British, White Irish and White Other participants. Survey participants from lower-income households were also more likely to reject a COVID-19 vaccine. In open-text survey responses and interviews, self-protection from COVID-19 was reported as the main reason for vaccine acceptance. Common concerns identified in open-text responses and interviews were around COVID-19 vaccine safety and effectiveness, mostly prompted by the newness and rapid development of the vaccine. CONCLUSION Information on how COVID-19 vaccines are developed and tested, including their safety and efficacy, must be communicated clearly to the public. To prevent inequalities in uptake, it is crucial to understand and address factors that may affect COVID-19 vaccine acceptability in ethnic minority and lower-income groups who are disproportionately affected by COVID-19.
Collapse
Affiliation(s)
- Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
| | - Richard Clarke
- Newcastle University Business School, Newcastle University London, 102 Middlesex Street, London E1 7EZ, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Jemma L Walker
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Department of Statistics, Modelling and Economics, Public Health England, National Infection Service, 61 Colindale Ave, London NW9 5EQ, UK
| | - Pauline Paterson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
38
|
Mizumachi K, Aoki H, Kitano T, Onishi T, Takeyama M, Shima M. How to recover lost vaccine acceptance? A multi-center survey on HPV vaccine acceptance in Japan. J Infect Chemother 2020; 27:445-449. [PMID: 33127289 DOI: 10.1016/j.jiac.2020.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The plummeting acceptance rate of the HPV vaccine in Japan is one of the most disappointing vaccine-related events in recent times. Since 2013, the national HPV vaccine coverage rate fell from more than 70% to less than 1%. This survey investigated parental HPV vaccine acceptance and the factors that influence it. METHODS A multi-center survey was conducted in eight hospitals in Nara prefecture, Japan, from July 2019 to March 2020. Parents were asked to answer a series of questions in a survey that included information on the HPV vaccine. RESULTS Among the 1884 parents who answered the questionnaire, 21.8% indicated that they had accepted the HPV vaccine even before reading the information provided in the questionnaire. The overall acceptance rate after everyone had read the information increased to 50.2% (p < 0.001). Among those who still did not accept the vaccine after reading the information (N = 925), 26.7% indicated that they might change their mind if more vaccine safety reports were to appear in the mass media; other potentially influencing factors were direct communication from health care providers (35.1%), a recommendation by government (19.5%), and peer behavior (16.8%). CONCLUSION The study showed that providing appropriate medical information significantly improves HPV vaccine acceptance. To reverse the loss of HPV vaccine acceptance in Japan, a multi-discipline approach that includes the mass media, health care providers, the government and the general population will be needed.
Collapse
Affiliation(s)
| | - Hirosato Aoki
- Department of Pediatrics, Nara Medical University, Japan; Department of Neonatolgy, Kanagawa Children's Medical Center, Japan
| | - Taito Kitano
- Department of Pediatrics, Nara Medical University, Japan; Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Tomoko Onishi
- Department of Pediatrics, Nara Medical University, Japan
| | | | - Midori Shima
- Department of Pediatrics, Nara Medical University, Japan
| |
Collapse
|
39
|
Munawar K, Sugi MD, Prabhu V. Radiology in the News: A Content Analysis of Radiology-Related Information Retrieved From Google Alerts. Curr Probl Diagn Radiol 2020; 50:825-830. [PMID: 33041161 PMCID: PMC7544702 DOI: 10.1067/j.cpradiol.2020.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/15/2020] [Indexed: 12/24/2022]
Abstract
Google Alerts highlighted a diverse set of topics present in online media. Most links were directly to non-radiology lay press, but <1% of links over the 6-month period sent the user directly to a primary peer-reviewed medical journal article. The most common topics were market trends, promotional, COVID-19, and artificial intelligence.
Introduction Radiology topics receive substantial online media attention, with prior studies focusing on social media platform coverage. We used Google Alerts, a content change detection and notification service, to prospectively analyze new radiology-related content appearing on the internet. Materials and Methods An automated notification was created on Google Alerts for the search term “radiology,” sending the user emails with up to 3 new links daily. All links from November 2019 through April 2020 were assessed by 2 of 3 independent raters using a coding system to classify the content source and primary topic of discussion. The top 5 primary topics were retrospectively evaluated to identify prevalent subcategories. Content viewing restrictions were documented. Results 526 links were accessed. The majority (68%) of links were created by non-radiology lay press, followed by radiology-related lay press (28%), university-based publications (2%), and professional society websites (2%). The primary topic of these links most frequently related to market trends (28%), promotional material (20%), COVID-19 (13%), artificial intelligence (8%), and new technology or equipment (5%). 15% of links discussed a topic sourced from another article, such as a peer-reviewed journal, though only 2 linked directly to the journal itself. 8% of links had content viewing restrictions. Conclusion New radiology content was largely disseminated via non-radiology news sources; radiologists should therefore ensure their research and viewpoints are presented in these outlets. Google Alerts may be a useful tool to stay abreast of the most current public radiology subject matters, especially during these times of social isolation and rapidly evolving clinical practice.
Collapse
Affiliation(s)
- Kamran Munawar
- NYU Langone Health, Department of Radiology, New York, NY.
| | - Mark D Sugi
- University of California, San Francisco, Department of Radiology, San Francisco, CA. https://twitter.com/markdsugi
| | - Vinay Prabhu
- NYU Langone Health, Department of Radiology, New York, NY. https://twitter.com/yaniv34
| |
Collapse
|
40
|
Lack A, Hiligsmann M, Bloem P, Tünneßen M, Hutubessy R. Parent, provider and vaccinee preferences for HPV vaccination: A systematic review of discrete choice experiments. Vaccine 2020; 38:7226-7238. [PMID: 33023774 DOI: 10.1016/j.vaccine.2020.08.078] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 07/11/2020] [Accepted: 08/29/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To systematically review, appraise and evaluate available evidence regarding discrete-choice experiments (DCEs) for the human papilloma virus (HPV) vaccination in order to support policymakers in making reasonable and effective vaccination program implementation decisions. METHODS A systematic literature review was conducted using the databases PubMed and Embase for DCEs in HPV up to May 2019. Extracted data was tabulated and two checklists were used for the quality appraisal of the included studies. All attributes were categorized in outcome, process or costs attributes and the relative importance of attributes was calculated using the range method. RESULTS Out of 164 identified studies, 12 met the inclusion criteria. Eight were from high income countries (HICs) and four from low and middle-income countries (LMICs). Five studies each examined vaccinee and parent preferences, while only two assessed the providers' preferences. The studies were rather heterogenous in terms of the populations investigated, the attributes included and the methodologic approach. Overall, outcome measures were the most prominent attributes and effectiveness consistently yielded high relative importance scores. But also process factors, such as the age at vaccination, played an important role for decision making. Discrepancies between HICs and LMICs were most prominent for cost attributes. CONCLUSION The heterogenous preferences this review elicited highlight the importance of context when making decisions grounded on consumer preferences. Especially the lack of evidence from LMICs, where the burden of cervical cancer is highest, is worrisome. In order to increase uptake, close vaccination gaps and reduce current inequities in (reproductive) healthcare, policy makers need to understand the features that drive individual vaccination decisions and adapt national and clinical guidelines accordingly. Future research therefore needs to focus on LMICs in order to elicit preferences of those most vulnerable populations.
Collapse
Affiliation(s)
- Alina Lack
- Department for Immunization, Vaccination and Biologicals, WHO Avenue Appia 20, 1202 Geneva, Switzerland.
| | - Mickael Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Duboisdomein 30, 6229 Maastricht, Netherlands
| | - Paul Bloem
- Department for Immunization, Vaccination and Biologicals, WHO Avenue Appia 20, 1202 Geneva, Switzerland
| | - Maike Tünneßen
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 Maastricht, Netherlands
| | - Raymond Hutubessy
- Department for Immunization, Vaccination and Biologicals, WHO Avenue Appia 20, 1202 Geneva, Switzerland.
| |
Collapse
|
41
|
de Figueiredo A, Simas C, Karafillakis E, Paterson P, Larson HJ. Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study. Lancet 2020; 396:898-908. [PMID: 32919524 PMCID: PMC7607345 DOI: 10.1016/s0140-6736(20)31558-0] [Citation(s) in RCA: 549] [Impact Index Per Article: 137.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. METHODS In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. FINDINGS Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. INTERPRETATION To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. FUNDING European Commission, Wellcome, and Engineering and Physical Sciences Research Council.
Collapse
Affiliation(s)
- Alexandre de Figueiredo
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Mathematics, Imperial College London, London, UK
| | - Clarissa Simas
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Emilie Karafillakis
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Pauline Paterson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi J Larson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
| |
Collapse
|
42
|
Gazibara T, Thygesen LC, Algren MH, Tolstrup JS. Human Papillomavirus Vaccination and Physical and Mental Health Complaints Among Female Students in Secondary Education Institutions in Denmark. J Gen Intern Med 2020; 35:2647-2654. [PMID: 32342482 PMCID: PMC7458962 DOI: 10.1007/s11606-020-05845-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous studies have not explored the effect of HPV vaccination on health status at a longer time interval. Similarly, self-reported physical and mental health in recipients of the HPV vaccine has not been studied. OBJECTIVE To evaluate whether HPV vaccination was associated with physical and mental health complaints among girls in secondary education institutions. DESIGN Prospective cohort study. PARTICIPANTS This study used data from girls aged 15-20 years who participated in the Danish National Youth Study (DNYS) 2014. Data on HPV vaccination was retrieved from the Danish Vaccination Register. MAIN MEASURES Participants were asked whether they had experienced headaches, stomachache, neck pain, menstrual cramps, sore throat, sadness, irritation, nervousness and sleep problems in the past 6 months. KEY RESULTS Of 41,333 girls, 39,145 (94.7%) received at least one dose of HPV vaccine. The most prevalent health complaint among the vaccinated and not vaccinated females was "been irritable" (88.2% and 88.4%, respectively). The lowest proportion of health complaints was stomachache (49.6% in vaccinated and in 50.4% in unvaccinated girls). Regression model, adjusted for socio-demographic characteristics and health behavior, showed that HPV vaccination was associated with a lower likelihood of reporting sore throat (odd ratio [OR] 0.86, 95% confidence interval [CI] 0.78-0.95) and being sad (OR 0.86, 95%CI 0.76-0.97). Similar results were observed when HPV vaccination status was analyzed according to the number of doses received. CONCLUSION We conclude that HPV vaccination was not associated with physical and mental health complaints among girls in secondary education institutions in Denmark after a median of 5.3 years since HPV vaccination.
Collapse
Affiliation(s)
- Tatjana Gazibara
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark.,Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, Belgrade, 11000, Serbia
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Maria Holst Algren
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | | |
Collapse
|
43
|
Wong LP, Wong PF, Megat Hashim MMAA, Han L, Lin Y, Hu Z, Zhao Q, Zimet GD. Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia. Hum Vaccin Immunother 2020; 16:1611-1622. [PMID: 32429731 PMCID: PMC7482900 DOI: 10.1080/21645515.2020.1756670] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/11/2020] [Indexed: 12/27/2022] Open
Abstract
HPV vaccine hesitancy in Asia is unique compared to Western countries due to multidimensional social-cultural norms that influence beliefs regarding vaccination. Reviews on HPV vaccine hesitancy in Asia lack of in-depth discussion regarding the traditional and social-cultural norms dimensions. This paper puts forward opinions in which culture, normative beliefs, and religion influence HPV vaccine hesitancy in Asian countries. Issues surrounding HPV hesitancy among parents, young adult women, adult women, men and the sexual and gender minority people in Asian countries were highlighted. The shortage of HPV vaccine supply would soon be reduced as some Asian countries are on the way to producing the HPV vaccine which production is currently dominated by Western European countries. The culture of favoring imported Western products among many in Asia and in addition to long-existing fake vaccine crisis pose a challenge for the newly emerging HPV vaccine produced in Asia. Some recommendations, research gaps, and future research needs were discussed.
Collapse
Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pooi-Fong Wong
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Liyuan Han
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qinjian Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian Province, China
| | - Gregory D. Zimet
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, U.S
| |
Collapse
|
44
|
Abstract
During the 20th century, the discovery of modern vaccines and ensuing mass vaccination dramatically decreased the incidence of many infectious diseases and in some cases eliminated them. Despite this, we are now witnessing a decrease in vaccine confidence that threatens to reverse the progress made. Considering the different extents of low vaccine confidence in different countries of the world, both developed and developing, we aim to contribute to the discussion of the reasons for this, and to propose some viable scientific solutions to build or help restore vaccine confidence worldwide.
Collapse
Affiliation(s)
- Selim Badur
- EM, Vaccines Scientific Affairs and Public Health, GSK, Istanbul, Turkey
| | - Martin Ota
- EM, Vaccines Scientific Affairs and Public Health, GSK, Wavre, Belgium
| | | | - Richard Adegbola
- Immunisation & Global Health Consulting, RAMBICON, Lagos, Nigeria
| | - Anil Dutta
- Vaccines R&D Medical, GSK, Wavre, Belgium
| |
Collapse
|
45
|
Jiménez ÁV, Mesoudi A, Tehrani JJ. No evidence that omission and confirmation biases affect the perception and recall of vaccine-related information. PLoS One 2020; 15:e0228898. [PMID: 32130217 PMCID: PMC7055885 DOI: 10.1371/journal.pone.0228898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/24/2020] [Indexed: 11/19/2022] Open
Abstract
Despite the spectacular success of vaccines in preventing infectious diseases, fears about their safety and other anti-vaccination claims are widespread. To better understand how such fears and claims persist and spread, we must understand how they are perceived and recalled. One influence on the perception and recall of vaccination-related information might be universal cognitive biases acting against vaccination. An omission bias describes the tendency to perceive as worse, and recall better, bad outcomes resulting from commissions (e.g. vaccine side effects) compared to the same bad outcomes resulting from omissions (e.g. symptoms of vaccine preventable diseases). Another factor influencing the perception and recall of vaccination-related information might be people's attitudes towards vaccines. A confirmation bias would mean that pre-existing pro-vaccination attitudes positively predict perceptions of severity and recall of symptoms of vaccine preventable diseases and negatively predict perceptions of severity and recall of vaccine side effects. To test for these hypothesized biases, 202 female participants aged 18-60 (M = 38.15, SD = 10.37) completed an online experiment with a between-subjects experimental design. Participants imagined that they had a 1-year old child who suffered from either vaccine side effects (Commission Condition) or symptoms of a vaccine-preventable disease (Omission Condition). They then rated a list of symptoms/side effects for their perceived severity on a 7-point Likert scale. Finally, they completed a surprise recall test in which they recalled the symptoms/side effects previously rated. An additional scale was used to measure their attitudes towards vaccines. Contrary to the hypotheses, perceptions of severity and the recall of symptoms/side effects were not associated with experimental condition, failing to support the omission bias, nor did they interact with attitudes towards vaccines, failing to support the confirmation bias. This cast doubt on the possibility that the spread of anti-vaccination claims can be explained by these particular universal cognitive biases.
Collapse
Affiliation(s)
- Ángel V. Jiménez
- Durham Cultural Evolution Research Centre, Department of Anthropology, Durham University, Durham, United Kingdom
- Conspiracy Theories in Health Special Interest Group, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, United Kingdom
- Human Behaviour and Cultural Evolution Group, Department of Biosciences, University of Exeter, Penryn, United Kingdom
| | - Alex Mesoudi
- Human Behaviour and Cultural Evolution Group, Department of Biosciences, University of Exeter, Penryn, United Kingdom
| | - Jamshid J. Tehrani
- Durham Cultural Evolution Research Centre, Department of Anthropology, Durham University, Durham, United Kingdom
- Conspiracy Theories in Health Special Interest Group, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, United Kingdom
| |
Collapse
|
46
|
Gold MS, MacDonald NE, McMurtry CM, Balakrishnan MR, Heininger U, Menning L, Benes O, Pless R, Zuber PLF. Immunization stress-related response - Redefining immunization anxiety-related reaction as an adverse event following immunization. Vaccine 2020; 38:3015-3020. [PMID: 32131975 DOI: 10.1016/j.vaccine.2020.02.046] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022]
Abstract
The Council for the International Organizations of Medical Sciences (CIOMS) and WHO working group on pharmacovigilance defines five cause specific AEFI which includes an immunization anxiety-related reaction. Historically this term has been used to describe a range of symptoms and signs that may arise after immunization that are related to "anxiety" about the immunization. However, the term "anxiety" does not adequately capture all the elements of this cause specific AEFI. In 2015, the Global Advisory Committee for Vaccine Safety convened an expert working group with the purpose of redefining, preventing and managing this particular AEFI. The term "Immunization Stress-Related Response" is proposed to replace the former terminology. We present a manual that redefines this AEFI and present a framework for prevention, diagnosis and management in both an individual and also when such events occur as clusters and affect multiple individuals. Since such mass events can result in cessation of immunization programmes and/or a loss of public confidence, a communication response is essential.
Collapse
Affiliation(s)
- Michael S Gold
- Discipline of Paediatrics, School of Medicine, University of Adelaide, Australia.
| | - Noni E MacDonald
- Department of Paediatrics, Dalhousie University, IWK Health Centre, Halifax, Canada
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph and Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Madhava Ram Balakrishnan
- Department of Essential Medicines and Health Products (EMP), World Health Organization, Genève, Switzerland
| | - Ulrich Heininger
- Division of Pediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland
| | - Lisa Menning
- Expanded Programme on Immunization, World Health Organisation, Geneva, Switzerland
| | - Oleg Benes
- Regional Office Europe, World Health Organisation, Denmark
| | - Robert Pless
- Clinical Evaluation Division, Vaccines/Blood Biologics and Genetic Therapies Directorate, Health Canada, Canada
| | - Patrick L F Zuber
- Department of Essential Medicines and Health Products (EMP), World Health Organization, Genève, Switzerland
| |
Collapse
|
47
|
Chen R, Wong E, Wu L, Zhu Y. Toward universal human papillomavirus vaccination for adolescent girls in Hong Kong: a policy analysis. J Public Health Policy 2020; 41:170-184. [PMID: 32054980 PMCID: PMC7228912 DOI: 10.1057/s41271-020-00220-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Studies have assessed early population-level impact of human papillomavirus (HPV) vaccination programs for preventing cervical cancer. Through a case study in Hong Kong we examined stakeholder engagement and interactions to promote a universal HPV vaccination program using the Health Policy Triangle framework for structured health policy analysis. Using data from a document review and semi-structured in-depth interviews, we used thematic and stakeholder analyses to describe the process of policy formation. Given Hong Kong’s political and health system, and a mix of Chinese and Western values, stakeholders judged legitimacy of the process differently. We discuss their varied ethical stances and the role of research evidence for informing policy-making. For effective HPV vaccination policy and promotion of universal free HPV vaccination among adolescent girls, new strategies are needed to broaden acceptance of the process, to frame policies in terms of facts and values, and to connect research to policy-making and improve coalition-building.
Collapse
Affiliation(s)
- Ruirui Chen
- Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China.
| | - Eliza Wong
- Division of Health System, Policy & Management, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lijuan Wu
- Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| | - Yuanfang Zhu
- Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| |
Collapse
|
48
|
Catalan-Matamoros D, Peñafiel-Saiz C. Exploring the relationship between newspaper coverage of vaccines and childhood vaccination rates in Spain. Hum Vaccin Immunother 2020; 16:1055-1061. [PMID: 32017659 DOI: 10.1080/21645515.2019.1708163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Despite the effectiveness of vaccines being well established and recognized by the research community, eleven European countries have adopted mandatory vaccination programs because of vaccine hesitancy. Lack of information and fake news are considered the main reasons. The media are a powerful tool for spreading vaccine-related information. The study of media effects on vaccine uptake has received little attention in Europe.Objective: To explore the association of childhood vaccination rates in Spain with vaccine-related coverage in print media.Methods: A content analysis of newspaper coverage of vaccines was conducted. The study variables were: national vaccination rates, article publication dates, tone and main theme of the articles. We conducted a correlation analysis to assess the association between media coverage and childhood vaccine uptake.Results: While vaccine coverage with positive and neutral tones significantly increased during the study period (p < .001), the number of articles with a negative tone remained unchanged (p = .306). There was a significant and inverse correlation between negative newspaper coverage and childhood vaccine uptake (r = -.771, p < .05). During 2016 and 2017, although the media reporting declined, vaccination rates kept increasing. The most frequent themes were about the development of the Ebola vaccine, and the chickenpox and meningitis vaccine crises.Conclusions: Our findings expand the understanding of media role on vaccination and suggest that the media need to be considered as an important player during vaccination campaigns. The study points to the important educational role of the media in public health.
Collapse
Affiliation(s)
- Daniel Catalan-Matamoros
- Department of Communication Studies, University Carlos III of Madrid, Madrid, Spain.,Health Research Centre, University of Almeria, Almeria, Spain.,Research Group for Analysis and Anticipation Journalism, University of Nebrija, Madrid, Spain
| | | |
Collapse
|
49
|
Steffens MS, Dunn AG, Leask J, Wiley KE. Using social media for vaccination promotion: Practices and challenges. Digit Health 2020; 6:2055207620970785. [PMID: 35173976 PMCID: PMC8842369 DOI: 10.1177/2055207620970785] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Vaccination misinformation is widespread on social media. Vaccine-promoting organisations are working to curb its influence, but face obstacles. We aimed to analyse their social media strategies and the challenges they encounter. METHODS In this qualitative study, we purposively sampled 21 participants responsible for social media from vaccine-promoting organisations. We used Framework Analysis to explore the data. RESULTS Vaccine-promoting organisations faced obstacles using social media, including fast-paced change, limited resources, and insufficient organisational buy-in. They experienced difficulties reaching audiences, exploiting social media listening, and measuring impact. Consequently, they may miss opportunities to counter misinformation, connect with groups low in vaccine confidence, and determine diverse audience responses. They lack strong evidence linking social media strategies with behaviour change, and have difficulty understanding silent audiences. CONCLUSIONS Vaccine-promoting organisations have an opportunity to embrace the participatory nature of social media. They could share listening insights with like-minded groups, and conduct research exploring associations between social media strategies and community attitude/behaviour change. Social media platforms could assist by renewing vaccine-promoting organisations' organic reach, supporting the development of tailored listening and credibility tools, and strengthening collaborations to promote credible content.
Collapse
Affiliation(s)
- Maryke S Steffens
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Adam G Dunn
- Faculty of Medicine and Health, Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, The University of Sydney, Sydney, Australia.,Computational Health Informatics Program, Boston Children's Hospital, Boston, USA
| | - Julie Leask
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia.,Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
| | - Kerrie E Wiley
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
50
|
Okita T, Enzo A, Kadooka Y, Tanaka M, Asai A. The controversy on HPV vaccination in Japan: Criticism of the ethical validity of the arguments for the suspension of the proactive recommendation. Health Policy 2019; 124:199-204. [PMID: 31924344 DOI: 10.1016/j.healthpol.2019.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
Abstract
The Human Papillomavirus (HPV) vaccine was integrated into Japan's national immunization program (NIP) in April 2013. However, numerous instances of serious adverse reactions were widely reported in the media, resulting in the Ministry of Health, Labor, and Welfare (MHLW) suspending the official recommendation of the HPV vaccine on June 14, 2013. Investigating the reported incidents, the Vaccine Adverse Reactions Review Committee (VARRC)-an MHLW advisory committee-found no high-quality evidence supporting a causal relationship between the reported events and the HPV vaccination. However, rather than lifting the suspension, they have opted to maintain a "pseudo informed consent" confirming the perceptions of Japanese citizens regarding the vaccine. Accordingly, there appears to be a fundamental difference in the approach to vaccine policymaking between Japan (MHLW/VARRC) and other countries and the World Health Organization, which base policy decisions on the effectiveness and safety of the vaccine. Consequently, the arguments for the suspension of the HPV vaccine recommendation are not ethically appropriate. Relevant bodies must make a clear decision regarding the HPV vaccine and its status in the NIP: the proactive recommendation must either be reinstated or the HPV vaccine legal framework altered to rely entirely on voluntary individual decisions.
Collapse
Affiliation(s)
- Taketoshi Okita
- Department of Medical Ethics, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Aya Enzo
- Department of Medical Ethics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiro Kadooka
- Department of Bioethics, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan
| | - Masashi Tanaka
- Department of Medical Ethics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Asai
- Department of Medical Ethics, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|