1
|
Ramot S, Tal O. Attitudes of healthcare workers and members of the public toward the COVID-19 vaccine: A cross-sectional survey. Hum Vaccin Immunother 2022; 18:2124782. [PMID: 36314896 PMCID: PMC9746361 DOI: 10.1080/21645515.2022.2124782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/25/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022] Open
Abstract
The COVID-19 pandemic has led to the rapid development and implementation of vaccines. However, uncertainty about their safety and effectiveness among some people has led to vaccine hesitancy. We conducted a cross-sectional survey in March 2021 among individuals from the general Israeli population and health-care workers (HCWs) to examine risk perception toward the COVID-19 vaccine, trust in health-care providers and information sources used for making health-related decisions. The study population included 739 respondents: 42.6% HCWs and 57.4% members of the public. Participants' perceived risk toward the vaccine was relatively low in both populations. Higher perceived benefit of the vaccine, higher perceived extent of knowledge that doctors have about the risk associated with the vaccine, higher perceived freedom to choose whether to get vaccinated and higher trust in health-care providers predicted lower perceived risk toward the vaccine. Individuals who showed greater health responsibility, those who usually get vaccinated against influenza and those who had greater objective knowledge on the COVID-19 vaccine demonstrated lower perceived risk. No statistically significant difference in trust level was found between HCWs and members of the public. Both populations regarded information from medical sources as their greatest influence on health-related decisions. The study points to the factors influencing the perceived risk toward the COVID-19 vaccine and emphasizes the unique status of HCWs having their own views and concerns about the vaccine as individual members. Policymakers should consider these factors when planning national vaccination campaigns.
Collapse
Affiliation(s)
- Shira Ramot
- Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel
| | - Orna Tal
- Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel
- Shamir Medical Center (Assaf Harofeh), Be’er Ya’akov, Israel
- ICET - Israeli Center for Emerging Technologies, Shamir Medical center, Be’er Ya’akov, Israel
| |
Collapse
|
2
|
Marlowe E, Pranikoff S, Borsheim B, Salafian K, Halvorson EE, Kram DE. Pilot study to determine effect of an altruism intervention focusing on herd immunity to enhance influenza vaccination rates. Vaccine 2022; 40:6625-6630. [PMID: 36210252 DOI: 10.1016/j.vaccine.2022.09.074] [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: 06/28/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE A prospective, single-arm clinical trial was conducted to evaluate an altruism-tailored educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents. METHODS Vaccine-hesitant parents at two primary care sites, spanning two influenza seasons from 2020 to 2021 were provided an intervention (spoken and written communication) which highlighted altruistic benefits of accepting the seasonal influenza vaccine to optimize herd immunity to help protect pediatric cancer patients. Eligible parents included those with children eligible for the seasonal influenza vaccine, those who were proficient in English, and those with scores on the adjusted Vaccine Hesitancy Scale (aVHS) suggesting vaccine hesitancy (score ≥ 3). Enrollees completed a demographic questionnaire, underwent the educational intervention, and repeated the aVHS. Vaccination status at that visit was assessed. The primary outcome was change in aVHS scores obtained pre- and post-intervention. Influenza vaccine acceptance, along with demographic information, were also analyzed. RESULTS We enrolled 510 parents of influenza vaccine eligible children and identified 73 vaccine-hesitant parents. There was an overall trend toward lower aVHS score, with a mean change in hesitancy score of -0.4 (P < 0.01). 43/73 (58.9 %) of the cohort experienced a positive effect toward a lower aVHS score, and 27/73 (37.0 %) of vaccine hesitant subjects became non-hesitant on the aVHS. Several demographic characteristics were associated with vaccine hesitancy in the screening population: educational level lower than bachelor's degree (p = 0.03), household income < 400 % of federal poverty level (p < 0.01), unmarried (p = 0.02), and identifying with a political affiliation other than Democrat (p < 0.01). However, no demographic characteristics were significantly associated with an individual becoming non-hesitant. Our altruism-tailored communication approach carried the largest positive impact on the altruism-specific question on the aVHS, decreasing the post-intervention response value by nearly 25 % (P < 0.01). CONCLUSIONS Our altruism-tailored communication approach significantly improved attitudes regarding childhood influenza vaccine among vaccine-hesitant parents. CLINICALTRIALS gov Identifier: NCT04568590.
Collapse
Affiliation(s)
- Elizabeth Marlowe
- Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Sarah Pranikoff
- Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Briana Borsheim
- Department of Pediatrics, Northwestern Feinberg School of Medicine, 225 E Chicago Ave, Chicago, IL 60611, USA
| | - Kiarash Salafian
- Department of Medicine, University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA 22903, USA
| | - Elizabeth E Halvorson
- Department of Pediatrics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - David E Kram
- Section of Pediatric Hematology/Oncology, Department of Pediatrics, University of North Carolina School of Medicine, 170 Manning Drive, Chapel Hill, NC 27599, USA.
| |
Collapse
|
3
|
Jing R, Fang H, Wang H, Wang J. The Role of General Attitudes and Perceptions Towards Vaccination on the Newly-Developed Vaccine: Results From a Survey on COVID-19 Vaccine Acceptance in China. Front Psychol 2022; 13:841189. [PMID: 35712143 PMCID: PMC9194573 DOI: 10.3389/fpsyg.2022.841189] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background Vaccination has been considered one of the most effective public health interventions. In the context of the global epidemic of coronavirus disease 2019 (COVID-19), it remains unclear what role general vaccination attitudes and perceptions have on the acceptance of COVID-19 vaccine. Objective This study aims to explore the impact of general attitudes and perceptions toward vaccination on the acceptance of a newly developed vaccine, taking COVID-19 vaccines as an example. Method A cross-sectional survey was conducted among 2,013 Chinese adult participants. Generalized order logistic regression and path analysis models were used to analyze impacts of general attitudes and perceptions toward vaccination on the acceptance of the COVID-19 vaccine. Results The prevalence of hesitancy to vaccination in general is 49.9% among the Chinese adult population. General perceptions of vaccination were associated with corresponding perceptions of the COVID-19 vaccine. A “no hesitancy” attitude toward vaccination is a significant determinant (aOR = 1.77, 95% CI = 1.36–2.31) of future COVID-19 vaccination compared to vaccine refusers, and perceptions of COVID-19 vaccine remain a significant determinant for the acceptance of the COVID-19 vaccine. Path analysis indicates that perceptions of the importance and safety of vaccination have a positive overall effect on the acceptance of the COVID-19 vaccine, and that general perceptions of vaccination as a whole on each measure indirectly influence the acceptance of the COVID-19 vaccine. Conclusion General attitudes and perceptions toward vaccination were associated with those of the COVID-19 vaccine and future vaccination intention. To prepare for possible emergence of diseases in the future, routine health campaigns should be launched by relevant government departments and vaccination authorities to enhance the overall awareness and knowledge of vaccination among the public and to ensure optimal vaccination experience. In addition, targeted knowledge dissemination and mass mobilizations should be urged for newly developed vaccines when some specific infectious diseases emerge, such as COVID-19 at present.
Collapse
Affiliation(s)
- Rize Jing
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Hai Fang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
- Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Peking University Health Science Center, Beijing, China
| | - Hufeng Wang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
- *Correspondence: Hufeng Wang,
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
- Jiahao Wang,
| |
Collapse
|
4
|
Tal O, Ne'eman Y, Sadia R, Shmuel R, Schejter E, Bitan M. Parents' attitudes toward children's vaccination as a marker of trust in health systems. Hum Vaccin Immunother 2021; 17:4518-4528. [PMID: 34613882 DOI: 10.1080/21645515.2021.1971472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Children's vaccination is a major goal in health-care systems worldwide; nevertheless, disparities in vaccination coverage expose socio-demographic accessibility gaps, unawareness, physicians' disapproval and parents' incomplete adherence reflecting insufficient public-provider trust. Our goal was to analyze parents' attitude toward children's vaccination in correlation with trust among stakeholders. A total of 1031 parents replied to a "snowball" questionnaire; 72% reported high trust in their physician, 42% trusted the authorities, 11% trusted internet groups. Among minorities, parents who fully vaccinate their children were younger, live in urban areas, eat all kinds of foods and trust the authorities, similar to the general population. Low adherence to children's vaccination was correlated with trusting internet groups. Females complied significantly more to child vaccination, although in our study mothers were more highly educated and trusted authorities more than males. The results enable to draw a profile of the "vaccination compliant parent" (with an academic degree, young, urban, eats all kinds of foods, uses conservative medicine). Trust is a major factor influencing vaccination, yet external forces such as community voices, social trends and opinions of religious leaders may play a role in vaccination adherence, beyond personal beliefs, individual habits and self-care. In Israel, education and "healthy behavior" perception alongside generous coverage encourage most parents to comply with the routine vaccination program. In the shade of pandemic outbreaks, we suggest a social-determinant transparent approach to encourage parents to vaccinate their children. Social and religious leaders can pose as agents of change, especially in the case of less educated parents.
Collapse
Affiliation(s)
- Orna Tal
- Medical Management Program, Israel Academic College, Ramat Gan, Israel.,Israeli Center for Emerging Technologies, ICET, Zrifin, Israel
| | - Yifat Ne'eman
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Rotem Sadia
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Rouchama Shmuel
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Eitan Schejter
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| | - Michal Bitan
- Medical Management Program, Israel Academic College, Ramat Gan, Israel
| |
Collapse
|
5
|
Gesser-Edelsburg A. How to Make Health and Risk Communication on Social Media More "Social" During COVID-19. Risk Manag Healthc Policy 2021; 14:3523-3540. [PMID: 34471393 PMCID: PMC8403670 DOI: 10.2147/rmhp.s317517] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/13/2021] [Indexed: 12/14/2022] Open
Abstract
Social media have changed the way citizens participate in and express opinions about government policy. Social media serve organizations in achieving four main goals: interacting with citizens; fostering citizen participation; furthering open government; and analyzing/monitoring public opinion and activities. We contend that despite the importance of social media, international and local health organizations have been slow to adopt to them, primarily due to the discrepancy between intraorganizational discourse modes and the type of discourse suitable for dialogue with the public. In this perspective paper, we recommend strategies for such public dialogue based on understanding the challenges faced by organizations on the road to becoming more “social” in their social media presence and in their health and risk communication. Subsequently, we propose an integrative approach that combines three complementary paths: (1) putting the “social” back into health organizations’ culture by inserting more “social” content into the internal organizational discourse through consultation with experts from different fields, including those who diverge from the scientific consensus. (2) Using strategies to enable health organizations to respond to the public on social networks, based on health communications research and studies on emerging infectious disease (EID) communication. (3) Engaging the public on social media based on the participatory approach, which considers the public as a partner that understands science and can work with the organizations to develop an open and innovative pandemic realm by using crowdsourcing to solve complex global health problems. For each path, we define the current challenges, among which are (1) overcoming organizational groupthink and hidden profiles, (2) treating all unofficial information as misleading, and (3) insufficient public engagement in solving complex global problems. We then offer recommendations for dealing with each challenge.
Collapse
Affiliation(s)
- Anat Gesser-Edelsburg
- School of Public Health and the Health and Risk Communication Research Center, University of Haifa, Haifa, 3498838, Israel
| |
Collapse
|
6
|
Green MS, Abdullah R, Vered S, Nitzan D. A study of ethnic, gender and educational differences in attitudes toward COVID-19 vaccines in Israel - implications for vaccination implementation policies. Isr J Health Policy Res 2021; 10:26. [PMID: 33741063 PMCID: PMC7977502 DOI: 10.1186/s13584-021-00458-w] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background Vaccines for COVID-19 are currently available for the public in Israel. The compliance with vaccination has differed between sectors in Israel and the uptake has been substantially lower in the Arab compared with the Jewish population. Aim To assess ethnic and socio-demographic factors in Israel associated with attitudes towards COVID-19 vaccines prior to their introduction. Methods A national cross-sectional survey was carried out In Israel during October 2020 using an internet panel of around 100,000 people, supplemented by snowball sampling. A sample of 957 adults aged 30 and over were recruited of whom 606 were Jews (49% males) and 351 were Arabs (38% males). Results The sample of Arabs was younger than for the Jewish respondents. Among the men, 27.3% of the Jewish and 23.1% of the Arab respondents wanted to be vaccinated immediately, compared with only 13.6% of Jewish women and 12.0% of Arab women. An affirmative answer to the question as to whether they would refuse the vaccine at any stage was given by 7.7% of Jewish men and 29.9% of Arab men, and 17.2% of Jewish women and 41.0% of Arab women. Higher education was associated with less vaccine hesitancy. In multiple logistic regression analysis, the ethnic and gender differences persisted after controlling for age and education. Other factors associated with vaccine hesitancy were the belief that the government restrictions were too lenient and the frequency of socializing prior to the pandemic. Conclusions The study revealed a relatively high percentage reported would be reluctant to get vaccinated, prior to the introduction of the vaccine. This was more marked so for Arabs then Jews, and more so for women within the ethnic groups. While this was not a true random sample, the findings are consistent with the large ethnic differences in compliance with the vaccine, currently encountered and reinforce the policy implications for developing effective communication to increase vaccine adherence. Government policies directed at controlling the pandemic should include sector-specific information campaigns, which are tailored to ensure community engagement, using targeted messages to the suspected vaccine hesitant groups. Government ministries, health service providers and local authorities should join hands with civil society organizations to promote vaccine promotion campaigns.
Collapse
Affiliation(s)
- Manfred S Green
- School of Public Health, University of Haifa, Abba Khoushy 199, 3498838, Haifa, Israel.
| | - Rania Abdullah
- School of Public Health, University of Haifa, Abba Khoushy 199, 3498838, Haifa, Israel
| | - Shiraz Vered
- Statistics Consulting Unit, University of Haifa, Haifa, Israel
| | - Dorit Nitzan
- World Health Organization, European Region, Copenhagen, Denmark
| |
Collapse
|
7
|
Glatman-Freedman A, Amir K, Dichtiar R, Zadka H, Vainer I, Karolinsky D, Enav T, Shohat T. Factors associated with childhood influenza vaccination in Israel: a cross-sectional evaluation. Isr J Health Policy Res 2019; 8:82. [PMID: 31771629 PMCID: PMC6878635 DOI: 10.1186/s13584-019-0349-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/25/2019] [Indexed: 11/15/2022] Open
Abstract
Background Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. Methods A cross-sectional language-specific telephone survey was conducted among adults 18 years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. Results Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ≥18 years old with children 1–18 years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child’s age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents’ reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. Conclusions We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.
Collapse
Affiliation(s)
- Aharona Glatman-Freedman
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel. .,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Kanar Amir
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Hila Zadka
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Ifat Vainer
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Dolev Karolinsky
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Teena Enav
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
8
|
Amit Aharon A, Nehama H, Rishpon S, Baron-Epel O. Different Reasons for Not Completing Routine Vaccinations Among Jewish and Arab Children in Israel. J Racial Ethn Health Disparities 2019; 7:298-304. [PMID: 31721110 DOI: 10.1007/s40615-019-00658-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/24/2022]
Abstract
Minority communities are at high risk for low childhood vaccination coverage rates. This paper compared the rate of children not fully vaccinated and the reasons for that between Jewish (majority) and Arab (minority) children in Israel. This cross-sectional study screened the medical files of 14,232 children (12,360 Jewish and 1872 Arab), registered at Mother-Child Health Clinics in two large geographical area, to identify children who did not complete the last dose of hepatitis B and DTaP or first dose of MMR vaccines. We compared the reasons for not completing the vaccine schedule registered by the nurses between Jewish and Arab children. We identified 1052 children who did not complete at least one of the vaccines: 975 Jewish children and 77 Arab children. Four causal categories were identified: medical reasons, parental decision, parental behaviour, and organizational reasons. Multinomial logistic regression analysis was performed to analyze the reasons for not completing the vaccination protocol. Arab children compared to Jewish children were more likely not to complete the vaccination protocol due to medical reasons (OR 3.81, CI 1.53-9.49) and less likely due to the reason parental decision (OR 0.35, CI 0.13-0.96). Therefore, patterns of reasons for not completing vaccinations vary, depending on population. Interventions to reduce the number of children not fully vaccinated should be tailored to the specific population.
Collapse
Affiliation(s)
- Anat Amit Aharon
- Sackler Faculty of Medicine, Nursing Department, Tel-Aviv University, Tel-Aviv, Israel.
| | - Haim Nehama
- Public Health Department, Tel Aviv-Yafo Municipality, Israel
| | - Shmuel Rishpon
- Ministry of Health and School of Public Health, Faculty of Welfare and Health Studies, Haifa University, Haifa, Israel
| | - Orna Baron-Epel
- School of Public Health, Faculty of Welfare and Health Studies, Haifa University, Haifa, Israel
| |
Collapse
|
9
|
Shahbari NAE, Gesser-Edelsburg A, Mesch GS. Perceived trust in the health system among mothers and nurses and its relationship to the issue of vaccinations among the Arab population of Israel: A qualitative research study. Vaccine 2019; 38:29-38. [PMID: 31611101 DOI: 10.1016/j.vaccine.2019.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 09/16/2019] [Accepted: 10/01/2019] [Indexed: 11/27/2022]
Abstract
The literature indicates that trust plays an important role in people's decision-making with respect to vaccinations. This research seeks to examine the impact of trust on the high response rate to vaccinations among the minority Arab population living in Israel. The research employs the qualitative phenomenological research method, using personal interviews to identify and analyze perceived trust among mothers of young children and teenagers (n = 70) and among nurses (n = 20) in the Arab population in the context of vaccinations and the high response rate to vaccinations among this population. The research findings point to differing levels of trust in the medical system. The participants placed the highest trust in the nurses working in the Tipat Halav Family Health Centers run by the Ministry of Health. These nurses are the main communicators of information about childhood vaccinations in Israel. Moreover, the interviewees saw vaccinations as an example of the state offering equal and optimal services to the Arab minority population. In addition, the interviewees consider the explanatory materials to be limited, superficial and not culturally appropriate. These positive attitudes toward vaccinations alongside reports that no importance is attributed to the explanatory materials due to their low quality may cause the population to accept vaccination recommendations as they are and to delegate responsibility and authority to the state.
Collapse
Affiliation(s)
- Nour Abed Elhadi Shahbari
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel.
| | - Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel; Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel.
| | - Gustavo S Mesch
- Department of Sociology, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel.
| |
Collapse
|
10
|
Gesser-Edelsburg A, Diamant A, Hijazi R, Mesch GS. Correcting misinformation by health organizations during measles outbreaks: A controlled experiment. PLoS One 2018; 13:e0209505. [PMID: 30566485 PMCID: PMC6300261 DOI: 10.1371/journal.pone.0209505] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/06/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND During epidemic crises, some of the information the public receives on social media is misinformation. Health organizations are required to respond and correct the information to gain the public's trust and influence it to follow the recommended instructions. OBJECTIVES (1) To examine ways for health organizations to correct misinformation concerning the measles vaccination on social networks for two groups: pro-vaccination and hesitant; (2) To examine the types of reactions of two subgroups (pro-vaccination, hesitant) to misinformation correction; and (3) To examine the effect of misinformation correction on these two subgroups regarding reliability, satisfaction, self-efficacy and intentions. METHODS A controlled experiment with participants divided randomly into two conditions. In both experiment conditions a dilemma was presented as to sending a child to kindergarten, followed by an identical Facebook post voicing the children mothers' concerns. In the third stage the correction by the health organization is presented differently in two conditions: Condition 1 -common information correction, and Condition 2 -recommended (theory-based) information correction, mainly communicating information transparently and addressing the public's concerns. The study included (n = 243) graduate students from the Faculty of Social Welfare and Health Sciences at Haifa University. RESULTS A statistically significant difference was found in the reliability level attributed to information correction by the Health Ministry between the Control condition and Experimental condition (sig<0.001), with the average reliability level of the subjects in Condition 2 (M = 5.68) being considerably higher than the average reliability level of subjects in Condition 1 (4.64). A significant difference was found between Condition 1 and Condition 2 (sig<0.001), with the average satisfaction from the Health Ministry's response of Condition 2 subjects (M = 5.75) being significantly higher than the average satisfaction level of Condition 1 subjects (4.66). Similarly, when we tested the pro and hesitant groups separately, we found that both preferred the response presented in Condition 2. CONCLUSION It is very important for the organizations to correct misinformation transparently, and to address the emotional aspects for both the pro-vaccination and the hesitant groups. The pro-vaccination group is not a captive audience, and it too requires a full response that addresses the public's fears and concerns.
Collapse
Affiliation(s)
- Anat Gesser-Edelsburg
- The Health and Risk Communication Research Center, University of Haifa, Haifa, Israel
- School of Public Health, University of Haifa, Haifa, Israel
| | - Alon Diamant
- The Health and Risk Communication Research Center, University of Haifa, Haifa, Israel
| | - Rana Hijazi
- School of Public Health, University of Haifa, Haifa, Israel
| | | |
Collapse
|
11
|
Parents' perceptions of childhood immunization in Israel: Information and concerns. Vaccine 2018; 36:8062-8068. [DOI: 10.1016/j.vaccine.2018.10.078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 10/15/2018] [Accepted: 10/23/2018] [Indexed: 11/15/2022]
|
12
|
Frew PM, Murden R, Mehta CC, Chamberlain AT, Hinman AR, Nowak G, Mendel J, Aikin A, Randall LA, Hargreaves AL, Omer SB, Orenstein WA, Bednarczyk RA. Development of a US trust measure to assess and monitor parental confidence in the vaccine system. Vaccine 2018; 37:325-332. [PMID: 30503657 DOI: 10.1016/j.vaccine.2018.09.043] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To develop a Vaccine Confidence Index (VCI) that is capable of detecting variations in parental confidence towards childhood immunizations centered on trust and concern issues that impact vaccine confidence. METHODS We used a web-based national poll of 893 parents of children <7 years in 2016 to assess the measures created for the Emory VCI (EVCI). EVCI measures were developed using constructs related to vaccine confidence identified by the U.S. National Vaccine Advisory Committee (i.e., "Information Environment", "Trust", "Healthcare Provider", "Attitudes and Beliefs", and "Social Norms"). Reliability for EVCI was assessed using Cronbach's alpha. Using the variables related to each of the constructs, we calculated an overall EVCI score that was then assessed against self-reported childhood vaccine receipt using chi-square and the Cochrane-Armitage trend tests. RESULTS Respondents' EVCI scores could range from 0 to 24, and the full range of values was observed in this sample (Mean = 17.5 (SD 4.8)). EVCI scores were significantly different (p ≤ 0.006 for all comparisons) between parents who indicated their child(ren) received routinely recommended vaccines compared with parents who indicated they had delayed or declined recommended immunizations. There was also a significant, consistent association between higher EVCI scores and greater reported vaccine receipt. CONCLUSIONS We developed EVCI to reliably measure parental vaccine confidence, with individuals' scores linked to parental vaccine-related attitudes, intentions, and behaviors. As such, EVCI may be a useful tool for future monitoring of both population and individual confidence in childhood immunization.
Collapse
Affiliation(s)
- Paula M Frew
- Emory University, School of Medicine, 1760 Haygood Road, Atlanta, GA 30322, United States; Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States.
| | - Raphiel Murden
- Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - C Christina Mehta
- Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - Allison T Chamberlain
- Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - Alan R Hinman
- Task Force for Global Health, 330 West Ponce de Leon Ave., Decatur, GA 30030, United States
| | - Glen Nowak
- University of Georgia Grady College of Journalism and Mass Communication, 120 Hooper St, Athens, GA 30602, United States
| | - Judith Mendel
- National Vaccine Program Office, Health and Human Services, Washington, D.C., United States
| | - Ann Aikin
- National Vaccine Program Office, Health and Human Services, Washington, D.C., United States
| | - Laura A Randall
- Emory University, School of Medicine, 1760 Haygood Road, Atlanta, GA 30322, United States; Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - Allison L Hargreaves
- Emory University, School of Medicine, 1760 Haygood Road, Atlanta, GA 30322, United States; Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - Saad B Omer
- Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - Walter A Orenstein
- Emory University, School of Medicine, 1760 Haygood Road, Atlanta, GA 30322, United States
| | - Robert A Bednarczyk
- Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States
| |
Collapse
|
13
|
Frew PM, Holloway IW, Goldbeck C, Tan D, Wu E, Jauregui J, Fenimore VL, Randall LA, Lutz CS, Mendel J, Aikin AL, Nowak GJ, Bednarczyk RA. Development of a measure to assess vaccine confidence among men who have sex with men. Expert Rev Vaccines 2018; 17:1053-1061. [PMID: 30433837 PMCID: PMC9993617 DOI: 10.1080/14760584.2018.1541405] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Recent serogroup C meningococcal disease outbreaks led to meningococcal vaccine recommendations for Southern California men who have sex with men (MSM). Assessment of vaccine confidence is critical to improving vaccine coverage in the context of disease outbreaks wherein immunization(s) are recommended. METHODS We surveyed MSM using venue-based sampling and began development of the vaccine confidence index (VCI) with 30 survey items corresponding to trust- and safety-related perceptions. We performed exploratory factor analyses and computed the Cronbach's alpha coefficient to assess internal consistency of the VCI. We created a categorical confidence variable (low, medium, and high confidence) and conducted bivariate and multivariate analyses to evaluate associations with reported confidence and immunization uptake. RESULTS Ten survey items were included in the final VCI and formed the confidence measure. Participants with low confidence had the lowest levels of reported uptake for both meningococcal vaccines. Confidence differed significantly (p ≤ 0.05) between MSM who indicated they received vaccines recommended within the context of the outbreak and those who did not. CONCLUSIONS Our VCI is sensitive to a number of issues that may influence vaccine confidence. It is useful for assessing MSM trust and acceptance of recommended immunizations and may be used to inform intervention development.
Collapse
Affiliation(s)
- Paula M Frew
- a Department of Medicine, Division of Infectious Diseases , Emory University School of Medicine , Atlanta , GA , USA.,b Rollins School of Public Health, Hubert Department of Global Health , Emory University , Atlanta , GA , USA.,c Emory Center for AIDS Research , Atlanta , GA , USA
| | - Ian W Holloway
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA.,e UCLA Center for AIDS Research , Los Angeles , CA , USA.,f California HIV/AIDS Policy Research Center , Los Angeles , CA , USA
| | - Cameron Goldbeck
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA.,f California HIV/AIDS Policy Research Center , Los Angeles , CA , USA
| | - Diane Tan
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA
| | - Elizabeth Wu
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA
| | - Juan Jauregui
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA
| | - Vincent L Fenimore
- b Rollins School of Public Health, Hubert Department of Global Health , Emory University , Atlanta , GA , USA
| | - Laura A Randall
- a Department of Medicine, Division of Infectious Diseases , Emory University School of Medicine , Atlanta , GA , USA
| | - Chelsea S Lutz
- a Department of Medicine, Division of Infectious Diseases , Emory University School of Medicine , Atlanta , GA , USA
| | - Judith Mendel
- g Health and Human Services , National Vaccine Program Office , Washington , DC , USA
| | - Ann L Aikin
- g Health and Human Services , National Vaccine Program Office , Washington , DC , USA
| | - Glen J Nowak
- h University of Georgia Grady College of Journalism and Mass Communication , Athens , GA , USA
| | - Robert A Bednarczyk
- b Rollins School of Public Health, Hubert Department of Global Health , Emory University , Atlanta , GA , USA.,i Emory Vaccine Center , Atlanta , GA , USA
| |
Collapse
|
14
|
Corben P, Leask J. Vaccination hesitancy in the antenatal period: a cross-sectional survey. BMC Public Health 2018; 18:566. [PMID: 29716556 PMCID: PMC5930425 DOI: 10.1186/s12889-018-5389-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/28/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Recent reports of childhood vaccination coverage in Australia have shown steadily improving vaccination coverage and narrowing differences between highest and lowest coverage regions, yet the NSW North Coast consistently has the lowest coverage rates nationally. Better understanding of parents' vaccination attitudes and actions within this region may guide strategies to improve uptake. The antenatal period is when many parents explore and consolidate vaccination attitudes and so is pivotal for study. METHODS Women attending public antenatal clinics at six NSW North Coast hospitals completed a 10-min cross-sectional survey capturing stage of decision-making and decisional-conflict as well as vaccination hesitancy, attitudes, intentions and actions. Unscored responses were analysed for individual items. Decisional conflict subscales were scored using published algorithms. For consented children, immunisation status was assessed at 8 months using the Australian Immunisation Register. For Likert scale items, odds ratios and Fisher's exact, chi-squared and Chasson's tests assessed differences between subgroups. Wilcoxon rank-sum tests assessed differences between subgroups for items on scales of 0-to-10 and decisional conflict sub-scale scores. RESULTS First-time mothers were 3 times more likely than others (OR = 3.40, 95% CI 1.34-8.60) to identify as unsure, somewhat or very hesitant. Most respondents (92.2%) wanted their new baby to receive all recommended vaccinations. Many had high or moderate levels of concern about vaccine side effects (25.4%), safety (23.6%) and effectiveness (23.1%). Increased hesitancy was associated with decreased confidence in the schedule (p < 0.001), decreased trust in child's doctor (p < 0.0001), decreased perceived protection from disease (p < 0.05) and increased decisional conflict on all measured subscales (p < 0.0001). First-time mothers had higher decisional conflict on values clarity, support and uncertainty sub-scales. By 8 months of age, 83.2% of infants were fully vaccinated. Those with none or a few minor concerns were over 8 times more likely than others to vaccinate on schedule (OR = 8.7, 1.3-56.7). CONCLUSIONS Importantly this study provides further strong justification to talk with women about vaccination during pregnancy and particularly to ensure that first-time mothers are offered assistance in making these important decisions, where indicated. Further research should focus on optimising the timing, content and delivery style of perinatal interventions.
Collapse
Affiliation(s)
- Paul Corben
- Director, North Coast Public Health, Mid North Coast Local Health District, PO Box 126, Port Macquarie, NSW 2444 Australia
| | - Julie Leask
- Associate Professor, Sydney Nursing School and, Principal Research Fellow, School of Public Health, University of Sydney, 88 Mallett Street (MO2), Sydney, NSW 2050 Australia
| |
Collapse
|
15
|
Knowledge, Attitudes and Perceptions About Routine Childhood Vaccinations Among Jewish Ultra-Orthodox Mothers Residing in Communities with Low Vaccination Coverage in the Jerusalem District. Matern Child Health J 2017; 21:1010-1017. [PMID: 28093690 DOI: 10.1007/s10995-017-2272-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background and aims Childhood vaccinations are an important component of primary prevention. Maternal and Child Health (MCH) clinics in Israel provide routine vaccinations without charge. Several vaccine-preventable-diseases outbreaks (measles, mumps) emerged in Jerusalem in the past decade. We aimed to study attitudes and knowledge on vaccinations among mothers, in communities with low immunization coverage. Methods A qualitative study including focus groups and semi-structured interviews. Results Low immunization coverage was defined below the district's mean (age 2 years, 2013) for measles-mumps-rubella-varicella 1st dose (MMR1\MMRV1) and diphtheria-tetanus-pertussis 4th dose (DTaP4), 96 and 89%, respectively. Five communities were included, all were Jewish ultra-orthodox. The mothers' (n = 87) median age was 30 years and median number of children 4. Most mothers (94%) rated vaccinations as the main activity in the MCH clinics with overall positive attitudes. Knowledge about vaccines and vaccination schedule was inadequate. Of vaccines scheduled at ages 0-2 years (n = 13), the mean number mentioned was 3.9 ± 2.8 (median 4, range 0-9). Vaccines mentioned more often were outbreak-related (measles, mumps, polio) and HBV (given to newborns). Concerns about vaccines were obvious, trust issues and religious beliefs were not. Vaccination delay was very common and timeliness was considered insignificant. Practical difficulties in adhering to the recommended schedule prevailed. The vaccinations visits were associated with pain and stress. Overall, there was a sense of self-responsibility accompanied by inability to influence others. Conclusion Investigating maternal knowledge and attitudes on childhood vaccinations provides insights that may assist in planning tailored intervention programs aimed to increase both vaccination coverage and timeliness.
Collapse
|
16
|
Stein-Zamir C, Israeli A. Age-appropriate versus up-to-date coverage of routine childhood vaccinations among young children in Israel. Hum Vaccin Immunother 2017; 13:2102-2110. [PMID: 28696824 DOI: 10.1080/21645515.2017.1341028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND AIMS Routine childhood vaccinations schedules recommend that children receive the vaccine doses at specific ages. Vaccination coverage data are conventionally reported by the up-to-date method. We aimed to assess vaccination timeliness by the age-appropriate method and compare with the up-to-date vaccination coverage. METHODS Assessment of age-appropriate and up-to-date vaccination coverage among children born in Israel in 2009 and followed to age 48 months (national representative sample, n = 3892). The vaccinations included: Hepatitis B vaccine (HBV), Diphtheria-Tetanus-acellular Pertussis-Polio-Haemophilus-influenzae-b (DTaP-IPV-Hib), Pneumococcal conjugate vaccine (PCV), Measles-mumps-rubella-varicella vaccine (MMR/MMRV) and Hepatitis A vaccine (HAV). The categories defined: age-appropriate (at the recommended age and up to 1 month), delayed less than 6 months, delayed 6 months and above and unvaccinated (48 months). RESULTS The age-specific vaccinations assessment showed considerable delay in receipt of routine vaccination. While most (96%, 95%, 91%, 96%, 94% and 86%) children were vaccinated up-to-date for HBV3, DTaP-IPV-Hib4, PCV3, MMR/MMRV1, HAV1and HAV2 vaccine doses; only 26%, 29%, 47%, 64%, 55% and 12% were vaccinated age-appropriate. Vaccination delay was more common in vaccines with multiple doses. Vaccination delay was associated with high child's birth order, low socio-economic rank, ethnicity (delay more common in Jews vs. Arabs), season of birth (winter) and delayed receipt of DTaP-IPV-Hib vaccine 1st dose. CONCLUSIONS This study assessed age-appropriate childhood vaccination coverage in a national cohort of children. While the overall vaccination coverage stands in line with the WHO goals, vaccination timeliness and equity are inadequate and targeted public health intervention programs aimed at vaccination timeliness are necessary.
Collapse
Affiliation(s)
- Chen Stein-Zamir
- a The Hebrew University of Jerusalem, Faculty of Medicine, the Hebrew University and Hadassah Braun School of Public Health and Community Medicine , Jerusalem , Israel.,b Jerusalem District Health Office , Ministry of Health , Jerusalem , Israel
| | - Avi Israeli
- c The Hebrew University of Jerusalem, Faculty of Medicine, the Hebrew University and Hadassah Braun School of Public Health and Community Medicine , Department of Health Policy and Management , Jerusalem , Israel.,d Ministry of Health , Jerusalem , Israel
| |
Collapse
|
17
|
Velan B, Yadgar Y. On the implications of desexualizing vaccines against sexually transmitted diseases: health policy challenges in a multicultural society. Isr J Health Policy Res 2017; 6:30. [PMID: 28666469 PMCID: PMC5493887 DOI: 10.1186/s13584-017-0153-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/12/2017] [Indexed: 12/16/2022] Open
Abstract
Two vaccines against sexually transmitted infections are included in many national vaccination programs: Hepatitis B Virus (HBV) vaccine and Human Papilloma Virus (HPV) vaccine. The trajectories of the implementation of these two programs were marked by differences in the way the sexual context of risk was communicated to the public. These trajectories fluctuated between full accounts of the sexual nature of the infection and attempts to desexualize the vaccines. Vaccine desexualization can be achieved by withholding information of sexual context, blurring information, and distancing the age of vaccination from the age of sexual debut. Desexualization may be advantageous in promoting public health and personal health of people who believe that HPV vaccination leads to increased promiscuity, people who believe that protection against STD is not relevant to their children, and people who are not comfortable discussing the sexuality of their children. On the other hand, desexualizing may be disadvantageous for children to parents who tend to express passiveness towards vaccination, parents who attribute importance to sex education, and teenagers with homosexual orientations. The ethical analysis of vaccine desexualization reveals a complex interplay of considerations related to utility, causation of harm, duty of transparency, right to know, and right not to know. This analysis suggests that the moral merits of applying desexualization are questionable. Lastly, a sociopolitical consideration of the matter, suggests that decisions on vaccine desexualization can have implications on the interrelationships between various social groups and subgroups composing a certain population, and may highlight intercultural schisms. All this indicates that shaping the sexual framework of vaccination programs bears implications far beyond the practical considerations of vaccine promotion.
Collapse
Affiliation(s)
- Baruch Velan
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel.
| | - Yaacov Yadgar
- Department of Political Studies, Bar-Ilan University, Ramat-Gan, Israel
| |
Collapse
|
18
|
Bühler S, Lang P, Bally B, Hatz C, Jaeger VK. Stop measles in Switzerland - The importance of travel medicine. Vaccine 2017; 35:3760-3763. [PMID: 28566252 DOI: 10.1016/j.vaccine.2017.05.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND In line with the worldwide strive to combat measles, the Swiss Federal Office of Public Heath (FOPH) launched a National Strategy for measles elimination 2011-2015. In this study, we highlight the importance of travel medicine consultations to complement measles vaccination programmes based on data from the Travel Clinic of the University of Zurich. METHOD We analysed measles vaccination data from the Zurich Travel Clinic between July 2010 and February 2016 and focused on three groups: (i) all clients who received the measles vaccination, (ii) all clients aged>two years who received the measles vaccination ("catch-up vaccination"), and (iii) all clients aged>two years and born after 1963 ("FOPH recommended catch-up vaccination"). RESULTS 107,669 consultations were performed from 2010 to 2016. In 12,470 (11.6%) of these, a measles vaccination was administered; 90.9% measles vaccinations were given during a pre-travel consultation, and 99.4% were administered to individuals aged>two years ("catch-up vaccinations"). An "FOPH recommended catch-up vaccination" was received by 13.6% of all Zurich Travel Clinic clients aged >2years and born after 1963. CONCLUSIONS In this study, we highlight the importance of travel medicine consultations to enhance the measles vaccination coverage in the adult Swiss population.
Collapse
Affiliation(s)
- Silja Bühler
- Department of Public Health, Division of Infectious Diseases/Travel Clinic, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
| | - Phung Lang
- Department of Public Health, Division of Infectious Diseases/Travel Clinic, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
| | - Bettina Bally
- Department of Health, Canton of Zurich, Cantonal Medical Service, Stampfenbachstrasse 30, 8090 Zurich, Switzerland.
| | - Christoph Hatz
- Department of Public Health, Division of Infectious Diseases/Travel Clinic, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland; Department of Medicine and Diagnostics, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland.
| | - Veronika K Jaeger
- Department of Rheumatology, Basel University Hospital, Petersgraben 4, 4031 Basel, Switzerland.
| |
Collapse
|
19
|
Gesser-Edelsburg A, Walter N, Shir-Raz Y, Sassoni Bar-Lev O, Rosenblat S. The behind-the-scenes activity of parental decision-making discourse regarding childhood vaccination. Am J Infect Control 2017; 45:267-271. [PMID: 27856072 DOI: 10.1016/j.ajic.2016.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 10/13/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Vaccine compliance has long been a cause for concern for health authorities throughout the world. However very little effort has been made to examine parental discourse during the decision-making process. METHODS An online survey was conducted (N = 437) to examine predictors of parents' attitudes regarding childhood vaccination. RESULTS Hesitant parents were 4 times more likely to conduct intrafamily discussion regarding vaccination compared with provaccination parents (Exp[B] = 4.26). There were no significant differences between hesitant and antivaccination parents with respect to intrafamily discussion. Hesitant parents were also 4 times more likely than provaccination parents to report intrafamily disagreements regarding vaccination (Exp[B] = 4.27). They were also twice as likely as antivaccination parents to express disagreements regarding vaccination within their families (Exp[B] = 2.33). Likewise, Jewish parents were significantly more likely to define themselves as vaccination-hesitant, whereas Muslim parents were significantly more likely to be provaccination. CONCLUSIONS To improve the way health organizations communicate information about vaccines and increase parental trust in immunization programs, we should not only look at the level of understanding, perceptions, and biases of different groups, but also thoroughly examine parents' decision-making processes and the discourse during this process. We must communicate risk to all groups, including the provaccination group, to improve parents' decision making and the process of informed consent.
Collapse
|
20
|
Shibli R, Shemer R, Lerner-Geva L, Rishpon S. Knowledge and recommendation regarding routine childhood vaccinations among pediatric healthcare providers in Israel. Vaccine 2016; 35:633-638. [PMID: 28043737 DOI: 10.1016/j.vaccine.2016.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/30/2016] [Accepted: 12/03/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND A recommendation by pediatric healthcare providers (HCPs) is a major factor influencing parents' decision to vaccinate their children. Consequently, it is important to understand the motives behind the HCPs' recommendations to vaccinate children according to the routine immunization program. OBJECTIVES To study the association of pediatric HCPs' knowledge about and attitudes towards childhood vaccinations and of their professional and demographic characteristics, with two variables: 1. Their recommendations to parents regarding adherence to the routine immunization program. 2. Their choices concerning routine immunization of their own children. STUDY DESIGN AND SETTINGS We conducted a cross-sectional study of pediatric nurses and physicians working at Mother-Child Health Clinics (MCHCs) in Haifa and Tel-Aviv districts and at a hospital in Hadera City, Israel. METHODS A structured, anonymous self-administered questionnaire was used. RESULTS The overall response rate was 60%, totaling 218 participants. 92% of whom were nurses. Misconceptions related to vaccine safety were found among a high percentage of the participants. The HCPs knowledge level was associated with the HCPs vaccinating their own children according to the recommended immunization program (OR=1.32; CI95% 1.06-1.64), but not with their recommendation to parents to adhere to the program. No association was found between attitudes and these variables. Workplace (MCHCs versus hospital) correlated with the above mentioned two dependent variables (OR=1.89; CI95% 1.21-2.97 and OR=2.42; CI95% 1.73-3.4, respectively). CONCLUSIONS Amplifying the knowledge of HCPs and addressing their concern about vaccinations can improve their adherence to the routine immunization program regarding their own children. This may lead to better adherence of other parents who are frequently interested in the HCPs' behavior and consider them as a role model. In general, there is a need to emphasize the HCP's responsibility for the successful implementation of the immunization program in the community and at hospitals.
Collapse
Affiliation(s)
- Rana Shibli
- Haifa District Health Office, Government Complex, Palyam Ave. 15a, P.O. Box 800, Haifa 31999, Israel.
| | - Rivka Shemer
- Haifa District Health Office, Government Complex, Palyam Ave. 15a, P.O. Box 800, Haifa 31999, Israel
| | - Liat Lerner-Geva
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, 1 Emek HaElah St., Ramat Gan 5262160, Israel; School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Shmuel Rishpon
- Haifa District Health Office, Government Complex, Palyam Ave. 15a, P.O. Box 800, Haifa 31999, Israel; School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa 349883, Israel
| |
Collapse
|
21
|
Exploring the Continuum of Vaccine Hesitancy Between African American and White Adults: Results of a Qualitative Study. PLOS CURRENTS 2016; 8. [PMID: 28239512 PMCID: PMC5309123 DOI: 10.1371/currents.outbreaks.3e4a5ea39d8620494e2a2c874a3c4201] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Vaccine delay and refusal present very real threats to public health. Since even a slight reduction in vaccination rates could produce major consequences as herd immunity is eroded, it is imperative to understand the factors that contribute to decision-making about vaccines. Recent scholarship on the concept of “vaccine hesitancy” emphasizes that vaccine behaviors and beliefs tend to fall along a continuum from refusal to acceptance. Most research on hesitancy has focused on parental decision-making about childhood vaccines, but could be extended to explore decision-making related to adult immunization against seasonal influenza. In particular, vaccine hesitancy could be a useful approach to understand the persistence of racial/ethnic disparities between African American and White adults. This study relied on a thematic content analysis of qualitative data, including 12 semi-structured interviews, 9 focus groups (N=90), and 16 in-depth interviews, for a total sample of 118 (N=118) African American and White adults. All data were transcribed and analyzed with Atlas.ti. A coding scheme combining both inductive and deductive codes was utilized to identify themes related to vaccine hesitancy. The study found a continuum of vaccine behavior from never-takers, sometimes-takers, and always-takers, with significant differences between African Americans and Whites. We compared our findings to the Three Cs: Complacency, Convenience, and Confidence framework. Complacency contributed to low vaccine acceptance with both races. Among sometimes-takers and always-takers, convenience was often cited as a reason for their behavior, while never-takers of both races were more likely to describe other reasons for non-vaccination, with convenience only a secondary explanation. However, for African Americans, cost was a barrier. There were racial differences in trust and confidence that impacted the decision-making process. The framework, though not a natural fit for the data, does provide some insight into the differential sources of hesitancy between these two populations. Complacency and confidence clearly impact vaccine behavior, often more profoundly than convenience, which can contribute either negatively or positively to vaccine acceptance. The Three Cs framework is a useful, but limited tool to understanding racial disparities. Understanding the distinctions in those cultural factors that drive lower vaccine confidence and greater hesitancy among African Americans could lead to more effective communication strategies as well as changes in the delivery of vaccines to increase convenience and passive acceptance.
Collapse
|
22
|
Repalust A, Šević S, Rihtar S, Štulhofer A. Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study. PSYCHOL HEALTH MED 2016; 22:1045-1055. [PMID: 27899030 DOI: 10.1080/13548506.2016.1263756] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18-88 years (Mage = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96-3.03, p < .01). Religiosity (AOR = 1.12, p < .05) and the use of alternative medicine (AOR = 2.85, p < .001) increased the odds of vaccine refusal. However, individual characteristics seem to be relatively poor predictors of CVRH intentions in Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.
Collapse
Affiliation(s)
- Anja Repalust
- a Department of Sociology, Faculty of Humanities and Social Sciences , University of Zagreb , Zagreb , Croatia
| | - Sandra Šević
- a Department of Sociology, Faculty of Humanities and Social Sciences , University of Zagreb , Zagreb , Croatia
| | - Stanko Rihtar
- b Institute of Social Sciences I. Pilar , Zagreb , Croatia
| | - Aleksandar Štulhofer
- a Department of Sociology, Faculty of Humanities and Social Sciences , University of Zagreb , Zagreb , Croatia
| |
Collapse
|
23
|
Orr D, Baram-Tsabari A, Landsman K. Social media as a platform for health-related public debates and discussions: the Polio vaccine on Facebook. Isr J Health Policy Res 2016; 5:34. [PMID: 27843544 PMCID: PMC5103590 DOI: 10.1186/s13584-016-0093-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 07/10/2016] [Indexed: 11/22/2022] Open
Abstract
Background Social media can act as an important platform for debating, discussing, and disseminating information about vaccines. Our objectives were to map and describe the roles played by web-based mainstream media and social media as platforms for vaccination-related public debates and discussions during the Polio crisis in Israel in 2013: where and how did the public debate and discuss the issue, and how can these debates and discussions be characterized? Method Polio-related coverage was collected from May 28 to October 31, 2013, from seven online Hebrew media platforms and the Facebook groups discussing the Polio vaccination were mapped and described. In addition, 2,289 items from the Facebook group “Parents talk about Polio vaccination” were analyzed for socio-demographic and thematic characteristics. Results The traditional media mainly echoed formal voices from the Ministry of Health. The comments on the Facebook vaccination opposition groups could be divided into four groups: comments with individualistic perceptions, comments that expressed concerns about the safety of the OPV, comments that expressed distrust in the Ministry of Health, and comments denying Polio as a disease. In the Facebook group “Parents talk about the Polio vaccination”, an active group with various participants, 321 commentators submitted 2289 comments, with 64 % of the comments written by women. Most (92 %) people involved were parents. The comments were both personal (referring to specific situations) and general in nature (referring to symptoms or wide implications). A few (13 %) of the commentators were physicians (n = 44), who were responsible for 909 (40 %) of the items in the sample. Half the doctors and 6 % of the non-doctors wrote over 10 items each. This Facebook group formed a unique platform where unmediated debates and discussions between the public and medical experts took place. Conclusion The comments on the social media, as well as the socio-demographic profiles of the commentators, suggest that social media is an active and versatile debate and discussion-facilitating platform in the context of vaccinations. This paper presents public voices, which should be seen as authentic (i.e. unmediated by the media or other political actors) and useful for policy making purposes. The policy implications include identifying social media as a main channel of communication during health crises, and acknowledging the voices heard on social media as authentic and useful for policy making. Human and financial resources need to be devolved specifically to social media. Health officials and experts need to be accessible on social media, and be equipped to readily provide the information, support and advice the public is looking for.
Collapse
Affiliation(s)
- Daniela Orr
- Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel
| | - Ayelet Baram-Tsabari
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Keren Landsman
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| |
Collapse
|
24
|
Socioeconomic status and vaccine coverage during wild-type poliovirus emergence in Israel. Epidemiol Infect 2016; 144:2840-7. [PMID: 27141821 DOI: 10.1017/s0950268816000844] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In August 2013, a nationwide vaccination campaign with bivalent oral polio vaccine (bOPV) was initiated after isolation of wild-type poliovirus type 1 (WPV-1) in routine sewage surveillance in Israel. The campaign started in the Southern district and later extended to the entire country. This study examined the association between socioeconomic status (SES), and compliance with bOPV vaccine during the campaign. Nationwide data relating to SES by geographical cluster were correlated with vaccine coverage rates in the same areas. All analyses were conducted separately for Jews and Arabs. Coverage with the bOPV vaccination campaign in the Arab population (92·4%) was higher than in the Jewish population (59·2%). This difference was consistently present in all SES clusters. In the Jewish population there was an inverse correlation between SES and vaccination coverage rates (R = -0·93, P < 0·001). Lower vaccination coverage with supplemental vaccine activities in higher SES groups is a challenge that needs to be addressed in future public health events and emergencies in order to achieve satisfactory protection rates for the public.
Collapse
|
25
|
Connelly Y, Ziv A, Goren U, Tal O, Kaplan G, Velan B. Using the social structure of markets as a framework for analyzing vaccination debates: The case of emergency polio vaccination. Hum Vaccin Immunother 2016; 12:1930-5. [PMID: 27058586 DOI: 10.1080/21645515.2016.1147637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The framework of the social structure of markets was used to analyze an online debate revolving around an emergency poliovirus vaccination campaign in Israel. Examination of a representative sample of 200 discussions revealed the activity of three parties: authoritative agents promoting vaccinations, alternative agents promoting anti-vaccination, both representing sellers, and the impartial agents, representing the customers-the general public deliberating whether to comply with vaccination or not. Both sellers interacted with consumers using mechanisms of luring and convincing. The authoritative agents conveyed their message by exhibiting professionalism, building trust and offering to share information. The alternative agents spread doubts and evoked negative emotions of distrust and fear. Among themselves, the alternative agents strived to discredit the authoritative agents, while the latter preferred to ignore the former. Content analysis of discussions conducted by the general public reveal reiteration of the messages conveyed by the sellers, implying that the transaction of pro and anti-vaccination ideas indeed took place. We suggest that the framework of the market as a social structure can be applied to the analysis of other vaccination debates, and thereby provide additional insights into vaccination polemics.
Collapse
Affiliation(s)
- Yaron Connelly
- a The Gertner Institute for Epidemiology and Health Policy Research , Tel-Hashomer, Ramat Gan , Israel
| | - Arnona Ziv
- a The Gertner Institute for Epidemiology and Health Policy Research , Tel-Hashomer, Ramat Gan , Israel
| | - Uri Goren
- b e-Pochondriac, digital health-consultancy , Zur Moshe , Israel
| | - Orna Tal
- a The Gertner Institute for Epidemiology and Health Policy Research , Tel-Hashomer, Ramat Gan , Israel
| | - Giora Kaplan
- a The Gertner Institute for Epidemiology and Health Policy Research , Tel-Hashomer, Ramat Gan , Israel
| | - Baruch Velan
- a The Gertner Institute for Epidemiology and Health Policy Research , Tel-Hashomer, Ramat Gan , Israel
| |
Collapse
|
26
|
Velan B. Vaccine hesitancy as self-determination: an Israeli perspective. Isr J Health Policy Res 2016; 5:13. [PMID: 27051517 PMCID: PMC4820980 DOI: 10.1186/s13584-016-0071-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 03/21/2016] [Indexed: 12/02/2022] Open
Abstract
Vaccine hesitancy can be portrayed as a broad spectrum of phenomena, ranging from a genuine call for help to complete defiance of authorities. The emphasis here is made on mid-spectrum hesitancy; hesitancy as an act of personal exploration and deliberation whether to get vaccinated or not. This form of vaccine hesitancy can be identified in the attitude of the Israeli public towards routine childhood vaccination programs, seasonal flu vaccination, newly introduced vaccines, such as human papilloma virus vaccine, as well as towards the emergency vaccination programs against poliovirus and H1N1 pandemic influenza. Vaccine hesitancy in Israel appears to be a process where individuals exercise self-determination and self-empowerment and make their own decisions based on assessment, reflection, choosing between various options and dealing with considerable complexities. Addressing this form of vaccine hesitancy could be challenging, but ultimately fruitful. This would require change of attitudes on the part of policymakers. The first steps should involve the realization that deliberative hesitancy is here to stay, and that hesitant individuals should be respected. This could pave the way for designing appropriate intervention strategies for convincing the hesitant public about the advantages of vaccination.
Collapse
Affiliation(s)
- Baruch Velan
- Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Ramat Gan, Israel
| |
Collapse
|
27
|
The Public Sphere in Emerging Infectious Disease Communication: Recipient or Active and Vocal Partner? Disaster Med Public Health Prep 2016; 9:447-58. [PMID: 26186579 DOI: 10.1017/dmp.2015.31] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Recent years have seen advances in theories and models of risk and crisis communication, with a focus on emerging epidemic infection. Nevertheless, information flow remains unilateral in many countries and does not take into account the public's polyvocality and the fact that its opinions and knowledge often "compete" with those of health authorities. This article addresses the challenges organizations face in communicating with the public sphere. METHODS Our theoretical approach is conceptualized through a framework that focuses on the public sphere and that builds upon existing guidelines and studies in the context of health and pandemics. We examine how health organizations cope with the public's transformation from recipients to an active and vocal entity, ie, how and to what extent health organizations address the public's anxiety and concerns arising in the social media during outbreaks. RESULTS Although international organizations have aspired to relate to the public as a partner, this article identifies notable gaps. CONCLUSIONS Organizations must involve the public throughout the crisis and conduct dialogues free of prejudices, paternalism, and preconceptions. Thereby, they can impart precise and updated information reflecting uncertainty and considering cultural differences to build trust and facilitate cooperation with the public sphere.
Collapse
|
28
|
Kumar D, Chandra R, Mathur M, Samdariya S, Kapoor N. Vaccine hesitancy: understanding better to address better. Isr J Health Policy Res 2016; 5:2. [PMID: 26839681 PMCID: PMC4736490 DOI: 10.1186/s13584-016-0062-y] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 01/25/2016] [Indexed: 11/18/2022] Open
Abstract
Vaccine hesitancy is an emerging term in the socio-medical literature which describes an approach to vaccine decision making. It recognizes that there is a continuum between full acceptance and outright refusal of some or all vaccines and challenges the previous understanding of individuals or groups, as being either anti-vaccine or pro-vaccine. The behaviours responsible for vaccine hesitancy can be related to confidence, convenience and complacency. The causes of vaccine hesitancy can be described by the epidemiological triad i.e. the complex interaction of environmental- (i.e. external), agent- (i.e. vaccine) and host (or parent)- specific factors. Vaccine hesitancy is a complex and dynamic issue; future vaccination programs need to reflect and address these context-specific factors in both their design and evaluation. Many experts are of the view that it is best to counter vaccine hesitancy at the population level. They believe that it can be done by introducing more transparency into policy decision-making before immunization programs, providing up-to-date information to the public and health providers about the rigorous procedures undertaken before introduction of new vaccines, and through diversified post-marketing surveillance of vaccine-related events.
Collapse
Affiliation(s)
- Dewesh Kumar
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Basni-II, Jodhpur, Rajasthan 342005 India
| | - Rahul Chandra
- Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, U.P, 243006 India
| | - Medha Mathur
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Basni-II, Jodhpur, Rajasthan 342005 India
| | - Saurabh Samdariya
- Department of Radiation Oncology, All India Institute of Medical Sciences, Basni-II, Jodhpur, Rajasthan 342005 India
| | - Neelesh Kapoor
- RMNCH + A Scale up project, IPE Global/USAID, Sixth Floor, DSHM, B block, Vikas Bhawan-2, Civil Lines, New Delhi, 110054 India
| |
Collapse
|
29
|
Amour S, Djhehiche K, Zamora A, Bergeret A, Vanhems P. Perception of the A/H1N1 influenza pandemic and acceptance of influenza vaccination by Université Claude Bernard Lyon 1 staff: A descriptive study. Hum Vaccin Immunother 2015; 11:727-31. [PMID: 25715115 DOI: 10.1080/21645515.2015.1008887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We assessed the perception and attitudes of university staff, including medical school and other science specialties, toward the 2009 A/H1N1 influenza pandemic and influenza vaccination program. A cross-sectional online survey was conducted among 4,529 university personnel on October 19-20, 2009. Seven hundred (15%) employees participated in the study. Only 18% were willing to be vaccinated, men more than women (29% versus 9%, P < 0.001), and professors/researchers more than administrative/technical staff (30% vs. 6%, P < 0.001). Intention to be vaccinated was insufficient. Additional efforts are needed to improve information dissemination among university staff. Medical university personnel should receive more information to increase vaccine coverage and protect them as well as patients.
Collapse
Affiliation(s)
- Sélilah Amour
- a Observatoire de la Santé des Personnels de Lyon 1; Université de Lyon; Université Claude Bernard Lyon 1 ; Lyon , France
| | | | | | | | | |
Collapse
|
30
|
Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion. PLOS CURRENTS 2015; 7:ecurrents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289. [PMID: 25789201 PMCID: PMC4353679 DOI: 10.1371/currents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Today, according to many public health experts, public confidence in vaccines is waning. The term "vaccine hesitancy" (VH) is increasingly used to describe the spread of such vaccine reluctance. But VH is an ambiguous notion and its theoretical background appears uncertain. To clarify this concept, we first review the current definitions of VH in the public health literature and examine its most prominent characteristics. VH has been defined as a set of beliefs, attitudes, or behaviours, or some combination of them, shared by a large and heterogeneous portion of the population and including people who exhibit reluctant conformism (they may either decline a vaccine, delay it or accept it despite their doubts) and vaccine-specific behaviours. Secondly, we underline some of the ambiguities of this notion and argue that it is more a catchall category than a real concept. We also call into question the usefulness of understanding VH as an intermediate position along a continuum ranging from anti-vaccine to pro-vaccine attitudes, and we discuss its qualification as a belief, attitude or behaviour. Thirdly, we propose a theoretical framework, based on previous literature and taking into account some major structural features of contemporary societies, that considers VH as a kind of decision-making process that depends on people's level of commitment to healthism/risk culture and on their level of confidence in the health authorities and mainstream medicine.
Collapse
|
31
|
Peretti-Watel P, Larson HJ, Ward JK, Schulz WS, Verger P. Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion. PLOS CURRENTS 2015. [PMID: 25789201 DOI: 10.1371/currents.outbreaks] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Today, according to many public health experts, public confidence in vaccines is waning. The term "vaccine hesitancy" (VH) is increasingly used to describe the spread of such vaccine reluctance. But VH is an ambiguous notion and its theoretical background appears uncertain. To clarify this concept, we first review the current definitions of VH in the public health literature and examine its most prominent characteristics. VH has been defined as a set of beliefs, attitudes, or behaviours, or some combination of them, shared by a large and heterogeneous portion of the population and including people who exhibit reluctant conformism (they may either decline a vaccine, delay it or accept it despite their doubts) and vaccine-specific behaviours. Secondly, we underline some of the ambiguities of this notion and argue that it is more a catchall category than a real concept. We also call into question the usefulness of understanding VH as an intermediate position along a continuum ranging from anti-vaccine to pro-vaccine attitudes, and we discuss its qualification as a belief, attitude or behaviour. Thirdly, we propose a theoretical framework, based on previous literature and taking into account some major structural features of contemporary societies, that considers VH as a kind of decision-making process that depends on people's level of commitment to healthism/risk culture and on their level of confidence in the health authorities and mainstream medicine.
Collapse
Affiliation(s)
- Patrick Peretti-Watel
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006, Marseille, France
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeremy K Ward
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France; Université Paris Diderot, UMR8236 (LIED), 75013 Paris
| | - William S Schulz
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Pierre Verger
- INSERM, UMR912 (SESSTIM), 13006, Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006, Marseille, France; Inserm, F-Crin, Innovative Clinical Research Network on Vaccination (I-Reivac)
| |
Collapse
|
32
|
Grotto I, Grefat R. Intervention programs to increase influenza vaccination in Israel: which is the preferred one? Isr J Health Policy Res 2014; 3:19. [PMID: 24949195 PMCID: PMC4062885 DOI: 10.1186/2045-4015-3-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 05/18/2014] [Indexed: 11/10/2022] Open
Abstract
Influenza vaccine is the most effective method of preventing influenza and its complications, but coverage rates are not satisfactory. Therefore, an effective intervention is required to increase vaccination coverage. In a recent study published in IJHPR, Yamin et al. identified the need to target risk perception in the public, as a major intervention tool. Risk perception and compliance with vaccination guidelines was found to be mostly influenced by physician recommendations. These findings are in-line with similar findings in the literature, stressing the importance of patient-physician interaction in the patients' decision to comply with vaccination guidelines produced by the public health authorities. They also underscore the need to involve primary physicians in both the decision making process as well in the vaccination campaign.
Collapse
Affiliation(s)
- Itamar Grotto
- Public Health Services, Ministry of Health, Jerusalem, Israel ; Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Rami Grefat
- Haifa District Health Office, Ministry of Health, Haifa, Israel
| |
Collapse
|
33
|
Yamin D, Gavious A, Davidovitch N, Pliskin JS. Role of intervention programs to increase influenza vaccination in Israel. Isr J Health Policy Res 2014; 3:13. [PMID: 24872874 PMCID: PMC4021634 DOI: 10.1186/2045-4015-3-13] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 04/11/2014] [Indexed: 11/29/2022] Open
Abstract
Background Influenza vaccination is the most efficient and cost-effective method to prevent influenza. To increase vaccination coverage, health authorities use various intervention programs (IPs), such as cost subsidies or placing vaccination centers in malls to make vaccination more accessible. Nevertheless, vaccination coverage has been sub-optimal in most developed countries, including in Israel. Methods To determine possible drivers of individual vaccination uptake and to examine the effectiveness of different IPs in increasing vaccination, we analyzed a telephone survey of a representative sample of the Israeli population conducted in March 2011 (n = 470), and paper questionnaires at the work place and at homes during April-July 2011 to several sub-populations : soldiers (n = 81), medical staff (n = 107), ultra-orthodox Jews (n = 72), Israeli Arabs (n = 87) and students (n = 85). Results The population can be stratified into three sub-groups: Acceptors, who receive vaccination regardless of IPs (22%), Conditional Acceptors, who are only vaccinated because of IP implementation (44%) and Non-Acceptors, who are not vaccinated despite IP implementation (34%). Our analysis shows that the risk perception towards influenza relative to vaccination is higher in the Acceptors than in the Conditional Acceptors, with the Non-Acceptors showing the lowest risk perception (P < 0.01). For Conditional Acceptors, physician recommendation is the most effective IP, regardless of the sub-population tested (P = 0.04). Students and low-income participants were more prone than any others to be persuaded to receive vaccination following IPs. In addition, financial incentives were more effective for ultra-religious orthodox Jews and students; vaccinations in more accessible areas were more effective for the ultra-religious orthodox, soldiers, and medical personnel; and TV and radio advertisements were more effective for people above 50 relative to other age groups. Conclusions Risk perception of influenza and vaccination governs the likelihood of successful implementation of IPs. Policy makers in Israel should invest efforts to increase the knowledge regarding influenza and vaccination, and should apply specific interventions customized to the preferences and diverse perceptions among the Israeli sub-populations.
Collapse
Affiliation(s)
- Dan Yamin
- Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Arieh Gavious
- Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Be'er Sheva, Israel ; School of Management, Ono Academic College, Kiryat Ono, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Joseph S Pliskin
- Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Be'er Sheva, Israel ; Department of Health Systems Management, Ben Gurion University of the Negev, Be'er Sheva, Israel
| |
Collapse
|
34
|
Ben-Natan M, Maor S. Factors related to Israeli lesbian women's intention to be vaccinated against human papillomavirus. Int J STD AIDS 2014; 25:800-5. [DOI: 10.1177/0956462414521167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Summary Lesbian women's susceptibility to human papillomavirus infection and, as a consequence, to cervical cancer, is similar to that of heterosexual women. However, little is known about factors related to lesbian women's intention to be vaccinated against human papillomavirus. The aim of the study was to identify factors related to Israeli lesbian women's intention to be vaccinated, using the Health Belief Model. The study has a cross-sectional design. A convenience sample of 207 lesbian women recruited at clubs in central Israel's lesbian community completed a questionnaire, based on the Health Belief Model. Thirty-two percent of the respondents reported having a high intention to be vaccinated. Perceived susceptibility to cervical cancer and perceived benefits of human papillomavirus vaccination were found to be related to intention to be vaccinated. The findings offer insights that can inform health care providers of strategies to promote vaccination against human papillomavirus in this unique population.
Collapse
Affiliation(s)
- Merav Ben-Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
- Department of Nursing, School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Shir Maor
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| |
Collapse
|
35
|
Velan B, Boyko V, Shenhar G, Lerner-Geva L, Kaplan G. Analysis of public responses to preparedness policies: the cases of H1N1 influenza vaccination and gas mask distribution. Isr J Health Policy Res 2013; 2:11. [PMID: 23537171 PMCID: PMC3621681 DOI: 10.1186/2045-4015-2-11] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 02/28/2013] [Indexed: 01/26/2023] Open
Abstract
Background During several months in 2009–2010, the Israeli population was asked to take part in two preparedness programs: Acquisition of gas masks against a potential chemical-warfare attack, and vaccination against the A/H1N1 influenza pandemics. Compliance with the first request was moderate and did not attract much attention, whereas compliance with the second request was very low and was accompanied by significant controversy. The aims of this study are to compare the public’s attitudes towards these two preparedness campaigns, and to explore the roles of trust, reasoned assessment, and reflexive reactions in the public’s response to governmental preparedness policies. Methods The comparative analysis was based on a telephone survey of 2,018 respondents representing a cross-section of the adult Israeli population. Univariate analysis to describe associations of public response and attitude was performed by Chi-square tests. Findings A set of queries related to actual compliance, trust in credibility of authorities, personal opinions, reasons for non-compliance, and attitudes towards uncertainties was used to characterize the response to mask-acquisition and vaccination. In the case of mask-acquisition, the dominant response profile was of trusting compliance based on non-conditional belief in the need to adhere to the recommendation (35.6% of respondents). In the case of vaccination, the dominant response profile was of trusting non-compliance based on a reflective belief in the need for adherence (34.8% of respondents). Among the variables examined in the study, passivity was found to be the major reason for non-compliance with mask-acquisition, whereas reasoned assessment of risk played a major role in non-compliance with vaccination. Realization of the complexity in dealing with uncertainty related to developing epidemics and to newly-developed vaccines was identified in the public’s response to the H1N1 vaccination campaign. Conclusions The newly identified profile of “trusting-reflective-non-complier” individuals should be of concern to policy makers. The public is not accepting governmental recommendations in an unconditional manner. This is not driven by lack of trust in authorities, but rather by the perception of the responsibility of individuals in confronting forthcoming risks. Nevertheless, under certain conditions the public may respond in a non-reflective way and delegate this responsibly to authorities in an uncontested manner. This leaves the policy makers with the complex challenge of interacting with a passive non-involved public or alternatively with an opinionated, reflexive public.
Collapse
Affiliation(s)
- Baruch Velan
- Genetic Policy and Bioethics Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer 52621, Israel.
| | | | | | | | | |
Collapse
|