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Araujo-Chaveron L, Sicsic J, Moffroid H, Díaz Luévano C, Blondel S, Langot F, Mueller JE. Impact of a COVID-19 certificate requirement on vaccine uptake pattern and intention for future vaccination. A cross-sectional study among French adults. Vaccine 2023; 41:5412-5423. [PMID: 37481404 DOI: 10.1016/j.vaccine.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/22/2023] [Accepted: 07/02/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND In August 2021, France enacted a COVID-19 certificate requirement (vaccination/recovery/test) to access specific services, with mandates for professional groups. We evaluated the impact of this incentive-coercive policy in terms of vaccine uptake equality, future vaccine intention and confidence in authorities' crisis management. METHODS In late August 2021, a representative sample of adults (18-75 years) completed an internet-based questionnaire. We classified vaccinated participants by stated reasons for vaccination and estimated adjusted prevalence ratios (aPR) using multivariable Poisson regression. Counterfactual vaccine status assumed non-vaccination of those vaccinated for the certificate. We analysed the association of free-text testimonial themes with level of confidence in authorities. RESULTS Among 972 participants, 85.7% were vaccinated or intended vaccination: 3.6% only for certificate/mandate, 17.7% mainly for certificate/mandate plus other reasons, and 64.4% mainly for other reasons. In the counterfactual situation, vaccine uptake would have been significantly more likely among older vs. younger participants (aPR = 1.35) and among those with moderate-high vs. low levels of confidence in authorities for COVID-19 crisis management (aPR = 2.04). In the observed situation, confidence was the only significant determinant of vaccine status (moderate-high vs. low, aPR = 1.39). Among those without genuine motivation for vaccination, professionally active persons were more likely to have ceded to the certificate requirement (aPR = 3.76). Those vaccinated only for the certificate were more likely to express future COVID-19 vaccine intention than unvaccinated persons (aPR = 6.41). Themes significantly associated with lower confidence were criticism of morality (aPR = 1.76) and poor communication by the authorities (aPR = 1.66). CONCLUSION The incentive-coercive policy has reduced the negative association of vaccine status with younger age and low confidence in authorities, but may have reinforced isolation of professionally inactive persons. The requirement did not negatively impact future COVID-19 vaccine intention. Future vaccine-incentive policies should pay special attention to populations with low levels of confidence in authorities.
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Affiliation(s)
- Lucia Araujo-Chaveron
- EHESP French School of Public Health, Rennes, France; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France
| | | | - Hadrien Moffroid
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; University of Melbourne, Australia
| | | | - Serge Blondel
- Université Paris Cité, LIRAES, F-75006 Paris, France; GRANEM - Groupe de Recherche Angevin en Economie et Management, Paris, France
| | - François Langot
- Le Mans Université (Gains-TEPP, IRA), Le Mans, France; IUF - Institut Universitaire de France, Paris, France; PSE - Paris School of Economics, Paris, France; CEPREMAP - Centre pour la recherche économique et ses applications, Paris, France; IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics, Bonn, Germany
| | - Judith E Mueller
- EHESP French School of Public Health, Rennes, France; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France.
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Pikkel Geva HZ, Gershgoren H, Nir D, Khazen M, Rose AJ. Vaccine hesitancy among health-care professionals in the era of COVID-19. HEALTH EDUCATION RESEARCH 2023; 38:193-203. [PMID: 36718591 DOI: 10.1093/her/cyad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/16/2022] [Accepted: 01/05/2023] [Indexed: 05/24/2023]
Abstract
Health-care professionals (HCPs) are key trusted figures in addressing coronavirus disease 2019 (COVID-19) challenges. They are thought to influence others' health decisions by personal example. However, during the COVID-19 crisis, some HCPs hesitated to be vaccinated. We examined factors contributing to that decision. We performed 12 semi-structured interviews, between February and May 2021, with Israeli HCPs who had declined or delayed COVID-19 vaccination. Three coders conducted a combined top-down and bottom-up analysis. We identified four main themes shaping vaccine decision-making: (i) sources of information, (ii) perceptions of necessity and risks of the vaccine, (iii) individual versus collective responsibility and (iv) political climate and media influence. Participants were worried about long-term effectiveness and safety, and while many agreed that high-risk populations should be vaccinated, all considered themselves to be at low risk for serious disease. Some felt they should avoid taking a perceived risk (accepting a new vaccine) to protect society, although they felt pressured to do so. Vaccination campaign politization and the way the media approached the subject also contributed to mistrust and hesitancy to be vaccinated. These findings help us understand HCP beliefs and uncertainties about COVID-19 vaccinations. This study can help inform future campaigns targeted at HCPs to promote the acceptance of vaccines.
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Affiliation(s)
- Hagar Z Pikkel Geva
- Rambam Medical Center, Ha'aliya Hashnia 8, Haifa 3525408, Israel
- Braum School of Public Health and Community Medicine, Faculty od Medicine, The Hebrew University of Jerusalem, Ein Kerem, P.O. Box 12271, Jerusalem 9112102, Israel
| | - Harel Gershgoren
- Faculty of Medicine, The Hebrew University of Jerusalem, Ein Keren, P.O. Box 12271, Jerusalem 9112102, Israel
| | - Dana Nir
- Soroka University Medical Center, Yitzhack I. Rager Blvd 151, Be'er-Sheva, Beer-Sheva 8400101, Israel
| | - Maram Khazen
- Braum School of Public Health and Community Medicine, Faculty od Medicine, The Hebrew University of Jerusalem, Ein Kerem, P.O. Box 12271, Jerusalem 9112102, Israel
- School of Public Health, University of Haifa, Abba Khoushy ave. 199, Haifa 3498838, Israel
| | - Adam J Rose
- Braum School of Public Health and Community Medicine, Faculty od Medicine, The Hebrew University of Jerusalem, Ein Kerem, P.O. Box 12271, Jerusalem 9112102, Israel
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Fan CW, Drumheller K, Chen IH, Huang HH. College students' sleep difficulty during COVID-19 and correlated stressors: A large-scale cross-sessional survey study. SLEEP EPIDEMIOLOGY 2021; 1:100004. [PMID: 35673622 PMCID: PMC8684700 DOI: 10.1016/j.sleepe.2021.100004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/11/2021] [Accepted: 09/08/2021] [Indexed: 01/05/2023]
Abstract
Objective Sleep difficulty is one of the main concerns during the COVID-19 pandemic. This study examined factors related to vaccination and physical and psychological health conditions, and sleep difficulty in college students in China. Methods An online, cross-sectional, anonymous survey was used to investigate college students' perceived sleep difficulty and relevant components (i.e., physical health condition, psychological distress, knowledge of vaccine, and autonomy of vaccine uptake). Hierarchical ordinal logistic regression was conducted to examine the proposed model with the control of participants' demographics (i.e., gender and age). Results Valid data of 3,145 students from 43 universities in mainland China was collected in January 2021. The average age of participants was 20.8 years old (S. D. = 2.09). The majority were single (97.4%), and about half were male (49.8%). Results showed that participants had less psychological distress when they had more knowledge about the COVID-19 vaccine and more autonomy to decide whether to receive it. In addition, participants with better physical health experienced less sleep difficulty. In contrast, those with more psychological distress experienced more sleep difficulty. Conclusions These findings can inform healthcare providers about the relationship between different factors and difficulty sleeping and aid them in developing interventions addressing sleep difficulties associated with the global pandemic. Health authorities also can improve vaccine uptake and reduce hesitancies in future vaccination campaigns based on the study results showing that greater vaccine knowledge and autonomy reduced psychological distress.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, Florida, USA,Corresponding author
| | - Kathryn Drumheller
- Department of Occupational Therapy, AdventHealth University, Orlando, Florida, USA
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Qufu City, Shandong, China,International College, Krirk University, Bangkok, Thailand
| | - Hsin-Hsiung Huang
- Department of Statistics and Data Sciences, University of Central Florida, Orlando, Florida, USA
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4
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Moon K, Riege A, Gourdon-Kanhukamwe A, Vallée-Tourangeau G. Development and validation of the treatmentself-regulation questionnaire assessing healthcare professionals' motivation for flu vaccination (TSRQ-Flu). Psychol Health 2021; 37:259-278. [PMID: 34076553 DOI: 10.1080/08870446.2021.1912343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We use self-determination theory to extend the conceptual understanding of flu vaccine hesitancy among health professionals. The scale sheds light on the role played by motivational factors above and beyond traditional cognitive factors such as biased risk judgements and health beliefs. DESIGN Across five phases using data from 718 healthcare professionals we establish factor structure, reliability, discriminant, convergent, criterion-related, incremental validity, and measurement invariance of the Treatment Self-Regulation Questionnaire assessing healthcare professionals' motivation for flu vaccination scale (TSRQ-Flu). MAIN OUTCOME MEASURES In addition to the four factors of the TSRQ-Flu (autonomous, introjection, external and amotivation regulations), we assess intentions to vaccinate, past vaccination behaviour and validate the scale using measures of cognitive empowerment, vaccine attitudes and social desirability. RESULTS Our findings indicate that the newly developed 11-item scale is distinct from and contributes over and beyond other psychosocial measures of flu vaccination intentions and can be used to understand the motivation of both vaccinated and not-vaccinated healthcare professionals. CONCLUSION This new scale has the potential to make a marked change in the conceptualisation of the roots of vaccine hesitancy among healthcare professionals and aid healthcare managers in developing evidence-based interventions to promote vaccination among their staff.
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Affiliation(s)
- Karis Moon
- Department of Management, Kingston University, Kingston, UK
| | - Anine Riege
- Department of Management, Kingston University, Kingston, UK.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Amélie Gourdon-Kanhukamwe
- Department of Management, Kingston University, Kingston, UK.,Institute for Globally Distributed Open Research and Education (IGDORE), London, UK
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5
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Gur-Arie R, Katz MA, Hirsch A, Greenberg D, Malosh R, Newes-Adeyi G, Davidovitch N, Rosenthal A. "You Have to Die Not to Come to Work": A Mixed Methods Study of Attitudes and Behaviors regarding Presenteeism, Absenteeism and Influenza Vaccination among Healthcare Personnel with Respiratory Illness in Israel, 2016-2019. Vaccine 2021; 39:2366-2374. [PMID: 33789798 DOI: 10.1016/j.vaccine.2021.03.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/23/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Healthcare personnel (HCP) have an increased risk of exposure to influenza and other respiratory pathogens. Increased presenteeism, decreased absenteeism, and low uptake of the influenza vaccine can contribute to the spread of influenza among HCP in healthcare settings. We used a mixed methods approach to investigate attitudes and behaviors of HCP in Israel towards influenza vaccination, presenteeism, and absenteeism. METHODS The study took place over three influenza seasons (2016-2017, 2017-2018, 2018-2019) at the largest hospital in southern Israel. We administered a Knowledge, Attitudes and Practices (KAP) questionnaire and conducted semi-structured interviews with HCP who had been recently ill with respiratory symptoms. The KAP questionnaire included closed-ended questions about attitudes and behaviors regarding influenza, working while sick, and influenza vaccination. The interviews investigated HCP's perceptions of influenza infection and attitudes about absenteeism, presenteeism, and the influenza vaccine. RESULTS We conducted 74 semi-structured interviews over three influenza seasons. Four HCP were interviewed twice, in separate seasons for different illness episodes. The 70 individuals interviewed included 16 physicians, 45 nurses or technicians, and 9 administrative staff. The median age was 42.5 years (range: 25-60), and most (79%) were female. Half (50%) got vaccinated against influenza before their illness episode. In interviews, most HCP said they come to work while sick (presenteeism) due to a strong personal work ethic and an institutional culture that discourages taking sick leave (absenteeism). HCP expressed skepticism about the effectiveness of the influenza vaccine as well as concern that the influenza vaccine causes severe illness. DISCUSSION Over three influenza seasons in Israel, HCP cited a number of reasons for working while sick, and doubted the usefulness of influenza vaccine. Addressing reasons for presenteeism and vaccine hesitancy among HCP is crucial to protect HCP and patients from influenza virus infection and other viral respiratory illnesses, such as COVID-19.
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Affiliation(s)
- Rachel Gur-Arie
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA; Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Mark A Katz
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel; School of Public Health, Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Avital Hirsch
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - David Greenberg
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Ryan Malosh
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Nadav Davidovitch
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Anat Rosenthal
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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Gur-Arie R, Jamrozik E, Kingori P. No Jab, No Job? Ethical Issues in Mandatory COVID-19 Vaccination of Healthcare Personnel. BMJ Glob Health 2021; 6:e004877. [PMID: 33597280 PMCID: PMC7893205 DOI: 10.1136/bmjgh-2020-004877] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 01/14/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Rachel Gur-Arie
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
- Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative, Oxford, UK, Baltimore, Maryland, USA
| | - Euzebiusz Jamrozik
- Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative, Oxford, UK, Baltimore, Maryland, USA
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Patricia Kingori
- Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative, Oxford, UK, Baltimore, Maryland, USA
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
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7
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Flanagan P, Dowling M, Gethin G. Barriers and facilitators to seasonal influenza vaccination uptake among nurses: A mixed methods study. J Adv Nurs 2020; 76:1746-1764. [PMID: 32202315 DOI: 10.1111/jan.14360] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/04/2020] [Accepted: 03/16/2020] [Indexed: 11/27/2022]
Abstract
AIM To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses. BACKGROUND Seasonal influenza causes significant mortality and morbidity among older people and high-risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low. DESIGN An explanatory sequential mixed methods study design. DATA SOURCES Qualified nurses attending mandatory training in two large acute hospitals in Ireland. METHODS A paper-based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 - February 2018. A self-selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 - October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process. RESULTS Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure. CONCLUSION Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi-faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence-based knowledge, accessibility, and external cues to action. IMPACT Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses.
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Affiliation(s)
| | - Maura Dowling
- School of Nursing and Midwifery, NUI Galway, Galway, Ireland
| | - Georgina Gethin
- School of Nursing and Midwifery, NUI Galway, Galway, Ireland.,School of Nursing, Monash University, Clayton, Vic., Australia.,Alliance for Research and Innovation in Wounds NUI Galway, Galway, Ireland
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A systematic review of adult tetanus-diphtheria-acellular (Tdap) coverage among healthcare workers. Vaccine 2019; 37:1030-1037. [PMID: 30630694 DOI: 10.1016/j.vaccine.2018.12.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/28/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022]
Abstract
During the last decades pertussis incidence raised globally. Several vaccination strategies targeting adults to reduce pertussis among young infants have been proposed, including vaccination of healthcare workers (HCWs). The aim of this study was to analyse, by performing a systematic review of literature, published papers that evaluated Tdap coverage among HCWs, variables associated with vaccine uptake and efforts implemented to raise vaccination rates. We searched the MedLine, Embase, SCOPUS, LILACS, Web of Science and Cochrane for full-text studies that evaluated Tdap coverage in HCW. Two independent reviewers screened the articles and extracted the data.Twenty-eight studies published from 2009 to 2018 were reviewed. Most studies were conducted in the USA. Initial Tdap coverage varied from 6.1% to 63.9%. USA and France are the only two countries with studies evaluating Tdap coverage within HCWs using national data. In the USA, Tdap coverage in HCWs raised from 6.1% to 45.1% from 2007 to 2015. In the analysis of French national data, a Tdap coverage of 63.9% was observed. Five studies used interventions to raise Tdap coverage in HCWs. Two intervention studies implemented mandatory vaccination and three used educational strategies. All of them achieved coverages over 86%. Only eleven studies analysed the association of Tdap vaccination with variables of interest. Previous immunization with other vaccines recommended for HCWs (like influenza, hepatitis B and MMR) was positively associated with Tdap uptake in four studies. In conclusion, overall Tdap coverage among HCWs is low, but seems to increase over the years after the vaccine introduction and with implementation of interventions to increase coverage.
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Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016. PLoS One 2017; 12:e0170550. [PMID: 28125629 PMCID: PMC5268454 DOI: 10.1371/journal.pone.0170550] [Citation(s) in RCA: 720] [Impact Index Per Article: 102.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. OBJECTIVE This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. METHODS Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. RESULTS Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. CONCLUSION Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
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Affiliation(s)
- Philipp Schmid
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Dorothee Rauber
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Gianni Lidolt
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Marie-Luisa Denker
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
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10
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Visser O, Hautvast JLA, van der Velden K, Hulscher MEJL. Intention to Accept Pertussis Vaccination for Cocooning: A Qualitative Study of the Determinants. PLoS One 2016; 11:e0155861. [PMID: 27253386 PMCID: PMC4890858 DOI: 10.1371/journal.pone.0155861] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 05/05/2016] [Indexed: 12/21/2022] Open
Abstract
Context Several countries have reported a resurgence of pertussis in the last decades. This puts infants (especially <6 months) at risk of severe complications, because they are too young to be fully protected by vaccination. The global pertussis initiative has proposed pertussis vaccination of young infants’ close contacts, in order to reduce pertussis transmission and the burden of the disease on infants. Our aim is to explore the perceived determinants (barriers and facilitators) of intention to accept vaccination among the possible target groups of pertussis vaccination for cocooning. Consideration of these determinants is necessary to optimise the uptake of the vaccination. Methods We conducted 13 focus groups and six individual semi-structured interviews with members of possible target groups for pertussis cocooning (i.e. parents, maternity assistants, midwives, and paediatric nurses) in the Netherlands. Here, both maternal pertussis vaccination as well as pertussis cocooning has not been implemented. The topic list was based on a literature review and a barrier framework. All interviews were transcribed verbatim and two researchers performed thematic content analysis. Findings The participants’ risk perception, outcome expectations, general vaccination beliefs, moral norms, opinion of others, perceived autonomy, anticipated regret, decisional uncertainty, and perceived organisational barriers were all factors that influenced the intention to accept pertussis vaccination for cocooning. Discussion This study has identified nine perceived determinants that influence the intention to accept pertussis cocooning vaccination. We add the following determinants to the literature: perceived cost-effectiveness (as a concept of outcome expectations), justice (as a concept of moral norms), anticipated regret, and decisional uncertainty. We recommend considering these determinants in vaccination programmes for pertussis cocooning vaccination. Experience, information and trust emerged as predominant themes within these determinants. These themes require particular attention in future research on vaccination acceptance, especially with regard to their role in use and implementation in policy and practice.
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Affiliation(s)
- Olga Visser
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- * E-mail:
| | - Jeannine L. A. Hautvast
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marlies E. J. L. Hulscher
- Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
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11
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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.
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Affiliation(s)
- Baruch Velan
- Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Ramat Gan, Israel
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12
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Alhammadi A, Khalifa M, Abdulrahman H, Almuslemani E, Alhothi A, Janahi M. Attitudes and perceptions among the pediatric health care providers toward influenza vaccination in Qatar: A cross-sectional study. Vaccine 2015; 33:3821-8. [PMID: 26144904 DOI: 10.1016/j.vaccine.2015.06.082] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 05/28/2015] [Accepted: 06/22/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Influenza is a communicable but preventable viral illness. Despite safe and effective vaccine availability, compliance rates are globally low. Neither local data on percentage of vaccination nor reasons for poor compliance among pediatric health providers are available in Qatar. AIM To estimate the percentage of vaccinated health care providers at pediatrics department and know their perception and attitudes toward influenza vaccinations. METHODS Cross-sectional survey, conducted on 300 pediatrics healthcare professionals from January through April 2013 at the main tertiary teaching hospital in Qatar, included details of demographics, frequency, perceptions and suggestive ways to improve the compliance. FINDING From among 230 respondents, 90 physicians and 133 allied health care professionals participated in this survey. Our study showed that percentages of participants who received flu vaccination were 67.7% and those who did not receive vaccination were 32.3%. Allied HCPs (69%) are more likely to get the vaccine compared to the physicians (66%). flu vaccination was approximately 5 times likely to be higher in the age group more than 40 years (P=0.002) compared to age less than or equals 40 years. Overall 70% healthcare providers were willing to recommend immunization to colleagues and patients compared to 30%, who were not willing. The reasons for noncompliance included fear of side effects, contracting the flu, vaccine safety and lack of awareness about the effectiveness. In order to promote immunization, participants believe that use of evidence-based statement, participating in an educational campaign, provides no cost/on site campaigns and leadership support is the most practical interventions. CONCLUSIONS In the present study, the vaccine coverage among pediatrics HCPs seems higher than previously reported rates. Despite their positive attitude toward influenza vaccination, low acceptance and misconceptions of seasonal influenza vaccination by pediatric HCPs may have a negative effect on the successful immunization delivery and children immunization rate. Our findings would be useful for designing and implementing educational programs targeted to improve vaccination coverage rates.
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Affiliation(s)
- Ahmed Alhammadi
- Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Mohamed Khalifa
- Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Hatem Abdulrahman
- Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Eman Almuslemani
- Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Abdullah Alhothi
- Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Mohamed Janahi
- Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
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