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Manandhar P, Katz J, Lama TP, Khatry SK, Moss WJ, Erchick DJ. COVID-19 vaccine hesitancy, trust, and communication in Sarlahi District, Nepal. Vaccine 2024:S0264-410X(24)00661-3. [PMID: 38862309 DOI: 10.1016/j.vaccine.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Strategies to increase COVID-19 vaccine coverage require an understanding of the extent and drivers of vaccine hesitancy and trust in government related to COVID-19 vaccine programs, especially in low-resource communities. METHODS We conducted a cross-sectional household survey post-COVID-19 vaccine introduction among adults (n = 362) in four municipalities in Sarlahi District, Nepal from August to December 2022. The survey included modules on participant demographics and socioeconomic factors and vaccine hesitancy, information seeking, and trust in authorities related to COVID-19 vaccination. RESULTS Of the study participants, 38.4 % expressed hesitancy related to COVID-19 vaccination. The adjusted odds of being "vaccine hesitant" were significantly lower among the older adults (51+ years) relative to younger (<30 years) (aOR: 0.49, CI: 0.24-0.97) and among males relative to females (aOR: 0.51, CI: 0.26, 0.95). The study population highly trusted the government's handling of the COVID-19 pandemic. While for most, self-reported access to vaccination opportunities was high (88.4 %), 70.4 % of participants did not know if vaccines were in stock at their local vaccination facility. Commonly reported statements of misinformation include the vaccine being developed in a rush or too fast (21.5 %), COVID-19 infection can be effectively treated with ayurvedic medicine(16.3 %) and obtaining immunity from natural infection is better than through vaccination (19.9 %). The primary sources of information on COVID-19 programs were family and friends (98.6 %), healthcare professionals (67.7 %), Female Community Health Volunteers (FCHVs) (61.9 %), television (56.4 %), and radio (43.1 %). CONCLUSION Although many respondents expressed concerns about COVID-19 effectiveness and safety, a high proportion trusted COVID-19 information provided by healthcare workers and approved of the government's response to the pandemic. This study highlights an opportunity to design new evidence-based communication strategies to improve vaccine confidence delivered through frontline government healthcare workers. Approaches could be targeted to certain communities in the region shown to have higher vaccine hesitancy, including younger people and women.
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Affiliation(s)
- Porcia Manandhar
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tsering Pema Lama
- Nepal Nutrition Intervention Project-Sarlahi (NNIPS), Kathmandu, Nepal
| | - Subarna K Khatry
- Nepal Nutrition Intervention Project-Sarlahi (NNIPS), Kathmandu, Nepal
| | - William J Moss
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel J Erchick
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Nikoloski Z, Chimenya D, Alshehari A, Hassan H, Bain R, Menchini L, Gillespie A. COVID-19 Vaccination Personas in Yemen: Insights from Three Rounds of a Cross-Sectional Survey. Vaccines (Basel) 2023; 11:1272. [PMID: 37515086 PMCID: PMC10386099 DOI: 10.3390/vaccines11071272] [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: 06/07/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
We used three rounds of a repeated cross-sectional survey on COVID-19 vaccination conducted throughout the entire territory of Yemen to: (i) describe the demographic and socio-economic characteristics associated with willingness to be vaccinated; (ii) analyse the link between beliefs associated with COVID-19 vaccines and willingness to be vaccinated; and (iii) analyse the potential platforms that could be used to target vaccine hesitancy and improve vaccine coverage in Yemen. Over two-thirds of respondents were either unwilling or unsure about vaccination across the three rounds. We found that gender, age, and educational attainment were significant correlates of vaccination status. Respondents with better knowledge about the virus and with greater confidence in the capacity of the authorities (and their own) to deal with the virus were more likely to be willing to be vaccinated. Consistent with the health belief model, practising one (or more) COVID-19 preventative measures was associated with a higher willingness to get a COVID-19 vaccination. Respondents with more positive views towards COVID-19 vaccines were also more likely to be willing to be vaccinated. By contrast, respondents who believed that vaccines are associated with significant side effects were more likely to refuse vaccination. Finally, those who relied on community leaders/healthcare workers as a trusted channel for obtaining COVID-19-related information were more likely to be willing to be vaccinated. Strengthening the information about the COVID-19 vaccination (safety, effectiveness, side effects) and communicating it through community leaders/healthcare workers could help increase the COVID-19 vaccine coverage in Yemen.
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Affiliation(s)
- Zlatko Nikoloski
- London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK
| | | | | | | | - Robert Bain
- UNICEF Middle East and North Africa Regional Office, Amman 11821, Jordan
| | - Leonardo Menchini
- UNICEF Middle East and North Africa Regional Office, Amman 11821, Jordan
| | - Amaya Gillespie
- UNICEF Middle East and North Africa Regional Office, Amman 11821, Jordan
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Sarfraz M, Mushtaque I, Mamun MA, Raza M. Death Anxiety Among Pakistani HCWs: The Role of COVID-19 Vaccine Acceptance and Positive Religious Coping Strategy. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231186360. [PMID: 37379515 PMCID: PMC10311371 DOI: 10.1177/00302228231186360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Background: The mental health of healthcare workers (HCWs) has been significantly impacted by the COVID-19 pandemic. To address this, spirituality and religious coping mechanisms have been suggested as a way to maintain well-being and reduce anxiety levels. Additionally, vaccination has been shown to play an essential role in lowering anxiety levels, including death anxiety. However, there is a lack of evidence on how positive religious coping strategies and COVID-19 immunization affect death anxiety levels. To fill this gap, this study uses a Pakistani HCWs sample. Methods: This study collected cross-sectional data from 389 HCWs on socio-demographics, positive religious coping strategies, vaccine acceptance, and death anxiety. Hypothesis testing was done using Statistical Package for the Social Sciences (SPSS) and Partial Least Squares (PLS) by adopting the Structural Equation Modeling (SEM) technique. Results: The results showed that the positive religious coping strategy and acceptance of the COVID-19 vaccine reduced death anxiety among HCWs in Pakistan. HCWs practicing the positive religious coping strategy and vaccine acceptance had lower levels of death anxiety symptoms. Thus, the positive religious coping strategy has a direct effect on reducing death anxiety. Conclusion: In conclusion, COVID-19 immunization positively affects individual mental health by reducing death anxiety. Vaccines protect individuals from COVID-19 infection, providing a sense of security that reduces the chance of death anxiety among HCWs attending to COVID-19 patients.
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Affiliation(s)
- Muddassar Sarfraz
- School of Management, Zhejiang Shuren University, Hangzhou, PR China
| | - Iqra Mushtaque
- Department of Psychology, BZU Bahadur Sub Campus Layyah, Multan, Pakistan
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Dhaka, Bangladesh
- Department of Public Health & Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Mohsin Raza
- School of Management, Phuket Rajabhat University, Phuket, Thailand
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Shabir A, Alkubaisi NA, Shafiq A, Salman M, Baraka MA, Mustafa ZU, Khan YH, Malhi TH, Meyer JC, Godman B. COVID-19 Vaccination Status as Well as Factors Associated with COVID-19 Vaccine Acceptance and Hesitancy among Prisoners and the Implications. Vaccines (Basel) 2023; 11:1081. [PMID: 37376470 DOI: 10.3390/vaccines11061081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/28/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Prisoners form a population who are highly vulnerable to COVID-19 due to overcrowding, limited movement, and a poor living environment. Consequently, there is a need to ascertain the status of COVID-19 vaccination and factors associated with hesitancy among prisoners. A cross-sectional questionnaire-based study was undertaken among prisoners at three district jails in Punjab Province, Pakistan. A total of 381 prisoners participated and none of the study participants had received an influenza vaccine this year. In total, 53% received at least one dose of a COVID-19 vaccine, with the majority having two doses. The top three reasons of vaccine acceptance were "fear of contracting SARS-CoV-2 infection" (56.9%), "desire to return to a pre-pandemic routine as soon as possible" (56.4%), and "having no doubts on the safety of COVID-19 vaccines" (39.6%). There was no statistically significant difference (p > 0.05) in any demographic variables between vaccinated and unvaccinated prisoners except for age, which was strongly association with COVID-19 vaccine uptake (χ2(3) = 76.645, p < 0.001, Cramer's V = 0.457). Among the unvaccinated prisoners (N = 179), only 16 subsequently showed willingness to receive a COVID-19 vaccine. The top three reasons for hesitancy were: COVID-19 is not a real problem/disease (60.1%), safety concerns (51.1%), and COVID-19 vaccine is a conspiracy (50.3%). Efforts are needed to address their concerns given this population's risks and high hesitancy rates, especially among younger prisoners.
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Affiliation(s)
- Alina Shabir
- Department of Medicines, Tehsil Headquarter (THQ) Hospital, Dera Ghazi Khan 32200, Pakistan
| | - Noorah A Alkubaisi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Amna Shafiq
- Department of Medicines, Tehsil Headquarter (THQ) Hospital, Dera Ghazi Khan 32200, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Mohamed A Baraka
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, AlAin Campus, Al Ain P.O. Box 64141, United Arab Emirates
- Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo 11651, Egypt
| | - Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Tauqeer Hussain Malhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Blahut R, Flint A, Orlando E, DesChatelets J, Khowaja A. A scoping review on the decision-making dynamics for accepting or refusing the COVID-19 vaccination among adolescent and youth populations. BMC Public Health 2023; 23:784. [PMID: 37118794 PMCID: PMC10141871 DOI: 10.1186/s12889-023-15717-5] [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: 10/07/2022] [Accepted: 04/20/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Global COVID-19 vaccinations rates among youth and adolescent populations prove that there is an opportunity to influence the acceptance for those who are unvaccinated and who are hesitant to receive additional doses. This study aimed to discover the acceptance and hesitancy reasons for choosing or refusing to be vaccinated against COVID-19. METHODS A scoping review was conducted, and articles from three online databases, PubMed, Wiley, and Cochrane Library, were extracted and screened based on exclusion and PICOs criteria. A total of 21 studies were included in this review. Data highlighting study attributes, characteristics, and decision-making dynamics were extracted from the 21 studies and put into table format. RESULTS The results showed that the primary drivers for accepting the COVID-19 vaccine include protecting oneself and close family/friends, fear of infection, professional recommendations, and employer obligations. Primary hesitancy factors include concerns about safety and side effects, effectiveness and efficacy, lack of trust in pharmaceuticals and government, conspiracies, and perceiving natural immunity as an alternative. CONCLUSIONS This scoping review recommends that further research should be conducted with adolescent and youth populations that focus on identifying health behaviors and how they relate to vaccine policies and programs.
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Affiliation(s)
- Roger Blahut
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, ON, L2S 3A1, St Catharines, Canada
| | - Amanda Flint
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, ON, L2S 3A1, St Catharines, Canada
| | | | - Joelle DesChatelets
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, ON, L2S 3A1, St Catharines, Canada
| | - Asif Khowaja
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, ON, L2S 3A1, St Catharines, Canada.
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Inam A, Mushtaq A, Zaman S, Wasif S, Noor M, Khan HA. Vaccine hesitancy and post-vaccination adherence to safety measures: A mixed-method study. Front Public Health 2023; 11:1072740. [PMID: 37064699 PMCID: PMC10102652 DOI: 10.3389/fpubh.2023.1072740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/28/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundDespite being recognized as one of the most successful public health measures, vaccination is still considered to be unnecessary and unreliable in the context of the COVID-19 pandemic. The current study utilized a two-pronged approach in analyzing vaccine hesitancy and health behaviors after vaccination by employing a mixed-method design. Phase 1 was aimed at identifying predictors of COVID-19 vaccine hesitancy and acceptance among the Pakistani population using protection motivation theory (PMT), whereas Phase 2 was aimed at exploring the factors related to the vaccination of COVID-19.MethodA convenient sample of 1,736 individuals from the vaccine-eligible population (12 years and above) was selected to collect data on vaccine hesitancy and acceptance (Phase 1). Phase 2 of the study explored post-vaccination health behaviors, especially adherence to safety measures for COVID-19, through 23 in-depth interviews with the vaccinated population.ResultsMultiple regression analyses showed that response cost is a major predictor of vaccine hesitancy (in Phase 1). In terms of the role of demographic variables, the results showed that being male (for severity: B = −0.481; threat appraisal: B = −0.737), old age (B = −0.044), not vaccinated, and not infected with COVID-19 (themselves and family members) are strongly associated with vaccination hesitancy. Results of thematic analysis in Phase 2 revealed that perceived individual experience and insensitivity toward the severity of the disease are strongly associated with a lack of adherence to safety measures of COVID-19. Faith and religious beliefs and reliance on traditional remedies are also key predictors of people's general non-compliance to health behaviors. One interesting aspect that was revealed in the analysis was the general financially and socially destabilized situation in the context of developing countries that contributed to general apathy in the pandemic situation.ConclusionThe findings of the current study may help in devising a health model for the public from the developing world to deal with future pandemic situations.
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Affiliation(s)
- Ayesha Inam
- Department of Humanities, COMSATS University Islamabad, Islamabad, Pakistan
| | - Asia Mushtaq
- Department of Applied Psychology, National University of Modern Languages, Islamabad, Pakistan
- *Correspondence: Asia Mushtaq
| | - Sahira Zaman
- Department of Gender Studies, Fatima Jinnah Women University Rawalpindi, Rawalpindi, Pakistan
| | - Samia Wasif
- Department of Humanities, COMSATS University Islamabad, Islamabad, Pakistan
| | - Mah Noor
- Department of Humanities, COMSATS University Islamabad, Islamabad, Pakistan
| | - Hania Asghar Khan
- Department of Humanities, COMSATS University Islamabad, Islamabad, Pakistan
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Rehman K, Arif N, Jawad M, Muhammad A. COVID-19 vaccine acceptance and its drivers among Pakistani population. Pak J Med Sci 2023; 39:553-556. [PMID: 36950442 PMCID: PMC10025727 DOI: 10.12669/pjms.39.2.6051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/09/2022] [Accepted: 01/06/2023] [Indexed: 02/18/2023] Open
Abstract
Background & Objective COVID-19 vaccine has become available within a record time but mere availability will not control the pandemic. High vaccine acceptance is required. The objective was to determine COVID-19 vaccine acceptance and its associated factors among Pakistani population. Methods An online survey using google form, was conducted from January 31st to February 9th, 2021 before the start of the mass vaccination in Pakistan. The questionnaire had questions about demographics plus vaccine hesitancy. We received a total of 1156 responses. Data was analyzed using STATA version 14. We employed descriptive statistics and chi square test. Result A total of 1156 responses were received. 65% were male and 35% female. Only 6% were uneducated. Thirty percent had tested positive for COVID-19 earlier. Forty-six percent of the respondents would take (acceptance) a vaccine if available. Forty-eight percent and 45% were confident in using USA/UK and Chinese vaccine respectively. Gender and marital status was statistically significantly associated with vaccine acceptance. Concerns about the side effects were 55% while for efficacy it was 69%. Twenty-three percent were concerned about the permissibility of the vaccine on religious grounds. Conclusion Gender and marital status was significantly associated with vaccine acceptance. Forty-six percent respondents were willing to take the vaccine. Among the vaccine hesitant group, respondents were worried about the side effects, safety and religious permissibility of vaccine. Policy makers and all the relevant stakeholders should consider low vaccine acceptance as a major bottleneck and should devise strategies to address this major issue in the fight against COVID-19.
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Affiliation(s)
- Khalid Rehman
- Khalid Rehman, PhD, MPH, MBBS, Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Nauman Arif
- Nauman Arif, Pharm-D, MSc, Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Muhammad Jawad
- Muhammad Jawad, MD, MCPS, MPH, Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Ali Muhammad
- Ali Muhammad, BS, MPH, Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
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Saeed H, Ali K, Nabeel M, Rasool MF, Islam M, Hashmi FK, Saeed A, Saleem Z. Knowledge, Attitudes, Perceptions, and Acceptance of COVID-19 Vaccination among Pharmacy and Non-Pharmacy Students. Vaccines (Basel) 2023; 11:vaccines11010176. [PMID: 36680020 PMCID: PMC9860991 DOI: 10.3390/vaccines11010176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
University students are a sub-group of the population at high risk of COVID-19 infection, and their judgments on vaccination affect the public attitudes towards vaccination. Thus, the present study aimed to assess the knowledge, attitudes, perceptions, and acceptance of the COVID-19 vaccine among pharmacy and non-pharmacy students. A cross-sectional study was conducted by enrolling pharmacy (375) and non-pharmacy (225) students from the universities in Lahore. Chi-square analysis was used for significant frequency distributions and a 5-point Likert scale was used to score attitude, perception, and acceptance. The majority of the students were aged between 19-24 years, hailing from urban and middle-class families with good self-reported health. The preferred vaccine was Pfizer, followed by Sinopharm and Sinovac. The major source of information was social media, followed by government campaigns and family members. The pharmacy students demonstrated better knowledge and positive attitudes toward COVID-19 vaccination. The non-pharmacy students scored higher for the questions based on scientific leads, myths, and baffling conspiracies. The non-pharmacy students showed higher hesitancy/barrier total scores related to their trust in the health system, COVID-19 vaccine storage, and efficacy. Data suggested that pharmacy students exhibited better knowledge, positive attitudes, and perceptions about COVID-19 vaccination. Overall, vaccine efficacy and safety were mutual concerns. Nonetheless, non-pharmacy students were hesitant due to mistrust in the health system of Pakistan.
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Affiliation(s)
- Hamid Saeed
- Department of Pharmaceutics, College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore 54000, Pakistan
- Correspondence:
| | - Khubaib Ali
- Akhtar Saeed College of Pharmaceutical Sciences, Bahria Town, Lahore 54000, Pakistan
- Cancer Care Hospital & Research Centre, Lahore 54000, Pakistan
| | - Muhammad Nabeel
- Akhtar Saeed College of Pharmaceutical Sciences, Bahria Town, Lahore 54000, Pakistan
- Cancer Care Hospital & Research Centre, Lahore 54000, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Muhammad Islam
- Department of Pharmaceutics, College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore 54000, Pakistan
| | - Furqan Khurshid Hashmi
- Department of Pharmaceutics, College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore 54000, Pakistan
| | - Amna Saeed
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710049, China
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
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Samo AA, Sayed RB, Valecha J, Baig NM, Laghari ZA. Demographic factors associated with acceptance, hesitancy, and refusal of COVID-19 vaccine among residents of Sukkur during lockdown: A cross sectional study from Pakistan. Hum Vaccin Immunother 2022; 18:2026137. [PMID: 35103572 PMCID: PMC8993050 DOI: 10.1080/21645515.2022.2026137] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/13/2021] [Accepted: 01/04/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The World Health Organization has identified vaccine hesitancy among one of the top 10 threats to global health. The ongoing COVID-19 pandemic has devastated global health with higher morbidities and mortality rates. Reducing vaccine hesitancy could achieve immunization. However, different sociodemographic conditions can also hamper these efforts in low- and middle-income countries. The objective of the present study was to assess the demographic factors associated with COVID-19 vaccine acceptance, hesitancy, and refusal among the general Pakistani population. METHODS This cross-sectional study was conducted during the months of February-March 2021 during the pandemic. Sample size was 479. Snowball sampling strategy was used for data collection. Study questionnaires were distributed online using e-mail, twitter, Facebook, and WhatsApp. RESULT The overall COVID-19 vaccine acceptance was 40.5%, vaccine hesitancy was 29%, and vaccine refusal was 30% among the study participants. Compared to younger, the vaccine hesitancy and refusal was higher in older people age > 30 years (χ2 = 7.45, p = .02). Compared to males, vaccine refusal was high among females (χ2 = 7.45, p = .02). Vaccine refusal was higher in people with less educated <12 compared to more education (χ2 = 28.68, p < .0001). CONCLUSION Older people, females, and less education groups are at more risk of COVID-19 infections due to vaccine hesitancy and refusal. We recommend these groups should be focused in COVID-19 vaccine education programs.
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Affiliation(s)
- Ayaz Ali Samo
- Department of Physiology, University of Sindh, Jamshoro, Pakistan
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Muacevic A, Adler JR, Ali Khan Q, Mumtaz H, Tango T, Aisha Mangrio M, Ul Ain H, Saravanan P, Vatikutti B, Kedir Bereka L, Farkouh CS. An Insight Into the Acceptance and Hesitancy of COVID-19 Vaccines in Pakistan: A Cross-Sectional Survey. Cureus 2022; 14:e32363. [PMID: 36628039 PMCID: PMC9826719 DOI: 10.7759/cureus.32363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND COVID-19 vaccines are found to be effective interventions to tackle COVID-19. However, the hesitancy towards its acceptance has been rising in Pakistan. This study highlights the opinion of the general population in Pakistan regarding the acceptance and hesitancy of COVID-19 vaccination. METHODS A descriptive cross-sectional survey study was conducted among Pakistanis from December 2021 to January 2022. Adult respondents that have and have not received COVID-19 vaccinations were included in this study. Data collection was obtained through questionnaires that assessed acceptance and hesitancy toward COVID-19 vaccines. Statistical analysis was performed using IBM SPSS software version 25 for Windows. RESULTS We obtained 367 respondents with 333 respondents completing the questionnaire. There were 259 respondents who have been vaccinated. A total of 67.9% of responses agreed that vaccines could control the COVID-19 pandemic. The reasons for not getting vaccination were afraid of adverse effects (48.6%) and COVID-19 vaccines not being tested thoroughly (30.9%). The main reason for vaccine acceptance was awareness about vaccines (23.1%), a belief that vaccines can stop severe COVID-19 disease (16.8%), and self-protection (14.7%). CONCLUSION Most Pakistanis agreed that vaccines could manage the pandemic. Vaccine acceptance was contributed by the awareness and belief regarding the protective effects of vaccines while vaccine hesitancy was due to the public's doubt about the vaccines' side effects and testing. The Pakistan government should focus on emphasizing knowledge about vaccines, educating the vaccines' adverse effects, and utilizing social media in doing so.
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Tharwani ZH, Kumar P, Marfani WB, Shaeen SK, Adnan A, Mohanan P, Islam Z, Essar MY. What has been learned about COVID-19 vaccine hesitancy in Pakistan: Insights from a narrative review. Health Sci Rep 2022; 5:e940. [PMID: 36425896 PMCID: PMC9679238 DOI: 10.1002/hsr2.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Vaccine hesitancy is not a new phenomenon to Pakistan. This is evidenced through the slow progress of previous vaccination campaigns and programs against MMR, BCG, and especially polio. This issue continues to persist and is therefore becoming the cause of low COVID-19 vaccination rates in Pakistan. Aim To provide insights about COVID-19 vaccine hesitancy among Pakistanis, and its potential harm on public health. Moreover, we aim provide recommendations to counter the factors limiting the COVID-19 vaccination in Pakistan. Methodology A Boolean search was conducted to find the literature in MEDLINE-PubMed, Google Scholar, and Clinicaltrials.gov databases up till March 16, 2022. Specific keywords were used which comprised of "SARS-CoV-2," "COVID-19," "vaccine hesitancy," "vaccine acceptance," "intention to vaccinate," and "Pakistan," with use of "OR" and "AND." Only free full-text original studies in English language were used to compare and contrast. Results As proven by various studies, COVID-19 vaccination rates are influenced by multiple factors, including inaccurate beliefs about COVID-19, hesitancy amongst healthcare workers, uncertainty regarding vaccine's efficacy and fear of side effects. Various conspiracy theories and lower testing rates among others also add up to impose a negative impact on the vaccination rates and public health of Pakistan. This may lead to newer strains of potentially harmful COVID-19, mental health deterioration, and prolonged lockdowns. Conclusion Vaccine hesitancy is a global public health threat, and its impacts are pronounced in Pakistan. This is reflected in the COVID-19 pandemic; low vaccination rates in Pakistan may lead to future outbreaks of new, potentially harmful, strains of COVID-19 which can prolong lockdowns in the country and affect mental health of the population. To improve the current situations, it is imperative for the government, educational institutes, and healthcare systems to develop trust and continually use dialogue, communication, and education to address misconceptions to improve COVID-19 vaccination in Pakistan.
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Affiliation(s)
- Zoaib Habib Tharwani
- Faculty of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Prince Kumar
- Faculty of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Wajeeha Bilal Marfani
- Faculty of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Sean Kaisser Shaeen
- Faculty of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
| | - Alishba Adnan
- Department of MBBSKarachi Medical and Dental CollegeKarachi cityPakistan
| | - Parvathy Mohanan
- Department of General MedicineMedical University SofiaSofiaBulgaria
| | - Zarmina Islam
- Faculty of Medicine, Dow Medical CollegeDow University of Health SciencesKarachiPakistan
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12
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COVID-19 Vaccine Booster Hesitancy (VBH) among Healthcare Professionals of Pakistan, a Nationwide Survey. Vaccines (Basel) 2022; 10:vaccines10101736. [PMID: 36298600 PMCID: PMC9610760 DOI: 10.3390/vaccines10101736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/05/2022] [Accepted: 10/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The waning vaccine immunity and emergence of new variants of SARS-CoV-2 led health authorities across the globe to administer booster doses (BDs) of the COVID-19 vaccine. Hence, the current study aimed to assess the COVID-19 vaccine booster hesitancy (VBH) amongst Pakistani healthcare professionals (HCPs). Methods: A nationwide survey-based study was carried out from April 2022 to May 2022. The online self-administered questionnaire was utilized to collect data regarding demographics (age, gender, marital status, profession, residential area, and province), COVID-19 infection history (infection history, onset, and clinical severity of disease), previous COVID-19 vaccination (type of vaccination and the number of doses), attitudes towards BDs (acceptance, rejection, and hesitancy), and psychological drivers of VBH (perceived effectiveness, vaccine safety, risk/benefit ratio, and vaccine type preference). We assessed the association between the dependent variable attitudes of study participants, regarding BDs and independent variables (demographics, COVID-19 infection history, previous COVID-19 vaccination, and psychological drivers of VBH), by using the Chi-square test/Fisher exact test. Results: Among the 1164 study participants, 51.4% were male, and 80.4% were medical professionals. The half of study participants (52.1%) agreed to take the COVID-19 vaccine BD or had already taken it, while the rest of them refused (34.7%) or hesitated (24.2%) to take it. These attitudes of the participants were significantly associated (p < 0.001) with psychological divers about the COVID-19 vaccine BD. Conclusion: This study revealed that Pakistani HCPs hesitant to take the COVID-19 vaccine BD had concerns about the safety, efficacy, and risk/benefits ratio of the vaccine’s BD. To eliminate the hesitancy, regarding BD in HCPs, certain educational strategies should be implemented by health authorities to address the concerns of HCPs.
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13
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Ennab F, Qasba RK, Uday U, Priya P, Qamar K, Nawaz FA, Islam Z, Zary N. COVID-19 vaccine hesitancy: A narrative review of four South Asian countries. Front Public Health 2022; 10:997884. [PMID: 36324470 PMCID: PMC9620518 DOI: 10.3389/fpubh.2022.997884] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/16/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives Vaccine hesitancy remains a global issue, especially within poverty-stricken countries where there's an interplay of financial and non-financial barriers. This narrative review aims to understand attitudes and behaviors toward COVID-19 vaccination in four South Asian countries and make context-specific recommendations to vaccine program drivers and decision-makers. Methods A search was conducted using PubMed and Science Direct, and CINHAL from January 2020 up to May 2022 restricted to the English language for terms: "Afghanistan" OR "Pakistan" OR "India" OR "Bangladesh" in combination with "COVID-19 vaccine" and other related terms. All articles were initially included, and those with relevance were included in the synthesis of this paper. Results A narrative review was performed for this study. Our narrative review included a total of eighteen studies with a sample size (n = 223-5,237) averaging about 1,325 participants per study conducted. The studies included revealed public hesitancy to receive the COVID-19 vaccine ranging from 6.3 to 56.2% with an average of 31.63% across all eighteen studies. Several reasons were linked to this observation in these four South Asian countries, and the predominant ones included: Insufficient information provided to the general public about the side effects of the vaccines, concerns regarding vaccine safety, and skepticism of vaccine efficacy. Conclusion Vaccine hesitancy is a global problem within the context of COVID-19, and issues regarding equity, misinformation, and poverty in South Asian countries makes it difficult to meet goals for herd immunity. Policymakers and governments should aim toward financial and non-financial incentives to drive the public toward vaccination.
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Affiliation(s)
- Farah Ennab
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates,*Correspondence: Farah Ennab
| | | | - Utkarsha Uday
- West Bengal University of Health Sciences, Kolkata, India
| | - Priya Priya
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Khulud Qamar
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Faisal A. Nawaz
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Zarmina Islam
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Nabil Zary
- Institute for Excellence in Health Professions Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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14
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Zoaib Habib T. Double trouble: COVID-19 vaccine misinformation amidst conflict in Ukraine. Ann Med Surg (Lond) 2022; 80:104127. [PMID: 35845861 PMCID: PMC9270185 DOI: 10.1016/j.amsu.2022.104127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Tharwani Zoaib Habib
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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15
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Moeed A, Najeeb H, Saleem A, Asghar MS, Rafi HM, Khattak AK, Bilal Z, Seboka BT. Willingness and Perceptions Regarding COVID-19 Vaccine Booster Dose in Pakistani Vaccinated Population: A Cross-Sectional Survey. Front Public Health 2022; 10:911518. [PMID: 35844859 PMCID: PMC9279681 DOI: 10.3389/fpubh.2022.911518] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/03/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives This study was conducted to evaluate COVID-19 vaccine booster dose willingness and identify predictors and factors of willingness and hesitance in the vaccinated population of Pakistan. Methods A cross-sectional web-based survey was undertaken between January and February 2022 to highlight the public perceptions regarding the COVID-19 booster dose and evaluate the willingness to get the additional dose. Demographic information and booster dose willingness were recorded through the questionnaire. Additionally, a 5-point Likert scale was employed to explore fears and beliefs regarding COVID-19 vaccinations. Univariate and multivariate regression was performed to identify booster dose willingness and hesitance factors. Results Of the 787 respondents, 69.6% were females, 75.3% fell in the 18–30 years age group, 53.5% were university students or had a Bachelor's degree. Overall, a 77.8% booster dose willingness was reported. Participants showed absence or low fear levels associated with a booster dose (47.3%). 60.1% agreed it was safe to receive an additional vaccine dose, with 44.1% agreeing that boosters are effective against coronavirus variants. Independent predictors of willingness included the absence of comorbidities, whereas not being willing to pay for the booster dose was a predictor of hesitance. Conclusion This study showed a suboptimal willingness level of booster dose uptake among the vaccinated Pakistani population. Public health policymakers must undertake necessary awareness campaigns to strategize vaccination drives and dispel myths.
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Affiliation(s)
- Abdul Moeed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hala Najeeb
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Arisha Saleem
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Hania Mansoor Rafi
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Zoha Bilal
- Department of Internal Medicine, Aga Khan University, Karachi, Pakistan
| | - Binyam Tariku Seboka
- School of Public Health, Dilla University, Dilla, Ethiopia
- *Correspondence: Binyam Tariku Seboka
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16
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Khalid S, Usmani BA, Siddiqi S. COVID-19 Vaccine Hesitancy in Pakistan: A Mini Review of the Published Discourse. Front Public Health 2022; 10:841842. [PMID: 35712302 PMCID: PMC9194092 DOI: 10.3389/fpubh.2022.841842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
This minireview provides a summary of the main findings, features, as well as limitations and gaps in the current epidemiologic research on COVID-19 vaccine hesitancy (VH) in Pakistani population. For this purpose, data on VH studies were extracted from January 2020 to October 2021, using a systematic review and meta-analysis approach. Literature review and other narrative studies were excluded. There exists a significant heterogeneity in the reported vaccine hesitancy in the population (pooled estimates from random-effects meta-analysis: 35% (95% CI, 28-43%). However, none of the co-variables included in the studies explained the observed variance/heterogeneity in the moderator analysis models. In this minireview and critical appraisal of current VH research, we conclude that an in-depth analysis of COVID-19 vaccine hesitancy in a representative sample of Pakistani population is crucial to measure the magnitude of VH as well to explore and identify the determinants of VH in Pakistani population. This is an important step toward informing intervention and policy design and to address this issue at its root cause. To this end, focused, methodologically robust and hypothesis-driven VH research is needed using a wide range of co-variables to support a detailed coverage of the individual and environmental level VH attributes.
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Affiliation(s)
- Sumaira Khalid
- Epidemiology and Biostatistics Section, Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Bilal Ahmed Usmani
- Epidemiology and Biostatistics Section, Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sameen Siddiqi
- Health Policy and Management Section, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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17
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Khan U. COVID-19 intermittent spikes in Pakistan and reluctancy towards vaccination due to lack of education- an incipient crisis. Ann Med Surg (Lond) 2022; 76:103418. [PMID: 35287297 PMCID: PMC8908576 DOI: 10.1016/j.amsu.2022.103418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 11/25/2022] Open
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18
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Sallam M, Al-Sanafi M, Sallam M. A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review. J Multidiscip Healthc 2022; 15:21-45. [PMID: 35046661 PMCID: PMC8760993 DOI: 10.2147/jmdh.s347669] [Citation(s) in RCA: 145] [Impact Index Per Article: 72.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/17/2021] [Indexed: 01/09/2023] Open
Abstract
The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Mariam Al-Sanafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City, Kuwait
- Department of Pharmaceutical Sciences, Public Authority for Applied Education and Training, College of Health Sciences, Safat, Kuwait
| | - Mohammed Sallam
- Department of Pharmacy, Mediclinic Welcare Hospital, Mediclinic Middle East, Dubai, United Arab Emirates
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Al Janabi T, Chinsky R, Pino MA. Perceptions of COVID-19 vaccines among osteopathic medical students (OMS). INT J OSTEOPATH MED 2021; 42:23-28. [PMID: 34745315 PMCID: PMC8560188 DOI: 10.1016/j.ijosm.2021.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/19/2021] [Accepted: 10/30/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Research has shown that physicians' recommendations are one of the top predictors for individuals to receive vaccines. This study examined the perceptions of new COVID-19 vaccines among the medical students at the X and the factors that influenced their opinions. OBJECTIVE To measure X students' perception of a new COVID-19 vaccine and the factors which drive their opinions. METHODS An electronic survey of 37 questions was distributed to Osteopathic Medical Students (OMS I-IV) of X in October of 2020. RESULTS 1770 total students received the survey, and 197 responded (11%). 45% (88/197) of the respondents reported that they would receive new COVID-19 vaccines if they were available at the time of the survey, while 19% (37/197) reported that they had not yet decided. Confidence in the US healthcare system, pharmaceutical trust, the United States Food and Drug Administration's (FDA)'s minimum effectiveness level, adequate vaccine testing, additional vaccine dose, and antivaccine acquaintances were significant predictors of intended vaccine uptake. CONCLUSIONS Our findings confirmed a low acceptance of the new COVID-19 vaccine among OMS students, which mirrored the general public's low acceptance rate. Better education of OMS about vaccination benefits and the vaccine development process may increase future immunization rates.
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Affiliation(s)
- Taysir Al Janabi
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), 101 Northern Blvd, Glen Head, NY 11545- 1980, USA
| | - Ravi Chinsky
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), 101 Northern Blvd, Glen Head, NY 11545- 1980, USA
| | - Maria A Pino
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), 101 Northern Blvd, Glen Head, NY 11545- 1980, USA
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