1
|
Oostdijk C, Ferreira JA, Ruijs WLM, Mollema L, Van Zoonen K. Adolescent and parental decision-making for the MenACWY vaccination: influential predictors and parental-adolescent differences among households in the Netherlands. BMC Public Health 2023; 23:947. [PMID: 37231425 DOI: 10.1186/s12889-023-15872-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Between 2015 and 2018 The Netherlands experienced increases of invasive meningococcal disease (IMD) serogroup W (MenW). Therefore in 2018 the MenACWY vaccination was introduced in the National Immunisation Programme (NIP) and a catch-up campaign was initiated targeting adolescents. This study aimed to gain insight into what factors played a role in the decision-making process regarding the MenACWY vaccination. The focus was on the differences in the decision-making of parents and adolescents in order to assess what factors influence the decisions made. METHODS An online questionnaire was offered to adolescents and one of their parents. We used random forest analyses to determine which factors best predict the outcome of the MenACWY vaccination decision. We carried out ROC (receiver-operator characteristics) analyses to confirm the predictive value of the variables. RESULTS Among parents several factors stand out, centring on the process of the decision, their attitude about the MenACWY vaccination, trust in the vaccination, and ideas of important people around them. Among adolescents the three stand-out predictors are the ideas of important people around them, the process of the decision and trust in the vaccination. Parents have prominent influence in the decision-making, while the adolescent's influence in the household decision-making is more limited. Adolescents tend to be less engaged and spend less time thinking about the decision compared to parents. Opinions of parents and adolescents from the same households concerning the factors that are influential do not differ a lot in the final decision-making. CONCLUSIONS Information about MenACWY vaccination might be mainly addressed to the parents of the adolescents and whereby the dialogue about MenACWY vaccination between parents and adolescents will be stimulated. With regard to the predictor trust in vaccination, raising the frequency of use of certain sources, especially those deemed very reliable among households such as conversations with a GP or the provider of the vaccination (GGD/JGZ), might prove a useful strategy to solidify vaccination uptake numbers.
Collapse
Affiliation(s)
- C Oostdijk
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands
| | - J A Ferreira
- Department of Statistics, Informatics and Mathematical Modeling, National Institute for Public Health and the Environment (RIVM), PO box 1, Bilthoven, 3720 BA, the Netherlands
| | - W L M Ruijs
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands
| | - L Mollema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - K Van Zoonen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands
| |
Collapse
|
2
|
Srivastav A, Lu PJ, Amaya A, Dever JA, Stanley M, Franks JL, Scanlon PJ, Fisher AM, Greby SM, Nguyen KH, Black CL. Prevalence of influenza-specific vaccination hesitancy among adults in the United States, 2018. Vaccine 2023; 41:2572-2581. [PMID: 36907734 PMCID: PMC10941755 DOI: 10.1016/j.vaccine.2023.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/17/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND The role of vaccine hesitancy on influenza vaccination is not clearly understood. Low influenza vaccination coverage in U.S. adults suggests that a multitude of factors may be responsible for under-vaccination or non-vaccination including vaccine hesitancy. Understanding the role of influenza vaccination hesitancy is important for targeted messaging and intervention to increase influenza vaccine confidence and uptake. The objective of this study was to quantify the prevalence of adult influenza vaccination hesitancy (IVH) and examine association of IVH beliefs with sociodemographic factors and early-season influenza vaccination. METHODS A four-question validated IVH module was included in the 2018 National Internet Flu Survey. Weighted proportions and multivariable logistic regression models were used to identify correlates of IVH beliefs. RESULTS Overall, 36.9% of adults were hesitant to receive an influenza vaccination; 18.6% expressed concerns about vaccination side effects; 14.8% personally knew someone with serious side effects; and 35.6% reported that their healthcare provider was not the most trusted source of information about influenza vaccinations. Influenza vaccination ranged from 15.3 to 45.2 percentage points lower among adults self-reporting any of the four IVH beliefs. Being female, age 18-49 years, non-Hispanic Black, having high school or lower education, being employed, and not having primary care medical home were associated with hesitancy. CONCLUSIONS Among the four IVH beliefs studied, being hesitant to receiving influenza vaccination followed by mistrust of healthcare providers were identified as the most influential hesitancy beliefs. Two in five adults in the United States were hesitant to receive an influenza vaccination, and hesitancy was negatively associated with vaccination. This information may assist with targeted interventions, personalized to the individual, to reduce hesitancy and thus improve influenza vaccination acceptance.
Collapse
Affiliation(s)
- Anup Srivastav
- Leidos Incorporated, Atlanta, GA, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Jill A Dever
- RTI International, District of Columbia, WA, USA.
| | | | | | - Paul J Scanlon
- Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
| | - Allison M Fisher
- Office of Health Communications, Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stacie M Greby
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kimberly H Nguyen
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Carla L Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| |
Collapse
|
3
|
Mahamid F, Veronese G. The psychometric properties and the factorial structure of COVID-19 Vaccines Acceptance scale (VAC-COVID-19) within the Arabic language in a Palestinian contex. BMC Public Health 2022; 22:1833. [PMID: 36175993 PMCID: PMC9521561 DOI: 10.1186/s12889-022-14229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 Vaccines Acceptance scale (VAC-COVID-19) is an international measure designed to evaluate vaccination acceptance against the COVID-19 virus. The current scale was translated from English to Arabic and validated within the Palestinian context. Aims Our study aimed to test the factorial structure and the psychotic properties of the VAC-COVID-19 within the Palestinian context using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) through 484 participants selected using online method techniques. Findings The VAC-COVID-19 was a reliable and valid method in assessing COVID-19 vaccine acceptance among Palestinians. Results of CFA indicated a stable construct of a two-factor solution in assessing COVID-19 vaccination acceptance in a Palestinian context. (1) Reasons for not receiving the vaccination, and (2) for receiving the vaccination. Conclusion The VAC-COVID-19 was a valid method to assess vaccination acceptance in the Arabic language within the Palestinian context. Therefore, it is recommended to conduct similar studies with diverse samples in Palestinian society; it would be prudent to target at-risk populations needed to develop the scale and its factorial structure. The VAC-COVID-19 can be a useful measure to assess vaccination acceptance among Palestinians, enabling health providers to implement interventions to modify negative attitudes toward not receiving vaccinations.
Collapse
Affiliation(s)
- Fayez Mahamid
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine.
| | | |
Collapse
|
4
|
Goren T, Beeri I, Vashdi DR. How to boost the boosters? A survey-experiment on the effectiveness of different policies aimed at enhancing acceptance of a "Seasonal" vaccination against COVID-19. Isr J Health Policy Res 2022; 11:27. [PMID: 35787730 PMCID: PMC9251947 DOI: 10.1186/s13584-022-00536-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background Evidence suggests a gradual decrease in the effectiveness of the anti-COVID-19 vaccines, stressing the potential need for periodical booster shots. However, it is hard to tell whether previously applied policies for enhancing vaccine acceptance will be as effective for repeated periodical booster shots during a pandemic. Hence, this study aims to explore the effectiveness of different health policies on periodical vaccination acceptance amidst an ongoing pandemic. Methods A cross sectional online experiment was performed in a representative sample of 929 Israeli citizens. Participants were randomly allocated to 4 groups simulating different hypothetical periodical-vaccination-promoting policy scenarios: (1) Mandate (N = 229); (2) a negative monetary incentive (N = 244); (3) a positive monetary incentive (N = 228) and (4) information provision (N = 228). Compliance intentions and vaccine-acceptance-related variables were measured. Analysis included multivariate hierarchic logistic and linear regressions. Results Compliance intentions levels were medium (M = 3.13 on a 1–5 scale). Only 20.2% of the sample demonstrated strong acceptance of periodical vaccination, which is lower than the acceptance rate of the seasonal flu shot in the country in the year preceding the pandemic. Type of policy was related to the extent to which a respondent strongly agreed to be periodically vaccinated or not. Specifically, strong acceptance was more likely when positive or negative incentives were presented in comparison to the mandate or information provision conditions. However, when examining the extent of compliance among respondents who were less decisive, the type of policy did not predict the extent to which these respondents intended to comply. In addition, compliance intentions were related with the perceived benefits and barriers of the vaccine, the perceived efficacy of getting vaccinated and social norms. Hesitator’s intentions were additionally associated with anti-COVID-19 vaccination history, perceived severity of the disease and trust in government. Conclusions Pandemic-containing vaccines may be perceived as less effective and beneficial than pandemic-preventing vaccines. Individuals with different levels of motivation for periodical vaccination during a pandemic may be affected by different factors. While strongly opinionated individuals are affected by the type of vaccination-promoting policy, hesitators are affected by a larger number of factors, which provide policy makers with greater opportunities to enhance their vaccination intentions.
Collapse
Affiliation(s)
- Talia Goren
- School of Political Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel.
| | - Itai Beeri
- School of Political Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Dana Rachel Vashdi
- School of Political Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| |
Collapse
|
5
|
Widdershoven V, Reijs RP, Verhaegh-Haasnoot A, Ruiter RAC, Hoebe CJPA. Psychosocial and organizational barriers and facilitators of meningococcal vaccination (MenACWY) acceptance among adolescents and parents during the Covid-19 pandemic: a cross-sectional survey. BMC Infect Dis 2022; 22:507. [PMID: 35641926 PMCID: PMC9152822 DOI: 10.1186/s12879-022-07473-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to identify differences and similarities among adolescents and parents in various psychosocial factors influencing meningococcal ACWY (MenACWY) vaccination acceptance. Besides, the impact of the Covid-19 pandemic was assessed as well as resulting organizational adjustments. METHODS We conducted a cross-sectional survey among adolescents that attended the appointment for the MenACWY vaccination in South Limburg between May and June 2020, and their parents. Independent t-tests and χ2 test were performed to explore differences in psychosocial and organisational factors between adolescents and parents. RESULTS In total, 592 adolescents (20%) and 1197 parents (38%) filled out the questionnaire. Adolescents scored lower on anticipated negative affect towards MenACWY vaccination refusal [t (985.688) = - 9.32; ρ < 0.001], moral norm towards MenACWY vaccination acceptance [t (942.079) = - 10.38; ρ < 0.001] and knowledge about the MenACWY vaccination and meningococcal disease [t (1059.710) = - 11.24; ρ < 0.001]. Both adolescents and parents reported a social norm favouring accepting childhood vaccinations, but adolescent scored higher [t (1122.846) = 23.10; ρ < 0.001]. The Covid-19 pandemic did barely influence the decision to accept the MenACWY vaccination. Only 6% of the participants indicated that Covid-19 influenced their decision. In addition, the individual vaccination appointment was rated very positive. Most adolescents (71.5%) and parents (80.6%) prefer future vaccinations to be offered individually rather than having mass vaccinations sessions. CONCLUSIONS This study provides an indication of which psychosocial and organisational factors should be addressed in future MenACWY vaccination campaigns. Individual vaccination appointments for adolescents should be considered, taking the costs and logistical barriers into account.
Collapse
Affiliation(s)
- Veja Widdershoven
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health South, Public Health Service South Limburg, Het Overloon 2, 6411 TE, Heerlen, The Netherlands. .,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
| | - Rianne P Reijs
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Youth Health Care, Living Lab Public Health South, Public Health Service South Limburg, Heerlen, The Netherlands
| | - Amanja Verhaegh-Haasnoot
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health South, Public Health Service South Limburg, Het Overloon 2, 6411 TE, Heerlen, The Netherlands
| | - Robert A C Ruiter
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health South, Public Health Service South Limburg, Het Overloon 2, 6411 TE, Heerlen, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| |
Collapse
|
6
|
Müller F, Heinemann S, Hummers E, Noack EM, Heesen G, Dopfer-Jablonka A, Mikuteit M, Niewolik J, Steffens S, Schröder D. [Immunosuppressed people's beliefs, expectations, and experiences with COVID-19 vaccinations : Results of a longitudinal study]. Z Rheumatol 2022; 82:342-354. [PMID: 35523964 PMCID: PMC9075708 DOI: 10.1007/s00393-022-01213-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Immunocompromised people are less likely to be vaccinated, despite an increased benefit of many vaccinations in terms of benefit-risk assessment, including the vaccines against SARS CoV-2 (COVID-19). Attitudes, expectations, and experiences with previous vaccinations influence the decision to get vaccinated. OBJECTIVE To explore the attitudes of immunocompromised people towards vaccinations in general and COVID-19 vaccination in particular and their experiences with COVID-19 vaccinations. MATERIAL AND METHODS As part of the CoCo Immune study, immunocompromised participants were surveyed in the spring and summer of 2021 (1 November 2021-7 September 2021) using questionnaires. Initially, they were asked about their expectations concerning a COVID-19 vaccination and followed up about their experience after COVID-19 vaccination. In addition, sociodemographic data, general attitudes toward vaccinations and experiences with previous vaccinations were collected. Analysis was performed using descriptive and bivariate statistics. RESULTS The 243 participants mostly approved vaccinations and expected the COVID-19 vaccination to be effective and well-tolerated. Women were more concerned about the safety of vaccinations and were more often worried about side effects. Older persons felt better informed than younger persons. Participants who reported subjective side effects of previous vaccinations were more skeptical about vaccinations as well as the government institutions that recommend vaccinations. They less often agreed with the statement "in retrospect, the COVID-19 vaccination has been harmless for me so far". DISCUSSION The participants mostly expressed a positive attitude and anticipation towards COVID-19 vaccinations; however, the age and sex differences found suggest that there are different information needs which should be addressed when educating individuals about vaccinations or designing vaccination campaigns.
Collapse
Affiliation(s)
- Frank Müller
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073, Göttingen, Deutschland.
| | - Stephanie Heinemann
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073, Göttingen, Deutschland
| | - Eva Hummers
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073, Göttingen, Deutschland
| | - Eva Maria Noack
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073, Göttingen, Deutschland
| | - Gloria Heesen
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073, Göttingen, Deutschland
| | - Alexandra Dopfer-Jablonka
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland
- Deutsches Zentrum für Infektionsforschung, Hannover-Braunschweig, Deutschland
| | - Marie Mikuteit
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Jacqueline Niewolik
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Sandra Steffens
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Dominik Schröder
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073, Göttingen, Deutschland
| |
Collapse
|
7
|
Wong LP, Alias H, Danaee M, Ahmed J, Lachyan A, Cai CZ, Lin Y, Hu Z, Tan SY, Lu Y, Cai G, Nguyen DK, Seheli FN, Alhammadi F, Madhale MD, Atapattu M, Quazi-Bodhanya T, Mohajer S, Zimet GD, Zhao Q. COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries. Infect Dis Poverty 2021; 10:122. [PMID: 34620243 PMCID: PMC8496428 DOI: 10.1186/s40249-021-00900-w] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/30/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.
Collapse
Affiliation(s)
- Li Ping Wong
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China.
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Jamil Ahmed
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Community Health Science, Muhammad Medical College, Mirpurkhas, Sindh, 69000, Pakistan
| | - Abhishek Lachyan
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- World Health Organization National Polio Surveillance Project (NPSP) Unit Belgaum World Customs Organization, Hindu Nagar, Tilakwadi, Belgaum, Karnataka, 590006, India
| | - Carla Zi Cai
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China.
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian, China.
| | - Si Ying Tan
- Leadership Institute for Global Health Transformation, Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive, Singapore, 117549, Singapore
| | - Yixiao Lu
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Guoxi Cai
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Di Khanh Nguyen
- Department of Academic Affairs and Testing, Dong Nai Technology University, Dong Nai, Vietnam
| | - Farhana Nishat Seheli
- Institute of Epidemiology, Disease Control & Research (IEDCR), Mohakhali, Dhaka, 1212, Bangladesh
| | - Fatma Alhammadi
- Ministry of Health and Prevention (MOHAP), Sharjah, United Arab Emirates
| | - Milkar D Madhale
- Vijaya College of Nursing, Belgaum, Ayodhya Nagar, Belgaum, Karnataka, 590001, India
| | - Muditha Atapattu
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Samira Mohajer
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gregory D Zimet
- Department of Pediatrics, School of Medicine, Indiana University, 410 W, 10th St., HS 1001, Indianapolis, IN, 46202, USA
| | - Qinjian Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
| |
Collapse
|
8
|
Abstract
BACKGROUND In England, influenza and pertussis vaccination has been recommended for all pregnant women since 2010 and 2012 respectively. However, in some areas, vaccination uptake rates have been low. A qualitative study was conducted to gain a contextualised understanding of factors influencing vaccination acceptance during pregnancy in Hackney, a borough in north-east London, UK. This paper draws on in-depth insights gained from the above study, to provide recommendations for increasing long-term maternal vaccination acceptance. METHODS Hackney was chosen as the study site because it has one of the lowest vaccination coverage rates in pregnancy in the UK. A maximum variation sampling method was used to recruit 47 pregnant and recently pregnant women from a wide range of backgrounds, as well as ten healthcare professionals from three general practices; two community antenatal clinics; nine parent-toddler groups; and four community centres. In-depth interviews and a video-recording of a pregnant patient's consultation, explored experiences of care within the National Health Service during pregnancy, and women's views about maternal vaccination. In-depth interviews with healthcare professionals explored their views towards, and how they discuss and provide maternal vaccination. Study data were analysed both deductively, through drawing on insights from anthropological works that address diverse conceptualisations and practices around vaccination; and inductively, with a thematic analysis approach. RESULTS The findings of this study and the recommendations based on them were divided into five broad themes: access to maternal vaccination; healthcare institution rhetoric and its effect on maternal vaccination acceptance; community and family influences on maternal vaccination decisions; healthcare professionals' views towards maternal vaccination; and the influence of patient-healthcare professional relationships on maternal vaccination acceptance. CONCLUSIONS The strategies to improve maternal vaccination acceptance recommended in this paper would engender a more open and democratised healthcare system.
Collapse
Affiliation(s)
- R Wilson
- LSHTM, Keppel Street, London, WC1E 7HT, UK.
| | - P Paterson
- LSHTM, Keppel Street, London, WC1E 7HT, UK
| | - H J Larson
- LSHTM, Keppel Street, London, WC1E 7HT, UK
| |
Collapse
|
9
|
Gerede R, Machekanyanga Z, Ndiaye S, Chindedza K, Chigodo C, Shibeshi ME, Goodson J, Daniel F, Kaiser R. How to Increase Vaccination Acceptance Among Apostolic Communities: Quantitative Results from an Assessment in Three Provinces in Zimbabwe. J Relig Health 2017; 56:1692-1700. [PMID: 28624983 PMCID: PMC5711555 DOI: 10.1007/s10943-017-0435-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A worldwide increasing trend toward vaccine hesitancy has been reported. Measles outbreaks in southern Africa in 2009-2010 were linked to objections originating from Apostolic gatherings. Founded in Zimbabwe in the 1950s, the Apostolic church has built up a large number of followers with an estimated 3.5 million in Zimbabwe in 2014. To inform planning of interventions for the 2015 measles-rubella vaccination campaign, we assessed vaccination status and knowledge, attitudes and practices among purposive samples of Apostolic caregivers in three districts each in Harare City, Manicaland and Matabeleland South in Zimbabwe. We conducted structured interviews among 97 caregivers of children aged 9-59 months and collected vaccination status for 126 children. Main Apostolic affiliations were Johanne Marange (53%), Madida (13%) and Gospel of God (11%) with considerable variation across assessment areas. The assessment also showed considerable variation among Apostolic communities in children ever vaccinated (14-100%) and retention of immunization cards (0-83%) of ever vaccinated. Overall retention of immunization cards (12%) and documented vaccination status by card (fully vaccinated = 6%) were low compared to previously reported measures in the general population. Mothers living in monogamous relationships reported over 90% of all DTP-HepB-Hib-3, measles and up to date immunizations during the first life year documented by immunization card. Results revealed opportunities to educate about immunization during utilization of health services other than vaccinations, desire to receive information about vaccinations from health personnel, and willingness to accept vaccinations when offered outside of regular services. Based on the results of the assessment, specific targeted interventions were implemented during the vaccination campaign, including an increased number of advocacy activities by district authorities. Also, health workers offered ways and timing to vaccinate children that catered to the specific situation of Apostolic caregivers, including flexible service provision after hours and outside of health facilities, meeting locations chosen by caregivers, using mobile phones to set up meeting locations, and documentation of vaccination in health facilities if home-based records posed a risk for caregivers. Coverage survey results indicate that considerable progress has been made since 2010 to increase vaccination acceptability among Apostolic communities in Zimbabwe. Further efforts will be needed to vaccinate all Apostolic children during routine and campaign activities in the country, and the results from our assessment can contribute toward this goal.
Collapse
Affiliation(s)
| | - Zorodzai Machekanyanga
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
| | - Serigne Ndiaye
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Messeret E Shibeshi
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
| | - James Goodson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Fussum Daniel
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
| | - Reinhard Kaiser
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe.
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- CDC Sierra Leone, Freetown, Sierra Leone.
| |
Collapse
|
10
|
Machekanyanga Z, Ndiaye S, Gerede R, Chindedza K, Chigodo C, Shibeshi ME, Goodson J, Daniel F, Zimmerman L, Kaiser R. Qualitative Assessment of Vaccination Hesitancy Among Members of the Apostolic Church of Zimbabwe: A Case Study. J Relig Health 2017; 56:1683-1691. [PMID: 28631171 PMCID: PMC5711523 DOI: 10.1007/s10943-017-0428-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Vaccine hesitancy or lack of confidence in vaccines is considered a threat to the success of vaccination programs. The rise and spread of measles outbreaks in southern Africa in 2009-2010 were linked to objections among Apostolic Church members, estimated at about 3.5 million in Zimbabwe as of 2014. To inform planning of interventions for a measles-rubella vaccination campaign, we conducted an assessment of the factors contributing to vaccine hesitancy using data from various stakeholders. Among nine districts in three regions of Zimbabwe, we collected data on religious attitudes toward, and perceptions of, vaccines through focus group discussions with health workers serving Apostolic communities and members of the National Expanded Programme on Immunization; semi-structured interviews with religious leaders; and open-ended questions in structured interviews with Apostolic parents/caregivers. Poor knowledge of vaccines, lack of understanding and appreciation of the effectiveness of vaccinations, religious teachings that emphasize prayers over the use of medicine, lack of privacy in a religiously controlled community, and low levels of education were found to be the main factors contributing to vaccine hesitancy among key community members and leaders. Accepting vaccination in public is a risk of sanctions. Poor knowledge of vaccines is a major factor of hesitancy which is reinforced by religious teachings on the power of prayers as alternatives. Because parents/caregivers perceive vaccines as dangerous for their children and believe they can cause death or disease, members of the Apostolic Church have more confidence in alternative methods such as use of holy water and prayers to treat diseases. Under these circumstances, it is important to debunk the myths about the power of holy water on the one hand and disseminate positive information of the efficacy of vaccines on the other hand in order to reduce hesitancy. Education about vaccines and vaccination in conjunction with government intervention, for example, through the use of social distancing policies can provide a framework for reducing hesitancy and increasing demand for vaccination.
Collapse
Affiliation(s)
- Z Machekanyanga
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
| | - S Ndiaye
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Atlanta, GA, 30333, USA.
| | - R Gerede
- Ministry of Health and Child Care, Harare, Zimbabwe
| | | | - C Chigodo
- Ministry of Health and Child Care, Harare, Zimbabwe
| | - M E Shibeshi
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
| | - J Goodson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - F Daniel
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
| | - L Zimmerman
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - R Kaiser
- Inter-country Support Team for East and Southern Africa, World Health Organization (WHO) Regional Office for Africa, Harare, Zimbabwe
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Atlanta, GA, 30333, USA
| |
Collapse
|
11
|
Nowak GJ, Shen AK, Schwartz JL. Using campaigns to improve perceptions of the value of adult vaccination in the United States: Health communication considerations and insights. Vaccine 2017; 35:5543-5550. [PMID: 28886947 DOI: 10.1016/j.vaccine.2017.08.064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/03/2017] [Accepted: 08/24/2017] [Indexed: 11/27/2022]
Abstract
Vaccines have much relevance and promise for improving adult health in the United States, but to date, overall use and uptake remain far below desired levels. Many adults have not received recommended vaccinations and many healthcare providers do not strongly and actively encourage their use with patients. This has led some public health and medical experts to conclude that adult vaccines are severely undervalued by the U.S. public and healthcare providers and to call for campaigns and communication-based efforts to foster increased appreciation, and in turn, higher adult immunization rates. A narrative integrative review that draws upon the vaccine valuation and health communication literatures is used to develop a framework to guide campaign and communication-based efforts to improve public, provider, and policymakers' assessment of the value of adult vaccination. The review does this by: (1) distinguishing social psychological value from economic value; (2) identifying the implications of social psychological value considerations for adult vaccination-related communication campaigns; and (3) using five core health communication considerations to illustrate how social psychological notions of value can be integrated into campaigns or communication that are intended to improve adult vaccination value perceptions and assessments, and in turn, motivate greater support for and uptake of recommended adult vaccines.
Collapse
Affiliation(s)
- Glen J Nowak
- Grady College Center for Health & Risk Communication, Grady College of Journalism and Mass Communication, University of Georgia, Athens, GA, United States; National Vaccine Program Office, U.S. Department of Health and Human Services, Washington, D.C., United States.
| | - Angela K Shen
- National Vaccine Program Office, U.S. Department of Health and Human Services, Washington, D.C., United States
| | - Jason L Schwartz
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States
| |
Collapse
|