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Akinsola KO, Bakare AA, Gobbo E, King C, Hanson C, Falade A, Herzig van Wees S. A systematic review of measures of healthcare workers' vaccine confidence. Hum Vaccin Immunother 2024; 20:2322796. [PMID: 38506574 PMCID: PMC10956625 DOI: 10.1080/21645515.2024.2322796] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, were conducted in high-income countries. There was variability in the quality of the validation process. There is limited existing literature on development and validation of tools for HCW vaccine confidence. Based on the tools currently available, the Pro-VC-Be tool is the most well validated. Further research needs to include low- and middle-income contexts.
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Affiliation(s)
| | - Ayobami A. Bakare
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Elisa Gobbo
- Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Carina King
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
| | - Claudia Hanson
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Adegoke Falade
- Department of Pediatrics, University College Hospital, Ibadan, Nigeria
- Pediatrics Department, University of Ibadan, Ibadan, Nigeria
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Biasio LR, Lorini C, Zanobini P, Bonaccorsi G. The still unexplored mediating role of vaccine literacy. Hum Vaccin Immunother 2024; 20:2310360. [PMID: 38314760 PMCID: PMC10863508 DOI: 10.1080/21645515.2024.2310360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Affiliation(s)
| | - Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy
| | - Patrizio Zanobini
- Department of Health Science, University of Florence, Florence, Italy
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Nguyen KH, Chen S, Bao Y, Lu Y, Bednarczyk RA, Vasudevan L. COVID-19 Diagnosis, Severity, and Long COVID Among U.S. Adolescents, National Health Interview Survey, 2022. Am J Health Promot 2024; 38:534-539. [PMID: 38311899 DOI: 10.1177/08901171241231642] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
PURPOSE Understanding disparities in COVID-19 outcomes, overall and stratified by vaccination status, is important for developing targeted strategies to increase vaccination coverage and protect adolescents from COVID-19. DESIGN The 2022 National Health Interview Survey (NHIS) is a cross-sectional nationally representative household survey of U.S. adults. SETTING A probability sample of households in the U.S. SAMPLE One child aged 12-17 years is randomly selected from each family in the household. A knowledgeable adult (eg, parent or guardian), responds on behalf of the child through an in-person interview (response rate = 49.9%). MEASURES Input measures-sociodemographic characteristics and COVID-19 vaccination status; output measures-ever had COVID-19, moderate/severe COVID-19, long COVID. ANALYSIS Prevalence of COVID-19 outcomes was assessed for adolescents aged 12-17 years. Factors associated with each COVID-19 outcome were assessed with multivariable logistic regression analyses. RESULTS Among 2758 adolescents aged 12-17 years in 2022, 60.5% had received ≥1 dose of COVID-19 vaccine, 30.2% had ever been diagnosed by a doctor that they had COVID-19, 29.5% had moderate/severe COVID-19, and 6.2% had long COVID. Adolescents who were vaccinated with ≥1 dose were less likely to be diagnosed with COVID-19 (aOR = .79) and less likely to have long COVID (aOR = .30). CONCLUSION Targeted messaging to highlight the importance of early treatment, the harms of long COVID-19, and the benefits of vaccination in protecting against long-term effects may be necessary to ensure that all adolescents and their families are adequately protected.
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Affiliation(s)
- Kimberly H Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, George Washington University School of Public Health and Health Sciences, Washington, DC, USA
| | - Siyu Chen
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Yingjun Bao
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Yang Lu
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Montalti M, Salussolia A, Capodici A, Scognamiglio F, Di Valerio Z, La Fauci G, Soldà G, Fantini MP, Odone A, Costantino C, Leask J, Larson HJ, Lenzi J, Gori D. Human Papillomavirus (HPV) Vaccine Coverage and Confidence in Italy: A Nationwide Cross-Sectional Study, the OBVIOUS Project. Vaccines (Basel) 2024; 12:187. [PMID: 38400170 PMCID: PMC10891781 DOI: 10.3390/vaccines12020187] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) vaccination rates are still below the target due to vaccine refusal or delay, lack of knowledge, and logistical challenges. Understanding these barriers is crucial for developing strategies to improve HPV vaccination rates. METHODS This cross-sectional study used a questionnaire to investigate social and behavioral factors influencing decision making about the HPV vaccine. The survey was conducted from 11 April to 29 May 2022 and involved 10,000 Italian citizens aged ≥ 18 years. The sample was stratified based on region of residence, gender, and age group. RESULTS 3160 participants were surveyed about themselves, while 1266 respondents were surveyed about their children's vaccine uptake. Among females aged ≥ 26 years, the national average HPV vaccine uptake was 21.7%, with variations across different regions. In the 18-25 age group, females had a vaccine uptake (80.8%) twice as much as males (38.1%), while vaccine uptake among male and female children aged 9-11 was similar. CONCLUSIONS The OBVIOUS study in Italy reveals factors influencing low HPV vaccine uptake, suggesting targeted approaches, tailored information campaigns, heightened awareness of eligibility, promoting early vaccination, addressing low-risk perception among males, addressing safety concerns, and enhancing perceived accessibility to improve vaccine uptake and mitigate health risks.
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Affiliation(s)
- Marco Montalti
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Aurelia Salussolia
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Angelo Capodici
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
- Interdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, 56127 Pisa, Italy
| | - Francesca Scognamiglio
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Zeno Di Valerio
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Giusy La Fauci
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Giorgia Soldà
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy
| | - Julie Leask
- School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Heidi J. Larson
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Institute of Health Metrics, London WC1E 7HT, UK
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Davide Gori
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
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Aghajafari F, Wall L, Weightman A, Ness A, Lake D, Anupindi K, Moorthi G, Kuk B, Santana M, Coakley A. COVID-19 Vaccinations, Trust, and Vaccination Decisions within the Refugee Community of Calgary, Canada. Vaccines (Basel) 2024; 12:177. [PMID: 38400160 PMCID: PMC10891815 DOI: 10.3390/vaccines12020177] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders.
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Affiliation(s)
- Fariba Aghajafari
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Laurent Wall
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Amanda Weightman
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Alyssa Ness
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Deidre Lake
- Alberta International Medical Graduates Association, Calgary, AB T2E 3K8, Canada
| | - Krishna Anupindi
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Gayatri Moorthi
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Bryan Kuk
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Maria Santana
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Annalee Coakley
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Mosaic Refugee Health Clinic, Calgary, AB T2A 5H5, Canada
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Salmon DA, Chen RT, Black S, Sharfstein J. Lessons learned from COVID-19, H1N1, and routine vaccine pharmacovigilance in the United States: a path to a more robust vaccine safety program. Expert Opin Drug Saf 2024; 23:161-175. [PMID: 38343204 DOI: 10.1080/14740338.2024.2305707] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Vaccine pharmacovigilance is an essential component of vaccine safety programs. Vaccine pharmacovigilance refers to detecting uncommon adverse events following immunization (AEFI), determining whether they are due to the vaccine or are only a coincidence, and, for those AEFI considered related to vaccination, characterizing them further. When AEFI are due to vaccination, it is important to characterize the attributable risk and ascertain the biological mechanism causing the adverse reaction to inform efforts to prevent or mitigate the risk. A robust post-authorization safety system is necessary for vaccine decision-making, clinical recommendations, vaccine compensation, and vaccine communication and confidence. AREAS COVERED This paper describes the key characteristics of vaccine pharmacovigilance programs, reviews US vaccine pharmacovigilance for routine vaccination programs, COVID-19, and H1N1, and makes recommendations for improving future vaccine safety systems. EXPERT OPINION The key characteristics of vaccine pharmacovigilance programs include passive surveillance, active surveillance, clinical investigation and special studies, and causality assessment. Recent examples illustrate the strengths of US pharmacovigilance systems, including systems for passive and active surveillance, as well as areas for improvement, including study of pathogenesis, consistent funding, and leadership. We make recommendations that would, if implemented, further strengthen the vaccine safety system for future routine and pandemic immunizations.
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Affiliation(s)
- Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert T Chen
- Brighton Collaboration, A program of the Task Force for Global Health, Decatur, GA, USA
| | - Steve Black
- Global Vaccine Data Network, Auckland, New Zealand
| | - Joshua Sharfstein
- Department of Health, Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Nguyen KH, Bao Y, Mortazavi J, Allen JD, Chocano-Bedoya PO, Corlin L. Prevalence and Factors Associated with Long COVID Symptoms among U.S. Adults, 2022. Vaccines (Basel) 2024; 12:99. [PMID: 38250912 PMCID: PMC10820629 DOI: 10.3390/vaccines12010099] [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: 12/19/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Long COVID and its symptoms have not been examined in different subpopulations of U.S. adults. Using the 2022 BRFSS (n = 445,132), we assessed long COVID and each symptom by sociodemographic characteristics and health-related variables. Multivariable logistic regression was conducted to examine factors associated with long COVID and the individual symptoms. Prevalence differences were conducted to examine differences in long COVID by vaccination status. Overall, more than one in five adults who ever had COVID-19 reported symptoms consistent with long COVID (21.8%). The most common symptom was tiredness or fatigue (26.2%), followed by difficulty breathing or shortness of breath (18.9%), and loss of taste or smell (17.0%). Long COVID was more common among adults under 65 years, women, American Indian or Alaska Native or other/multi race group, smokers, and people with a disability, depression, overweight or obesity compared to their respective counterparts. The prevalence of long COVID was higher among unvaccinated adults (25.6%) than vaccinated adults (21.6%) overall, and for 20 of 32 subgroups assessed. These findings underscore the benefits of vaccination, the importance of early treatment, and the need to better inform health care resource allocation and support services for those experiencing long COVID.
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Affiliation(s)
- Kimberly H. Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
- Department of Epidemiology, George Washington University Milken School of Public Health, Washington, DC 20037, USA
| | - Yingjun Bao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA; (Y.B.); (J.M.); (L.C.)
| | - Julie Mortazavi
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA; (Y.B.); (J.M.); (L.C.)
| | - Jennifer D. Allen
- Department of Community Health, Tufts School of Arts and Sciences, Medford, MA 02115, USA;
| | | | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA; (Y.B.); (J.M.); (L.C.)
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA 02155, USA
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Galagoda GCS, Perera J, de Silva R, Wickramasinghe HT, Dasanayake D, Bravo L, Ismail Z, Goh DYT, Nelson EAS. ASVAC2022 : 8 th Asian Vaccine Conference. Hum Vaccin Immunother 2023; 19:2165360. [PMID: 36655357 PMCID: PMC9980669 DOI: 10.1080/21645515.2023.2165360] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aiming to further the Immunization Partners in Asia Pacific (IPAP)'s vision of a world where no one suffers from a vaccine preventable disease, the 8th Asian Vaccine Conference (ASVAC 2022) was held in Colombo, Sri Lanka and virtually from 15 to 18, September 2022 (www.asianvaccine.com). This conference followed those held in Siem Reap, Cambodia (2009), Manila, Philippines (2010), Jakarta, Indonesia (2011), Cebu, Philippines (2013), Hanoi, Vietnam (2015), Singapore (2017) and Naypyidaw and Yangon, Myanmar (2019). The ASVAC2022 themed "Immunization: in Era of Pandemics," commenced with the EPI Managers' Workshop, followed by pre-conference workshops and Vaccinology Masterclass, followed by the main conference featuring 5 plenary lectures, 6 partner-led symposia, free paper and poster presentations, and industry-supported lunch and evening sessions. There were over 1830 registered participants, with 112 attending in person and 998 virtually from 63 countries. The conference was organized by IPAP and hosted by the Vaccine and Infectious Disease Forum of Sri Lanka, Sri Lanka College of Pediatricians, Sri Lanka College of Microbiologists and College of General Practitioners of Sri Lanka, with the support of the Ministry of Health, Sri Lanka. The 9th ASVAC is scheduled to be held in Davao City, Philippines in late 2023.
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Affiliation(s)
| | - Jennifer Perera
- Department of Medical Microbiology and Immunology, University of Colombo, Colombo, Sri Lanka
| | - Rajiva de Silva
- Department of Immunology, Medical Research Institute, Colombo 8, Sri Lanka
| | - H T Wickramasinghe
- Department of Paediatrics, Neville Fernando Teaching Hospital, Colombo, Sri Lanka
| | | | - Lulu Bravo
- Department of Pediatrics, University of the Philippines Manila, Manila, Philippines
| | - Zulkifli Ismail
- Department of Paediatrics, KPJ Selangor Specialist Hospital, Shah Alam, Malaysia.,Graduate School, KPJ Healthcare University College, Nilai, Malaysia
| | - Daniel Y T Goh
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - E Anthony S Nelson
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong, PR China.,Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
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Fernandes A, Wang D, Domachowske JB, Suryadevara M. Vaccine knowledge, attitudes, and recommendation practices among health care providers in New York State. Hum Vaccin Immunother 2023; 19:2173914. [PMID: 36749617 PMCID: PMC10026857 DOI: 10.1080/21645515.2023.2173914] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Community-wide vaccine uptake remains sub-optimal. Healthcare provider (HCP) vaccine recommendations influence patient vaccination; however, provider vaccine recommendation behavior is highly influenced by one's own vaccine attitudes and/or knowledge. We aim to describe vaccine knowledge, attitudes, and recommendation practices (KAP) among New York State HCPs. A survey to assess HCP KAP was developed and electronically distributed to NYS members of national medical organizations via their local chapter administrators. Descriptive statistical methods were used to define provider KAP. A total of 864 surveys were included, 500 (60%) and 336 (40%) primary and specialty care providers, respectively. Eighty-one percent (402/499) of primary care providers (PCPs) report encountering vaccine hesitant patients daily or weekly. Of the 500 PCPs who responded, only 204 (41%) stated strong agreement with confidence in their communications with vaccine hesitant patients. HCPs who correctly answered all four knowledge questions were more likely to self-report routine recommendations of standard vaccines to all patients when compared to those who correctly answered fewer questions (489/588 (83%) vs 135/241 (56%), p < .05). HCPs were more likely to routinely recommend standard vaccines to all patients if they also report initiating vaccine discussion (476/485 (98%) vs 148/344 (43%), p < .05) and reviewing and recommending vaccinations at each encounter (315/320 (98%) vs 308/508 (61%), p < .05). Vaccine hesitancy exists across healthcare specialties and provider roles. Focused interventions should include reaching all HCPs to promote vaccinations for disease prevention, tailoring messages to reduce HCP vaccine misperceptions, and increasing awareness of evidence-based office strategies known to facilitate immunizations.
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Affiliation(s)
| | - Dongliang Wang
- Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
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Razai MS, Mansour R, Goldsmith L, Freeman S, Mason-Apps C, Ravindran P, Kooner P, Berendes S, Morris J, Majeed A, Ussher M, Hargreaves S, Oakeshott P. Interventions to increase vaccination against COVID-19, influenza and pertussis during pregnancy: a systematic review and meta-analysis. J Travel Med 2023; 30:taad138. [PMID: 37934788 PMCID: PMC10755181 DOI: 10.1093/jtm/taad138] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Pregnant women and their babies face significant risks from three vaccine-preventable diseases: COVID-19, influenza and pertussis. However, despite these vaccines' proven safety and effectiveness, uptake during pregnancy remains low. METHODS We conducted a systematic review (PROSPERO CRD42023399488; January 2012-December 2022 following PRISMA guidelines) of interventions to increase COVID-19/influenza/pertussis vaccination in pregnancy. We searched nine databases, including grey literature. Two independent investigators extracted data; discrepancies were resolved by consensus. Meta-analyses were conducted using random-effects models to estimate pooled effect sizes. Heterogeneity was assessed using the I2 statistics. RESULTS From 2681 articles, we identified 39 relevant studies (n = 168 262 participants) across nine countries. Fifteen studies (39%) were randomized controlled trials (RCTs); the remainder were observational cohort, quality-improvement or cross-sectional studies. The quality of 18% (7/39) was strong. Pooled results of interventions to increase influenza vaccine uptake (18 effect estimates from 12 RCTs) showed the interventions were effective but had a small effect (risk ratio = 1.07, 95% CI 1.03, 1.13). However, pooled results of interventions to increase pertussis vaccine uptake (10 effect estimates from six RCTs) showed no clear benefit (risk ratio = 0.98, 95% CI 0.94, 1.03). There were no relevant RCTs for COVID-19. Interventions addressed the 'three Ps': patient-, provider- and policy-level strategies. At the patient level, clear recommendations from healthcare professionals backed by text reminders/written information were strongly associated with increased vaccine uptake, especially tailored face-to-face interventions, which addressed women's concerns, dispelled myths and highlighted benefits. Provider-level interventions included educating healthcare professionals about vaccines' safety and effectiveness and reminders to offer vaccinations routinely. Policy-level interventions included financial incentives, mandatory vaccination data fields in electronic health records and ensuring easy availability of vaccinations. CONCLUSIONS Interventions had a small effect on increasing influenza vaccination. Training healthcare providers to promote vaccinations during pregnancy is crucial and could be enhanced by utilizing mobile health technologies.
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Affiliation(s)
- Mohammad S Razai
- Population Health Research Institute, St George’s University of London, London, UK
| | - Rania Mansour
- Population Health Research Institute, St George’s University of London, London, UK
| | - Lucy Goldsmith
- Population Health Research Institute, St George’s University of London, London, UK
| | - Samuel Freeman
- Primary Care Unit, University Hospitals Sussex NHS Foundation Trust, Sussex, UK
| | - Charlotte Mason-Apps
- Population Health Research Institute, St George’s University of London, London, UK
| | - Pahalavi Ravindran
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Foundation Trust, Leicester, UK
| | | | - Sima Berendes
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Joan Morris
- Population Health Research Institute, St George’s University of London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George’s University of London, London, UK
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Sally Hargreaves
- Population Health Research Institute, St George’s University of London, London, UK
- The Migrant Health Research Unit, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Pippa Oakeshott
- Population Health Research Institute, St George’s University of London, London, UK
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Dimitrova V, Stoitsova S, Rangelov V, Raycheva R, Martinova M, Nenova G, Iakimova M, Georgieva I, Georgiev I, Krumova S, Minkova A, Vladimirova N, Nikolaeva-Glomb L. High vaccine confidence and strong approval of the mandatory immunization schedule among Bulgarian general practitioners in 2022. Hum Vaccin Immunother 2023; 19:2265640. [PMID: 37846744 PMCID: PMC10583620 DOI: 10.1080/21645515.2023.2265640] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
In a context of recently decreasing childhood immunization coverage and low uptake of COVID-19 vaccines in Bulgaria, this study measures vaccine hesitancy among general practitioners (GPs) in the country, as they are central to forming patients' attitudes. In 2022, a face-to-face survey was conducted through a simple random sample from an exhaustive national database of Bulgarian GPs. This study measured attitudes on vaccine importance, safety, and effectiveness, and attitudes toward the Bulgarian immunization schedule. Information was collected on demographic and GP practice characteristics and possible predictors of vaccine confidence in order to test for associations with attitudes toward immunization. GP attitudes toward vaccines and the immunization schedule in Bulgaria were generally positive. Among 358 respondents, 351 (98%,95%CI96-99%) strongly agreed/agreed that vaccines are important, 352 (98%,95%CI96-99%) that vaccines are effective, and 341 (95%,95%CI93-97%) that vaccines are safe. 347 respondents (97%,95%CI95-98%) affirmed that "it's good that vaccines from the children's immunization schedule are mandatory", and 331 (92%,95%CI89-95%) agreed with the statement "Bulgaria's childhood immunization has my approval". Trust in information from official institutions was among the strongest predictors of vaccine confidence. Respondents' vaccine confidence levels are within the ranges reported by GPs in other European countries and above those reported within the general Bulgarian population. GPs' vaccine confidence is highly associated with trust in official institutions. It is important to maintain trust in official institutions and to support GPs in communicating vaccine knowledge with patients so that vaccine hesitancy in the general population is countered.
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Affiliation(s)
- Veronika Dimitrova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Savina Stoitsova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Vanya Rangelov
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
- Department of Epidemiology and Disaster Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Maria Martinova
- Communities and Identities Department, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Gergana Nenova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Milena Iakimova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Irina Georgieva
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivo Georgiev
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Stefka Krumova
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Antoaneta Minkova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Nadezhda Vladimirova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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12
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Hurstak E, Farina FR, Paasche-Orlow MK, Hahn EA, Henault LE, Moreno P, Weaver C, Marquez M, Serrano E, Thomas J, Griffith JW. COVID-19 Vaccine Confidence Mediates the Relationship between Health Literacy and Vaccination in a Diverse Sample of Urban Adults. Vaccines (Basel) 2023; 11:1848. [PMID: 38140251 PMCID: PMC10747333 DOI: 10.3390/vaccines11121848] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
We sought to analyze the relationship between health literacy, confidence in COVID-19 vaccines, and self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. We recruited (N = 271) English- and Spanish-speaking adults in Boston and Chicago from September 2018 to September 2021. We performed a probit mediation analysis to determine if confidence in COVID-19 vaccines and health literacy predicted self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. Participants were on average 50 years old, 65% female, 40% non-Hispanic Black, 25% Hispanic, and 30% non-Hispanic White; 231 (85%) reported at least one COVID-19 vaccination. A higher mean vaccine confidence score (t = -7.9, p < 0.001) and higher health literacy (t = -2.2, p = 0.03) were associated with vaccination, but only vaccine confidence predicted vaccination in a multivariate model. Vaccine confidence mediated the relationship between health literacy and COVID-19 vaccination (mediated effects: 0.04; 95% CI [0.02, 0.08]). We found that using a simple tool to measure vaccine confidence identified people who declined or delayed COVID-19 vaccination in a diverse sample of adults with varying levels of health literacy. Simple short survey tools can be useful to identify people who may benefit from vaccine promotion efforts and evidence-based communication strategies.
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Affiliation(s)
- Emily Hurstak
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02119, USA;
| | - Francesca R. Farina
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Michael K. Paasche-Orlow
- Department of Medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, MA 02116, USA;
| | - Elizabeth A. Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Lori E. Henault
- Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02119, USA;
| | - Patricia Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Claire Weaver
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Melissa Marquez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Eloisa Serrano
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - Jessica Thomas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
| | - James W. Griffith
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (F.R.F.); (E.A.H.); (C.W.); (M.M.); (E.S.); (J.T.); (J.W.G.)
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13
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Pouvrasseau A, Jeannot E. Vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland: protocol for an online national study. Front Public Health 2023; 11:1302676. [PMID: 38155889 PMCID: PMC10754524 DOI: 10.3389/fpubh.2023.1302676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Vaccine hesitancy is a persistent challenge in public health, exacerbated by the proliferation of anti-vaccine sentiments facilitated by social networks. The COVID-19 pandemic has underscored the importance of addressing vaccine hesitancy, designated by the WHO as a top global health threat. This study explores vaccine hesitancy among nursing and midwifery undergraduate students in Switzerland-a cohort crucial to public health given their future roles as healthcare professionals-with a particular emphasis on the HPV vaccine, which exhibits lower confidence levels compared to other vaccines. Methods This study will employ an online questionnaire distributed to nursing and midwifery undergraduate students from various healthcare universities. The questionnaire will collect data on vaccine hesitancy (general confidence in vaccines and specifically in the HPV vaccine), HPV vaccine coverage, socio-demographics, likelihood to recommend vaccines to patients, perception of vaccination education and interest in complementary medicine. Conclusion The study's findings will contribute to our understanding of vaccine hesitancy among nursing and midwifery undergraduate students, providing insights that can inform targeted interventions and education strategies to bolster vaccine confidence among future healthcare professionals, thereby enhancing public health efforts.
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Affiliation(s)
- Audrey Pouvrasseau
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Emilien Jeannot
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Center for Excessive Gambling, Addiction Medicine (Service), Lausanne University Hospital (CHUV), Lausanne, Switzerland
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14
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Brunson EK, Rohde RE, Fulton LV. College students' willingness to accept COVID-19 vaccines. J Am Coll Health 2023; 71:2804-2812. [PMID: 34905717 DOI: 10.1080/07448481.2021.1996375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/27/2021] [Accepted: 10/17/2021] [Indexed: 06/14/2023]
Abstract
Objective To assess college students' willingness to accept COVID-19 vaccines and the factors that influence their decisions. Participants: Traditional (aged 18-23) undergraduate students at a university in central Texas. Methods: An online survey was administered in fall 2020 to 614 students stratified by sex and race/ethnicity. Results: 40.9% of students planned to take the vaccine as soon as possible, 37.1% eventually, 11.4% only if required, and 10.6% did not intend to be vaccinated. Analyses indicated that gender, major/minor, political affiliation, receiving a flu shot in the preceding 12 months, perception of risk for COVID-19, and vaccine hesitancy were all associated with willingness to accept COVID-19 vaccines. Conclusion: Results confirm that no one-size-fits-all approach to promoting COVID-19 vaccination among college students is possible. Instead, administrators interested in increasing vaccine uptake should address concerns of specific groups, while also utilizing the prosocial beliefs of college students (e.g., being vaccinated will protect others).
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Affiliation(s)
- Emily K Brunson
- Department of Anthropology, Texas State University, San Marcos, TX, USA
| | - Rodney E Rohde
- Clinical Laboratory Science Program, Texas State University, San Marcos, TX, USA
| | - Lawrence V Fulton
- School of Health Administration, Texas State University, San Marcos, TX, USA
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15
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Nguyen KH, Levisohn A, McChesney C, Vasudevan L, Bednarczyk RA, Corlin L. Disparities in child and adolescent COVID-19 vaccination coverage and parental intent toward vaccinations for their children and adolescents. Ann Med 2023; 55:2232818. [PMID: 37449878 PMCID: PMC10351440 DOI: 10.1080/07853890.2023.2232818] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Despite recommendations for COVID-19 primary series completion and booster doses for children and adolescents, coverage has been less than optimal, particularly in some subpopulations. This study explored disparities in childhood/adolescent COVID-19 vaccination, parental intent to vaccinate their children and adolescents, and reasons for non-vaccination in the US. METHODS Using the U.S. Census Bureau's Household Pulse Survey (HPS), we analyzed households with children aged <18 years using data collected from September 14 to November 14, 2022 (n = 44,929). Child and adolescent COVID-19 vaccination coverage (≥1 dose, completed primary series, and booster vaccination) and parental intentions toward vaccination were assessed by sociodemographic characteristics. Factors associated with child and adolescent vaccination coverage were examined using multivariable regression models. Reasons for non-vaccination were assessed overall, by the child's age group and respondent's age group. RESULTS Overall, approximately half (50.1%) of children aged < 18 years were vaccinated against COVID-19 (≥1 dose). Completed primary series vaccination was 44.2% among all children aged <18 years. By age group, completed primary series was 13.2% among children <5 years, 43.9% among children 5-11 years, and 63.3% among adolescents 12-17 years. Booster vaccination among those who completed the primary series was 39.1% among children 5-11 years and 55.3% among adolescents 12-17 years. Vaccination coverage differed by race/ethnicity, educational attainment, household income, region, parental COVID-19 vaccination status, prior COVID-19 diagnosis, child's age group, and parental age group. Parental reluctance was highest for children aged <5 years (46.8%). Main reasons for non-vaccination among reluctant parents were concerns about side effects (53.3%), lack of trust in COVID-19 vaccines (48.7%), and the belief that children do not need a COVID-19 vaccine (38.8%). CONCLUSION Disparities in COVID-19 vaccination coverage among children and adolescents continue to exist. Further efforts are needed to increase COVID-19 primary series and booster vaccination and parental confidence in vaccines.
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Affiliation(s)
- Kimberly H. Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ariella Levisohn
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Cheyenne McChesney
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
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16
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Nabirova D, Horth R, Kassabekova L, Henderson A, Yesmagambetova A, Alaverdyan S, Nuorti JP, Smagul M. Corrigendum: Factors associated with COVID-19 vaccine confidence among primary care providers in Kazakhstan, March-April 2021. Front Public Health 2023; 11:1308374. [PMID: 38026420 PMCID: PMC10660272 DOI: 10.3389/fpubh.2023.1308374] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2023.1245750.].
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Affiliation(s)
- Dilyara Nabirova
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Roberta Horth
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Lena Kassabekova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center of Sanitary-Epidemiological Examination and Monitoring, Branch of the National Center for Public Health, Almaty, Kazakhstan
| | - Alden Henderson
- Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Sevak Alaverdyan
- Manoogian Simone College of Business and Economics, American University of Armenia, Yerevan, Armenia
| | - J. Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Infectious Diseases and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Manar Smagul
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center of Sanitary-Epidemiological Examination and Monitoring, Branch of the National Center for Public Health, Almaty, Kazakhstan
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17
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D'Souza-Vazirani D, Behrmann E, Alvarez C, Walsh C, Griffin AR, White S. Champions for School Health-An NASN Initiative to Increase Vaccine Confidence, Equity, and Uptake in COVID-19 and School-Required Vaccinations: Part 2. NASN Sch Nurse 2023; 38:301-309. [PMID: 37926933 DOI: 10.1177/1942602x231202745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
NASN, with generous funding from Kaiser Permanente (KP) and partnered with the Institute for Educational Leadership, developed and implemented the Champions for School Health (CSH) grant initiative. The CSH initiative awarded 54 Implementation Grants in two funding cycles in 2022, funding school districts and community-based organizations (CBOs) to increase access to the pediatric COVID-19 vaccine as well as school-required immunizations and to increase vaccine confidence among underserved populations in KP's footprint: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and the District of Columbia. These grantees administered a total of 17,630 COVID-19 vaccines to individuals ages 5 or older and 34,025 routine immunizations, of which 8,233 school-required vaccinations went to children of ages 5-11 years. Over 851,000 people were reached by vaccine education events in all nine KP markets. A notable takeaway from the project's results was the new partnerships created and the continuation of existing partnerships by the grantees. NASN's implementation of the CSH initiative and results provides a model and a source of critical data on how school health services and community-based organizations can partner to provide hyper-local responses to community/public health crises. This Part 2 article provides an overview of the key results of the project.
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18
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Sacco A, Robbins ML, Paiva AL, Monahan K, Lindsey H, Reyes C, Rusnock A. Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model. Am J Health Promot 2023; 37:1109-1120. [PMID: 37612233 DOI: 10.1177/08901171231197899] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination. DESIGN Cross-sectional measurement development. SETTING Online survey. SAMPLE 528 US adults ages 18-75. MEASURES Demographics, stage of change (SOC), DCBL, SE, myths, and barriers. ANALYSIS The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs. RESULTS For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) (n1 = 8, α = .97; n2 = 5, α = .93; n3 = 4, α = .84). For SE, two correlated factors were revealed (n1 = 12, α = .96; n2 = 3, α = .89). Single-factor solutions for Myths (n = 13, α = .94) and Barriers (n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers. CONCLUSION This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.
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Affiliation(s)
- Allegra Sacco
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Mark L Robbins
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea L Paiva
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kathleen Monahan
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Hayley Lindsey
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Cheyenne Reyes
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea Rusnock
- Department of History, College of Arts and Sciences, University of Rhode Island, Kingston, RI, USA
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19
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Bechini A, Vannacci A, Salvati C, Crescioli G, Lombardi N, Chiesi F, Shtylla J, Del Riccio M, Bonanni P, Boccalini S. Attitudes and perceptions of Italian Students in Healthcare Settings on COVID-19 vaccines and vaccinations strategies, one year after the immunization campaign. Ann Ig 2023. [PMID: 37916765 DOI: 10.7416/ai.2023.2584] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Background The topic of vaccine confidence is increasingly relevant, particularly due to the COVID-19 pandemic and the global distribution of COVID-19 vaccines. This issue is even more critical for students in healthcare settings, given their future role not only as vaccine recipients but also as advocates for vaccination. In light of this, achieving a good level of vaccine acceptance is crucial. Hence, the aim of our study was to evaluate the attitudes and perceptions of healthcare students regarding vaccines and COVID- 19 vaccination. Methods Medical and pharmaceutical area students attended an Elective Teaching Activity on COVID-19 vaccines and vaccination campaign, organized at the University of Florence (Italy) and participated in filling two anonymous questionnaires. The first questionnaire was submitted before the Elective Teaching Activity was focused on students' attitudes and perceptions toward vaccines. The second questionnaire was designed to evaluate the students' satisfaction with the course topics. Both descriptive and inferential analyses were performed on the results. In addition, the Vaccine Confidence Index was calculated to evaluate the propensity of students toward vaccinations. Results A total of 423 students attended the Elective Teaching Activity in the early beginnings of 2022. Overall, students have shown greater confidence in vaccines, compared to COVID-19 vaccines, especially as regards the safety profile. Students' Vaccine Confidence Index was very close to 0.25 value, which indicates being in favor of vaccinations. Nevertheless, in the satisfaction questionnaire filled in at the end of the course, the percentage of students in favor of COVID-19 vaccination increased for both medical (from 94% to 99%) and pharmaceutical area students (from 81% to 97%). Conclusions Our study suggests that educational activities such as this Elective Teaching Activity, could be considered an effective teaching strategy to improve vaccine acceptance rates among students in healthcare settings.
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Affiliation(s)
- A Bechini
- Department of Health Sciences, University of Florence, Italy
| | - A Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - C Salvati
- Department of Health Sciences, University of Florence, Italy
| | - G Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - N Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - F Chiesi
- Central Tuscany LHU, Florence, Italy
| | - J Shtylla
- SIAF-Digital Learning and IT Training Process Unit, Area for the Innovation and Management of Information and Computer Systems, University of Florence, Italy
| | - M Del Riccio
- Department of Health Sciences, University of Florence, Italy
| | - P Bonanni
- Department of Health Sciences, University of Florence, Italy
| | - S Boccalini
- Department of Health Sciences, University of Florence, Italy
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20
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Coulter A, McElrone M, Ford D, Hamilton K. Exploring predictors of COVID-19 vaccine acceptance among students, faculty, and staff at a Southeastern University in the United States. J Am Coll Health 2023:1-9. [PMID: 37856399 DOI: 10.1080/07448481.2023.2258408] [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] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/07/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Explore predictors of early COVID-19 vaccine adoption on a university campus. PARTICIPANTS Students, faculty, staff, and administration (N = 1,234) completed an online survey exploring COVID-19 vaccine-related experiences, perspectives, and knowledge, from September to October 2021. METHODS Based on vaccination status participants were identified as vaccine hesitant or early vaccine adopters. Binary logistic regression was used to examine association between independent variables and vaccine adoption status. RESULTS Democrats (OR = 4.3, p = <.001), participants without a positive COVID-19 test (OR = 2.5, p = <.001), noted seeing/hearing COVID-19 misinformation (OR = 1.8, p = 0.27), and reported trust in public health agencies (OR = 26.2, p = <.001) were more likely to be early COVID-19 vaccine adopters, compared to Republicans, those with a positive COVID-19 test, those who had not seen/heard COVID-19 misinformation, and those reporting distrust in public health agencies, respectively. CONCLUSION Findings indicate that COVID-19 vaccine adoption is multifactorial. Future research should focus on vaccination status-related trust and health communication.
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Affiliation(s)
- Abigail Coulter
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Marissa McElrone
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Dawn Ford
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Kara Hamilton
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
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21
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Chen CX, Cabugao P, Nguyen M, Villegas D, Batra K, Singh A, Kioka M. Comparing demographics, clinical characteristics, and hospital outcomes by vaccine uptake status: A single-institution cross-sectional study. Medicine (Baltimore) 2023; 102:e35421. [PMID: 37800810 PMCID: PMC10553062 DOI: 10.1097/md.0000000000035421] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Abstract
Vaccination against Coronavirus disease 2019 (COVID-19) has been the cornerstone of reducing morbidity and mortality of this disease, as it has been shown to decrease the risk of viral transmission, severity of disease, hospitalization, and intubation. However, true understanding of its impact is skewed by heterogeneous vaccine administration due to lack of equitable access, vaccine hesitancy, and varying social determinants of health. Therefore, this study aims to identify groups that are less likely to be vaccinated and understand whether the resultant differences in vaccination rates affect morbidity and mortality in socially marginalized COVID-19 patients. A retrospective cohort analysis was performed on a randomized and stratified population of 939 COVID-19 patients from January 2021 to December 2021. Bivariate analysis and logistic regression were used to assess demographic and clinical characteristic trends in unvaccinated, partially vaccinated, and fully vaccinated groups. No one age (P = .21), gender (P = .9), race (P = .12), ethnicity (P = .09), or health insurance status (P = .13) group was more vaccinated than the other. Similarly, no subgroup was at increased odds of intubation (P = .08) or death. However, patients with all categories of comorbidities including cardiopulmonary disease (P = <.001, effect size .17), renal disease (P = <.001, effect size 0.138), metabolic disease (P = .04), and immunocompromised (P = .01) states were found to have significantly higher vaccination rates. Our study also shows that full vaccination protects against mortality and decreases the odds of intubation by 55% (adjusted odds ratio = 0.453, P value = .015) compared to no vaccination or partial vaccination. Findings from this study show an encouraging trend that sicker patients had higher rates of vaccination against COVID-19. This trend highlights the need for further identification of motivators that may be applied to vaccine-hesitant populations, which can help guide population-level policy, increase vaccination campaign yield, and reach for health equity.
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Affiliation(s)
- Claire Xinning Chen
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
| | - Paul Cabugao
- Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
| | - Max Nguyen
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
| | - Daniel Villegas
- Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
| | - Kavita Batra
- Office of Research, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
- Department of Medical Education and Office of Academic Affairs, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
| | - Aditi Singh
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
| | - Mutsumi Kioka
- Department of Pulmonary and Critical Care Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA
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Ashfield S, Donelle L, Uppal G, Bauer MA, Kothari A. Community organization perspectives on COVID-19 vaccine hesitancy and how they increased COVID-19 vaccine confidence: a Canadian Immunization Research Network, social sciences and humanities network study. Front Public Health 2023; 11:1258742. [PMID: 37849717 PMCID: PMC10577219 DOI: 10.3389/fpubh.2023.1258742] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023] Open
Abstract
Background COVID-19 vaccines play a critical role in reducing the morbidity and mortality associated with SARS-CoV-2 infection and despite vaccine availability, disparities in COVID-19 vaccine uptake among Canadian subgroups exist. Community organizations are uniquely situated to relay important vaccine messaging around all vaccines, understand components of vaccine hesitancy, and facilitate vaccine uptake within the communities they serve. The objective of this research was to solicit community organizations perspectives specific to COVID-19 vaccines and explore strategies of increasing vaccine uptake within their communities. Methods A qualitative focus group study was held in the spring of 2021 with 40 community organizations from across the country. Discussions focused on COVID-19 vaccine communication and awareness within their communities, vaccine misinformation, and strategies to increase vaccine acceptance and access. Data were analyzed utilizing thematic and inductive techniques. Results Vaccine hesitancy was identified among staff and clients. Vaccine confidence, complacency, convenience, and mistrust in government and authorities were identified as contributors to vaccine hesitancy. Community organizations utilized innovative and novel methods to encourage vaccine uptake and increase vaccine confidence. Leveraging established trusting relationships was key to successful messaging within communities. Conclusion Community organizations used innovative methods, built on established trust, to increase vaccine confidence within their communities and among their staff. Community agencies played an important role in COVID-19 vaccine uptake within subgroups of the Canadian population. Community organizations are key public health partners and play a critical role in increasing COVID-19 vaccine confidence.
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Affiliation(s)
- Sarah Ashfield
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
- Emily Myrtle Smith Endowed Professor of Nursing, Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Gina Uppal
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - Michael A. Bauer
- Department of Computer Science, The University of Western Ontario, London, ON, Canada
| | - Anita Kothari
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
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23
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Bwanali AN, Lubanga AF, Mphepo M, Munthali L, Chumbi GD, Kangoma M. Vaccine hesitancy in Malawi: a threat to already-made health gains. Ann Med Surg (Lond) 2023; 85:5291-5293. [PMID: 37811119 PMCID: PMC10552950 DOI: 10.1097/ms9.0000000000001198] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/05/2023] [Indexed: 10/10/2023] Open
Abstract
Malawi faces a growing concern about vaccine hesitancy. This threatens to undermine significant strides in the fight against infectious diseases in the country. Vaccine hesitancy in Malawi is driven by multiple factors. This short communication discusses the extent of vaccine hesitancy in Malawi and its main drivers according to SAGE's (Strategic Advisory Group of Expert) 3Cs (confidence, complacency and convenience) model of vaccine hesitancy. As an escalating health concern, it is imperative to address it urgently. It is imperative to address it urgently through comprehensive and sustainable awareness campaigns that should aim to increase acceptance and demand for vaccines.
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Affiliation(s)
- Akim N. Bwanali
- Clinical Research Education and Management Services Limited (CREAMS)
- Kamuzu University of Health Sciences, Blantyre, Malawi
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
| | - Adriano F. Lubanga
- Clinical Research Education and Management Services Limited (CREAMS)
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
| | - Mzati Mphepo
- Clinical Research Education and Management Services Limited (CREAMS)
| | | | | | - Melina Kangoma
- Kamuzu Central Hospital, Ministry of Health (MoH), Lilongwe
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24
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Tan CM, Owuamalam C, Sarma VJ, Ng PK. Confidence in COVID-19 vaccines moderates the association between vaccination status and mental distress. Stress Health 2023; 39:744-752. [PMID: 36574671 PMCID: PMC9880626 DOI: 10.1002/smi.3216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
Previous research has demonstrated that becoming vaccinated with the Coronavirus vaccine may lower mental distress. However, it remains uncertain whether this relationship holds amid concerns of vaccine side effects and doubts of the vaccine's protective capabilities. We presented three studies that showed how vaccine confidence negatively influences the relationship between vaccine uptake and mental distress. Using two-way fixed effects regression models, Study 1 analyzes longitudinal survey of respondents from Los Angeles County in the US, while Study 2 uses the same analytical strategy but generalises findings by analysing longitudinal data of participants across all 50 US states. Main results of both studies show that (i) vaccination uptake is linked with reduced mental distress among individuals with high vaccine confidence (ii) vaccine uptake has no effect on mental distress among individuals with low vaccine confidence. Lastly, Study 3 applies multilevel analysis to a large-scale pseudo-panel study of 15 developed countries. Results for the third study corroborate finding (i) but not (ii) in that the multinational study finds that vaccine uptake is actually associated with higher mental distress among individuals with low vaccine confidence. In sum, our paper shows that the palliative effect of vaccination on mental health only exists when vaccine confidence is high. Results are mixed on whether vaccination affects mental distress when individual vaccine confidence is low.
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Affiliation(s)
- Chee Meng Tan
- Nottingham University Business SchoolUniversity of Nottingham MalaysiaSemenyihSelangorMalaysia
| | | | - Vengadeshvaran J. Sarma
- Nottingham University Business SchoolUniversity of Nottingham MalaysiaSemenyihSelangorMalaysia
| | - Pek Kim Ng
- Centre for English Language and Foundation EducationUniversity of Nottingham MalaysiaSemenyihSelangorMalaysia
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Nabirova D, Horth R, Kassabekova L, Henderson A, Yesmagambetova A, Alaverdyan S, Nuorti JP, Smagul M. Factors associated with COVID-19 vaccine confidence among primary care providers in Kazakhstan, March-April 2021. Front Public Health 2023; 11:1245750. [PMID: 37744481 PMCID: PMC10517263 DOI: 10.3389/fpubh.2023.1245750] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Vaccination is a critical public health intervention, and vaccine hesitancy is a major threat. Globally, confidence in COVID-19 vaccines has been low, and rates of routine immunizations decreased during the COVID-19 pandemic. Because healthcare providers are a trusted source of information on vaccination in Kazakhstan, it was vital to understand their knowledge, attitudes and practices (KAP) related to both routine and COVID-19 vaccines. Methods From March to April 2021, we conducted a cross-sectional study among the healthcare providers responsible for vaccination in 54 primary care facilities in three cities in Kazakhstan. All consenting providers anonymously completed structured online questionnaires at their place of work. A provider was classified as having COVID-19 vaccine confidence if they planned to get a COVID-19 vaccine, believed that COVID-19 vaccines are important to protect their community and either believed the vaccine was important to protect themselves or believed that getting a vaccine was safer than getting COVID-19. Statistical analysis included chi-square, Spearman's rank correlation coefficient, and Poisson regression. Results Of 1,461 providers, 30% had COVID-19 vaccine confidence, 40% did not, and 30% would refuse vaccination. Participants were mostly female (92%) and ≤ 35 years old (57%). Additionally, 65% were nurses, 25% were family physicians, and 10% were pediatricians. Adequate KAP for routine vaccines was low (22, 17, and 32%, respectively). Adequate knowledge was highest among pediatricians (42%) and family physicians (28%) and lowest among nurses (17%). Misconceptions about vaccines were high; 54% believed that influenza vaccines cause flu, and 57% believed that there is a scientifically proven association between vaccination and autism and multiple sclerosis. About half (45%) of the practitioners felt confident answering patient vaccine-related concerns. In adjusted models, COVID-19 vaccine confidence was positively associated with adequate knowledge of vaccines (prevalence ratio: 1.2, 95% confidence interval: 1.0-1.4) and adequate attitudes related to routine vaccines (3.1, 2.7-3.6). Conclusion Our study uncovers critical areas for interventions to improve KAP related to routine immunizations and COVID-19 vaccine confidence among providers in Kazakhstan. The complex relationship between KAP of routine vaccines and COVID-19 vaccine confidence underscores the importance of addressing vaccine hesitancy more broadly and not focusing solely on COVID-19.
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Affiliation(s)
- Dilyara Nabirova
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Roberta Horth
- Division of Global Health Protection in Central Asia, United States Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Lena Kassabekova
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center of Sanitary-Epidemiological Examination and Monitoring, Branch of the National Center for Public Health, Almaty, Kazakhstan
| | - Alden Henderson
- Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Sevak Alaverdyan
- Manoogian Simone College of Business and Economics, American University of Armenia, Yerevan, Armenia
| | - J. Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Infectious Diseases and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Manar Smagul
- Central Asia Field Epidemiology Training Program, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
- Scientific and Practical Center of Sanitary-Epidemiological Examination and Monitoring, Branch of the National Center for Public Health, Almaty, Kazakhstan
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Collini F, Bonaccorsi G, Del Riccio M, Bruschi M, Forni S, Galletti G, Gemmi F, Ierardi F, Lorini C. Does Vaccine Confidence Mediate the Relationship between Vaccine Literacy and Influenza Vaccination? Exploring Determinants of Vaccination among Staff Members of Nursing Homes in Tuscany, Italy, during the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:1375. [PMID: 37631943 PMCID: PMC10458978 DOI: 10.3390/vaccines11081375] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Low coverage of influenza vaccination in nursing home (NH) staff may be attributed to factors such as vaccine confidence (VC) and vaccine literacy (VL). Our study aimed to evaluate the role of VL and VC in predicting the intention to get the influenza vaccine in a sample of employees of NHs in Tuscany, Italy. METHODS Data from staff members in Tuscany were collected using an online questionnaire that examined influenza vaccination history, intentions, demographic information, health status, and VL. Statistical analyses explored the relationships between VC, VL, and vaccination intentions. RESULTS The study included 1794 respondents, (86.3%) and assistants/aides (58.1%), with a median age of 46 years. The intention to get vaccinated was significantly higher among those with health risk conditions, and there was a positive association between VC and VL, specifically its interactive/critical component. The mediation analysis showed that VC completely mediated the relationship between VL and the intention to get vaccinated, with significant effects observed in different subgroups. CONCLUSIONS VC is a key factor that mediates the effect of VL on vaccine intention. These results suggest that interventions aimed at improving VL alone may not be sufficient to increase vaccine uptake unless VC is also addressed.
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Affiliation(s)
- Francesca Collini
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | | | - Marco Del Riccio
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Mario Bruschi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Silvia Forni
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Giacomo Galletti
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Fabrizio Gemmi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Francesca Ierardi
- Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
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Hong C, Holloway IW, Bednarczyk R, Javanbakht M, Shoptaw S, Gorbach PM. High Vaccine Confidence Is Associated with COVID-19 Vaccine Uptake in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Substances. LGBT Health 2023; 10:480-485. [PMID: 36976808 PMCID: PMC10468549 DOI: 10.1089/lgbt.2022.0255] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Purpose: We examined associations between vaccine confidence and COVID-19 vaccine uptake among gay, bisexual, and other men who have sex with men (GBMSM). Methods: Computer-assisted self-interviews were conducted among 249 GBMSM participating in mSTUDY from May to October 2021-a cohort of GBMSM with a history of substance use in Los Angeles. Data were collected using a vaccine confidence index. The association between vaccine confidence and COVID-19 vaccine uptake was assessed using multivariable log-binomial regression. Results: Two-thirds (64.7%) of GBMSM reported receiving at least one dose of COVID-19 vaccine. Vaccine confidence was positively associated with COVID-19 vaccine uptake. Participants expressed neutral attitudes on government trust and vaccine safety. Perceived health benefit and vaccine effectiveness were statistically significantly associated with vaccine uptake (adjusted prevalence ratio [APR] = 1.59, 95% confidence interval [CI]: 1.20-2.16; APR = 1.51, 95% CI: 1.07-2.15). Conclusions: Public health programs should prioritize public benefit and vaccine effectiveness messaging to advance vaccination among GBMSM who use substances.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Ian W. Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Robert Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University, Atlanta, Georgia, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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Hopkins KL, Underwood T, Iddrisu I, Woldemeskel H, Bon HB, Brouwers S, De Almeida S, Fol N, Malhotra A, Prasad S, Bharadwaj S, Bhatnagar A, Knobler S, Lihemo G. Community-Based Approaches to Increase COVID-19 Vaccine Uptake and Demand: Lessons Learned from Four UNICEF-Supported Interventions. Vaccines (Basel) 2023; 11:1180. [PMID: 37514996 PMCID: PMC10384848 DOI: 10.3390/vaccines11071180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/28/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 07/30/2023] Open
Abstract
Vaccination is critical to minimize serious illness and death from COVID-19. Yet uptake of COVID-19 vaccines remains highly variable, particularly among marginalized communities. This article shares lessons learned from four UNICEF interventions that supported Governments to generate acceptance and demand for COVID-19 vaccines in Zambia, Iraq, Ghana, and India. In Zambia, community rapid assessment provided invaluable real-time insights around COVID-19 vaccination and allowed the identification of population segments that share beliefs and motivations regarding COVID-19 vaccination. Findings were subsequently used to develop recommendations tailored to the different personas. In Iraq, a new outreach approach (3iS: Intensification of Integrated Immunization) utilized direct community engagement to deliver health messages and encourage service uptake, resulting in over 4.4 million doses of COVID-19 and routine immunization vaccines delivered in just 8 months. In Ghana, a human-centered design initiative was applied to co-develop community-informed strategies to improve COVID-19 vaccination rates. In India, a risk communication and community engagement initiative reached half a million people over six months, translating into a 25% increase in vaccination rates. These shared approaches can be leveraged to improve COVID-19 vaccination coverage and close gaps in routine immunization across diverse and marginalized communities.
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Affiliation(s)
| | | | - Iddi Iddrisu
- UNICEF Ghana Country Office, Accra-North P.O. Box 5051, Ghana
| | | | - Helena Ballester Bon
- UNICEF Regional Office for East and Southern Africa, Nairobi P.O. Box 44145, Kenya
| | - Symen Brouwers
- UNICEF Regional Office for East and Southern Africa, Nairobi P.O. Box 44145, Kenya
| | - Sofia De Almeida
- UNICEF Regional Office for East and Southern Africa, Nairobi P.O. Box 44145, Kenya
| | - Natalie Fol
- UNICEF Regional Office for East and Southern Africa, Nairobi P.O. Box 44145, Kenya
| | - Alka Malhotra
- UNICEF India Country Office, New Delhi 110 003, India
| | | | - Sowmyaa Bharadwaj
- Praxis Institute for Participatory Practices, New Delhi 110 016, India
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Salazar-Fernández C, Baeza-Rivera MJ, Manríquez-Robles D, Salinas-Oñate N, Sallam M. From Conspiracy to Hesitancy: The Longitudinal Impact of COVID-19 Vaccine Conspiracy Theories on Perceived Vaccine Effectiveness. Vaccines (Basel) 2023; 11:1150. [PMID: 37514966 PMCID: PMC10386435 DOI: 10.3390/vaccines11071150] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
The embrace of coronavirus disease 2019 (COVID-19) vaccine conspiracies has been linked to vaccine hesitancy. This study aimed to investigate the relationship between COVID-19 vaccine conspiracy theories and perceived vaccine effectiveness. The study utilized a longitudinal follow-up study in which adults in Chile completed surveys in December 2020 (T1) and May 2021 (T2). The psychometric properties of the five-item instrument on conspiracy theories for the COVID-19 vaccine were evaluated using data from T1 (n = 578). A confirmatory one-factor structure with suitable indicators of reliability was found. The longitudinal analysis (n = 292) revealed that conspiracy theories about the COVID-19 vaccine in T1 were associated with lower beliefs in its effectiveness in T2. However, no significant association was found between beliefs in effectiveness in T1 and conspiracy theories in T2. The study suggests that beliefs in conspiracy theories may temporally precede beliefs in vaccine effectiveness for COVID-19. The results have implications for strategies to address vaccine conspiracy beliefs and their implementation at the public policy level.
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Affiliation(s)
| | - María José Baeza-Rivera
- Laboratorio de Interacciones, Cultura y Salud, Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4810101, Chile
| | - Diego Manríquez-Robles
- Laboratorio de Interacciones, Cultura y Salud, Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4810101, Chile
| | - Natalia Salinas-Oñate
- Department of Psychology, Faculty of Education, Social Sciences and Humanities, Universidad de La Frontera, Temuco 4811322, Chile
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
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30
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McGuinness SL, Eades O, Seale H, Cheng AC, Leder K. Pre-travel vaccine information needs, attitudes, drivers of uptake and the role for decision aids in travel medicine. J Travel Med 2023; 30:taad056. [PMID: 37074157 PMCID: PMC10289516 DOI: 10.1093/jtm/taad056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Many travellers do not receive vaccines pre-travel. Tools such as vaccine decision aids could support informed vaccine decision-making. We aimed to characterise Australians' pre-travel vaccine attitudes, behaviours and information needs and examine the role for decision aids in travel medicine. METHODS Online cross-sectional survey of Australian adults in December 2022. We included questions on demographics, pre-travel health-seeking behaviour, and information needs. We measured vaccine confidence (Vaccine Confidence Index Index) and used hypothetical disease scenarios to evaluate behavioural and social drivers of vaccination. We used multivariable logistic regression models to identify predictors of vaccine uptake and thematically analysed free-text responses. RESULTS We received complete survey responses from 1223/1326 Australians (92% response rate). Amongst those reporting previous overseas travel, 67% (778/1161) reported past pre-travel health encounter(s) and 64% (743/1161) reported past pre-travel vaccination. Half (50%) strongly agreed that vaccines were important for their health; fewer strongly agreed that vaccines were safe (37%) and effective (38%). In multivariable analyses, past pre-travel vaccine uptake was associated with increasing age (OR = 1.17 [95% CI 1.08-1.27] p < 0.001 per ten-year increase) and travel to higher-risk destinations (OR = 2.92 [2.17-3.93] p < 0.001); travellers visiting friends and relatives (VFRs) were less likely to have received pre-travel vaccines (OR = 0.74 [0.56-0.97] p = 0.028). Predictors for wanting vaccination against hypothetical diseases included past pre-travel vaccination (Disease X: OR 2.60 [1.91-3.56] p < 0.001) and confidence in vaccine safety (Disease X: OR 7.18 [5.07-10.18], p < 0.001); past VFR travel was predictive of not wanting vaccination (Disease X: OR 0.72 [0.52-1.00], p = 0.049). Most (63%) were interested in using a vaccine decision aid, generally together with a trusted health professional. CONCLUSIONS Health professionals play an important role in supporting pre-travel vaccine decision-making. However, our findings indicate that reliable, accurate and engaging digital resources, such as decision aids, could support travellers to make informed pre-travel vaccine decisions.
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Affiliation(s)
- Sarah L McGuinness
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne 3004, Australia
| | - Owen Eades
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne 3004, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia
| | - Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Monash Infectious Diseases Service, Monash Health and School of Clinical Sciences, Monash University, Melbourne 3168, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne 3000, Australia
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de Figueiredo A, Temfack E, Tajudeen R, Larson HJ. Declining trends in vaccine confidence across sub-Saharan Africa: A large-scale cross-sectional modeling study. Hum Vaccin Immunother 2023:2213117. [PMID: 37290478 DOI: 10.1080/21645515.2023.2213117] [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: 12/29/2022] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 06/10/2023] Open
Abstract
Current WHO/UNICEF estimates of routine childhood immunization coverage reveal the largest sustained decline in uptake in three decades with pronounced setbacks across Africa. Although the COVID-19 pandemic has induced significant supply and delivery disruptions, the impact of the pandemic on vaccine is less understood. We here examine trends in vaccine confidence across eight sub-Saharan countries between 2020 and 2022 via a total of 17,187 individual interviews, conducted via a multi-stage probability sampling approach and cross-sectional design and evaluated using Bayesian methods. Multilevel regression combined with poststratification weighting using local demographic information yields national and sub-national estimates of vaccine confidence in 2020 and 2022 as well as its socio-demographic associations. We identify declines in perceptions toward the importance of vaccines for children across all eight countries, with mixed trends in perceptions toward vaccine safety and effectiveness. We find that COVID-19 vaccines are perceived to be less important and safe in 2022 than in 2020 in six of the eight countries, with the only increases in COVID-19 vaccine confidence detected in Ivory Coast. There are substantial declines in vaccine confidence in the Democratic Republic of Congo and South Africa, notably in Eastern Cape, KwaZulu-Natal, Limpopo, and Northern Cape (South Africa) and Bandundu, Maniema, Kasaï-Oriental, Kongo-Central, and Sud-Kivu (DRC). While over 60-year-olds in 2022 have higher vaccine confidence in vaccines generally than younger age groups, we do not detect other individual-level socio-demographic associations with vaccine confidence at the sample sizes studied, including sex, age, education, employment status, and religious affiliation. Understanding the role of the COVID-19 pandemic and associated policies on wider vaccine confidence can inform post-COVID vaccination strategies and help rebuild immunization system resilience.
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Affiliation(s)
- A de Figueiredo
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - E Temfack
- Africa Centers for Disease Control and Prevention, African Union Commission, Addis Ababa, Ethiopia
| | - R Tajudeen
- Africa Centers for Disease Control and Prevention, African Union Commission, Addis Ababa, Ethiopia
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Health Metrics and Evaluation, University of Washington, Hans Rosling Center, Seattle, WA, USA
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Panameno M, Blanco LR, Hernandez AM, Escobar R, Zendejas B, Rafaela S, Castellon-Lopez YM. Using Digital Technology to Build COVID-19 Vaccine Confidence: A Qualitative Study among Latinx Parents of Children Aged 5-11 in Under-Resourced Communities across Los Angeles County. Vaccines (Basel) 2023; 11:1042. [PMID: 37376431 DOI: 10.3390/vaccines11061042] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Latinx school-aged children are more than twice as likely to be infected with and die from COVID-19 as non-Latinx White children in Los Angeles. Although COVID-19 vaccination has the potential to mitigate health disparities exacerbated by the pandemic, vaccination uptake among Latinx children remains limited. MiVacunaLA (MVLA) is a mobile-phone-delivered digital intervention that improved vaccination rates in 12- to 17-year-old Latinx children and parental intention to vaccinate 2- to 11-year-old children. Since piloting MVLA, the COVID-19 vaccine became available to children aged 5-11. We sought to understand parental experiences with the MVLA intervention and their attitudes and beliefs about vaccinating their young children to improve vaccination confidence in the Latinx community. Methods: We conducted six virtual focus groups with 47 parents/caregivers of children aged 5-11 who participated in the MVLA intervention. We used standard qualitative content analysis methods and rigid and accelerated data reduction to identify and analyze major themes discussed in the sessions. Results: Each salient theme from our focus groups was mapped to one of the 5Cs constructs. The themes included the parents' need for more contemplation about vaccinating their children than about vaccinating themselves; the parents' need for trusted sources of vaccine information; the parents' motivations to vaccinate their children against COVID-19; parental concern about short- and long-term effects of the vaccine in children; digital technology and videos as useful engagement tools; and age and health stratification as an approach to parental vaccination decision-making. Conclusions: The results of this study clarify the key factors that influence the decision of Latinx parents and caregivers to vaccinate their children against COVID-19. Our findings can inform efforts to increase COVID-19 vaccination rates among children in underserved Latinx communities, especially regarding the use of digital technologies for promoting vaccine confidence.
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Affiliation(s)
- Michael Panameno
- David Geffen School of Medicine, University of California, Los Angeles, CA 90069, USA
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90069, USA
| | - Luisa R Blanco
- Pepperdine School of Public Policy, Pepperdine University, Malibu, CA 90069, USA
| | - Ann Marie Hernandez
- David Geffen School of Medicine, University of California, Los Angeles, CA 90069, USA
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90069, USA
| | - Renato Escobar
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90069, USA
| | - Brittney Zendejas
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90069, USA
| | - Susana Rafaela
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90069, USA
| | - Yelba M Castellon-Lopez
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, PDC Green, G500, West Hollywood, CA 90069, USA
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Chaney SC, Mechael P. So Many Choices, How Do I Choose? Considerations for Selecting Digital Health Interventions to Support Immunization Confidence and Demand. J Med Internet Res 2023; 25:e47713. [PMID: 37223980 DOI: 10.2196/47713] [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: 03/30/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 05/25/2023] Open
Abstract
Childhood vaccines are a safe, effective, and essential component of any comprehensive public health system. Successful and complete child immunization requires sensitivity and responsiveness to community needs and concerns while reducing barriers to access and providing respectful quality services. Community demand for immunization is influenced by multiple complex factors, involving attitudes, trust, and the dynamic relationship between caregivers and health workers. Digital health interventions have the potential to help reduce barriers and enhance opportunities for immunization access, uptake, and demand in low- and middle-income countries. But with limited evidence and many interventions to choose from, how do decision makers identify promising and appropriate tools? Early evidence and experiences with digital health interventions for immunization demand are presented in this viewpoint to help stakeholders make decisions, guide investment, coordinate efforts, as well as design and implement digital health interventions to support vaccine confidence and demand.
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Pinkney JA, Bogart LM, Carroll KN, Bryan L, Witter G, Ashour D, Shebl FM, Hurtado RM, Goldfarb IT, Hyle EP, Psaros C, Ojikutu BO. Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica. Open Forum Infect Dis 2023; 10:ofad201. [PMID: 37234512 PMCID: PMC10208745 DOI: 10.1093/ofid/ofad201] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/10/2023] [Indexed: 05/28/2023] Open
Abstract
Background Despite high rates of coronavirus disease 2019 (COVID-19)-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women. Methods We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1 to 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy. Results Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio [aPR] = 0.68 [95% confidence interval {CI}, .49-.95], aPR = 0.61 [95% CI, .40-.95], and aPR = 0.68 [95% CI, .52-.89], respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model. Conclusions Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing "opt-out" vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.
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Affiliation(s)
- Jodian A Pinkney
- Correspondence: Jodian A. Pinkney, MD, Massachusetts General Hospital, 55 Fruit Street, Cox 5, Boston, MA 02114 (); Laura Bogart, PhD, RAND Corporation, 1776 Main Street, Santa Monica, CA ()
| | - Laura M Bogart
- Correspondence: Jodian A. Pinkney, MD, Massachusetts General Hospital, 55 Fruit Street, Cox 5, Boston, MA 02114 (); Laura Bogart, PhD, RAND Corporation, 1776 Main Street, Santa Monica, CA ()
| | | | - Lenroy Bryan
- University of the West Indies, Kingston, Jamaica
| | | | - Dina Ashour
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Fatma M Shebl
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Rocio M Hurtado
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Ilona T Goldfarb
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily P Hyle
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Christina Psaros
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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D'Souza-Vazirani D, Walsh C, Tanner AL, Clark E, Griffin AR, White S. Champions for School Health-An NASN Initiative to Increase Vaccine Confidence, Equity, and Uptake in COVID-19 and School-Required Vaccinations Part 1. NASN Sch Nurse 2023; 38:125-130. [PMID: 37042123 PMCID: PMC10119644 DOI: 10.1177/1942602x231165693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The National Association of School Nurses (NASN) received a U.S.$2 million grant from Kaiser Permanente in January 2022 to increase confidence, equity, and uptake in the COVID-19 vaccine and other school required vaccinations in children ages 5 to 11 in Kaiser's nine markets (eight states and the District of Columbia). NASN was partnered with the Institute of Educational Leadership (IEL) in this initiative to examine ways both organizations could learn how school nurses (SNs) and community schools (CSs) could collaborate to address the goals of this project. NASN gave 54 Implementation Grants in two funding cycles in 2022 and is co-funding two SN-CS collaboration projects with IEL. The Part 1 article provides an overview of the project's goals, grant strategy and processes, grantee information, NASN created tools that resulted from this funding, and successful implementation of the project, which demonstrates NASN's capacity for future similar projects.
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Mtei M, Mboya IB, Mgongo M, Manongi R, Amour C, Bilakwate JS, Nyaki AY, Ngocho J, Jonas N, Farah A, Amour M, Kalolo A, Kengia JT, Tinuga F, Ngalesoni F, Bakari AH, Kirakoya FB, Araya A, Kapologwe NA, Msuya SE. Confidence in COVID-19 vaccine effectiveness and safety and its effect on vaccine uptake in Tanzania: A community-based cross-sectional study. Hum Vaccin Immunother 2023; 19:2191576. [PMID: 37017234 PMCID: PMC10088920 DOI: 10.1080/21645515.2023.2191576] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
COVID-19 is a major public health threat associated with increased disease burden, mortality, and economic loss to countries and communities. Safe and efficacious COVID-19 vaccines are key in halting and reversing the pandemic. Low confidence in vaccines has been one of the factors leading to hesitancy. We aimed to assess the COVID-19 vaccine confidence (safety and effectiveness), associated factors, and its effects on vaccine uptake among general community members in Tanzania. This was a community-based cross-sectional survey conducted from December 2021 to April 2022 in six regions of Tanzania mainland and two regions in Zanzibar. Participants were interviewed using an electronic questionnaire. Multiple logistic regression models estimated odds ratios (ORs) and 95% confidence interval (CI) for factors associated with vaccine confidence. All analyses were performed using SPSS version 25.0. The study enrolled 3470 general Tanzanian community members; their mean age was 40.3 (standard deviation ±14.9) years, and 34% were males. The proportion of COVID-19 vaccine confidence was 54.6%. Geographical region, residence area, COVID-19 disease risk perception, and good knowledge of COVID-19 vaccines were significantly associated with COVID-19 vaccine confidence. Confidence in COVID-19 vaccines was associated with over three times higher odds of vaccine uptake. Confidence in COVID-19 vaccines was low in Tanzania. Innovative community engagement strategies and region-specific interventions are needed to improve comprehensive knowledge and address community perceptions and attitudes toward COVID-19 vaccines.
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Affiliation(s)
- Monica Mtei
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Faculty of epidemiology and population health, London School of Hygiene and Tropical Medicine, London, UK
| | - Innocent B Mboya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Translational Medicine, Lund University, Malmo, Sweden
| | - Melina Mgongo
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Caroline Amour
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Julieth S Bilakwate
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Ahmed Y Nyaki
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - James Ngocho
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Norman Jonas
- Internal Medicine Department, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Amina Farah
- Joint Malaria Program, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Maryam Amour
- Department of community health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania
| | - James T Kengia
- Department of health, President's Office - Regional Administration and Local Government, Dodoma, Tanzania
| | - Florian Tinuga
- Ministry of Health, Immunization and Vaccine Development Department, Dodoma, Tanzania
| | - Frida Ngalesoni
- Department of Health, African Medical and Research Foundation, Dar-es-salaam, Tanzania
| | - Abdalla H Bakari
- School of Natural Science, The State University of Zanzibar, Zanzibar, Tanzania
| | | | - Awet Araya
- Department of Health, UNICEF, Tanzania Office, Dar-es-salaam, Tanzania
| | - Ntuli A Kapologwe
- Department of health, President's Office - Regional Administration and Local Government, Dodoma, Tanzania
| | - Sia E Msuya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Community Health Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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Hamed Hammoud, Soha S. Albayat, Jesha Mundodan, Saif Alateeg, Nada Adli, Doaa Sabir, Tasneem Bendari, Hamad E. Al-Romaihi, Iheb Bougmiza. Development and validation of a multi-dimensional COVID-19 vaccine hesitancy questionnaire. Vaccine X 2023:100286. [PMID: 36994092 PMCID: PMC10033149 DOI: 10.1016/j.jvacx.2023.100286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/24/2023] Open
Abstract
Background Since the emergence of the COVID-19 pandemic, vaccines have been developed to tackle the disease. However, many people worldwide were not confident enough to take the vaccines. Developing a questionnaire to measure COVID-19 vaccine hesitancy will give the health authorities and policymakers a clear picture to establish appropriate interventions addressing vaccine hesitancy among the community. Methods In this study, we used a mixed-method design over two phases. Phase 1 entailed a qualitative approach to developing the questionnaire, including a literature search, expert panel review, and focus group discussion. Phase 2 used a quantitative method for establishing the content and construct validity of the questionnaire via exploratory and confirmatory factor analysis (EFA & CFA). Internal consistency was checked using Cronbach's Alpha and intraclass correlation coefficient. Results We developed a 50-item instrument designed to measure COVID-19 vaccine hesitancy among adults in the state of Qatar. The study involved 545 adult participants. In terms of content validity, our study showed a value of 0.92 for the scale-level content validity index based on the average and a value of 0.76 for the scale-level content validity index - universal agreement. In the EFA, the Kaiser-Meyer-Olkin measure of sampling adequacy was calculated at 0.78, with statistical significance (P = 0.001). Regarding model fit indices of the seven-factor model, our findings showed an acceptable model-data-fit, with a relative chi-square: 1.7 (<3), Root mean square error of approximation: 0.05 (<0.08), PCLOSE = 0.41, Comparative fit index: 0.909, Tucker-Lewis index: 0.902, Incremental Fit Index: 0.910 and, Standardized Root mean square residual: 0.067 (<0.08). The seven-factor model of the questionnaire met the criterion of good internal consistency (Cronbach's alpha =0.73). Conclusion This tool is deemed of methodological merits in terms of validity, reliability, and determining the underlying conceptual structure of COVID-19 vaccine hesitancy and its associating factors.
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Aqel O, Alqadheeb B, Felix M, Amundson C, Bingham JM, Meyer K, Warholak T, Axon DR. Cultivating COVID-19 Vaccine Confidence in Pharmacy Professionals. Pharmacy (Basel) 2023; 11:pharmacy11020050. [PMID: 36961028 PMCID: PMC10037576 DOI: 10.3390/pharmacy11020050] [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: 02/04/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
Pharmacists promote vaccinations and challenge misconceptions about vaccine hesitancy, yet pharmacists' knowledge of vaccine confidence has not been assessed. The objective of this study was to compare pharmacists' knowledge of coronavirus disease 2019 (COVID-19) vaccine confidence before and after a live continuing education (CE) session. This pretest-posttest study evaluated the differences before and after a live CE session on COVID-19 vaccine confidence provided to pharmacists at a nationwide health technology company. Participants' total pretest and posttest scores were compared using paired t-tests, while pretest and posttest scores for each item were compared using chi-squared tests. A Bonferroni correction was applied, resulting in an alpha level of 0.005. A total of 279 pharmacists participated in this study. After the CE session, mean knowledge scores increased (5.2 ± 1.5 to 7.4 ± 1.35, p < 0.0001). After the CE session, there was no significant increase in pharmacists' knowledge about the approach that is not recommended when discussing vaccination beliefs with a patient (71.3% to 77.4%, p = 0.099), determinants of vaccine uptake (83.9% to 87.8%, p = 0.182), and social determinants of health that can influence vaccination rates (93.6% to 96.4%, p = 0.121). There was a significant change in pre- and posttest knowledge for the remaining seven items.
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Affiliation(s)
- Osama Aqel
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ 85721, USA
| | - Banin Alqadheeb
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ 85721, USA
| | - Mariana Felix
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ 85721, USA
| | - Collin Amundson
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ 85721, USA
| | - Jennifer M Bingham
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ 85721, USA
| | - Katie Meyer
- American Pharmacist's Association, 2215 Constitution Avenue NW, Washington, DC 20037, USA
| | - Terri Warholak
- St. Louis College of Pharmacy, University of Health Sciences & Pharmacy in St. Louis, 1 Pharmacy Place, St. Louis, MO 63110, USA
| | - David R Axon
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ 85721, USA
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Allen JD, Matsunaga M, Lim E, Zimet GD, Nguyen KH, Fontenot HB. Parental Decision Making Regarding COVID-19 Vaccines for Children under Age 5: Does Decision Self-Efficacy Play a Role? Vaccines (Basel) 2023; 11:478. [PMID: 36851355 PMCID: PMC9959902 DOI: 10.3390/vaccines11020478] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND COVID-19 vaccines are now available under Emergency Use Authorization for children ages 6 months to 5 years. We examined parents' intentions to vaccinate their children under the age of 5 years and assessed whether their confidence in making an informed decision about vaccination (decision self-efficacy) was associated with these intentions. METHOD We conducted a cross-sectional online survey of U.S. parents between 23 March and 5 April 2022. We examined associations between parental intention to vaccinate their young children ( RESULTS Of the 591 parents in this sample, 49% indicated that they intended to vaccinate their child(ren), 29% reported that they would not, and 21% were undecided. In bivariate analyses, race/ethnicity, health insurance, flu vaccination in the past 12 months, and parental COVID-19 vaccination status were significantly related to parental intention to vaccinate their child(ren). In the multivariable analyses, which controlled for these factors, parents who intended to vaccinate their child(ren) had greater confidence in their ability to make informed decisions about COVID-19 vaccinations compared to those who were unsure about vaccination. Each one standard deviation in the Decision Self-Efficacy score was associated with a 39% increase in intention to vaccinate one's child versus being unsure about vaccination (AOR 1.39, 95% CI 1.09, 1.77). CONCLUSIONS Parents who are unsure about vaccinating their children against COVID-19 may benefit from interventions designed to increase their ability to obtain, understand, and utilize information to make informed decisions.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Ave, Medford, MA 02155, USA
| | - Masako Matsunaga
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, Suite 1001, Indianapolis, IN 46202, USA
| | - Kimberly H. Nguyen
- Department of Public Health and Community Medicine, Tufts University Medical School, 136 Harrison Ave, Boston, MA 02111, USA
| | - Holly B. Fontenot
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA
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Reichelt M, Cullen JP, Mayer-Fried S, Russell HA, Bennett NM, Yousefi-Nooraie R. Addressing COVID-19 vaccine hesitancy in rural communities: A case study in engaging trusted messengers to pivot and plan. Front Public Health 2023; 11:1059067. [PMID: 36844863 PMCID: PMC9947642 DOI: 10.3389/fpubh.2023.1059067] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/19/2023] [Indexed: 02/11/2023] Open
Abstract
The pandemic declaration of COVID-19 in 2020 presented unique challenges, lessons, and opportunities for public health practice in the United States. Despite clear evidence of COVID-19 vaccine effectiveness, vaccine uptake and vaccine confidence remained low in many regions. Vaccine holdouts, or those who are vaccine hesitant, have been an increasingly difficult population to reach. Several factors influence vaccine hesitancy and behavior in rural areas, including health care access challenges, misinformation, political loyalties, and concerns regarding the perceived lack of trustworthy evidence and knowledge of long-term effects. In March 2021, the Finger Lakes Rural Immunization Initiative (FLRII) engaged stakeholders to address vaccine hesitancy in a nine-county region of rural New York known as the Finger Lakes. Driven by data collected from community partners, physicians, and local health departments regarding their biggest barriers and greatest needs, the FLRII team created an interactive program for trusted messengers (TMs) including a stakeholder panel, called the Trusted Messenger Forum (TMF). The TMF met every 2 weeks from August 2021- August 2022 to engage local TMs and disseminate up-to-date knowledge in real time. During forum sessions, TMs shared detailed accounts of their experiences combating vaccine hesitancy in their communities and supported one another in their efforts through positive interaction and reaffirming conversations. Collaborations between community stakeholders can form a scaffolding to support a rapid response to a variety of public health problems and result in impactful change. For researchers implementing community-based research projects, modeling stakeholder panels after trusted messenger forums can be effective for diversifying the scope of the project and reacting to emergent problems in real-time.
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Affiliation(s)
- Melhaney Reichelt
- Department of Public Health Sciences, University of Rochester, Rochester, NY, United States
| | - John Patrick Cullen
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States,Susan B. Anthony Center, University of Rochester, Rochester, NY, United States
| | - Sara Mayer-Fried
- Center for Community Health and Prevention, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States,Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Holly Ann Russell
- Center for Community Health and Prevention, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States,Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Nancy M. Bennett
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States,Center for Community Health and Prevention, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States,Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Reza Yousefi-Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, NY, United States,Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY, United States,*Correspondence: Reza Yousefi-Nooraie ✉
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Costiniuk CT, Singer J, Needham J, Yang Y, Qian H, Chambers C, Burchell AN, Samji H, Colmegna I, Del Canto S, Godin GH, Habanyama M, Hui C, Kroch A, Mandarino E, Margolese S, Martin C, Owino M, Mohammadi T, Zhang W, Pelaez S, Kovacs C, Benko E, Vulesevic B, Cooper CL, Anis AH. Understanding COVID-19 Vaccine Confidence in People Living with HIV: A pan-Canadian Survey. AIDS Behav 2023. [PMID: 36738344 DOI: 10.1007/s10461-023-03991-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/05/2023]
Abstract
Understanding the roots of Covid-19 vaccine hesitancy in at-risk groups, such as persons living with HIV (PLWH), is of utmost importance. We developed a modified Vaccine Hesitancy Scale (VHS) questionnaire using items from the National Advisory Committee on Immunization Acceptability Matrix. To examine factors associated with receiving COVID-19 vaccine and the link between vaccine attitudes and beliefs with vaccine behavior, PLWH were recruited via social media and community-based organizations (February-May 2022). Descriptive statistics were used to summarize results. Total VHS score was generated by adding Likert scale scores and linear regression models used to compare results between participants who received or did not receive COVID-19 vaccines. Logistic regression models were used to identify factors associated with vaccine uptake. A total of 246 PLWH indicated whether they received a COVID-19 vaccine. 89% received ≥ 1 dose. Mean total VHS(SD) for persons having received ≥ 1 COVID-19 vaccine was 17.8(6.2) vs. 35.4(9.4) for participants not having received any COVID-19 vaccine. Persons who received ≥ 1 dose were significantly older than those who had not received any (48.4 ± 13.8 vs. 34.0 ± 7.7 years, p < 0.0001). The majority of participants considered COVID-19 vaccination important for their health(81.3%) and the health of others(84.4%). Multivariate logistic regression revealed the odds of taking ≥ 1dose were increased 2.4-fold [95% CI 1.6, 3.5] with each increase in age of 10 years (p < 0.0001). Sex and ethnicity were not different between groups. In conclusion, PLWH accept COVID-19 vaccines for both altruistic and individual reasons. With evolving recommendations and increasing numbers of booster vaccines, we must re-examine the needs of PLWH regularly.
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Ghazy RM, Yazbek S, Gebreal A, Hussein M, Addai SA, Mensah E, Sarfo M, Kofi A, AL-Ahdal T, Eshun G. Monkeypox Vaccine Acceptance among Ghanaians: A Call for Action. Vaccines (Basel) 2023; 11:vaccines11020240. [PMID: 36851118 PMCID: PMC9959510 DOI: 10.3390/vaccines11020240] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Ghana ranked 31st worldwide and 3rd in Africa in the number of confirmed cases worldwide. We aimed to assess the intention to receive the monkeypox (MPOX) vaccine and its associated psychological antecedents among the Ghanaian population. Methods: A cross-sectional online survey was conducted in Ghana from November to December 2022. Snowball sampling was used to recruit participants via social media platforms, such as WhatsApp, LinkedIn, Telegram, and Facebook. The validated 5C scale was used to assess five psychological factors that influence vaccination behavior and intent: confidence, complacency, constraints, calculation, and collective responsibility. Results: The study drew 605 participants; their mean age was 30.0 ± 6.8; 68.1% were single; 60.8 % were males, and 51.9% were living in Greater Accra (The capital and largest city of Ghana). About 53.9% of the studied Ghanaian population did not intend to receive the MPOX vaccination. Vaccine acceptance among non-healthcare workers (non-HCWs) was significantly lower than among HCWs (41.7 vs. 55.3, p < 0.001). The determinants of vaccine acceptance were male gender (AOR = 1.48, 95% CI, 1.00-2.18, p = 0.049), urban residence (AOR = 0.63, 95% CI, 0.41-0.96, p = 0.033), refusal of coronavirus 2019 vaccine (AOR = 0.29, 95% CI, 0.16-0.52, p < 0.001), confidence in vaccination ((AOR = 2.45, 95% CI, 1.93-3.15, and p < 0.001), and collective responsibility (AOR = 1.34, 95% CI, 1.02-1.75, p = 0.034)). Conclusions: The participants in this study did not show high levels of intention to accept the MPOX vaccination. Consequently, tailoring the efforts aiming to promote MPOX vaccination is needed especially among non-HCWs through increasing their confidence in vaccine effectiveness and safety and promoting the importance of self-vaccination to protect others.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
- Correspondence: (R.M.G.); (T.A.-A.)
| | - Saja Yazbek
- Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21568, Egypt
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria 21554, Egypt
- Ministry of Health and Population, Cairo 71529, Egypt
| | - Sylvia Agyeman Addai
- Department of Science & Department of Educational Administration and Management, University of Education, Winneba CE-119-9961, Ghana
- Business School, Datalink University, Tema GN-03-266605, Ghana
- Human Resource & Marketing Department, Central University, Miotso-Prampram GT-001-5571, Ghana
| | - Ernestina Mensah
- Department of Midwifery, Seventh Day Adventist Nursing and Midwifery Training College, Agona-Asamang P.O. Box GN 37, Ghana
| | - Michael Sarfo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Agyapong Kofi
- Manhyia Government Hospital, Kumasi AK-039-5028, Ghana
| | - Tareq AL-Ahdal
- Institute of Global Health (HIGH), Heidelberg University, Neuenheimer Feld 130/3, 69120 Heidelberg, Germany
- Correspondence: (R.M.G.); (T.A.-A.)
| | - Gilbert Eshun
- Seventh Day Adventist Hospital, Agona-Asamang AZ-0581-8540, Ghana
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Alderotti G, Corvo MF, Buscemi P, Stacchini L, Giorgetti D, Lorini C, Bonaccorsi G, Pinilla MJC, Lastrucci V. Communicating with Patients about COVID-19 Vaccination: A Qualitative Study on Vaccinators in Tuscany Region, Italy. Vaccines (Basel) 2023; 11:vaccines11020223. [PMID: 36851101 PMCID: PMC9968224 DOI: 10.3390/vaccines11020223] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The rapid development of the vaccine and the infodemia have challenged communication about COVID-19 vaccines. This study aims to characterize-through the experience of vaccinators-the challenges faced during COVID-19 vaccination consultations and the communication strategies adopted. A qualitative study was conducted on COVID-19 vaccinators in Tuscany, Italy. Face-to-face interviews were conducted and examined by thematic analysis. In total, 30 vaccinators were interviewed. Four main themes emerged. The first highlighted distinct profiles of users' attitudes toward COVID-19 vaccination. Barriers and promoters of vaccine uptake emerged in the second theme: concerns over the vaccine, excessive exposure to information, and a lack of clear guidance from institutions were the main factors behind hesitancy. The third theme highlighted users' information-seeking behaviors; vaccinators observed that users ideologically opposed to the vaccine (IOV) unconsciously seek information that confirms their theories. The last theme comprised communication strategies for dealing with hesitancy. Empathy, first-hand examples, transparency, and tailored communication style appear to be effective in building vaccine trust. Lastly, the impossibility of developing a decision-making partnership with IOVs was noticed. These findings may help to better characterize public attitudes toward COVID-19 vaccination and highlight key communication principles and strategies to foster vaccine confidence.
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Affiliation(s)
- Giorgia Alderotti
- Epidemiology Unit, Meyer Children’s Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy
| | - Martina Felicia Corvo
- Global Health Center, Meyer Children’s University Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy
| | - Primo Buscemi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | - Lorenzo Stacchini
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | - Duccio Giorgetti
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | | | - Maria José Caldés Pinilla
- Global Health Center, Meyer Children’s University Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy
| | - Vieri Lastrucci
- Epidemiology Unit, Meyer Children’s Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
- Correspondence:
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Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
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Hsu C, Evers S, Ibrahim A, Patricia M, Throne P, Melton M, Marcuse EK, Ali A, Dunn J, Hofstetter AM. Sometimes Your Heart Says 'I Don't Know': Insights From Parents of Undervaccinated Children. Acad Pediatr 2023; 23:57-67. [PMID: 36228981 DOI: 10.1016/j.acap.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 01/19/2023]
Abstract
STUDY OBJECTIVE To explore drivers of suboptimal vaccination rates by understanding why parents without strong antivaccine beliefs do not fully vaccinate their children. METHODS Four focus groups were conducted in Washington state with 41 parents of children aged 24 to 48 months who delayed, declined, or missed some but not all vaccines. During the focus groups, parents were asked about reasons their child was undervaccinated, information that might address their concerns, and additional support they needed. Transcripts were analyzed using template analysis with deductive and inductive codes. RESULTS Focus groups identified multiple reasons for parents deciding to delay or decline vaccines for their children, including issues of individualism and control. The groups emphasized the impact of personal circumstances, such as changes in insurance, on whether children were vaccinated. Our data also shed light on the reasons that parents do vaccinate their children, including school vaccination requirements, negative experiences with vaccine-preventable diseases, and a family tradition of vaccinating. Focus group participants offered suggestions for improving vaccine communication with parents such as having more parent/patient-friendly vaccine information, providing forums to discuss their concerns, and offering vaccination information in advance of well-child appointments. CONCLUSIONS To achieve the full benefit of vaccines on individual and community health, we need better ways to address vaccine hesitancy and decrease barriers. We suggest that many hesitant parents would benefit from more dialog with health care providers about vaccines, more approachable educational materials, and enforcement of existing policies requiring vaccines in schools and childcare facilities.
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Affiliation(s)
- Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute (C Hsu, S Evers, and J Dunn), Seattle, Wash.
| | - Sarah Evers
- Kaiser Permanente Washington Health Research Institute (C Hsu, S Evers, and J Dunn), Seattle, Wash
| | - Anisa Ibrahim
- Department of Pediatrics, University of Washington School of Medicine (A Ibrahim, EK Marcuse, and AM Hofstetter), Seattle, Wash; Somali Health Board (A Ibrahim and A Ali), Tukwila, Wash
| | - M Patricia
- Washington State Department of Health (M Patricia deHart, P Throne, and AM Hofstetter), Tumwater, Wash
| | - Paul Throne
- Washington State Department of Health (M Patricia deHart, P Throne, and AM Hofstetter), Tumwater, Wash
| | | | - Edgar K Marcuse
- Department of Pediatrics, University of Washington School of Medicine (A Ibrahim, EK Marcuse, and AM Hofstetter), Seattle, Wash; Seattle Children's Research Institute (EK Marcuse), Seattle, Wash
| | - Ahmed Ali
- Somali Health Board (A Ibrahim and A Ali), Tukwila, Wash
| | - John Dunn
- Kaiser Permanente Washington Health Research Institute (C Hsu, S Evers, and J Dunn), Seattle, Wash
| | - Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine (A Ibrahim, EK Marcuse, and AM Hofstetter), Seattle, Wash; Washington State Department of Health (M Patricia deHart, P Throne, and AM Hofstetter), Tumwater, Wash
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Abstract
As the novel coronavirus (COVID-19) continues to spread, vaccine hesitancy increasingly threats public health worldwide. Health information from traditional, online and social media may influence vaccine hesitancy. The purpose of this study was to explore the influence of exposure to COVID-19 information from various media on vaccine hesitancy, as well as the mediating roles of public trust in government and vaccine confidence. With a sample of 438 online participants (mean age = 30.69 years) responding to an anonymous questionnaire, the study tested a mediation model using bias-corrected bootstrap. The results indicated that exposure to COVID-19 information from online news media and traditional media can reduce vaccine hesitancy indirectly. Whereas a positive and indirect relationship between COVID-19 information exposure on social media and vaccine hesitancy was revealed. Trust in government and vaccine confidence were found to be salient mediators between exposure to COVID-19 information from various media and vaccine hesitancy. Findings from this study offer implications for strategies to address vaccine hesitancy.
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Affiliation(s)
| | - Xinshu Zhao
- Department of Communication, University of Macau, Macao, Macao
| | - Bo Wan
- Institute of Neurology, University College London, London
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Trabucco Aurilio M, Mennini FS, Ferrari C, Somma G, Di Giampaolo L, Bolcato M, De-Giorgio F, Muscatello R, Magrini A, Coppeta L. Main Predictors of COVID-19 Vaccination Uptake among Italian Healthcare Workers in Relation to Variable Degrees of Hesitancy: Result from a Cross-Sectional Online Survey. Trop Med Infect Dis 2022; 7:419. [PMID: 36548674 PMCID: PMC9780995 DOI: 10.3390/tropicalmed7120419] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/26/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Hesitancy remains one of the major hurdles to vaccination, regardless of the fact that vaccines are indisputable preventive measures against many infectious diseases. Nevertheless, vaccine hesitancy or refusal is a growing phenomenon in the general population as well as among healthcare workers (HCWs). Many different factors can contribute to hesitancy to COVID-19 vaccination in the HCWs population, including socio-demographic characteristics (female gender, low socio-economical status, lower age), individual beliefs regarding vaccine efficacy and safety, as well as other factors (occupation, knowledge about COVID-19, etc.). Understanding the determinants of accepting or refusing the COVID-19 vaccination is crucial to plan specific interventions in order to increase the rate of vaccine coverage among health care workers. Methods: We conducted a cross-sectional online survey on HCWs in seventeen Italian regions, between 30 June and 4 July 2021, in order to collect information about potential factors related to vaccine acceptance and hesitancy. Results: We found an overall vaccine uptake rate of 96.4% in our sample. Acceptance was significantly related to job task, with physicians showing the highest rate of uptake compared to other occupations. At univariate analysis, the HCWs population’s vaccine hesitancy was significantly positively associated with fear of vaccination side effects (p < 0.01), and negatively related to confidence in the safety and efficacy of the vaccine (p < 0.01). Through multivariate analysis, we found that only the fear of possible vaccination side effects (OR: 4.631, p < 0.01) and the confidence in vaccine safety and effectiveness (OR: 0.35 p < 0.05) remained significantly associated with hesitancy. Conclusion: Action to improve operator confidence in the efficacy and safety of the vaccine should improve the acceptance rate among operators.
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Affiliation(s)
- Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V.Tiberio”, University of Molise, 86100 Campobasso, Italy
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), 00144 Rome, Italy
| | - Francesco Saverio Mennini
- Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, University of Rome “Tor Vergata”, Via Columbia 2, 00133 Rome, Italy
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Luca Di Giampaolo
- Department of Medicine and Science of Ageing, Specialization School of Allergy and Clinical Immunology, G. D’Annunzio University Chieti-Pescara, 66100 Chieti, Italy
| | - Matteo Bolcato
- Department of Neuroscience, University of Padua, 35121 Padua, Italy
| | - Fabio De-Giorgio
- Department of Healthcare Surveillance and Bioethics, Section of Legal Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario IRCCS A. Gemelli, 00168 Rome, Italy
| | - Roberto Muscatello
- Office of Medical Forensic Coordination, Italian National Social Security Institute (INPS), 00144 Rome, Italy
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Luca Coppeta
- Department of Occupational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
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Nguyen KH, Nguyen K, Geddes M, Allen JD, Corlin L. Trends in adolescent COVID-19 vaccination receipt and parental intent to vaccinate their adolescent children, United States, July to October, 2021. Ann Med 2022; 54:733-742. [PMID: 35238263 PMCID: PMC8903754 DOI: 10.1080/07853890.2022.2045034] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There was a five-fold increase in COVID-19 hospitalization case counts among children and adolescents between June and October 2021. However, polls suggest that adolescent COVID-19 vaccination coverage has plateaued in the United States. METHODS Using the Census Bureau's Household Pulse Survey, we assessed trends in COVID-19 vaccination among adolescents ages 12-17 years, parents' intention to vaccinate their adolescent children, and their reasons for not intending to vaccinate their children from July to October 2021 using a large, nationally representative survey of U.S. households (n = 59,424). Trends in COVID-19 adolescent vaccination coverage, nationally and by sociodemographic characteristics, factors associated with adolescent vaccination status and parental intent to vaccinate their adolescent children, as well as changes in reasons for non-vaccination were examined using regression models. RESULTS Receipt of ≥1 dose of a COVID-19 vaccine among adolescents ages 12-17 years increased five percentage points, from 56% (July) to 61% (October), with significant increases across most sociodemographic variables. However, there were no significant changes in parental intention to vaccinate their adolescent children during the same time period. Approximately one-quarter of parents were unsure about or reluctant to vaccinate their children, which remained consistent from July to October. Among those who had not vaccinated their children, lack of trust in the government and vaccines, and the belief that the COVID-19 vaccine is not needed or effective, was higher in October compared to July. CONCLUSIONS Parental intention to vaccinate their children has remained relatively stable throughout the late summer and early fall of 2021. Encouraging paediatricians to discuss the importance and safety of COVID-19 vaccines, addressing concerns and misinformation, as well as recommending and offering vaccines are important for increasing parental confidence in vaccines as well as vaccination uptake among adolescents.KEY MESSAGEReceipt of ≥1 dose of a COVID-19 vaccine among adolescents ages 12-17 years increased five percentage points, from 56% (July) to 61% (October), with significant increases across most sociodemographic variables.Approximately one quarter of parents were unsure about or reluctant to vaccinate their children, which remained consistent from July to October.Encouraging paediatricians to discuss the importance and safety of COVID-19 vaccines, addressing concerns and misinformation, as well as recommending and offering vaccines is important for increasing parental confidence in vaccines as well as vaccination uptake among adolescents.
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Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Kimchi Nguyen
- Department of Medicine, Children's Hospital, Boston, MA, USA
| | - Megan Geddes
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Jennifer D Allen
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Laura Corlin
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.,Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
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49
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Huang N, Wang C, Han B, Zhao T, Liu B, Chen L, Xie M, Zheng H, Zhang S, Wang Y, Juan D, Liu Y, Lu Q, Cui F. Change in willingness to COVID-19 vaccination in China: Two online surveys during the pandemic. J Med Virol 2022; 94:5271-5278. [PMID: 35848516 PMCID: PMC9349959 DOI: 10.1002/jmv.28004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/02/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE As the variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge, periodic vaccine booster immunization may become a normal policy. This study investigated the changes and factors associated with vaccination intentions in various epidemic situations, which can provide suggestions for the construction and modification of routine vaccination program strategies. METHODS Two cross-sectional online surveys were conducted in January and June of 2021. The willingness and confidence of the coronavirus disease 2019 (COVID-19) vaccination were measured following propensity score matching (PSM) treatment. The difference in the willingness for COVID-19 Vaccination in the two surveys was analyzed by single or multi-factor analyses. RESULTS The willingness to accept the SARS-CoV-2 vaccine was higher in the second survey than that in the first survey (90.5% vs. 66.6%, p < 0.001). Concerns about the vaccine's safety declined (71.0% vs. 47.6%, p < 0.001), but concerns about the efficacy increased (22.4% vs. 30.9%, p < 0.001). Confidence in the SARS-CoV-2 vaccine had an important impact on the increased uptake willingness (odds ratio = 3.19, 95% confidence interval: 2.23-4.58, p < 0.001). CONCLUSIONS There has been a significant increase in attitudes towards the SARS-CoV-2 vaccine which was associated with higher vaccine confidence. Vaccine effectiveness received more concerns from respondents rather than safety after nearly 6 months' utilization of the SARS-CoV-2 vaccine. It indicates that aggressive communication and timely disclosure of vaccine data can build vaccine confidence.
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Affiliation(s)
- Ninghua Huang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina,Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Chao Wang
- Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
| | - Bingfeng Han
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Tianshuo Zhao
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Bei Liu
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
| | - Linyi Chen
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Mingzhu Xie
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
| | - Hui Zheng
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Sihui Zhang
- Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Yu Wang
- Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - Du Juan
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
| | - YaQiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina
| | - QingBin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina,Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina,Department of Global Health, School of Public HealthPeking UniversityBeijingChina
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina,Vaccine Research Center, School of Public HealthPeking UniversityBeijingChina,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina,Department of Global Health, School of Public HealthPeking UniversityBeijingChina
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Mansour I, Collatuzzo G, De Pasquale V, Mirra I, Ciocan C, Godono A, Pira E, Boffetta P. Vaccination Confidence among Healthcare Workers: Results from Two Anamnestic Questionnaires Adopted in the COVID-19 and Influenza Campaign. Vaccines (Basel) 2022; 10:1835. [PMID: 36366344 PMCID: PMC9697632 DOI: 10.3390/vaccines10111835] [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: 08/31/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Following the announcement of the development of COVID-19 vaccines, hesitancy about the safety of vaccinations and their side effects have spread, despite having the approval of international drug agencies. The aim of this study was to test the hypothesis that concern about side effects may have led people to fill out the COVID-19 anamnestic vaccine questionnaire with greater attention compared to the similar instrument used for the influenza vaccination. METHODS We analyzed vaccination questionnaires of 218 healthcare workers (HCWs) who underwent both COVID-19 and influenza vaccines in 2020/2021. Outcomes included self-reported allergies, chronic pharmacological treatments, and chronic diseases. We tested the difference in prevalence, analyzed differences using the kappa statistics and concordance correlation, and explored factors associated with differences in reporting. RESULTS HCWs reported more allergies to substances other than drugs and a higher prevalence of chronic drug intake in the COVID-19 questionnaires than in the influenza ones. Technical staff reported more drug allergies than physicians, and other HCWs reported more outcomes than physicians in the COVID-19 questionnaire. CONCLUSIONS We found that this population of HCWs reported higher conditions during the 2020 COVID-19 vaccination campaign compared to that of the influenza vaccine. The identification of socio-demographic characteristics of the less vaccine-confident HCWs could help in planning targeted interventions to enhance vaccine adherence.
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Affiliation(s)
- Ihab Mansour
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Vittoria De Pasquale
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Ilenia Mirra
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Enrico Pira
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Paolo Boffetta
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
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