Parental intention to vaccinate children against seasonal influenza in the Eastern Mediterranean region: A cross-sectional study using the health belief model

Seasonal influenza vaccine is the most effective strategy for reducing influenza incidence and severity. Parental decision-making regarding childhood vaccination is influenced by one's vaccine-related beliefs. A cross-sectional study was conducted to determine the role of the Health Belief Model (HBM) in predicting parental intention to vaccinate their children against influenza in the Eastern Mediterranean Region (EMR). An anonymous online survey was distributed to parents of children aged 6 months to 18 years in 14 EMR countries. Out of the 5964 participants, 28.2% intended to vaccinate their children against influenza. Urban residents (OR = 0.55, 95%CI: 0.35-0.85), decision-making regarding child's health by the father alone (OR = 0.43, 95%CI: 0.34-0.55) or the mother alone (OR = 0.78, 95%CI: 0.65-0.93), having a child with a chronic illness (OR = 0.45, 95%CI: 0.38-0.53), reporting high perceived severity, susceptibility, and benefits (OR = 0.35, 95%CI: 0.30-0.40), and cues to action (OR = 0.45, 95%CI: 0.39-0.51) were inversely associated with parental unwillingness to vaccinate their children against influenza. While parents with a higher number of children in the household (OR = 1.08, 95%CI:1.03-1.12) and higher perceived barriers (OR = 2.92, 95%CI: 2.56-3.34) showed an increased likelihood of unwillingness to vaccinate their children. Interventions targeting parental beliefs and perceptions are necessary to improve influenza vaccination acceptance and coverage among children.

Declared Intention to Vaccinate against COVID-19 and Actual Vaccination-The Role of Trust in Science, Conspiratorial Thinking and Religiosity

AIMS

The study aims to investigate how trust in science, conspiratorial thinking, and religiosity affected people's declared willingness to vaccinate against COVID-19 at the onset of the vaccination program in Poland, their actual vaccination, and the consistency between intention and vaccination.

METHODS

In a longitudinal design, a representative sample of 918 members of the Polish general population was polled at the beginning of the vaccination program (February 2021) and polled again after 6 months of mass vaccination (August 2021). We measured the willingness to vaccinate, actual vaccination after 6 months, and individual variables-trust in science, conspiratorial thinking and religiosity.

RESULTS

The actual vaccination rate was higher than the declared intent, especially in the initially undecided and unwilling groups. Higher Trust in science and lower Conspiratorial Thinking were associated with declared intent to vaccinate and actual vaccination, while Religiosity was not clearly associated with vaccination.

CONCLUSIONS

Declared willingness to vaccinate is not an effective indicator of actual vaccination. Trust in science and Conspiratorial thinking are important factors associated with vaccine hesitancy. There may be a possibility to influence those unwilling to vaccinate and that are undecided to eventually get vaccinated.

A study on the willingness and influencing factors of novel coronavirus vaccination among medical personnel in North China

Aim

To understand the awareness of the willingness to be vaccinated and influencing factors of the new coronavirus vaccine (neo-crown vaccine) among medical personnel in North China and to provide a theoretical basis and application guidelines for the feasibility of coronavirus vaccination by medical personnel to guide the public to actively be vaccinated by taking initiative and obtaining a coronavirus vaccination as soon as possible.

Methods

From April 2021 to June 2021, medical staff in North China were selected to complete an online questionnaire survey using Questionnaire Star to analyze the willingness rate to be vaccinated with the new coronavirus vaccine, and the influencing factors were analyzed using binary logistic regression.

Results

Among 621 respondents, 85.7% were willing to be vaccinated after the launch of the new vaccine. In the questionnaire, respondents were asked to answer questions such as “Do you think it is better to receive as few vaccines as possible at the same time?,” “If I get the new coronavirus vaccine, I may have serious side effects.,” “The new coronavirus vaccine is safe.,” “Specifically, for the new coronavirus vaccine, do you think it is safe?,” and “Specifically, for the new coronavirus vaccine, do you think it is easy to administer?.” These beliefs have an important influence on the vaccination of medical staff with the new coronavirus vaccine in Northern China (OR = 1.610,95% CI: 1.055 ~ 2.456; OR = 1.715,95% CI: 1.164 ~ 2.526; OR = 0.401, 95% CI: 0.212 ~ 0.760; OR = 0.352,95% CI: 0.147 ~ 0.843; OR = 3.688,95% CI: 1.281 ~ 10.502, respectively; All P values < .05).

Conclusions

Medical staff have a high willingness to be vaccinated with the new coronavirus vaccine, which plays a positive role in the publicity of the vaccine.

I have decided about my COVID-19 vaccine, what about my child?

Vaccination has been instrumental in controlling the COVID-19 pandemic, with numbers of new cases decreasing rapidly even as restrictions to control the spread of the virus were removed. The first stage of the vaccination campaign in Israel covered individuals aged 16 and older, following the U.S. Food and Drug Administration's approval of the vaccine. While the campaign was later extended to those aged 12 and older, some parents continue to have doubts and concerns about the vaccine. Data were collected via an online questionnaire during April 2021; 516 parents participated. This research adopted a holistic approach that combines factors relating to vaccine acceptance previously reported in the literature. The acceptance of pediatric COVID-19 vaccination among parents varied by their children's age groups, at 44.7%, 53.2%, and 66.4% among parents with children aged 0-6, 6-12, and 12-16, respectively. The results of this study indicate that different sets of variables affect the willingness of parents to vaccinate their children, depending on their child's age. Moreover, a holistic approach is necessary in order to correctly verify the significant variables. Parents who evaluate the vaccine as more beneficial have a higher probability of being willing to vaccinate. In addition, for ages 12-16, parental willingness to vaccinate is associated with access to information, trust, and neighborhood norms. Those evaluating information about the vaccine as more fake news show higher probability to vaccinate their children. The timing of the survey is highly relevant, especially considering the uncertainty about the effectiveness and side effects of the vaccine.

The Efficacy of the Combination of Naproxen and Fexofenadine (SJP-003) to Prevent or Reduce Side Effects of Receiving Multiple Travel Vaccines: A Case Report

A considerable number of travelers receive multiple travel vaccinations before going on holiday. Here, we present a case report of a 56-year-old male traveler. On day 1, he received vaccinations against influenza, Tdab (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis), MMR (measles, mumps, and rubella), yellow fever, and cholera. On days 1,3, 5, and 7, he self-administered an oral vaccine against typhoid. Treatment comprised the combination of 220 mg naproxen and 180 mg fexofenadine (SJP-003), to be taken 4h before and 6h after the vaccinations on day 1, and every 12 h thereafter until the end of day 7. Side effects were noted daily, and their severity was scored on a scale ranging from 0 (absent) to 10 (severe). These reports revealed that, except from a slight bruising at the injection site, no side effects were experienced from day 1 to day 4. After the second dose on day 3, treatment was discontinued. Two hours after taking the typhoid vaccine on Day 5, various flu-like symptoms were reported of moderate to high severity, including fever, muscle aches (both with severity score of 8), headache (severity score 7), and nausea (severity score 6). Therefore, at 2 h after typhoid vaccination on day 5, naproxen and fexofenadine were self-administered. At 4 h thereafter, all symptoms were resolved. Treatment was continued at the 12 h schedule. On day 6 and 7, no side effects were reported. Taken together, this case study suggests that the combination of naproxen and fexofenadine was effective in preventing or reducing vaccination side effects. Therefore, more research is warranted to further evaluate the efficacy of SJP-003.

A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review

The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination.

National COVID-19 vaccine program progress and parents' willingness to vaccinate their children

Vaccinating children against COVID-19 is critical as a public health strategy in order to reach herd immunity and prevent illness among children and adults. The aim of the study was to identify correlation between willingness to vaccinate children under 12 years old, and vaccination rate for adult population in Canada, the United States, and Israel. This was a secondary analysis of a cross-sectional survey study (COVID-19 Parental Attitude Study) of parents of children 12 years and younger presenting to 12 pediatric emergency departments (EDs). Parental reports of willingness to vaccinate against COVID-19 when vaccines for children will be approved was correlated to country-specific rate of vaccination during December 2020-March 2021, obtained from ourworldindata.org. Logistic regression models were fit with covariates for week and the corresponding vaccine rate. A total of 720 surveys were analyzed. In Canada, administering mostly first dose to the adult population, willingness to vaccinate children was trending downward (correlation = -0.28), in the United States, it was trending upwards (correlation = 0.21) and in Israel, initially significant increase with decline shortly thereafter (correlation = 0.06). Odds of willingness to vaccinate in Canada, the United States, and Israel was OR = 0.82, 95% CI = 0.63-1.07, OR = 1.24, 95% CI = 0.99-1.56, and OR = 1.03, 95% CI = 0.95-1.12, respectively. A robust population-based vaccination program as in Israel, and to a lesser degree the United States, led to increasing willingness by parents to vaccinate their children younger than 12 years against COVID-19. In Canada, slow rate of vaccination of the adult population was associated with lower willingness to vaccinate children.

Willingness of parents to vaccinate their 6-60-month-old children with EV71 vaccines: a cross-sectional study in rural areas of northern Jiangsu Province

Enterovirus 71 (EV71) is the dominant pathogen in severe and fatal hand-foot-mouth disease (HFMD) cases. Since 2015, three inactivated EV71 vaccines have been approved in China. The vaccination coverage of the EV71 vaccine has been relatively low, especially in rural areas. A cross-sectional survey from July 19 to August 22, 2018, was conducted in three rural counties of northern Jiangsu Province among parents of children aged 6-60 months. We adopted a pretested validated questionnaire to assess knowledge, awareness, and attitude of HFMD and EV71 vaccines among respondents and used univariate and multivariate binary logistic analyses to explore potential factors associated with the acceptance of EV71 vaccines. Of the 1,112 parents who participated, 87.8% were willing to vaccinate their children with EV71 vaccines. Parents over 40 y old were less likely to have their children vaccinated [adjusted odds ratio (aOR) = 2.12, 95% confidence interval (CI): 1.13-3.97]. Parents who lived in Ganyu (aOR = 0.50, 95% CI: 0.31-0.79) or Xinyi county (aOR = 0.33, 95% CI: 0.20-0.53), had a university or higher degree (aOR = 0.26, 95% CI: 0.11-0.64), had good knowledge of EV71 vaccines (aOR = 0.81, 95% CI: 0.67-0.98), perceived their children's disease susceptibility, and worried about the severity of HFMD had a higher willingness to vaccinate their children. Most parents were willing to vaccinate their children against EV71-related HFMD. Parental age, location, education level, knowledge of EV71 vaccines, concern about susceptibility, and severity of HFMD were all factors that influenced willingness to vaccinate.

Study on Status and Willingness towards Hepatitis B Vaccination among Migrant Workers in Chongqing, China: A Cross-Sectional Study

Background: Rural-to-urban migrant workers may serve as a bridge population for the cross-regional spread of hepatitis B vaccination (HBV) due to frequent shifts between their work areas and homelands, and they are less likely to be covered by the national hepatitis B (HB) immunization program. This study aimed to investigate the current inoculation status of HB vaccine among migrant workers and the willingness to be vaccinated among non-vaccinated ones. Methods: We conducted a cross-sectional survey using anonymous interviews with migrant workers selected by two-stage cluster sampling from July to December 2018. Binary logistic regression models were adopted to detect influencing factors associated with HB inoculation status and vaccination willingness. Results: 1574 respondents were recruited in the surveys, and 773 (49.11%) respondents reported that they had been inoculated with HB vaccine. Only 285 (35.58%) non-vaccinated respondents were willing to be inoculated. Logistic regression indicated that younger age, higher education level, less wearing of condoms, higher knowledge scores of HB, and higher risk perception of HBV infection were positively associated with inoculation of HB vaccine. Respondents who were more highly educated, and drinkers, with higher knowledge scores of HB and with higher risk perception of HBV infection were more willing to be vaccinated. Conclusions: the HB vaccination rate of migrant workers in Chongqing was relatively low and only a small section of non-vaccinated migrant workers had vaccination willingness. Health interventions and policies are needed to improve knowledge and cognition of HB among migrant workers, particularly for those who are older, less educated, poor in HB knowledge, less likely to wear condoms, and non-drinkers. Peer education, as well as the combination of traditional and new media, would be accessible and effective ways to disseminate HB related knowledge for migrant workers.

Analysis of factors influencing parents' willingness to accept the quadrivalent influenza vaccine for school-aged children in the Nanhai District, China

Recently, China has attached great importance to promoting immunization, prompting the media, scholars, and public to focus on its coverage and efficacy. This study aimed to understand the factors influencing parental willingness to have their school-aged children vaccinated with quadrivalent influenza vaccines (QIVs). A cross-sectional study through face-to-face interviews was conducted between September and December 2018. Forty-four kindergartens and primary and junior high schools were randomly selected via stratified three-stage cluster sampling. Of 4,430 participants, 24.6% reported having heard of QIV and 24.2% reported having previously received information on QIV. Of these, 42.8% expressed willingness to obtain the QIV for their children. A junior college degree (adjusted odds ratio [aOR] = 1.447; 95% confidence interval [95% CI]: 1.202-1.742), higher influenza knowledge level (medium level, aOR = 1.150, 95% CI, 1.006-1.314; high level, aOR = 1.332, 95% CI, 1.045-1.697), and previous influenza information (aOR = 2.241; 95% CI, 1.604-3.130) were positively correlated with vaccination willingness. In contrast, no previous QIV-related information (aOR = 0.490; 95% CI, 0.418-0.575), no perceived susceptibility of children to influenza (aOR = 0.576; 95% CI, 0.489-0.680), fear of side effects (aOR = 0.599; 95% CI, 0.488-0.735), concern that vaccines need to be carefully administered (aOR = 0.728; 95% CI, 0.593-0.894), and mistrust of new vaccines (aOR = 0.730; 95% CI, 0.628-0.849) were pivotal barriers hindering parents from having their children vaccinated. This study provides baseline information for future immunization programs and delivery, with the ultimate goal of increasing vaccine uptake and minimizing school-wide influenza outbreaks.