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Mercogliano M, Valdecantos RL, Fevola G, Sorrentino M, Buonocore G, Triassi M, Palladino R. An ecological analysis of socio-economic determinants associated with paediatric vaccination coverage in the Campania Region: A population-based study, years 2003-2017. Vaccine X 2024; 18:100482. [PMID: 38585381 PMCID: PMC10997839 DOI: 10.1016/j.jvacx.2024.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Vaccines are the most cost-effective and straightforward intervention against severe infectious diseases. However, in Europe and in Italy, paediatric vaccination coverage for certain vaccines remains suboptimal, with considerable regional differences in Italy. Vaccine coverage varies significantly due to socio-economic and organisational factors. Aim of this study was to assess the influence of the Deprivation Index, the density of General Practitioners and General Paediatricians per inhabitants on the coverage of both mandatory and non-mandatory paediatric vaccinations across local health authorities and health districts in the Campania Region for birth cohorts from 2001 to 2015. Materials and methods Population-based, ecological time series analysis focusing on the Campania Region, most populous region in the south of Italy. Vaccination coverage data were extracted from the regional immunization database, whilst information on the Deprivation Index and number of primary care doctors and primary care paediatricians per local health district were extracted from public health records. Univariate descriptive statistics were employed to describe study characteristics, as appropriate, whilst and mixed-effect linear regression models were employed to assess the associations between variables of interest and vaccination coverage. Results Overall vaccination coverage has generally increased, except for the MMR vaccine, which showed coverage fluctuations. An increase in the Deprivation Index, indicative of less favourable socio-economic conditions, was associated with decreased vaccination coverage in the 24-month age group for some mandatory vaccines (DTaP: Coef -0.97, 95% CI -1.77 | -0.17; Poliomyelitis: Coef -0.98, 95% CI -1.78 | -0.17; Hepatitis B: Coef -0.90, 95% CI -1.71 | -0.10). Moreover, areas with a greater density of General Paediatricians per inhabitants saw increased coverage for Haemophilus influenzae type b in the 6-year age group (Coef 9.78, 95% CI 1.00 | 18.56). Conclusions It is necessary to target public health policies to address vaccination inequalities. These efforts should include expanding vaccination campaigns, enhancing catch-up programs, and increase resource allocation in primary care settings to facilitate the role of General Practitioners and Paediatricians in fostering awareness and adherence.
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Affiliation(s)
| | | | - Gianluca Fevola
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Gaetano Buonocore
- Clinical Directorate, University Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131 Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131 Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
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Marron L, Ferenczi A, O'Brien KM, Cotter S, Jessop L, Morrissey Y, Migone C. A national survey of parents' views on childhood vaccinations in Ireland. Vaccine 2023:S0264-410X(23)00522-4. [PMID: 37183073 DOI: 10.1016/j.vaccine.2023.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 04/11/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Vaccine hesitancy is complex and multifactorial and a threat to global health. Uptake of some recommended childhood immunisations in Ireland remains below World Health Organisation targets. The aim of this study was to determine factors associated with vaccine uptake in Ireland. METHODS A cross-sectional, national survey of parental attitudes towards childhood vaccination for children aged 0 to 48 months was conducted between June and August 2021 (N = 855). A descriptive analysis of questionnaire responses was conducted. Univariate and multivariable logistic regression models were constructed to identify the association of demographic parental characteristics and parental vaccine attitude scores with a delay in or lack of parental vaccine acceptance. RESULTS There was a strongly positive sentiment towards childhood vaccinations. Self-reported uptake of recommended vaccines was 96.1 % with a strong belief in the importance (94.4 %) and safety (89.2 %) of vaccines. Trust in official vaccine information sources was high; 91.5 % and 89.2 % reported trust in the vaccine information provided by healthcare professionals and the Health Service Executive (HSE) respectively. The most commonly identified reasons for missed vaccines were concerns about safety and vaccine side effects. In multivariable regression analysis, parental trust in official vaccine information sources was a significant predictor of vaccine acceptance. For every one unit increase in the median parental trust in official vaccine information score, the odds of a parent having reduced vaccine acceptance decreased significantly (aOR 0.27 95 % CI 0.16, 0.46, p < 0.001). CONCLUSION Understanding parental attitudes towards vaccination will inform the development of evidence-informed, targeted interventions to increase childhood immunisation uptake. Vaccine information for parents should focus on vaccine safety and public health action should be taken to build trust and engage communities in order to increase and sustain the uptake of childhood vaccines delivered as part of the national childhood primary immunisation programme in Ireland.
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Affiliation(s)
- Louise Marron
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland; Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland.
| | - Annamaria Ferenczi
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Katie M O'Brien
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Suzanne Cotter
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Lucy Jessop
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland
| | - Yvonne Morrissey
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland
| | - Chantal Migone
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland
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3
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Bektas İ, Bektas M. The effects of parents' vaccine hesitancy and COVID-19 vaccine literacy on attitudes toward vaccinating their children during the pandemic. J Pediatr Nurs 2023:S0882-5963(23)00105-7. [PMID: 37142496 PMCID: PMC10130325 DOI: 10.1016/j.pedn.2023.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/22/2023] [Accepted: 04/22/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The study was conducted to examine the effects of parents' vaccine hesitancy and COVID-19 vaccine literacy on their attitudes toward vaccinating their children during the COVID-19 pandemic. DESIGN AND METHODS The study was descriptive, cross-sectional, and comparative. The data were collected from 199 parents with children aged 0-18 using a Google Form on social media. In the study, the Parent Introductory Information Form, the Vaccine Hesitancy Scale in Pandemics, and the COVID-19 Vaccine Literacy Scale were used. In the analysis of the data, numbers, percentages, and means were calculated, and the significance test of the difference between the two means and the logistic regression analysis were used. RESULTS Parents' vaccination hesitancy scale sub-dimensions and COVID-19 vaccine literacy scale sub-dimensions together explain 25.4% of their attitudes toward having their children vaccinated against COVID-19. When the variables were examined individually, it was determined that the sub-dimensions of the Vaccine Hesitancy Scale in Pandemics alone significantly affected their attitudes during the pandemic period (p < 0.001). CONCLUSIONS Parents are hesitant about getting their children vaccinated against COVID-19. Improving vaccine literacy can increase vaccination rates in special groups to overcome vaccine hesitancy.
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Affiliation(s)
- İlknur Bektas
- İzmir Bakırçay University, Faculty of Health Science, Nursing Department, Izmir, Turkey.
| | - Murat Bektas
- Dokuz Eylul University Faculty of Nursing, Inciraltı, Izmir, Turkey
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4
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Lelliott M, Sahker E, Poudyal H. A Review of Parental Vaccine Hesitancy for Human Papillomavirus in Japan. J Clin Med 2023; 12:jcm12052004. [PMID: 36902790 PMCID: PMC10003921 DOI: 10.3390/jcm12052004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Globally, Japan has the lowest rate of vaccine confidence. The persistent parental vaccine hesitancy has been attributed to safety and efficacy concerns and is primarily driven by the negative experience with human papillomavirus (HPV) vaccines. This literature review aimed to identify factors associated with HPV vaccine uptake and potential strategies to reduce vaccine hesitancy among Japanese parents. Articles published in English or Japanese between January 1998 and October 2022 that examined Japanese parental factors for HPV vaccine uptake were identified from PubMed, Web of Science, and Ichushi-Web. In total, 17 articles met the inclusion criteria. Four key themes which affected HPV vaccine hesitancy and acceptance were identified: perceptions of risk and benefits, trust and recommendation, information and knowledge, and sociodemographic characteristics. While governmental and healthcare provider recommendations are important factors, efforts to improve parental confidence in the HPV vaccine are required. Future interventions to counteract HPV vaccine hesitancy should actively disseminate information on vaccine safety and effectiveness, along with information on the severity and susceptibility of HPV infection.
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Affiliation(s)
- Madoka Lelliott
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto 606-8501, Japan
| | - Ethan Sahker
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto 606-8501, Japan
- Population Health and Policy Research Unit, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Hemant Poudyal
- Population Health and Policy Research Unit, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Correspondence:
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Sahoo SS, Parida SP, Singh AK, Palepu S, Sahoo DP, Bhatia V. Decision-making in childhood vaccination: vaccine hesitancy among caregivers of under-5 children from a tertiary care institution in Eastern India. Ther Adv Vaccines Immunother 2023; 11:25151355231152650. [PMID: 36756042 PMCID: PMC9900653 DOI: 10.1177/25151355231152650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 01/05/2023] [Indexed: 02/07/2023] Open
Abstract
Background Acceptance of vaccines has been on a decline in recent times, with vaccine hesitancy being listed as one of the top 10 global health threats. This study analysed vaccine hesitancy and belief towards vaccination among caregivers of children aged below 5 years. Methods In this cross-sectional study, 196 caregivers of children aged 6 months to below 5 years who had attended an immunization clinic at a tertiary care institute of Eastern India from March to May 2019 were surveyed. Consecutive sampling was used to recruit eligible study participants. The survey assessed the attitudes of parents towards childhood vaccination by using the Vaccine Hesitancy Scale and their beliefs towards vaccination. Univariate analysis was performed to assess the association of various sociodemographic factors with vaccine hesitancy. Results Among the caregivers, most (48%) mothers were aged 26-35 years, literate and homemakers. Vaccine hesitancy was observed in 9.18% of the participants. Only the age of the child was significantly associated with vaccine hesitancy. Nearly half (48.5%) of the participants were concerned about the serious adverse effects of vaccines, and a third (30.6%) agreed that newer vaccines are associated with higher risks than the older ones. Caregivers felt that vaccines are no longer required for uncommon diseases. Conclusion Concerns regarding vaccine hesitancy are prevalent even among caregivers attending a tertiary care institute. Thus, additional studies are required to assess hesitancy in urban, rural, remote and inaccessible areas. Policymakers ought to conduct periodic assessments and implement necessary remedial measures for the long-term sustenance of the benefits of the national immunization programme.
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Affiliation(s)
- Soumya Swaroop Sahoo
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Bathinda 151001, Punjab,
India
| | - Swayam Pragyan Parida
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Odisha, Bhubaneswar, India
| | - Arvind Kumar Singh
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Odisha, Bhubaneswar, India
| | - Sarika Palepu
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Durgesh Prasad Sahoo
- Department of Community & Family Medicine,
All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Vikas Bhatia
- All India Institute of Medical Sciences,
Bibinagar, Telangana, India
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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7
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Al-Qerem W, Al Bawab AQ, Hammad A, Jaber T, Khdair SI, Kalloush H, Ling J, Mosleh R. Parents' attitudes, knowledge and practice towards vaccinating their children against COVID-19: a cross-sectional study. Hum Vaccin Immunother 2022; 18:2044257. [PMID: 35240943 PMCID: PMC9225601 DOI: 10.1080/21645515.2022.2044257] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/04/2022] [Accepted: 02/16/2022] [Indexed: 12/31/2022] Open
Abstract
The question of whether children should be vaccinated against COVID-19 is currently being argued. The risk-benefit analysis of the vaccine in children has been more challenging because of the low prevalence of acute COVID-19 in children and the lack of confidence in the relative effects of the vaccine and the disease. One of the most convincing arguments for vaccinating healthy children is to protect them from long-term consequences. The aim of this study was to assess Jordanian parents' intention to vaccinate their children. This is an Internet-based cross-sectional survey. The researchers prepared a Google Forms survey and shared the link with a number of Jordanian Facebook generic groups. Data were gathered between September and November 2021. In this study, convenience sampling was used. Knowledge about COVID-19 and preventive practices against COVID-19 were calculated for each participant. A total of 819 participants completed the survey (female = 70.9%). Of these, 274 (30.2%) participants intended to vaccinate their children, whereas the rest were either unsure 176 (21.5%) or intended not to vaccinate their children 396 (48.4%). The variables that increased the odds of answering "No" vs "Yes" to "will you vaccinate your children against COVID-19" included not willing to take the vaccines themselves (OR 3.75; CI, 1.46-9.62) and low protective practice group (OR 1.73;CI, 1.12-2.68). Participants had significant levels of refusal/hesitancy. Several barriers to vaccination were identified; attempts to overcome these should be stepped up.
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Affiliation(s)
- Walid Al-Qerem
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Alaa Hammad
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Tasneem Jaber
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Sawsan I Khdair
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Haneen Kalloush
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Jonathan Ling
- School of Health Sciences & Wellbeing, University of Sunderland, Sunderland, UK
| | - Rami Mosleh
- Department of Pharmacy, Faculty of Medicine & Health Sciences, An-Najah National University, Nablus, Palestine
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8
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Changes in Parents' COVID-19 Vaccine Hesitancy for Children Aged 3-17 Years before and after the Rollout of the National Childhood COVID-19 Vaccination Program in China: Repeated Cross-Sectional Surveys. Vaccines (Basel) 2022; 10:vaccines10091478. [PMID: 36146556 PMCID: PMC9502861 DOI: 10.3390/vaccines10091478] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
China started to implement COVID-19 vaccination programs for children in July 2021. This study investigated the changes in parents’ COVID-19 vaccine hesitancy for children before and after the vaccination program rollout. Repeated cross-sectional online surveys among full-time adult factory workers were conducted in Shenzhen, China. This analysis was based on 844 (first round) and 1213 parents (second round) who had at least one child aged 3−17 years. The prevalence of vaccine hesitancy for children aged 3−11 years dropped from 25.9% (first round) to 17.4% (second round), while such a prevalence for children aged 12−17 years dropped from 26.0% (first round) to 3.5% (second round) (p < 0.001). Positive attitudes, a perceived subjective norm, and perceived behavioral control related to children’s COVID-19 vaccination were associated with lower vaccine hesitancy in both rounds. In the second round and among parents with children aged 3−11 years, negative attitudes and exposure to information on SARS-CoV-2 infection after receiving a primary vaccine series were associated with higher vaccine hesitancy, while exposure to experiences shared by vaccine recipients and infectiousness of variants of concern were associated with lower vaccine hesitancy. Regular monitoring of vaccine hesitancy and its associated factors among parents should be conducted to guide health promotion.
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Yang L, Yang G, Wang Q, Cui T, Shi N, Xiu S, Zhu L, Xu X, Jin H, Ji L. Understanding drivers of influenza vaccine hesitancy among pregnant women in China: evidence from an extended theory of planned behavior. Expert Rev Vaccines 2022; 21:1655-1665. [PMID: 36017619 DOI: 10.1080/14760584.2022.2117695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pregnant women have a low uptake of influenza vaccination, although being recommended as a priority. RESEARCH DESIGN AND METHODS We conducted a cross-sectional questionnaire survey in China from June to July 2021. Hierarchical regression analysis and structural equation modeling were performed based on the extended theory of planned behavior, in which attitudes, subjective norms, perceived behavioral control, and intention each affect the vaccine hesitancy; four variables of response efficacy, knowledge, vulnerability, and severity were added as extended dimensions; vaccination history played a moderator role in this model-to test the validity of the framework. RESULTS Totally, 1283 pregnant women participated in this study. The intention existed as a mediator between attitude [βindirect=0.142 (95% confidence interval (CI): 0.084, 0.206), P<0.001], subjective norms [βindirect=0.568 (95%CI: 0.424, 0.754), P<0.001], perceived behavioral control [βindirect=0.070 (95%CI: 0.025, 0.118), P=0.004] and vaccine hesitancy. Further, the differences in indirect effect between the two dimensions of attitude (P<0.001), perceived behavioral control (P<0.001), and subjective norms were each statistically significant. Vaccination history did not moderate the association between attitude (P=0.679), subjective norms (P=0.645), and hesitancy. CONCLUSIONS The subjective norms dimension has a strong association with influenza vaccine hesitancy. Vaccination history had limited ability to reduce hesitancy during pregnancy.
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Affiliation(s)
- Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Guoping Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Shixin Xiu
- Department of Immunization Planning, Wuxi Center for Disease Control and Prevention, Wuxi, PR China
| | - Lin Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xuepeng Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Lili Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Marron L, Ferenczi A, O'Brien KM, Cotter S, Jessop L, Morrissey Y, Migone C. Views on COVID-19 vaccination of young children in Ireland, results from a cross-sectional survey of parents. Vaccine 2022; 40:5716-5725. [PMID: 36038408 PMCID: PMC9393176 DOI: 10.1016/j.vaccine.2022.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/13/2022] [Accepted: 08/15/2022] [Indexed: 12/09/2022]
Abstract
Vaccination of children aged 5 years and older is recommended as part of a multifaceted strategy to protect children against SARS CoV-2 infection and serious disease, and to control the spread of infection. COVID-19 vaccine trials in children aged less than5 years are underway, however, parental acceptance of vaccines for this age group is unknown. Between June and August 2021, a cross-sectional national survey of parental attitudes towards childhood vaccination in Ireland was conducted. Parents of children aged 0–48 months were surveyed to determine their attitudes towards COVID-19 vaccines for their children. A total of 855 parents were surveyed. Overall, 50.6 % reported that they intend to vaccinate their child, 28.7 % reported that they did not intend to vaccinate and 20.2 % were unsure. Among those who stated that they did not intend to vaccinate their child, concern about risks and side effects of vaccination was the primary reason reported (45.6 %). The most frequently reported information needs related to side effects of the vaccine (64.7 %) and vaccine safety (60.3 %). Results of the multivariable analysis showed that believing COVID-19 can be a serious illness in children was a strong predictor of parental intention to vaccinate (aOR 4.88, 95 % CI 2.68, 8.91, p-value < 0.001). In comparison with Irish-born parents, parents born in a Central and Eastern European country were less likely to report intention to vaccinate (aOR 0.21, 95 % CI 0.09, 0.47, p-value, <0.001). Parental belief in vaccine importance and safety and parental trust in official vaccine information sources were associated with increased parental intention to vaccinate. Understanding parental attitudes to vaccination of young children against COVID-19 is important to tailor the provision of information to parents’ needs, and to inform the development of vaccination information and communication campaigns for current and future COVID-19 immunisations programmes for children.
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Affiliation(s)
- Louise Marron
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland; Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland.
| | - Annamaria Ferenczi
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Katie M O'Brien
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Suzanne Cotter
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Lucy Jessop
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland
| | - Yvonne Morrissey
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland
| | - Chantal Migone
- National Immunisation Office, Unit 8-9 Manor Street Business Park, Manor Street, Dublin 7, Ireland
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11
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Napolitano F, Miraglia del Giudice G, Angelillo S, Fattore I, Licata F, Pelullo CP, Di Giuseppe G. Hesitancy towards Childhood Vaccinations among Parents of Children with Underlying Chronic Medical Conditions in Italy. Vaccines (Basel) 2022; 10:vaccines10081254. [PMID: 36016141 PMCID: PMC9416633 DOI: 10.3390/vaccines10081254] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 02/04/2023] Open
Abstract
Background: This study was designed to evaluate vaccination hesitancy and behaviors among parents of children with chronic conditions. Methods: This cross-sectional study was conducted from June to December 2021 in three public hospitals in southern Italy. Data were collected using a face-to-face interview of parents of children up to 17 years of age with at least one chronic condition. Results: Of the 532 parents approached, 444 agreed to participate, with a response rate of 83.4%. Almost half of parents (43%) knew that children with chronic diseases are at greater risk of complications from VPDs, and 21.6% knew all the vaccinations available in Italy. Additionally, 55.9% felt that vaccine-preventable diseases (VPDs) are very dangerous for their children, and 28.7% were very worried about the side effects of vaccines. The result of the Parent Attitudes about Childhood Vaccine (PACV) score indicated that 23.2% of parents were hesitant about vaccinations. Parental vaccine hesitancy was significantly more common among parents who had female children, among those who did not know the recommended vaccinations, among those who had a higher concern of potential side effects of the vaccines, among those who believed that the administration of the vaccinations was not useful, and among who received information on recommended vaccination from the internet, social and mass media. Conclusions: Important efforts by policy makers and healthcare providers must be implemented to counter vaccine hesitancy among parents.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | | | - Silvia Angelillo
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, 88100 Catanzaro, Italy
| | - Italo Fattore
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesca Licata
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, 88100 Catanzaro, Italy
| | - Concetta Paola Pelullo
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-081-5667708
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Ferreira MU, Giacomini I, Sato PM, Lourenço BH, Nicolete VC, Buss LF, Matijasevich A, Castro MC, Cardoso MA. SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity. PLoS Negl Trop Dis 2022; 16:e0010580. [PMID: 35849564 PMCID: PMC9292121 DOI: 10.1371/journal.pntd.0010580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background The epidemiology of childhood SARS-CoV-2 infection and COVID-19-related illness remains little studied in high-transmission tropical settings, partly due to the less severe clinical manifestations typically developed by children and the limited availability of diagnostic tests. To address this knowledge gap, we investigate the prevalence and predictors of SARS-CoV-2 infection (either symptomatic or not) and disease in 5 years-old Amazonian children. Methodology/Principal findings We retrospectively estimated SARS-CoV-2 attack rates and the proportion of infections leading to COVID-19-related illness among 660 participants in a population-based birth cohort study in the Juruá Valley, Amazonian Brazil. Children were physically examined, tested for SARS-CoV-2 IgG and IgM antibodies, and had a comprehensive health questionnaire administered during a follow-up visit at the age of 5 years carried out in January or June-July 2021. We found serological evidence of past SARS-CoV-2 infection in 297 (45.0%; 95% confidence interval [CI], 41.2–48.9%) of 660 cohort participants, but only 15 (5.1%; 95% CI, 2.9–8.2%) seropositive children had a prior medical diagnosis of COVID-19 reported by their mothers or guardians. The period prevalence of clinically apparent COVID-19, defined as the presence of specific antibodies plus one or more clinical symptoms suggestive of COVID-19 (cough, shortness of breath, and loss of taste or smell) reported by their mothers or guardians since the pandemic onset, was estimated at 7.3% (95% CI, 5.4–9.5%). Importantly, children from the poorest households and those with less educated mothers were significantly more likely to be seropositive, after controlling for potential confounders by mixed-effects multiple Poisson regression analysis. Likewise, the period prevalence of COVID-19 was 1.8-fold (95%, CI 1.2–2.6-fold) higher among cohort participants exposed to food insecurity and 3.0-fold (95% CI, 2.8–3.5-fold) higher among those born to non-White mothers. Finally, children exposed to household and family contacts who had COVID-19 were at an increased risk of being SARS-CoV-2 seropositive and–even more markedly–of having had clinically apparent COVID-19 by the age of 5 years. Conclusions/Significance Childhood SARS-CoV-2 infection and COVID-19-associated illness are substantially underdiagnosed and underreported in the Amazon. Children in the most socioeconomically vulnerable households are disproportionately affected by SARS-CoV-2 infection and disease. The epidemiology of childhood COVID-19 in the tropics remains a relatively neglected research topic, in part because SARS-CoV-2 typically causes fewer severe illnesses, hospitalizations, and deaths in children than in adults. Here we show that 45% of 660 participants in a birth cohort study in the Brazilian Amazon had SARS-CoV-2 antibodies at the age of 5 years, although only 5% of them reported previously diagnosed COVID-19 episodes–implying that as many as 8 in 9 SARS-CoV-2 infections had remained undiagnosed in these young children. Only 16% of the seropositive children had reportedly experienced cough, shortness of breath, and/or loss of taste or smell. The most socioeconomically vulnerable participants were more likely to have experienced SARS-CoV-2 infection and overt COVID-19 by the age of 5 years. Importantly, children exposed to household food insecurity, which affects 54% of our study participants, had their COVID-19 risk increased by 76%.
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Affiliation(s)
- Marcelo U. Ferreira
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Isabel Giacomini
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Priscila M. Sato
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Barbara H. Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Vanessa C. Nicolete
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Lewis F. Buss
- Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brasil
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Marly A. Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- * E-mail:
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13
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Salazar TL, Pollard DL, Pina-Thomas DM, Benton MJ. Parental vaccine hesitancy and concerns regarding the COVID-19 virus. J Pediatr Nurs 2022; 65:10-15. [PMID: 35367855 PMCID: PMC8970879 DOI: 10.1016/j.pedn.2022.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/11/2022] [Accepted: 03/23/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE This study assessed parental vaccine hesitancy in a metropolitan area of the United States. The study aimed to determine what characteristics and contributing factors influenced parental vaccine hesitancy and concerns regarding COVID-19. DESIGN AND METHODS An online survey was used to recruit 93 parents to answer demographic and vaccine hesitancy information. Vaccine hesitancy was measured using the Parent Attitudes about Childhood Vaccines survey. The study was conducted between June 2020 and September 2020 during the COVID-19 pandemic. RESULTS The rate of vaccine hesitancy was 15%. One hundred percent of vaccine hesitant parents were mothers, at least 30 years of age, married, and had completed at least some college. When characteristics of vaccine hesitant parents were compared to non-hesitant parents, the hesitant parents reported having more children, with 93% reporting two or more children compared to only 74% of non-hesitant parents (p = 0.046). Fifty percent of hesitant parents reported no concerns regarding COVID-19 compared to only 20% of non-hesitant parents (p = 0.006), and significantly less hesitant parents reported willingness to have their children receive a safe, effective COVID-19 vaccine if it were available compared to non-hesitant parents (p < 0.001). CONCLUSIONS Our findings indicate that older mothers with two or more children are more likely to be vaccine hesitant and this hesitancy extends to the current COVID-19 pandemic. PRACTICE IMPLICATIONS Healthcare providers can use the results of this study to identify parents at risk for vaccine hesitancy and initiate individualized education to promote on-time childhood vaccination.
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Affiliation(s)
- Teresa L Salazar
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America; Hampden Medical Group, Englewood, CO, United States of America
| | - Deborah L Pollard
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America
| | - Deborah M Pina-Thomas
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America
| | - Melissa J Benton
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, United States of America.
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14
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Sabahelzain MM, Moukhyer M, van den Borne B, Bosma H. Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan. Vaccines (Basel) 2022; 10:205. [PMID: 35214664 PMCID: PMC8875338 DOI: 10.3390/vaccines10020205] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 12/10/2022] Open
Abstract
Vaccine uptake is one of the indicators that has been used to guide immunization programs. This study aimed to evaluate whether measles vaccine uptake is predicted by measles vaccine hesitancy. A community-based cross-sectional study was conducted in urban districts in Khartoum state in February 2019. Measles vaccine uptake among children was measured as either fully vaccinated or partially/not vaccinated. The Parent Attitudes about Childhood Vaccines (PACV) scale was used to measure measles vaccine hesitancy. Multivariate logistic regression was run to identify the predictors of measles vaccination uptake, controlling for sociodemographic variables, and the adjusted odds ratios (aORs) with 95% CI were calculated. The receiver operator characteristic (ROC) curve was created, and the area under the curve (AUC) for the PACV was computed. Data were collected from 495 participants. We found that measles vaccine hesitancy (PACV scores) predicts the uptake of measles vaccine after controlling for other potential social confounders, such as the mother's age and the number of children (aOR 1.055; 95% CI 1.028-1.028). Additionally, the ROC for the PACV yielded an area under the curve (AUC 0.686 (95% CI 0.620-0.751; p < 0.001)). Our findings show that measles vaccine hesitancy in Sudan directly influences the uptake of the measles vaccine. Addressing the determinants of vaccine hesitancy through communication strategies will improve vaccine uptake.
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Affiliation(s)
- Majdi M. Sabahelzain
- Department of Public Health, School of Health Sciences, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Mohamed Moukhyer
- Department of Research and Development, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia;
- Department of Emergency Medical Services, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia
- Public Health Programmes, School of Medicine, University of Limerick, V94 PX58 Limerick, Ireland
| | - Bart van den Borne
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
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15
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Han Y, Wang Q, Zhao S, Wang J, Dong S, Cui T, Liu M, Shi N, Yang L, Han Y, Xiu S, Wang X, Jin H. Parental category B vaccine hesitancy and associated factors in China: an online cross-sectional survey. Expert Rev Vaccines 2021; 21:145-153. [PMID: 34792433 DOI: 10.1080/14760584.2022.2008247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Vaccine hesitancy is one of the top ten health threats. We aimed to (1) assess parental Category B vaccines hesitancy and associated sociodemographic factors in China, and (2) explore the association between attitude toward vaccines and self-reported hesitant behavior. METHODS A cross-sectional study was performed through a web-based anonymous online questionnaire survey between 9 February and 7 April 2021. Chinese parents aged ≥ 18 years with one child aged < 6 years were included to assess vaccine hesitancy using the vaccine-hesitancy scale (VHS). Structural equation model was used to determine relationships between variables. RESULTS Of 2952 Chinese parents included in the analysis, 17.5% were highly hesitant in Category B vaccines. Parents who were younger, less educated, engaged in health-related occupations, and had been vaccinated against influenza in the past year were more hesitant when vaccinating their children (P < 0.001). VHS score accuracy to identify vaccine-hesitant behavior was acceptable, and the optimal cutoff was 37.50 (with 61.96% parental vaccine hesitancy). Parents who lack confidence or believe vaccines were risk were more likely to show vaccine hesitant behavior (P < 0.001). CONCLUSIONS In China, effective interventions need to be implemented to eliminate parental Category B vaccines hesitancy.
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Affiliation(s)
- Ying Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Shuangyu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Jianli Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Shuheng Dong
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Minqi Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Yue Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
| | - Shixin Xiu
- Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Xuwen Wang
- Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China
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Marshall S, Moore AC, Sahm LJ, Fleming A. Parent Attitudes about Childhood Vaccines: Point Prevalence Survey of Vaccine Hesitancy in an Irish Population. PHARMACY 2021; 9:pharmacy9040188. [PMID: 34842830 PMCID: PMC8628985 DOI: 10.3390/pharmacy9040188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/16/2021] [Accepted: 11/21/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding parental attitudes to their children’s vaccination is critical to developing and implementing interventions that address parents’ hesitancy and improve vaccine uptake. The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated tool for identifying vaccine hesitancy in parents. We evaluated the rate of vaccine hesitancy and areas of concern regarding childhood vaccinations using an adapted version of the PACV survey, in a convenience sample of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Ireland, in 2018. A score ≥ 50 identified vaccine hesitant parents. Of 105 parents who completed the survey, the prevalence of vaccine hesitancy was 6.7%, (7/105). Parents had concerns around vaccine side effects (36.2%, n = 38), vaccine safety (20%, n = 21) and the number of vaccines administered (13.3%, n = 14). Parents trusted the vaccine information they received (85.6%, n = 90) and 81.9% (n = 86) believed that the vaccine schedule was good for their child. The findings indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines with further research necessary to address parents’ vaccine concerns. Future research should explore further, by qualitative methods, parents’ vaccine concerns. There is also potential to identify vaccine hesitant parents with the PACV survey as a surveillance method in healthcare settings; for example, in community pharmacies, family doctor clinics and out-patient clinics.
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Affiliation(s)
- Sarah Marshall
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland; (S.M.); (L.J.S.)
| | - Anne C. Moore
- School of Biochemistry and Cell Biology, University College Cork, T12 XF62 Cork, Ireland;
| | - Laura J. Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland; (S.M.); (L.J.S.)
- Pharmacy Department, Mercy University Hospital, T12 WE28 Cork, Ireland
| | - Aoife Fleming
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland; (S.M.); (L.J.S.)
- Pharmacy Department, Mercy University Hospital, T12 WE28 Cork, Ireland
- Correspondence:
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Abstract
PURPOSE OF REVIEW We reviewed the literature about parental vaccine hesitancy, focusing on publications from October 2019 to April 2021 to describe patterns and causes of hesitancy and interventions to address hesitancy. RECENT FINDINGS Recent studies expand understanding of the prevalence of vaccine hesitancy globally and highlight associated individual and contextual factors. Common concerns underlying hesitancy include uncertainty about the need for vaccination and questions about vaccine safety and efficacy. Sociodemographic factors associated with parental vaccine hesitancy vary across locations and contexts. Studies about psychology of hesitancy and how parents respond to interventions highlight the role of cognitive biases, personal values, and vaccination as a social contract or norm. Evidence-based strategies to address vaccine hesitancy include presumptive or announcement approaches to vaccine recommendations, motivational interviewing, and use of immunization delivery strategies like standing orders and reminder/recall programs. A smaller number of studies support use of social media and digital applications to improve vaccination intent. Strengthening school vaccine mandates can improve vaccination rates, but policy decisions must consider local context. SUMMARY Vaccine hesitancy remains a challenge for child health. Future work must include more interventional studies to address hesitancy and regular global surveillance of parental vaccine hesitancy and vaccine content on social media.
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Affiliation(s)
- Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
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18
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Bagateli LE, Saeki EY, Fadda M, Agostoni C, Marchisio P, Milani GP. COVID-19 Vaccine Hesitancy among Parents of Children and Adolescents Living in Brazil. Vaccines (Basel) 2021; 9:1115. [PMID: 34696223 PMCID: PMC8540804 DOI: 10.3390/vaccines9101115] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The immunization of large portions of populations in low/middle-income countries is considered one of the key measures to limit the development of new SARS-CoV-2 variants. However, parental vaccine hesitancy might be an important obstacle to pediatric vaccination. The aim of this survey was to study the prevalence and extent of COVID-19 vaccine hesitancy among parents of children and adolescents living in Brazil. METHODS Caregivers of children and adolescents referred to the emergency department of Hospital Estadual de Bauru, São Paulo (Brazil) were invited to fill in a validated questionnaire on vaccine hesitancy and to report their willingness for themselves and their offspring to receive a COVID-19 vaccine. RESULTS A total of 501 consecutive caregivers filled in the survey. Response rate was 100%. A minority (N = 14, 2.8%) of caregivers were hesitant about vaccines. Despite this, half of them declared they were willing to vaccinate their offspring against COVID-19. CONCLUSIONS This survey identifies that vaccine hesitancy is very low among caregivers living in Brazil and that even many of the hesitant caregivers are willing to vaccinate their offspring against COVID-19. This study highlights the importance of offering the COVID-19 vaccination to the whole population, including subjects that present uncertainty about other vaccines.
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Affiliation(s)
- Leonardo Evangelista Bagateli
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
| | - Edna Yayoi Saeki
- Pediatrics, Hospital Estadual de Bauru, Bauru 17033-360, Brazil;
| | - Marta Fadda
- Facoltà di Scienze Biomediche, Università della Svizzera Italiana, 6900 Lugano, Switzerland;
| | - Carlo Agostoni
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Polcilinico, 20122 Milan, Italy
| | - Paola Marchisio
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Polcilinico, 20122 Milan, Italy
| | - Gregorio Paolo Milani
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Polcilinico, 20122 Milan, Italy
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