1
|
Marhánková JH, Kotherová Z, Numerato D. Navigating vaccine hesitancy: Strategies and dynamics in healthcare professional-parent communication. Hum Vaccin Immunother 2024; 20:2361943. [PMID: 38855961 PMCID: PMC11168214 DOI: 10.1080/21645515.2024.2361943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024] Open
Abstract
Understanding the communication dynamics between vaccine-hesitant parents and healthcare professionals (HCPs) is vital for addressing parent concerns and promoting informed decision-making. This paper focuses on strategies used by HCPs to communicate with vaccine-hesitant parents. It draws on empirical evidence generated as part of the international project VAX-TRUST. More specifically, 60 hours of observations were carried out in three different pediatric practices during vaccination-related visits, and 19 physicians and nurses were interviewed. We focused on the specific context of the Czech Republic, which represents a country with a mandatory vaccination system and in which children's immunization is the responsibility of pediatric general practitioners. We demonstrate that the dynamics between parents and HCPs and their willingness to invest time in the vaccination discussion are influenced by how HCPs categorize and label parents. Furthermore, we outline some of the different strategies HCPs employ while addressing concerns regarding vaccination. We identified two different strategies HCPs use to manage the fears of vaccine-hesitant parents. The first strategy focused on the communication of risks associated with vaccination (and lack thereof). HCPs used a variety of discursive practices to familiarize the unfamiliar risks of vaccine-preventable diseases (by mobilizing representations that are part of collective memory, incorporating personal experiences to materialize the presence of risk and the confidence in the safety of vaccines and by situating risk as embedded in everyday processes and integral to the uncertainty of the global world). The second strategy involved the conscious employment of medical procedures that may contribute to reducing vaccination fears.
Collapse
Affiliation(s)
| | - Zuzana Kotherová
- Department of Public and Social Policy, Faculty of Social Sciences, Charles University, Praha, Czech Republic
- Department of Public and Social Policy, Faculty of Social Sciences and Institute of Public Health and Medical Law, First Faculty of Medicine, Charles University, Praha, Czech Republic
| | - Dino Numerato
- Department of Sociology, Faculty of Social Sciences, Charles University, Praha, Czech Republic
| |
Collapse
|
2
|
Lu Q, Schulz PJ, Chang A. Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources. PATIENT EDUCATION AND COUNSELING 2024; 123:108209. [PMID: 38367304 DOI: 10.1016/j.pec.2024.108209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 01/01/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. METHODS A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression. RESULTS Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. CONCLUSIONS Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.
Collapse
Affiliation(s)
- Qianfeng Lu
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland; Department of Communication & Media, Ewha Womans University, Seoul, South Korea.
| | - Angela Chang
- Faculty of Social Sciences, University of Macau, Macau, China
| |
Collapse
|
3
|
Rand CM, Stephens-Shields AJ, Kelly MK, Localio R, Hannan C, Grundmeier RW, Shone LP, Steffes J, Davis K, Albertin C, Humiston SG, McFarland G, Abney DE, Szilagyi PG, Fiks AG. Clinician Prompts for Human Papillomavirus Vaccination: A Cluster Randomized Trial. Acad Pediatr 2024; 24:579-586. [PMID: 37925070 PMCID: PMC11056302 DOI: 10.1016/j.acap.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE We assessed the impact of an online intervention using clinician prompts for human papillomavirus (HPV) vaccination with a cluster randomized controlled trial. METHODS The randomized trial occurred July 2021-January 2022 in 48 primary care pediatric practices (24 intervention, 24 control) across the US. We trained clinicians via two online learning modules, plus weekly ''quick tips'' delivered via text or email. The training taught practices to implement a staff prompt to the clinician (e.g., printed reminders placed on the keyboard) plus electronic health record (EHR) prompts (if not already done) at well and acute/chronic visits for initial and subsequent HPV vaccination. We assessed missed opportunities for HPV vaccination using logistic regression models accounting for clustering by practice on an intent to treat basis. Surveys assessed facilitators and barriers to using prompts. RESULTS During the 6-month intervention, missed opportunities for HPV vaccination increased (worsened) in both intervention and control groups. However, at well child care visits, missed opportunities for the initial HPV vaccine increased by 4.5 (95% CI: -9.0%, -0.1%) percentage points less in intervention versus control practices. Change in missed opportunities for subsequent doses at well child care and non-well child care visits did not differ between trial groups. An end-of trial survey found understaffing as a common challenge. CONCLUSIONS Clinician prompts reduced missed opportunities for HPV vaccination at well child care visits. Understaffing related to the COVID-19 pandemic may have led to worsening missed opportunities for both groups and likely impeded practices in fully implementing changes.
Collapse
Affiliation(s)
- Cynthia M Rand
- Department of Pediatrics (CM Rand), University of Rochester School of Medicine and Dentistry, Rochester, NY.
| | - Alisa J Stephens-Shields
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Mary K Kelly
- Clinical Futures (MK Kelly and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Russell Localio
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chloe Hannan
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Robert W Grundmeier
- Department of Biostatistics (AJ Stephens-Shields, R Localio, C Hannan, and RW Grundmeier), Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Biomedical and Health Informatics (RW Grundmeier and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa
| | | | - Jennifer Steffes
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill; Primary Care Research (J Steffes and K Davis), American Academy of Pediatrics, Itasca, Ill
| | - Kristin Davis
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill; Primary Care Research (J Steffes and K Davis), American Academy of Pediatrics, Itasca, Ill
| | - Christina Albertin
- Department of Pediatrics (C Albertin), University of California at Los Angeles, Mattel Children's Hospital, Los Angeles, Calif
| | - Sharon G Humiston
- Department of Pediatrics, Mattel Children's Hospital, UCLA, Los Angeles, CA, USA
| | - Greta McFarland
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| | - Dianna E Abney
- Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| | - Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, UCLA, Los Angeles, CA, USA
| | - Alexander G Fiks
- Clinical Futures (MK Kelly and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Biomedical and Health Informatics (RW Grundmeier and AG Fiks), Children's Hospital of Philadelphia, Philadelphia, Pa; Pediatric Research in Office Settings (J Steffes, K Davis, G McFarland, DE Abney, and AG Fiks), American Academy of Pediatrics, Itasca, Ill
| |
Collapse
|
4
|
Bergenfeld I. What can public health communicators learn from Reddit? A perspective for the next pandemic. Front Public Health 2024; 12:1348095. [PMID: 38651132 PMCID: PMC11033353 DOI: 10.3389/fpubh.2024.1348095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Irina Bergenfeld
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| |
Collapse
|
5
|
Dudley MZ, Schuh HB, Forr A, Shaw J, Salmon DA. Changes in vaccine attitudes and recommendations among US Healthcare Personnel during the COVID-19 pandemic. NPJ Vaccines 2024; 9:49. [PMID: 38418562 PMCID: PMC10901873 DOI: 10.1038/s41541-024-00826-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/01/2024] [Indexed: 03/01/2024] Open
Abstract
A recommendation from healthcare personnel (HCP) is a strong predictor of vaccination. This study aimed to measure how HCP vaccine attitudes and recommendations changed during the COVID-19 pandemic. HCP were surveyed in January 2023 using a double opt-in network panel. Survey responses were summarized and stratified by HCP type and COVID-19 booster status. Multivariable logistic regression models were fitted. Comparisons were made to a September 2021 survey, with differences tested for significance (p < 0.05) using Pearson's χ2 Test. Nearly 82% of the 1207 HCP surveyed had received a COVID-19 booster, most commonly pediatricians (94%), followed by family medicine doctors (87%), pharmacists (74%), and nurses (73%) (p < 0.01). HCP with high trust in the Centers for Disease Control and Prevention (CDC) had nearly 6 times the odds (OR: 5.5; 95%CI: 3.9-7.7) of being boosted compared to HCP with low trust. From September 2021 to January 2023, the proportion of HCP recommending vaccines (COVID-19 and routine) to their patients decreased substantially for nearly all vaccines and patient populations specified. Trust in CDC also decreased (from 79 to 73%, p < 0.01), as did support for HCP COVID-19 vaccine mandates (from 65 to 46%, p < 0.01). HCP interest in additional online resources to improve their vaccine discussions with patients increased from 46 to 66% (p < 0.01). Additional regularly updated online resources from trusted medical sources that clarify progressing science and address dynamic public concerns are needed to improve vaccine confidence among HCP and help them support their patients' decision-making.
Collapse
Affiliation(s)
- Matthew Z Dudley
- 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.
| | - Holly B Schuh
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amanda Forr
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Element A LLC, Hershey, PA, USA
| | - Jana Shaw
- Division of Infectious Diseases, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - 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
| |
Collapse
|
6
|
Are EB, Card KG, Colijn C. The role of vaccine status homophily in the COVID-19 pandemic: a cross-sectional survey with modelling. BMC Public Health 2024; 24:472. [PMID: 38355444 PMCID: PMC10868109 DOI: 10.1186/s12889-024-17957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Vaccine homophily describes non-heterogeneous vaccine uptake within contact networks. This study was performed to determine observable patterns of vaccine homophily, as well as the impact of vaccine homophily on disease transmission within and between vaccination groups under conditions of high and low vaccine efficacy. METHODS Residents of British Columbia, Canada, aged ≥ 16 years, were recruited via online advertisements between February and March 2022, and provided information about vaccination status, perceived vaccination status of household and non-household contacts, compliance with COVID-19 prevention guidelines, and history of COVID-19. A deterministic mathematical model was used to assess transmission dynamics between vaccine status groups under conditions of high and low vaccine efficacy. RESULTS Vaccine homophily was observed among those with 0, 2, or 3 doses of the vaccine. Greater homophily was observed among those who had more doses of the vaccine (p < 0.0001). Those with fewer vaccine doses had larger contact networks (p < 0.0001), were more likely to report prior COVID-19 (p < 0.0001), and reported lower compliance with COVID-19 prevention guidelines (p < 0.0001). Mathematical modelling showed that vaccine homophily plays a considerable role in epidemic growth under conditions of high and low vaccine efficacy. Furthermore, vaccine homophily contributes to a high force of infection among unvaccinated individuals under conditions of high vaccine efficacy, as well as to an elevated force of infection from unvaccinated to suboptimally vaccinated individuals under conditions of low vaccine efficacy. INTERPRETATION The uneven uptake of COVID-19 vaccines and the nature of the contact network in the population play important roles in shaping COVID-19 transmission dynamics.
Collapse
Affiliation(s)
- Elisha B Are
- Mathematics, Simon Fraser University, Burnaby, BC, Canada.
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada.
| | - Kiffer G Card
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Institute for Social Connection, Victoria, BC, Canada
| | - Caroline Colijn
- Mathematics, Simon Fraser University, Burnaby, BC, Canada
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
7
|
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] [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.
Collapse
Affiliation(s)
| | - Dongliang Wang
- Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | | |
Collapse
|
8
|
Dudley MZ, Schwartz B, Brewer J, Kan L, Bernier R, Gerber JE, Budigan Ni H, Proveaux TM, Rimal RN, Salmon DA. COVID-19 vaccination attitudes, values, intentions: US parents for their children, September 2021. Vaccine 2023; 41:7395-7408. [PMID: 37951793 DOI: 10.1016/j.vaccine.2023.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES To compare vaccine-related attitudes and values of parents of children 2-17 years old to other adults, examine intentions to vaccinate their children, and identify factors associated with intending to vaccinate children. METHODS A nationally representative survey was conducted in September 2021 (just before the EUA for children 5-11 years old) using Ipsos KnowledgePanel, a probability-based web panel. The survey measured COVID-19 vaccination status, intentions, attitudes, values, and trust in public health authorities among US adults. Scale response options to survey items were dichotomized, and cross-tabulations and logistic regressions were performed. RESULTS Parents had lower odds of reporting being vaccinated against COVID-19 than other adults even after adjusting for associated sociodemographic characteristics such as age (aOR: 0.66; 95 %CI: 0.50-0.87). The most prevalent parental concerns about COVID-19 vaccines included the speed of their development (88 %), potential side effects (78 %), suspicion of government (77 %), and suspicion of pharmaceutical companies (72 %). Fewer than half (42 %) of parents intended to vaccinate their children 5-11 years old, while 38 % were uncertain and 20 % were unlikely to ever vaccinate their children. Vaccinated parents had higher odds than unvaccinated parents of intending to vaccinate their children (OR: 675.51; 95 %CI: 106.46-4286.12). Discussions with healthcare providers who encouraged COVID-19 vaccination were positively associated with intent to vaccinate children (OR: 11.29; 95 %CI: 2.60-49.02). CONCLUSIONS We found parental vaccination and conversations with providers were positively associated with intent to vaccinate children. Decisions about childhood vaccination need to be supported by healthcare providers and a public health system that makes vaccine access and related information equitable and accessible. Vaccination-related decision making should be guided by healthcare providers and provide information about safety and risk to children.
Collapse
Affiliation(s)
- Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States.
| | | | - Janesse Brewer
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States
| | - Lilly Kan
- National Association of County and City Health Officials, United States; The Pew Charitable Trusts, United States
| | - Roger Bernier
- Retired, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States
| | | | - Haley Budigan Ni
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States; Office of Health Equity, California Department of Public Health, United States
| | - Tina M Proveaux
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States
| | - Rajiv N Rimal
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States
| |
Collapse
|
9
|
Iova CF, Badau D, Daina MD, Șuteu CL, Daina LG. Knowledge, Attitudes, Intentions and Vaccine Hesitancy among Postpartum Mothers in a Region from the Northwest of Romania. Vaccines (Basel) 2023; 11:1736. [PMID: 38140141 PMCID: PMC10747489 DOI: 10.3390/vaccines11121736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/08/2023] [Accepted: 11/19/2023] [Indexed: 12/24/2023] Open
Abstract
This study aims to identify the presence of vaccine hesitancy and the factors that could have determined it in a group of mothers in the postpartum period, with an evaluation of both the level of knowledge and information, as well as the attitudes, perceptions, intentions and sources of information about vaccination. The study was based on a survey-Vaccine Hesitancy Identification Survey-applied in two maternity wards from Bihor County and structured into six subscales (34 items). Based on the answers to the key questions ("Which of the following statements best describes your plans for vaccinating your child?"-item 1 of subscale 4; "Overall, how hesitant do you consider yourself to be about vaccinating your child?"-item 4 of subscale 4), we identified two groups: the group of mothers without hesitant behavior (non-hesitant), called the group pro vaccine (GPV), and the group of mothers with hesitant behavior, called the group non vaccine (GNV). Vaccine hesitancy was identified in our study in 47.28% of the participants (191 of the 404 mothers included). Most of them come from an urban environment (57.59%), have university and post-secondary education (58.64%) and are prim parous (58.64%). The behavior of participants from GNV is influenced by a low level of knowledge and information regarding vaccination and by concerns related to adverse reactions, new vaccines and the number of vaccines administered. Also, this group is characterized by an increased perception of the risks related to vaccination, while the perception of the risks associated with the disease is low. For all subscales, important differences were registered between the two groups in favor of GPV, a group characterized by positive attitudes and perceptions and a better level of knowledge compared to GNV. This study aims to represent a starting point for the organization and running of information campaigns regarding vaccination at the level of Bihor County, especially in areas with low vaccination coverage, where this behavior is identified.
Collapse
Affiliation(s)
- Camelia Florina Iova
- Faculty of Medicine and Pharmacy, Doctoral School, University of Oradea, 1 December Sq., 410081 Oradea, Romania (M.D.D.)
| | - Dana Badau
- Faculty of Physical Education and Mountain Sports, Transilvania University, 500068 Brasov, Romania
| | - Mădălina Diana Daina
- Faculty of Medicine and Pharmacy, Doctoral School, University of Oradea, 1 December Sq., 410081 Oradea, Romania (M.D.D.)
| | - Corina Lacramioara Șuteu
- Department of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania (L.G.D.)
| | - Lucia Georgeta Daina
- Department of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania (L.G.D.)
| |
Collapse
|
10
|
Limaye RJ, Schulz G, Michel AE, Collins ME, Johnson SB. Leveraging a Peer-to-Peer Approach to Mitigate Vaccine Misinformation and Improve Vaccine Communication During a Pandemic: Experiences From the Development of a Massive Open Online Course. Health Secur 2023; 21:467-472. [PMID: 38084962 DOI: 10.1089/hs.2023.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
The COVID-19 pandemic has not only led to massive global mortality and morbidity, but it has also fueled an infodemic of false and misleading information about COVID-19 and vaccines. The spread of misinformation and disinformation on vaccine safety and efficacy has contributed to vaccine hesitancy and distrust of public health institutions and has undermined the public health response to the COVID-19 pandemic. Because communication plays a monumental role in pandemic preparedness, a promising approach to countering the COVID-19 infodemic is empowering peers to serve as trusted messengers to provide accurate information using evidence-based communication approaches. With this in mind, we developed a massive open online course (MOOC) to provide the general public with the knowledge, skills, and resources to effectively navigate potentially contentious vaccine conversations with their peers, with a specific focus on parents. Within the first year of the course launch, 29,000 people had enrolled. Learners appreciated the information related to vaccine development, communication tips and techniques, and identifying and responding to vaccine misinformation. Over 1,000 learners who completed the course participated in an online evaluation survey. To address public distrust in healthcare providers, government, and science, our survey results indicate that peer-to-peer approaches to addressing vaccine hesitancy can empower community members to educate others and promote vaccine acceptance at scale.
Collapse
Affiliation(s)
- Rupali Jayant Limaye
- Rupali Jayant Limaye, PhD, is an Associate Professor, Global Disease Epidemiology and Control, in the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Gretchen Schulz
- Gretchen Schulz, MSPH, is a Research Assistant, in the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alexandra E Michel
- Alexandra E. Michel, MPH, is a Research Associate, International Vaccine Access Center, in the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Megan E Collins
- Megan E. Collins, MD, is an Associate Professor, Department of Ophthalmology, at the Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sara B Johnson
- Sara B. Johnson, MD, is a Professor, Department of Pediatrics, at the Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
11
|
Lo Moro G, Ferrara M, Langiano E, Accortanzo D, Cappelletti T, De Angelis A, Esposito M, Prinzivalli A, Sannella A, Sbaragli S, Vuolanto P, Siliquini R, De Vito E. Countering vaccine hesitancy: a systematic review of interventions to strengthen healthcare professionals' action. Eur J Public Health 2023; 33:905-915. [PMID: 37581903 PMCID: PMC10567238 DOI: 10.1093/eurpub/ckad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Vaccine hesitancy is relevant for healthcare professionals (HCPs) who face challenges in building trusting relationships with patients. Accordingly, the VAX-TRUST project has been developed to improve experiences of HCPs and patients dealing with vaccinations. To support VAX-TRUST, this work aimed to identify latest interventions targeted at HCPs to address hesitancy and increase vaccine uptake. METHODS A systematic review was conducted according to PRISMA by searching PubMed, Scopus and Embase. The protocol was registered on PROSPERO. Articles were eligible if evaluated interventions directly targeted at HCPs/healthcare students. The search was run on 26 January 2022. Articles published in 2016 or after were included. RESULTS A total of 17 492 records were identified; 139 articles were selected. Most articles were set in USA (n = 110). Over half had a pre-post design without a control group (n = 78). A total of 41 articles focused on single-component interventions, 60 on multi-component interventions involving only HCPs and/or students and 38 on multi-component interventions involving also other professionals. Main components were in-person education (n = 76), synchronous (n = 10) and asynchronous (n = 23) online learning, educational materials (n = 26), performance assessment and feedback (n = 33), electronic record changes (n = 30), role play/simulation (n = 21) and online games/apps (n = 5). Educational sessions were mainly about scientific update or communication. Outcomes of interventions were grouped in: vaccination rates (n = 69), knowledge (n = 32), attitudes (n = 26), confidence in counselling (n = 30) and acceptability (n = 16). CONCLUSIONS Apps, gaming, role play/simulations could represent innovative interventions. This review highlighted the need of delving into communication strategies and using more robust evaluations, longer follow-up and standardized measurements.
Collapse
Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Maria Ferrara
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Elisa Langiano
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Davide Accortanzo
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Toni Cappelletti
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Aldo De Angelis
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - Maurizio Esposito
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | | | - Alessandra Sannella
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Sara Sbaragli
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| | - Pia Vuolanto
- Research Centre for Knowledge, Science, Technology and Innovation Studies of Tampere University, Tampere, Finland
| | - Roberta Siliquini
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
- AOU City of Health and Science of Turin, Turin, Italy
| | - Elisabetta De Vito
- Department of Human, Social and Health Sciences, University of Cassino and Southern Lazio, Cassino, Italy
| |
Collapse
|
12
|
O’Leary ST, Campbell JD, Ardura MI, Banerjee R, Bryant KA, Caserta MT, Frenck RW, Gerber JS, John CC, Kourtis AP, Myers A, Pannaraj P, Ratner AJ, Shah SS, Bryant KA, Hofstetter AM, Chaparro JD, Michel JJ, Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, Bernstein HH, Cardemil CV, Farizo KM, Kafer LM, Kim D, López Medina E, Moore D, Panagiotakopoulos L, Romero JR, Sauvé L, Starke JR, Thompson J, Wharton M, Woods CR, Frantz JM, Gibbs G. Recommendations for Prevention and Control of Influenza in Children, 2023-2024. Pediatrics 2023; 152:e2023063773. [PMID: 37641884 DOI: 10.1542/peds.2023-063773] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
This technical report accompanies the recommendations of the American Academy of Pediatrics for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2023-2024 season. The rationale for the American Academy of Pediatrics recommendation for annual influenza vaccination of all children without medical contraindications starting at 6 months of age is provided. Influenza vaccination is an important strategy for protecting children and the broader community against influenza. This technical report summarizes recent influenza seasons, morbidity and mortality in children, vaccine effectiveness, and vaccination coverage, and provides detailed guidance on vaccine storage, administration, and implementation. The report also provides a brief background on inactivated and live-attenuated influenza vaccines, available vaccines this season, vaccination during pregnancy and breastfeeding, diagnostic testing for influenza, and antiviral medications for treatment and chemoprophylaxis. Strategies to promote vaccine uptake are emphasized.
Collapse
|
13
|
Danso SE, Frimpong A, Seneadza NAH, Ofori MF. Knowledge, attitudes, and practices of caregivers on childhood immunization in Okaikoi sub-metro of Accra, Ghana. Front Public Health 2023; 11:1230492. [PMID: 37780451 PMCID: PMC10540614 DOI: 10.3389/fpubh.2023.1230492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Background Immunization remains one of the most cost-effective health interventions. However, there are still issues of vaccine hesitancy especially in caregivers who are required to protect their children from vaccine-preventable diseases. This thwarts the overall vaccine coverage in disease-endemic areas such as sub-Saharan Africa. Therefore, to determine the factors that promote vaccine hesitancy in caregivers, this study sought to assess the knowledge, attitude, and practices of caregivers on childhood immunization in Okaikoi, a sub-metro of Accra in Ghana. Methods A cross-sectional study on childhood immunization was conducted to determine the knowledge, attitudes, and practices of caregivers. A total of 120 caregivers with infants aged 12 months to 23 months were interviewed with a structured questionnaire containing open-ended and closed-ended queries. Results From the community, infants whose caregivers had adhered completely to immunization constituted 53.3% while the rest were partially immunized. The two main deterrents to complete immunization were time constraints (25.8%) and forgetfulness (17.5%). It was observed that vaccination uptake and maternal level of education, as well as vaccination adverse reaction, did not impact the completion of the EPI program by these caregivers. Unfortunately, it was noted that caregivers with higher education levels were unable to complete their vaccination schedules due to their busy work schedules. Nonetheless, the main deterrent to adhering to complete childhood immunization was poor maternal knowledge (58%). Conclusion The study revealed that, the caregivers in the community had poor knowledge on vaccination and its benefits, and therefore, with no strict adherence to vaccination schedules. This promoted the incomplete immunization of children in the community by their caregivers. Also, since the main source of information with regard to immunization in the sub-metro was through the antenatal and postnatal child welfare clinics and the media, we recommend that the health workers collaborate with media personnel to ensure that standardized information is disseminated.
Collapse
Affiliation(s)
- Samuel E. Danso
- Department of Community Health, University of Ghana Medical and Dental School, College of Health Science, Accra, Ghana
- GA East Hospital, Accra, Ghana
| | - Augustina Frimpong
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Nana A. H. Seneadza
- Department of Community Health, University of Ghana Medical and Dental School, College of Health Science, Accra, Ghana
| | - Michael F. Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
14
|
Moonpanane K, Thepsaw J, Pitchalard K, Purkey E. Parental perceptions, attitudes, and beliefs regarding vaccination of children aged 0-5 years: A qualitative study of hill-tribe communities, Thailand. Hum Vaccin Immunother 2023; 19:2233398. [PMID: 37460107 PMCID: PMC10353339 DOI: 10.1080/21645515.2023.2233398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
The widespread availability and use of vaccines have tremendously reduced morbidity and deaths related to infectious diseases globally. However, in hill-tribe communities in Northern Thailand, vaccination rates remain low, and there is limited literature on parental perceptions, attitudes, and beliefs about vaccination for children under five years of age. We conducted a qualitative study employing semi-structured interviews to understand parents' perceptions, attitudes, and beliefs about vaccinations. A purposive sample was used to recruit participants. Data were analyzed using thematic analysis. 74 hill-tribe parents (14 Akha, 11 Hmong, 12 Lahu, 13 Lisu, 12 Karen, and 12 Yao) were interviewed. Four themes emerged from the interviews: 1) traditional beliefs, and practices 2) traumatic experiences, 3) lack of information and effective communication, and 4) trust and support from the community. Findings highlight that it is crucial to build trust by providing knowledge, appropriate information, and advice about vaccinations in order to improve vaccine coverage in children under five years of age in the hill-tribe context.
Collapse
Affiliation(s)
| | - Jintana Thepsaw
- School of Nursing, Mae Fah Luang University, Chiang Rai, Thailand
| | | | - Eva Purkey
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| |
Collapse
|
15
|
Licata F, Romeo M, Di Gennaro G, Citrino EA, Bianco A. Pertussis immunization during pregnancy: results of a cross-sectional study among Italian healthcare workers. Front Public Health 2023; 11:1214459. [PMID: 37483935 PMCID: PMC10359148 DOI: 10.3389/fpubh.2023.1214459] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023] Open
Abstract
Background This study aimed to assess whether Italian healthcare workers (HCWs) recommend the reduced antigen content tetanus-diphtheria-acellular pertussis vaccination (Tdap) to pregnant people, as well as what variables could predict their decision to advise and recommend immunization to pregnant people. Methods This cross-sectional study took place between August 2021 and June 2022 in a sample of obstetricians-gynecologists, midwives, and primary-care physicians in two regions of Southern Italy. A self-administered questionnaire was used to gather the data. Results The results showed 91.3% (379) of participants knew that receiving the Tdap vaccine during pregnancy protects against pertussis in both the expectant person and the newborn before active immunization. Only 68.9% (286) knew that the Tdap vaccination has to be administered during the third trimester of gestation. A small but still significant proportion of participants (14.7%) (61) believed that the potential risks of vaccines administered during pregnancy outweighed the benefits. An improvable proportion of HCWs regularly provided information [71.8% (298)] and recommended [81% (336)] Tdap vaccination to pregnant people. The strongest factors that drove HCWs to inform pregnant people about the Tdap vaccination were to be aware that vaccinating those in close contact with newborns is an effective strategy to prevent pertussis (OR: 2.38; 95% CI: 1.11-5.13) and that the Tdap vaccine is provided only in the third trimester of pregnancy (OR: 1.74; 95% CI: 1.06-2.86). Informing pregnant people about the possibility of receiving the Tdap vaccine during pregnancy (OR: 60.13; 95% CI: 23.50-153.8) was the strongest predictor of having recommended the Tdap vaccination during pregnancy. Conclusion Educational and informative interventions to improve HCWs' knowledge about the importance of the Tdap vaccine and their communication skills to properly counsel pregnant people are needed. Beyond vaccine recommendations, how well immunization strategies are implemented in real-world situations impacts vaccination uptake. Therefore, during regular care visits, expecting people must have easy access to vaccines. Prenatal immunizations should become common practice, and there should be no conceptual doubt about vaccinations among HCWs to safeguard pregnant people and their unborn children from vaccine-preventable diseases.
Collapse
Affiliation(s)
| | | | | | | | - Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| |
Collapse
|
16
|
Grosso FM, Baldassarre ME, Grosso R, Di Mauro F, Greco C, Greco S, Laforgia N, Di Mauro A. Do social media interventions increase vaccine uptake? Front Public Health 2023; 11:1077953. [PMID: 37457259 PMCID: PMC10340521 DOI: 10.3389/fpubh.2023.1077953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/31/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction The Italian mass COVID-19 vaccination campaign has included children aged 5-11 years as part of the target population since December 2021. One of the biggest challenges to vaccine uptake was vaccine hesitancy among parents and children's caregivers. Primary care pediatricians (PCPs), as the first point of contact between the National Health Service (NHS) and parents/caretakers, initiated various communication strategies to tackle this hesitancy. This study aims to evaluate the impact of a PCP-led social media intervention and a digital reminder service (DRS) on parental hesitancy regarding vaccinating their 5-11-year-old children against COVID-19. Methods A prospective cohort study was designed, and the chosen target populations were parents and caretakers of children aged 5-11 years. Two PCP cohorts were recruited. The first group received a social media intervention and a DRS; while the second group did not. Both cohorts had access to traditional face-to-face and telephone-based counseling. The vaccination coverage rate in the two groups was evaluated. Results A total of 600 children were enrolled. The exposed cohort (277 patients) received social media intervention, DRS, and counseling options (face-to-face and telephone-based), whereas the non-exposed cohort (323 patients) received only counseling options. In total, 89 patients from the exposed cohort did not receive any dose of the COVID-19 vaccine (32.5%), 165 were fully immunized (59.5%), and 23 received only one dose (8.5%). A total of 150 non-exposed patients did not receive any dose of the COVID-19 vaccine (47%), 147 were fully immunized (45.5%), and 24 only received one dose (7.4%). The difference between the two groups was statistically significant (chi square = 11.5016; p = 0.0006). Conclusion Social media and DRS interventions had a positive impact on vaccine uptake and may be helpful in tackling vaccine hesitancy. Better-designed studies are needed to corroborate these findings.
Collapse
Affiliation(s)
- Francesca Maria Grosso
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
| | - Maria Elisabetta Baldassarre
- Department of Biomedical Science and Human Oncology, Neonatal Intensive Care Unit, Aldo Moro University of Bari, Bari, Italy
| | - Roberto Grosso
- Pediatric Primary Care, National Pediatric Health Care System, Bari, Italy
| | - Federica Di Mauro
- Department of Prevention, Local Health Authority of Bari, Bari, Italy
| | - Chiara Greco
- Department of Biomedical Science and Human Oncology, Hygiene and Preventive Medicine (Public Health), Aldo Moro University of Bari, Bari, Italy
| | - Silvia Greco
- Department of Pediatrics, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Neonatal Intensive Care Unit, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Margherita di Savoia, Barletta-Andria-Trani, Italy
| |
Collapse
|
17
|
Thaker J, Albers AN, Newcomer SR. Nurses' perceptions, experiences, and practices regarding human papillomavirus vaccination: results from a cross-sectional survey in Montana. BMC Nurs 2023; 22:211. [PMID: 37337180 PMCID: PMC10278302 DOI: 10.1186/s12912-023-01379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Nationally, much of the focus on improving human papillomavirus (HPV) vaccine uptake has been on effective strategies that physicians use to promote vaccination. However, in large, predominately rural states like Montana, nurses and medical assistants play critical roles in immunization services delivery, and their viewpoints are imperative in designing strategies to increase vaccination rates. We conducted a cross-sectional, descriptive study to determine nurses' perceptions, experiences, and practices regarding human papillomavirus vaccination in a rural and medically underserved region of the United States. METHODS We designed, pilot-tested, and disseminated an online survey instrument to nurses and medical assistants working in clinics participating in the Vaccines for Children program in Montana. The online surveys were administered from November 2020 to March 2021. Survey questions focused on clinic vaccination practices, respondents' perceptions of the HPV vaccine, perceived barriers to vaccine uptake, and general opinions on potential strategies to improve HPV vaccination rates. RESULTS We analyzed data from 227 respondents. Overall, 90% of nurses strongly agreed or agreed that the HPV vaccine is important and had confidence in the vaccine's safety. More nurses reported experiencing greater parental vaccine refusal or delay for male patients regardless of age. About 53.7% of nurses reported that their clinics had reminder/recall systems to encourage parents to bring their children for vaccination. Nurses identified misinformation from social media, infrequent wellness visits, and vaccine safety concerns as barriers to HPV vaccine uptake. CONCLUSIONS Study findings identified several promising initiatives to accelerate vaccination in primarily rural states like Montana, including promoting widespread adoption of reminder/recall systems, training nurses in evidence-based techniques to provide strong vaccine recommendations, and leveraging social media to disseminate consistent messages about the HPV vaccine recommendations for both sexes and its role in cancer prevention.
Collapse
Affiliation(s)
- Juthika Thaker
- School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Skaggs 173, Missoula, MT, 59803, USA.
- Center for Population Health Research, The University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Alexandria N Albers
- School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Skaggs 173, Missoula, MT, 59803, USA
- Center for Population Health Research, The University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Sophia R Newcomer
- School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Skaggs 173, Missoula, MT, 59803, USA
- Center for Population Health Research, The University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| |
Collapse
|
18
|
Bates BR, Finkelshteyn S, Odunsi IA. 'We were having a rather long conversation about the uproar': memorable messages about COVID-19 vaccinations in a mostly young, white sample. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023:1-11. [PMID: 37326437 DOI: 10.1080/17538068.2023.2223437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Interpersonal communication motivates many decisions related to COVID-19 prevention practices. Previous research shows that the frequency of interpersonal communication is significant. Less is known, however, about who messages interpersonal communication about COVID-19 and what information those messages convey. We sought to understand better these interpersonal communication messages for individuals who are asked to become vaccinated against COVID-19. METHODS Using a memorable messages approach, we interviewed 149 adults, mostly young, white, college students, about their vaccination choices as they were influenced by messages about vaccination they had received from respected members of their interpersonal networks. Date was analyzed using thematic analysis. RESULTS Three themes emerged from these interviews of primarily young, white, college students: a dialectic of feeling forced to become vaccinated vs. choice to become vaccinated; a tension between protecting oneself vs. protecting others through vaccination; and, finally, perceptions that family members who were also medical experts were particularly influential. CONCLUSIONS The dialectic between feelings of choice versus force may require further study into the longer-term impacts of messages that may prompt feelings of reactance and produce undesired outcomes. The dialectic between messages being remembered for their altruism as compared to their selfishness opens opportunities to consider the relative influence of these two impulses. These findings also provide insight into broader topics about countering vaccine hesitancy for other diseases. These findings may not be generalizable to older, more diverse populations.
Collapse
Affiliation(s)
- Benjamin R Bates
- School of Communication Studies, Scripps College of Communication, Ohio University, Athens, OH, USA
- Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Sheyla Finkelshteyn
- School of Communication Studies, Scripps College of Communication, Ohio University, Athens, OH, USA
| | | |
Collapse
|
19
|
Dudley MZ, Schuh HB, Shaw J, Salmon DA. Attitudes and Values of US Adults Not Yet Up-to-Date on COVID-19 Vaccines in September 2022. J Clin Med 2023; 12:3932. [PMID: 37373627 DOI: 10.3390/jcm12123932] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Periodic resurgences in COVID-19 due to more contagious variants highlight the need to increase coverage of booster doses. (2) Methods: Our September 2022 nationally representative survey of US adults measured COVID-19 vaccination status, intentions, attitudes, values, and confidence in information sources. (3) Findings: Although 85% of the weighted sample reported receiving at least one dose of a COVID-19 vaccine, only 63% reported being up-to-date on COVID-19 vaccines (e.g., received a booster dose). Only 12% of those not yet up-to-date indicated they were likely to get up-to-date as soon as possible, whereas 42% were unlikely to ever get up-to-date, and 46% were still uncertain. Most of those not up-to-date on their COVID-19 vaccines were under 45 years of age (58%), without a bachelor's degree (76%), making under $75,000 annually (53%), and Republican or Independent (82%). Prevalent concerns about COVID-19 vaccines among those uncertain about getting up-to-date included: potential side effects that have not been figured out yet (88%), speed of development (77%), newness (75%), ingredients (69%), drug companies making money (67%), allergic reactions (65%), and experimenting on people (63%). (4) Conclusions: Nearly half of adults not yet up-to-date on COVID-19 vaccines were uncertain about doing so, indicating an opportunity to support their decision-making.
Collapse
Affiliation(s)
- Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Holly B Schuh
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jana Shaw
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| |
Collapse
|
20
|
Licata F, Pelullo CP, Della Polla G, Citrino EA, Bianco A. Immunization during pregnancy: do healthcare workers recommend vaccination against influenza? Front Public Health 2023; 11:1171142. [PMID: 37333535 PMCID: PMC10272812 DOI: 10.3389/fpubh.2023.1171142] [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: 02/21/2023] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Background A variety of circumstances can influence how widely vaccination during pregnancy is accepted. Healthcare workers (HCWs) are often seen as the main resource for recommending vaccination. The purpose of the current study was to determine whether Italian HCWs advise and recommend pregnant people to receive the influenza vaccinations, as well as what knowledge and attitudes affect their practices. A secondary aim of the study was to evaluate HCWs' knowledge and attitudes towards COVID-19 vaccination. Methods This cross-sectional study, took place between August 2021 and June 2022 in a randomly selected sample of HCWs in three Italian regions. The target population comprised obstetricians-gynecologists, midwives and primary care physicians, who provide medical care to pregnant people. The questionnaire consisted of 19 items divided into 5 parts gathered information about the participants' sociodemographic and professional characteristics, general knowledge about vaccinations during pregnancy, and vaccine-preventable diseases (VPDs), attitudes and practices towards immunization, and strategies to potentially increase vaccination uptake during pregnancy. Results Among the participants, 78.3% knew that pregnant people are at increased risk of severe complications from influenza, 57.8% that the influenza vaccine is not provided only in the 2nd/3rd trimester of pregnancy and 60% that pregnancy is a risk factor for severe COVID-19 infection. Of the enrolled HCWs, 10.8% believed that the potential risks of vaccines administered during pregnancy are greater than the benefits. An even higher proportion of the participants was unsure (24.3%) or did not deem (15.9%) that vaccinating against influenza during pregnancy reduces the risk of preterm birth and abortion. Moreover, 11.8% of the sample did not believe or was uncertain that COVID-19 vaccine must be offered to all pregnant people. Among HCWs, 71.8% advised women about influenza vaccination during pregnancy, and 68.8% recommended getting vaccinated against influenza during pregnancy. Results showed that good knowledge and positive attitudes were the strongest factors positively associated with advising women about influenza vaccination during pregnancy. Conclusion The gathered data showed that a sizable portion of the HCWs lacks up-to-date knowledge, underestimates the risks of contracting a VPD, and overestimates the risks of vaccine side effects during pregnancy. The findings shed light on such attributes useful to promote adherence to evidence-based recommendations among HCWs.
Collapse
Affiliation(s)
- Francesca Licata
- Department of Health Sciences, School of Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Concetta Paola Pelullo
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Giorgia Della Polla
- Health Direction, Teaching Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Emma Antonia Citrino
- Department of Health Sciences, School of Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| |
Collapse
|
21
|
Cernasev A, Hohmeier KC, Oyedeji O, Hagemann T, Kintziger KW, Wisdom T, Gatwood J. Perspectives Associated with Human Papillomavirus Vaccination in Adults: A Qualitative Study. Vaccines (Basel) 2023; 11:vaccines11040850. [PMID: 37112762 PMCID: PMC10146521 DOI: 10.3390/vaccines11040850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In the last several decades, vaccine hesitancy has become a significant global public health concern. The human papillomavirus (HPV) vaccine has been on the United States of America (USA) market since 2006, with extended approval up to age 45 granted in 2018. To date, there is limited research evaluating barriers and facilitators related to HPV vaccine initiation among adults and the influence of the COVID-19 pandemic on individuals' vaccine-related behaviors. This study's main objective was to characterize the contributing factors that could promote or inhibit HPV vaccine uptake for adults. METHODS A qualitative approach consisting of focus group discussions (FGDs) was used for this study. The FGD guide was informed by concepts from the Transtheoretical Model, Health Belief Model, and Social Cognitive Theory. All virtual FGDs were led by two researchers, who recorded audio for data collection. The data were transcribed by a third party, and the transcripts were imported into Dedoose® software and analyzed using the six steps recommended by thematic analysis. RESULTS A total of 35 individuals participated in 6 focus groups over a 6-month period. Thematic analysis revealed four themes: (1) Intrinsic motivators for HPV vaccination, (2) Extrinsic motivators for HPV vaccination, (3) Vaccine promotion strategies, and (4) Impact of COVID-19 Pandemic on vaccine hesitancy. CONCLUSION Both intrinsic and extrinsic factors play a role in influencing HPV vaccine uptake, and such considerations can guide efforts to improve the odds of HPV vaccination in working-age adults.
Collapse
Affiliation(s)
- Alina Cernasev
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA
| | - Kenneth C Hohmeier
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA
| | - Oluwafemifola Oyedeji
- Department of Public Health, University of Tennessee Knoxville, Knoxville, TN 37996, USA
| | - Tracy Hagemann
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA
| | - Kristina W Kintziger
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Taylor Wisdom
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA
| | - Justin Gatwood
- US Health Outcomes Vaccines, GSK, Philadelphia, PA 19104, USA
| |
Collapse
|
22
|
English A, Middleman AB. Adolescents, Young Adults, and Vaccine Hesitancy: Who and What Drives the Decision to Vaccinate? Pediatr Clin North Am 2023; 70:283-295. [PMID: 36841596 DOI: 10.1016/j.pcl.2022.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Although vaccines are important for all age groups, issues of vaccine uptake and vaccine hesitancy have particular salience for the adolescent and young adult age group. This article reviews the importance of vaccination for adolescents and young adults, the variability in uptake of different vaccines, the reasons for vaccine hesitancy for this age group, and the legal framework for consent for vaccination. One important difference between vaccine hesitancy for adolescents and hesitancy for younger children or adults is the unique developmental, clinical, ethical, and legal context in which the decision to vaccinate is made.
Collapse
Affiliation(s)
- Abigail English
- Center for Adolescent Health & the Law, PO Box 3795, Chapel Hill, NC 27515, USA; Gillings School of Global Publlic Health, University of North Carolina, Chapel Hill.
| | - Amy B Middleman
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Avenue, Suite 12200, Oklahoma City, OK 73104, USA
| |
Collapse
|
23
|
Stinchfield P, Kurland J, Gigi Chawla P. Optimizing Your Pediatric Office for Vaccine Confidence. Pediatr Clin North Am 2023; 70:343-357. [PMID: 36841601 DOI: 10.1016/j.pcl.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Parents trust their pediatric clinicians for up-to-date information about vaccines. To reduce vaccine hesitancy, clinics must promote confidence by building trust, communicating clearly, using patient safety and infection control principles to reduce errors, and reducing missed opportunities by having a vaccination infrastructure that makes every visit a vaccine visit. Education and communication must be consistent among all staff and culturally competent to optimize vaccine confidence. Parents have a role in seeking reliable resources, raising concerns, and seeking trusted, evidence-based experts for vaccination conversations. Safe, effective vaccines are vital; however, vaccination, a complex operational process, prevents disease and saves lives.
Collapse
Affiliation(s)
| | - Joseph Kurland
- Children's Minnesota, 2525 Chicago Avenue, Minneapolis, MN 55404, USA
| | | |
Collapse
|
24
|
Opel DJ. Clinician Communication to Address Vaccine Hesitancy. Pediatr Clin North Am 2023; 70:309-319. [PMID: 36841598 DOI: 10.1016/j.pcl.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
There are several factors that influence childhood vaccine uptake. Pediatric clinicians play a particularly influential role in parent vaccine decision-making. It is critical therefore that pediatric clinicians have a "communication toolbox"--a set of effective, evidence-based communication strategies to facilitate uptake of childhood vaccines--that they can use in conversations with parents about vaccines. In this article, recent advances in our understanding of what constitutes effective clinician vaccine communication with parents are discussed.
Collapse
Affiliation(s)
- Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine, Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S: JMB-6, 1900 Ninth Avenue, Seattle, WA 98101, USA.
| |
Collapse
|
25
|
Morales-Campos DY, Zimet GD, Kahn JA. Human Papillomavirus Vaccine Hesitancy in the United States. Pediatr Clin North Am 2023; 70:211-226. [PMID: 36841591 DOI: 10.1016/j.pcl.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Although the US Advisory Committee on Immunization Practices recommends vaccinating adolescents against the human papillomavirus (HPV) to prevent HPV-associated cancers, vaccine initiation and completion rates are suboptimal. Parental and provider hesitancy contributes significantly to low HPV vaccine uptake. This review describes sources of HPV vaccine hesitancy using a World Health Organization framework that categorizes determinants of vaccine hesitancy as follows: contextual factors (historical, sociocultural, environmental, or political factors), individual and group factors (personal perception or influences of the social/peer environment), and vaccine/vaccination-specific issues (directly related to vaccine or vaccination).
Collapse
Affiliation(s)
- Daisy Y Morales-Campos
- Department of Mexican American and Latino/a Studies, Latino Research Institute, The University of Texas at Austin, 210 West 24th Street, GWB 1.102, F9200, Austin, TX 78712, USA.
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA
| | - Jessica A Kahn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 4000, Cincinnati, OH 45229, USA
| |
Collapse
|
26
|
Real FJ, Zackoff MW, Rosen BL. Using Technology to Overcome Vaccine Hesitancy. Pediatr Clin North Am 2023; 70:297-308. [PMID: 36841597 DOI: 10.1016/j.pcl.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Technology holds great potential to address many vaccine hesitancy determinants and support vaccine uptake given its ability to amplify positive messages, support knowledge, and enhance providers' recommendations. Modalities previously implemented with variable success have included automated reminder systems, decision support for clinicians, online education programs, social media campaigns, and virtual reality curricula. Further research is needed to identify the optimal uses of technology at the patient/parent and provider levels to overcome vaccine hesitancy. The most effective interventions will likely be multipronged providing patients, parents, and providers with information related to vaccine status.
Collapse
Affiliation(s)
- Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, USA.
| | - Matthew W Zackoff
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, USA; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, USA
| | - Brittany L Rosen
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, USA; Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, USA
| |
Collapse
|
27
|
Dudley MZ, Schuh HB, Shaw J, Rimal RN, Harvey SA, Balgobin KR, Zapf AJ, Salmon DA. COVID-19 vaccination among different types of US Healthcare Personnel. Vaccine 2023; 41:1471-1479. [PMID: 36707335 PMCID: PMC9867799 DOI: 10.1016/j.vaccine.2023.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/29/2022] [Accepted: 01/14/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Increasing vaccine coverage remains the best way to control the COVID-19 pandemic. Healthcare personnel (HCP) have long been the most credible and frequently used source of vaccine information for the public, and an HCP recommendation is a strong predictor of vaccination. METHODS A survey of HCP was conducted in September 2021 via a double opt-in network panel. Responses to survey items were summarized and stratified by HCP type and adjusted logistic regression models were fitted. RESULTS >94% of the 1074 HCP surveyed reported receiving at least one dose of COVID-19 vaccine or intending to soon, with vaccinating most common among pediatricians (98%), followed by family medicine doctors (96%), pharmacists (94%), and nurses/nurse practitioners/physician assistants (88%). HCP with high trust in the Centers for Disease Control and Prevention had 26 times the odds of vaccinating of HCP with low trust (95%CI: 9, 74). Nearly half of unvaccinated HCP (47%) were concerned about side effects, and one third of unvaccinated HCP (33%) were concerned the vaccine was developed too quickly. About three quarters of HCP reported strongly recommending the Pfizer-BioNTech (75%) and Moderna (70%) vaccines to their patients, compared to about one quarter (24%) strongly recommending Johnson & Johnson. CONCLUSIONS Although most HCP are vaccinated against COVID-19 and strongly recommend vaccination to their patients, some harbor similar concerns to the public. Additional resources - regularly updated to explain the progressing scientific landscape and address ever evolving public concerns - are needed to further improve vaccine coverage among HCP and aid them in supporting the decision-making of their patients.
Collapse
Affiliation(s)
- Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Holly B Schuh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jana Shaw
- Division of Infectious Diseases, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Rajiv N Rimal
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States
| | - Steven A Harvey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kristian R Balgobin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States
| | - Alexander J Zapf
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States
| |
Collapse
|
28
|
Uttekar S, MacDonald N, Orenstein WA, Danchin M, Blaser V, Thomson A, Menning L, Shimp L, Rath B, Limaye R, Esangbedo D, Abeyesekera S, Malue Nielsen S, Mackay S, Purnat T, Duraisamy K, Karthickeyan V, Siddique A, Thacker N. Empowering Health Workers to Build Public Trust in Vaccination: Experience from the International Pediatric Association's Online Vaccine Trust Course, 2020-2021. Vaccine 2023; 41:435-443. [PMID: 36470688 DOI: 10.1016/j.vaccine.2022.11.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The quality of interactions between health workers (HWs) and caregivers is key in vaccine acceptance. To optimize this, HWs need knowledge about best vaccine communication practices in person and on social media. Most pre-service curricula do not include such approaches. COVID-19 necessitated the International Pediatric Association (IPA) to shift from in-person train the trainer workshops to developing an online Vaccine Trust Course to address these gaps. METHOD The seven-module, 8-hour Vaccine Trust Course was offered online in seven languages and promoted globally. Course outcomes for participants between September 1, 2020 and September 30, 2021 were assessed using enrollment, participation, and completion data; pre-and post-training surveys of attitudes, knowledge, and practice skills; and follow-up practice surveys 3 months post course completion. RESULTS Of the 4,926 participants across 137 countries who registered; 2,381 (48.3 %) started the course, with 1,217 (51.1 %) completing. The majority were 25 - 39 years (57 %), female (57 %), and in pediatrics (70 %); 31 % came from India. 62 % of completers rated course structure/design as excellent, 36 % as good. Over 80 % rated the content as the most valuable aspect. Three months post training, 61 % HWs reported increased empathy towards caregivers, confidence while counseling and increased vaccine acceptance amongst their patients. 21 % identified the course as the only factor in these positive changes. CONCLUSION Shifting from face-to-face to online training due to the COVID-19 pandemic helped increase the global reach of HWs course engagement and uptake. Trained HWs reported increased empathy towards caregivers and confidence while counseling and increased patient vaccine acceptance.
Collapse
Affiliation(s)
| | - Noni MacDonald
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada
| | | | - Margie Danchin
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
| | - Vince Blaser
- Sabin Vaccine Institute, Washington, DC 20037, United States
| | | | | | - Lora Shimp
- John Snow, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, United States
| | - Barbara Rath
- Vaccine Safety Initiative, Berlin, Germany; Université de Bourgogne Franche Comté, 32 Av. de l'Observatoire, 25000 Besançon, France
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E5521, Baltimore, MD 21205, United States
| | | | | | - Siff Malue Nielsen
- World Health Organization Regional Office for Europe, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark
| | | | - Tina Purnat
- World Health Organization, Geneva, Switzerland
| | | | | | - Aninda Siddique
- University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Naveen Thacker
- International Pediatric Association, Gandhidham, Gujarat, India; Deep Child Hospital and Research Centre, Plot No. 208, Sector 1A, Gandhidham, Gujarat, India.
| |
Collapse
|
29
|
Garbutt J, Wang R, Graham S, McKay V, Haire-Joshu D, Barker A, Liu L. Provider and Practice Factors Associated With On-Time HPV Vaccination in Primary Care. Acad Pediatr 2022; 23:800-807. [PMID: 36592791 DOI: 10.1016/j.acap.2022.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND In 2018, only one third of girls and boys completed the 2-dose series of the human papillomavirus vaccine by their 13th birthday, the target for on-time vaccination. The study objective was to identify key patient, provider and practice-level factors associated with on-time vaccination in the primary care setting. METHODS We examined data from 20 primary care pediatric practices (89 providers) in St. Louis including: the percentage of eligible patients with on-time vaccination assessed from medical records; providers' knowledge, attitudes and behaviors regarding on-time vaccination assessed with a survey; and practice-level strategies used to optimize vaccine delivery assessed with a 19-item vaccine delivery system score (VDSS). Factors that increased on-time vaccination were identified using logistic regression, controlling for clustering within providers. RESULTS Completion of on-time vaccination occurred in 1347/3125 (43.10%) of patients (95% confidence interval [CI], 41.36%-44.86%) and varied among practices (7.39%-64.24%) and among providers (2.63%-82.50%). Independent predictors for higher completion of on-time vaccination included more frequent use by providers of the announcement style for vaccine recommendation (odds ratio [OR] 1.18, 95% CI, 1.04, 1.35), higher provider self-efficacy to deliver the vaccine according to guideline recommendations if parents were hesitant (OR 1.21, 95% CI, 1.05, 1.40), and higher VDSS (OR 1.20, 95% CI, 1.10, 1.31). CONCLUSIONS Provider and practice-level factors were identified that may represent modifiable targets for improvement in on-time vaccine uptake. Future research is needed to test interventions built on these findings.
Collapse
Affiliation(s)
- Jane Garbutt
- Department of Medicine and Department of Pediatrics, Washington University School of Medicine (J Garbutt), St. Louis, Mo.
| | - Ruoyun Wang
- Department of Pediatrics, Washington University School of Medicine (R Wang and S Graham), St. Louis, Mo
| | - Sharon Graham
- Department of Pediatrics, Washington University School of Medicine (R Wang and S Graham), St. Louis, Mo
| | - Virginia McKay
- Brown School, Washington University (V McKay, D Haire-Joshu, and A Barker), St. Louis, Mo
| | - Debra Haire-Joshu
- Brown School, Washington University (V McKay, D Haire-Joshu, and A Barker), St. Louis, Mo
| | - Abigail Barker
- Brown School, Washington University (V McKay, D Haire-Joshu, and A Barker), St. Louis, Mo
| | - Lei Liu
- Division of Biostatistics, Washington University School of Medicine (L Liu), St. Louis, Mo
| |
Collapse
|
30
|
Mitilian E, Gosselin V, Casanova L, Fressard L, Berthiaume P, Verger P, Gagneur A. Assessment of training of general practice interns in motivational interviews about vaccination. Hum Vaccin Immunother 2022; 18:2114253. [PMID: 36494997 PMCID: PMC9746523 DOI: 10.1080/21645515.2022.2114253] [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] [Indexed: 01/14/2023] Open
Abstract
The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.
Collapse
Affiliation(s)
- Eva Mitilian
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France,CONTACT Eva Mitilian Aix Marseille Univ, DUMG, département universitaire de médecine générale, 40, rue Saint-Bruno, Marseille13004
| | - Virginie Gosselin
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ludovic Casanova
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Lisa Fressard
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | | | - Pierre Verger
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| |
Collapse
|
31
|
Debela MS, Garrett APN, Charania NA. Vaccine hesitancy and its determinants among refugee parents resettled in Aotearoa New Zealand. Hum Vaccin Immunother 2022; 18:2131336. [PMID: 36315907 PMCID: PMC9746517 DOI: 10.1080/21645515.2022.2131336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Vaccine hesitancy is an important factor underpinning suboptimal vaccine uptake and evidence on marginalized subgroups, such as refugees, is limited. This cross-sectional survey was conducted in 2020/21 with former refugee parents who resettled in Aotearoa New Zealand (NZ). The Parent Attitudes about Childhood Vaccines (PACV) was offered in Somali, Oromo, Arabic, and English languages, and the reliability of the four versions were evaluated. The prevalence of parental vaccine hesitancy was explored and the association between vaccine hesitancy and sociodemographic factors was examined using logistic regression. One hundred and seventy-eight responses were included in the analysis. The Cronbach's alpha scores for Somali, Oromo, Arabic, and English PACV were 0.89, 0.64, 0.53, and 0.77, respectively. The rate of parental vaccine hesitancy was 16.3%, 95% CI (10.7, 21.3). Most caregivers were concerned about vaccine side effects (47%), safety (43%), and efficacy (40%). Less than a quarter (21%) of parents had delayed their child receiving a vaccine and 12% had refused to vaccinate their child for reasons other than medical exemptions. After adjusting for covariate/s, parents' primary source of information and education status were significantly associated with vaccine hesitancy. Media as a primary source of vaccine information and low education status were associated with higher vaccine hesitancy. Vaccine hesitancy is relatively low among former refugees and is influenced by modifiable factors, including educational level and primary source of vaccine information. Vaccine information tailored to former refugee parents' concerns are required to reduce vaccine hesitancy and improve vaccine uptake.
Collapse
Affiliation(s)
- Mulisa Senbeta Debela
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - A. P. Nick Garrett
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nadia A. Charania
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand,Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand,CONTACT Nadia A. Charania Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| |
Collapse
|
32
|
Dudley MZ, Omer SB, O'Leary ST, Limaye RJ, Ellingson MK, Spina CI, Brewer SE, Bednarczyk RA, Chamberlain AT, Malik F, Frew PM, Church-Balin C, Riley LE, Ault KA, Orenstein WA, Halsey NA, Salmon DA. MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial. BMC Public Health 2022; 22:2134. [PMID: 36411403 PMCID: PMC9676851 DOI: 10.1186/s12889-022-14498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/13/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Many pregnant women and parents have concerns about vaccines. This analysis examined the impact of MomsTalkShots, an individually tailored educational application, on vaccine attitudes of pregnant women and mothers. METHODS MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomizing at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia between June 2017 and July 2018. All participants (n = 2087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and two follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1041) were randomly assigned to receive educational videos through MomsTalkShots, algorithmically tailored to their vaccine intentions, attitudes, and demographics. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots regardless of the practice/provider intervention. RESULTS By 1 month post-birth, MomsTalkShots increased perceived risk of maternal influenza disease (61% among MomsTalkShots recipients vs 55% among controls; Odds Ratio: 1.61, 95% Confidence Interval: 1.23-2.09), confidence in influenza vaccine efficacy (73% vs 63%; OR: 1.97, 95%CI: 1.47-2.65), and perceived vaccine knowledge (55% vs 48%; OR: 1.39, 95%CI: 1.13-1.72). Among those intending not to vaccinate at baseline, MomsTalkShots increased perceived risk of maternal influenza disease (38% vs 32%; OR: 2.07, 95%CI: 1.15-3.71) and confidence in influenza vaccine efficacy (44% vs 28%; OR: 2.62, 95%CI: 1.46-4.69). By 1 year post-birth, MomsTalkShots increased perceived vaccine knowledge (62% vs 50%; OR: 1.74, 95%CI: 1.36-2.24) and trust in vaccine information from obstetricians and pediatricians (64% vs 55%; OR: 1.53, 95%CI: 1.17-2.00). Among those uncertain about vaccinating at baseline, MomsTalkShots increased perceived vaccine knowledge (47% vs 12%; OR: 6.89, 95%CI: 1.52-31.25) and reduced infant vaccine safety concerns (71% vs 91%; OR: 0.24, 95%CI: 0.06-0.98). CONCLUSIONS MomsTalkShots improved pregnant women's and mothers' knowledge and perceptions of maternal and infant vaccines and the diseases they prevent, and offers a scalable tool to address vaccine hesitancy. TRIAL REGISTRATION Registered at Clinicaltrials.gov on 13/09/2016 (registration number: NCT02898688).
Collapse
Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA.
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Saad B Omer
- Yale Institute for Global Health, Yale School of Medicine, New Haven, USA
- Department of Infectious Diseases, Yale School of Medicine, New Haven, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, USA
| | - Sean T O'Leary
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, 80045, USA
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Mallory K Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
| | - Christine I Spina
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
| | - Sarah E Brewer
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Allison T Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Fauzia Malik
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-0834, USA
| | - Paula M Frew
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- School of Public Health; School of Medicine; Population Health & Health Equity Initiative, Office of Research and Economic Development, University of Nevada, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Cathy Church-Balin
- Center for Communication Programs, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA
| | - Kevin A Ault
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Walter A Orenstein
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
| | - Neal A Halsey
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| |
Collapse
|
33
|
Olusanya OA, White B, Malik F, Hester KA, Davis RL, Bednarczyk RA, Shaban-Nejad A. Healthcare professionals' perceptions and recommendations regarding adolescent vaccinations in Georgia and Tennessee during the COVID-19 pandemic: A qualitative research. PLoS One 2022; 17:e0277748. [PMID: 36399477 PMCID: PMC9674128 DOI: 10.1371/journal.pone.0277748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Despite its benefits, HPV vaccine uptake has been historically lower than other recommended adolescent vaccines in the United States (US). While hesitancy and misinformation have threatened vaccinations for many years, the adverse impacts from COVID-19 pandemic on preventive services have been far-reaching. OBJECTIVES To explore the perceptions and experiences of adolescent healthcare providers regarding routine vaccination services during the COVID-19 pandemic. METHODOLOGY Between December 2020 and May 2021, in-depth qualitative interviews were conducted via Zoom video conferencing among a purposively selected, diverse group of adolescent healthcare providers (n = 16) within 5 healthcare practices in the US southeastern states of Georgia and Tennessee. Audio recordings were transcribed verbatim and analyzed using a rapid qualitative analysis framework. Our analysis was guided by the grounded theory and inductive approach. RESULTS Participants reported that patient-provider communications; effective use of presumptive languaging; provider's continuing education/training; periodic reminders/recall messages; provider's personal conviction on vaccine safety/efficacy; early initiation of HPV vaccination series at 9 years; community partnerships with community health navigators/vaccine champions/vaccine advocates; use of standardized forms/prewritten scripts/standard operating protocols for patient-provider interactions; and vaccine promotion through social media, brochures/posters/pamphlets as well as outreaches to schools and churches served as facilitators to adolescent HPV vaccine uptake. Preventive adolescent services were adversely impacted by the COVID-19 pandemic at all practices. Participants highlighted an initial decrease in patients due to the pandemic, while some practices avoided the distribution of vaccine informational materials due to sanitary concerns. CONCLUSION As part of a larger study, we provided contextual information to refine an intervention package currently being developed to improve adolescent preventive care provision in healthcare practices. Our results could inform the implementation of comprehensive intervention strategies that improve HPV vaccination rates. Additionally, lessons learned (e.g. optimizing patient- provider interactions) could be adopted to expand COVID-19 vaccine acceptance on a sizable scale.
Collapse
Affiliation(s)
- Olufunto A. Olusanya
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
- * E-mail: (OAO); (AS-N)
| | - Brianna White
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Fauzia Malik
- Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Kyra A. Hester
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Robert L. Davis
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Arash Shaban-Nejad
- Department of Pediatrics, Center for Biomedical Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
- * E-mail: (OAO); (AS-N)
| |
Collapse
|
34
|
Jamison KC, Ahmed AH, Spoerner DA, Kinney D. Best shot: A motivational interviewing approach to address vaccine hesitancy in pediatric outpatient settings. J Pediatr Nurs 2022; 67:124-131. [PMID: 36108393 DOI: 10.1016/j.pedn.2022.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 08/01/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vaccine hesitancy in parents and childhood vaccine refusal is increasing. A standard of care to address this problem has not been identified. PURPOSE To identify if the use of motivational interviewing by pediatric providers during routine well child visits, when compared to standard of care, would increase vaccine rates in children 0-12 months of age. Factors associated with vaccine hesitancy were also investigated. METHODS A quasi-experimental study was completed on a convenience sample of pediatric providers (N = 6) and caregivers of children 0-12 months of age (N = 66). Four providers were trained to use motivational interviewing. During the well child visit the Parent Attitudes About Childhood Vaccines survey was completed, and the motivational interviewing intervention was implemented. Clinic's data were compared with other clinic data of non-trained providers. FINDINGS Vaccine refusal/delays rate was 11.4% among caregivers. Vaccine refusal rate decreased after the intervention (9.00% pre-intervention and 6.40% post-intervention). An ordinal regression identified caregivers with higher vaccine hesitancy scores and more children were more likely to delay or refuse vaccines, while caregivers ≥30 years or with high income were less likely to delay/refuse vaccines. A difference in difference analysis identified that an additional 2.6% of children received vaccines when seen by trained providers compared to non-trained (β = -0.330, OR = 0.719, p = 0.470). DISCUSSION Findings indicate a condensed motivational interviewing education session may be clinically significant in decreasing vaccine hesitancy among this population. APPLICATIONS TO PRACTICE A more robust study to confirm these findings is recommended prior to practice implementation.
Collapse
Affiliation(s)
- Kristin C Jamison
- Advanced Practice Nursing, Beacon Medical Group, Indiana, United States; Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States.
| | - Azza H Ahmed
- Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States.
| | - Deborah A Spoerner
- Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907, United States.
| | - Daniel Kinney
- Pediatrician, Beacon Medical Group, 1815 E Ireland Rd, South Bend, Indiana, United States.
| |
Collapse
|
35
|
Raikhel AV, Blau K, Alberty K, Redinger JW. An Interactive COVID-19 Vaccine Hesitancy Workshop for Internal Medicine Residents and Medical Students. Cureus 2022; 14:e27079. [PMID: 36000126 PMCID: PMC9391063 DOI: 10.7759/cureus.27079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Since being first identified in December 2019, SARS-CoV-2 has resulted in millions of illnesses and deaths worldwide. Despite the safety and availability of effective vaccines that offer protection from severe COVID-19 disease, a sizable minority of the United States population has reported COVID-19 vaccine hesitancy and remains unvaccinated. Methods We developed an interactive workshop for internal medicine residents and medical students in which a framework is utilized to aid the subtyping of COVID-19 vaccine hesitancy. Learners then interactively apply this framework through vaccine counseling in a role-playing exercise. Results The workshop increased confidence in the learner's ability to determine the COVID-19 vaccine hesitancy subtype after participation in the workshop (53% preworkshop, 81% postworkshop, p=0.01). The workshop also increased reported confidence in tailoring COVID-19 vaccine counseling after participation in the workshop (60% preworkshop, 90% postworkshop, p=0.005). These gains were also seen when participant learners were compared with nonparticipant learners for both subtyping confidence (81% postworkshop, 26% nonparticipant, p<0.0001) and confidence in providing tailored counseling (90% postworkshop, 60% nonparticipant, p=0.004). Conclusion The implementation of our workshop correlated with an increase in the reported trainee confidence related to COVID-19 vaccine counseling. This offers a promising early step in developing educational programs that build trainee skills in this domain. More work is needed to establish robust curricula to support learners in reaching patients who express COVID-19 vaccine hesitancy.
Collapse
|
36
|
Hohmeier KC, Renfro C, Loomis B, Alexander CE, Patel U, Cheramie M, Cernasev A, Hagemann T, Chiu CY, Chisholm-Burns MA, Gatwood JD. The Lean Six Sigma Define, Measure, Analyze, Implement, Control (LSS DMAIC) Framework: An Innovative Strategy for Quality Improvement of Pharmacist Vaccine Recommendations in Community Pharmacy. PHARMACY 2022; 10:pharmacy10030049. [PMID: 35645328 PMCID: PMC9149925 DOI: 10.3390/pharmacy10030049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022] Open
Abstract
Community pharmacies represent a highly accessible and convenient setting for vaccination. However, setting-specific barriers exist which contribute to suboptimal vaccination rates, particularly for pneumococcal vaccinations. One proven quality improvement framework growing in use within healthcare settings is Lean Six Sigma (LSS). This paper describes the application of the LSS framework in select locations of a national pharmacy chain. The implementation of a training program for improved recommendation techniques to promote higher rates of pneumococcal vaccinations in high-risk adult populations is also addressed. A mixed-methods approach including pre/post quasi-experimental design and in-depth key informant interviews was used.
Collapse
Affiliation(s)
- Kenneth C. Hohmeier
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
- Correspondence: ; Tel.: +1-615-532-0228
| | - Chelsea Renfro
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | | | - Connor E. Alexander
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Urvi Patel
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| | - Matthew Cheramie
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Alina Cernasev
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| | - Tracy Hagemann
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| | - Chi-Yang Chiu
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Marie A. Chisholm-Burns
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (C.R.); (C.E.A.); (M.C.); (C.-Y.C.); (M.A.C.-B.)
| | - Justin D. Gatwood
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA; (U.P.); (A.C.); (T.H.); (J.D.G.)
| |
Collapse
|
37
|
An Informed Approach to Vaccine Hesitancy and Uptake in Children. Dela J Public Health 2022; 8:60-64. [PMID: 35402930 PMCID: PMC8982918 DOI: 10.32481/djph.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
38
|
Understanding COVID-19 vaccination willingness among youth: A survey study in the Netherlands. Vaccine 2022; 40:833-836. [PMID: 35042646 PMCID: PMC8730787 DOI: 10.1016/j.vaccine.2021.12.062] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/08/2023]
Abstract
Vaccination of youth could be key to preventing future outbreaks of SARS-CoV-2. Given the limited direct health benefit for young people, it is important to understand how youth themselves perceive obtaining a vaccination. This survey study in a representative sample of Dutch youth aged 12-18 showed that 73% were willing to get vaccinated against COVID-19. In regression analyses, vaccination willingness was strongly related to age, perceived personal (protect own health) and societal benefits (to get rid of restrictive policies), and their peers' and parents' vaccination uptake. Negative associations with vaccination willingness were perceived side-effects and potential unknown long term consequences. On-going and transparent communication with up-to-date information about safety and risks, delivered by independent and trusted experts (as perceived by the recipients) seems important for addressing questions and concerns. Local information sessions for youth and parents where a vaccination can be obtained without appointment could have merit in addition to mass media communication.
Collapse
|
39
|
Parental COVID-19 Vaccine Hesitancy in Diverse Communities: A National Survey. Acad Pediatr 2022; 22:1399-1406. [PMID: 35803490 PMCID: PMC9254650 DOI: 10.1016/j.acap.2022.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We surveyed a diverse group of US participants to understand parental coronavirus disease 2019 (COVID-19) vaccine hesitancy. METHODS We administered a telephone and online survey from May 7 to June 7, 2021 using stratified sampling to ensure robust sample sizes of racial and ethnic minorities. Of the 20,280 contacted, 12,288 respondents completed the survey (response rate 61%). We used chi-square tests and adjusted risk ratios to compare results by racial/ethnic group. RESULTS Overall, 23% of parents stated that they plan to (or have) vaccinated their children; 30% said that they would not vaccinate their children, and 25% were unsure. Latino/a, Native American, and Asian American-Pacific Islander (AAPI) parents were generally more likely to vaccinate their children than Black or White parents. After adjusting for demographic factors, AAPI parents were significantly more likely to vaccinate their children than were others. Of parents who said that they would not vaccinate their child, 55% stated it was due to insufficient research. However, over half of parents stated that they would follow their child's health care provider's recommendations. After adjusting for demographic factors, trust in their primary care doctor was significantly lower among AAPI, Black, and Native American parents than White parents. CONCLUSIONS Parental vaccine hesitancy was similar overall, but drivers of hesitancy varied by racial/ethnic groups. While the perception that vaccines had been "insufficiently researched" was a major concern among all groups, we found that parents are generally inclined to follow health providers' recommendations. Health professionals can play an important role in COVID-19 vaccine education and should provide access to vaccines.
Collapse
|
40
|
Milne Wenderlich A, Rand C, Halterman J. COVID-19 Vaccination for Caregivers in the Pediatric Medical Home: A Call to Action to Improve Community Vaccination Rates. JAMA Pediatr 2022; 176:16-17. [PMID: 34623392 DOI: 10.1001/jamapediatrics.2021.4214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Andrea Milne Wenderlich
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Cynthia Rand
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Jill Halterman
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York
| |
Collapse
|
41
|
Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake. Vaccines (Basel) 2021; 10:vaccines10010007. [PMID: 35062668 PMCID: PMC8777721 DOI: 10.3390/vaccines10010007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families.
Collapse
|
42
|
Fernández-Basanta S, Lagoa-Millarengo M, Movilla-Fernández MJ. Encountering Parents Who Are Hesitant or Reluctant to Vaccinate Their Children: A Meta-Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147584. [PMID: 34300041 PMCID: PMC8306550 DOI: 10.3390/ijerph18147584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Abstract
(1) Background: Health professionals play an important role in addressing parents who are hesitant or reluctant to immunise their children. Despite the importance of this topic, gaps remain in the literature about these experiences. This meta-ethnography aimed to synthesise the available body of qualitative work about the care experiences of community and hospital health professionals in encounters with parents hesitant or reluctant to vaccinate their children. The aim is to provide key information for the creation of strategies that address vaccine hesitancy or refusal and ensure public trust in vaccination programs, which are required in a pandemic context such as the current one. (2) Methods: Noblit and Hare’s interpretive meta-ethnography of 12 studies was followed. A line of argument synthesis based on a metaphor was developed. (3) Results: The metaphor “The stone that refuses to be sculpted”, accompanied by three themes, symbolises the care experiences of health professionals in their encounters with parents that hesitate or refuse to vaccinate their children. (4) Conclusions: The creation of clearer communication strategies, the establishment of a therapeutic alliance, health literacy and the empowerment of parents are recommended. The incorporation of health professionals in decision making and the strengthening of multidisciplinary teams interacting with such parents are also included.
Collapse
Affiliation(s)
- Sara Fernández-Basanta
- Research Group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain;
- Correspondence: ; Tel.: +34-981-337400-3544
| | - Manuel Lagoa-Millarengo
- Galician Health Service (SERGAS), University Hospital Complex of Ferrol, Av. da Residencia, S/N, 15405 Ferrol, Spain;
| | - María-Jesús Movilla-Fernández
- Research Group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain;
| |
Collapse
|
43
|
Stokley S, Kempe A, Stockwell MS, Szilagyi PG. Improving Pediatric Vaccination Coverage in the United States. Acad Pediatr 2021; 21:S1-S2. [PMID: 33958085 DOI: 10.1016/j.acap.2021.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (S Stokley), Atlanta, Ga.
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Center and Children's Hospital Colorado (A Kempe), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Center (A Kempe), Aurora, Colo
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University (MS Stockwell), New York, NY; Department of Population and Family Health, Mailman School of Public Health, Columbia University (MS Stockwell), New York, NY; New York - Presbyterian Hospital (MS Stockwell), New York, NY
| | - Peter G Szilagyi
- Department of Pediatrics, University of California at Los Angeles (PG Szilagyi); Mattel Children's Hospital (PG Szilagyi), Los Angeles, Calif
| |
Collapse
|