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Ligeti AS, Oroszi B, Luca C, Bilics E, Ágoston J, Röst G, Koltai J. Socioeconomic determinants and reasons for non-acceptance to vaccination recommendations during the 3 rd - 5 th waves of the COVID-19 pandemic in Hungary. BMC Public Health 2024; 24:1796. [PMID: 38969991 PMCID: PMC11225232 DOI: 10.1186/s12889-024-19267-2] [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: 03/05/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND In Hungary, although six types of vaccines were widely available, the percentage of people receiving the primary series of COVID-19 vaccination remained below the EU average. This paper investigates the reasons for Hungary's lower vaccination coverage by exploring changing attitudes towards vaccination, socio-demographic determinants, and individual reasons for non-acceptance during the 3rd - 5th pandemic waves of COVID-19. METHODS The study's empirical analysis is based on representative surveys conducted in Hungary between February 19, 2021, and June 30, 2022. The study used a total of 17 surveys, each with a sample size of at least 1000 respondents. Binomial logistic regression models were used to investigate which socio-demographic characteristics are most likely to influence vaccine hesitancy in Hungary. The study analysed 2506 open-ended responses to identify reasons for vaccine non-acceptance. The responses were categorised into four main categories and 13 sub-categories. RESULTS Between the third and fifth wave of the pandemic, attitudes towards COVID-19 vaccination have significantly changed. Although the proportion of vaccinated individuals has increased steadily, the percentage of individuals who reported not accepting the vaccine has remained almost unchanged. Socio-demographic characteristics were an important determinant of the observed vaccine hesitancy, although they remained relatively stable over time. Individuals in younger age groups and those with lower socioeconomic status were more likely to decline vaccination, while those living in the capital city were the least likely. A significant reason behind vaccine refusal can undoubtedly be identified as lack of trust (specifically distrust in science), facing an information barrier and the perception of low personal risk. CONCLUSION Although compulsory childhood vaccination coverage is particularly high in Hungary, voluntary adult vaccines, such as the influenza and COVID-19 vaccines, are less well accepted. Vaccine acceptance is heavily affected by the social-demographic characteristics of people. Mistrust and hesitancy about COVID-19 vaccines, if not well managed, can easily affect people's opinion and acceptance of other vaccines as well. Identifying and understanding the complexity of how vaccine hesitancy evolved during the pandemic can help to understand and halt the decline in both COVID-19 and general vaccine confidence by developing targeted public health programs to address these issues.
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Affiliation(s)
- Anna Sára Ligeti
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Budapest, Hungary
| | - Beatrix Oroszi
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, Budapest, Hungary
| | - Csaba Luca
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, Budapest, Hungary
| | - Edit Bilics
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, Budapest, Hungary
| | | | - Gergely Röst
- National Laboratory for Health Security, Bolyai Institute, University of Szeged, Szeged, Hungary
| | - Júlia Koltai
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Budapest, Hungary.
- Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary.
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Huebl L, Nnyombi A, Kihumuro A, Lukwago D, Walakira E, Kutalek R. Perceptions of yellow fever emergency mass vaccinations among vulnerable groups in Uganda: A qualitative study. PLoS Negl Trop Dis 2024; 18:e0012173. [PMID: 38739650 PMCID: PMC11115279 DOI: 10.1371/journal.pntd.0012173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/23/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Yellow fever (YF), a mosquito-borne viral hemorrhagic fever, is endemic in Uganda and causes frequent outbreaks. A total of 1.6 million people were vaccinated during emergency mass immunization campaigns in 2011 and 2016. This study explored local perceptions of YF emergency mass immunization among vulnerable groups to inform future vaccination campaigns. METHODOLOGY In this qualitative study, we conducted 43 semi-structured interviews, 4 focus group discussions, and 10 expert interviews with 76 participants. Data were collected in six affected districts with emergency mass vaccination. We included vulnerable groups (people ≥ 65 years and pregnant women) who are typically excluded from YF vaccination except during mass immunization. Data analysis was conducted using grounded theory. Inductive coding was utilized, progressing through open, axial, and selective coding. PRINCIPAL FINDINGS Participants relied on community sources for information about the YF mass vaccination. Information was disseminated door-to-door, in community spaces, during religious gatherings, and on the radio. However, most respondents had no knowledge of the vaccine, and it was unclear to them whether a booster dose was required. In addition, the simultaneous presidential election during the mass vaccination campaign led to suspicion and resistance to vaccination. The lack of reliable and trustworthy information and the politicization of vaccination campaigns reinforced mistrust of YF vaccines. CONCLUSIONS/SIGNIFICANCE People in remote areas affected by YF outbreaks rely on community sources of information. We therefore recommend improving health education, communication, and engagement through respected and trusted community members. Vaccination campaigns can never be seen as detached from political systems and power relations.
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Affiliation(s)
- Lena Huebl
- Unit Medical Anthropology and Global Health, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Aloysious Nnyombi
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
| | - Aban Kihumuro
- Department of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Denis Lukwago
- Cluster Monitoring and Evaluation Lead, Rakai Health Sciences Program, Masaka, Uganda
| | - Eddy Walakira
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
| | - Ruth Kutalek
- Unit Medical Anthropology and Global Health, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Tsui N, Edwards SA, Simms AJ, King KD, Mecredy G. COVID-19 vaccination intention and vaccine hesitancy among citizens of the Métis Nation of Ontario. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:209-219. [PMID: 38189860 PMCID: PMC11006635 DOI: 10.17269/s41997-023-00836-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/06/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE The study objective is to measure the influence of psychological antecedents of vaccination on COVID-19 vaccine intention among citizens of the Métis Nation of Ontario (MNO). METHODS A population-based online survey was implemented by the MNO when COVID-19 vaccines were approved in Canada. Questions included vaccine intention, the short version of the "5C" psychological antecedents of vaccination scale (confidence, complacency, constraint, calculation, collective responsibility), and socio-demographics. Census sampling via the MNO Registry was used achieving a 39% response rate. Descriptive statistics, bivariate analyses, and multinomial logistic regression models (adjusted for sociodemographic variables) were used to analyze the survey data. RESULTS The majority of MNO citizens (70.2%) planned to be vaccinated. As compared with vaccine-hesitant individuals, respondents with vaccine intention were more confident in the safety of COVID-19 vaccines, believed that COVID-19 is severe, were willing to protect others from getting COVID-19, and would research the vaccines (Confident OR = 19.4, 95% CI 15.5-24.2; Complacency OR = 6.21, 95% CI 5.38-7.18; Collective responsibility OR = 9.83, 95% CI 8.24-11.72; Calculation OR = 1.43, 95% CI 1.28-1.59). Finally, respondents with vaccine intention were less likely to let everyday stress prevent them from getting COVID-19 vaccines (OR = 0.47, 95% CI 0.42-0.53) compared to vaccine-hesitant individuals. CONCLUSION This research contributes to the knowledge base for Métis health and supported the MNO's information sharing and educational activities during the COVID-19 vaccines rollout. Future research will examine the relationship between the 5Cs and actual uptake of COVID-19 vaccines among MNO citizens.
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Affiliation(s)
- Noel Tsui
- Métis Nation of Ontario, Ottawa, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- ICES Central, Toronto, ON, Canada.
| | - Sarah A Edwards
- Métis Nation of Ontario, Ottawa, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES Central, Toronto, ON, Canada
| | - Abigail J Simms
- Métis Nation of Ontario, Ottawa, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES Central, Toronto, ON, Canada
| | - Keith D King
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Israeli T, Popper-Giveon A, Keshet Y. Information gaps in persuasion knowledge: The discourse regarding the Covid-19 vaccination. Health (London) 2024; 28:58-73. [PMID: 35852156 DOI: 10.1177/13634593221113208] [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] [Indexed: 12/18/2023]
Abstract
Persuasion knowledge is personal knowledge about persuasion attempts that has an effect on the way people respond to these attempts. Persuasion attempts are made to effectively handling the Covid-19 pandemic, which is dependent on high public compliance with vaccination programs. Drawing on the idea of persuasion knowledge, we aimed at elaborating the various categories of perceived information gaps experienced by vaccine hesitants during the Covid-19 vaccination campaign. At the beginning of 2021 we conducted 20 in-depth interviews with Israelis who had decided not to be vaccinated against Covid-19. Analysis of the interviews revealed three main categories of information gaps experienced by the interviewees: missing information, manipulated information, and discrepant information. We analyzed how these are associated with distrust and may impair the persuasion efforts of governments and health authorities. Perceived information gaps, as part of persuasion knowledge, may increase negative responses, and therefore constitute an important factor in persuasion campaigns.
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Wu J, Wei Z, Yang Y, Sun X, Zhan S, Jiang Q, Fu C. Gap between cognitions and behaviors among children's guardians of influenza vaccination: The role of social influence and vaccine-related knowledge. Hum Vaccin Immunother 2023; 19:2166285. [PMID: 36703498 PMCID: PMC9980667 DOI: 10.1080/21645515.2023.2166285] [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: 01/28/2023] Open
Abstract
The seasonal influenza vaccine coverage remains suboptimal among children even though guardians expressed high willingness to vaccinate their children. This study aimed to determine the association between vaccine hesitancy and uptake to facilitate vaccination; thus, bridging the gap. A cross-sectional design, using stratified cluster random sampling, was conducted among guardians of 0-59-month-old Chinese children from July to October in 2019. A structural equation model was applied to explore the interrelationships between factors including vaccine hesitancy, vaccination, social influence, and relative knowledge among guardians. Of the 1,404 guardians, 326 were highly hesitant to vaccinate their children, 33.13% (108/326) of whom had vaccinated their children. Moreover, 517 and 561 guardians had moderate and low vaccine hesitancy, with corresponding vaccine coverage of 42.75% (221/517) and 47.95% (269/516). Guardians' gender, age, and education level were demographic variables with significant moderating effects. Social influence considered impact of communities, family members, friends, neighbors, healthcare workers, bad vaccination experience and sense on price. Actual vaccine uptake was negatively significantly associated with hesitancy (β = -0.11, p < .001) with positive association with social influence (β = 0.61, p < .001). Vaccine hesitancy was negatively significantly associated with relative knowledge (β = -2.14, p < .001) and social influence (β = -1.09, p < .001). A gap is noted between cognitions and behaviors among children's guardians regarding influenza vaccination. A comprehensive strategy including emphasizing benefits of the influenza vaccination, risk of infection, and ensuring high vaccine confidence among healthcare workers can help transform the willingness to engage in the behavior of vaccination.
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Affiliation(s)
- Jing Wu
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheng Wei
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingying Yang
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiu Sun
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Siyi Zhan
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qijing Jiang
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chuanxi Fu
- From the Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
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Afsharinia B, Gurtoo A. Role of leadership and incentive-based programs in addressing vaccine hesitancy in India. Vaccine X 2023; 15:100346. [PMID: 37577213 PMCID: PMC10413069 DOI: 10.1016/j.jvacx.2023.100346] [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: 10/11/2022] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/15/2023] Open
Abstract
The current study goes beyond the popular 5Cs model of vaccine hesitancy to explore perceived social norms, role of leadership and the role of incentive-based intervention for improving the likelihood of vaccination, in a population-representative sample of adults in India (N = 1129). We investigated differences in socio-demographic status, perceived descriptive norms like vaccine behaviours, beliefs, experience and perceived injunctive norms like community and political leadership within the context of the COVID-19 pandemic are related to vaccination. Further, we examined the role of incentive-based intervention as a potentially salient predictor of adults' vaccine uptake. The study is based on a cross-sectional survey conducted in July-November 2021, which included questions about impacts of pandemic collected by phone call interview from adults' beneficiaries of Government free food schemes, across 11 states in India. The data include 81 % vaccinated and 19 % vaccine hesitant participants, with a higher proportion of business or self-employed (53.1 %) as vaccine hesitant. We performed the t-test to assess the variation between vaccinated and vaccine hesitant adults, and Exploratory Factor Analysis to uncover the underlying dimension of vaccine hesitancy. Subsequently, Binary Logistic Regression model probed the factors associated with likelihood of vaccination uptake. In contrast to the prevailing evidence, results demonstrated community and political leadership has significant negative impact on vaccination (p-value < 0.06, 95 % CI, 0.57-1.01). Incentive-based intervention offer a vital leverage to enhance positive attitude towards vaccination (p-value < 0.05, 95 % CI, 1.01-1.80). The results thus broadly highlight the limited role of political and community leaders in leveraging their influence on vaccination, the role of timely, accurate information, applications of telemedicine as an important tool to provide healthcare and the need for optimal design of incentive-based vaccination programs recommended by trusted sources.
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Affiliation(s)
- Bita Afsharinia
- Senior Research Scholar, Department of Management Studies, Indian Institute of Science, Bangalore 560012, India
| | - Anjula Gurtoo
- Senior Research Scholar, Department of Management Studies, Indian Institute of Science, Bangalore 560012, India
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Jacobson A, Spitzer S, Gorelik Y, Edelstein M. Barriers and enablers to vaccination in the ultra-orthodox Jewish population: a systematic review. Front Public Health 2023; 11:1244368. [PMID: 37900036 PMCID: PMC10602685 DOI: 10.3389/fpubh.2023.1244368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Background The Jewish Ultra-Orthodox (UO) population is an under-vaccinated minority group that has been disproportionally affected by outbreaks of vaccine-preventable diseases (VPD) such as measles and polio. Underlying reasons remain poorly characterized. We aimed to identify vaccination barriers and enablers in this population. Methods We systematically reviewed the literature (PROSPERO: CRD42021273001), searching Pub-med, Web of science, Medline, PsychNet and Scopus from 1995 to 2021 for quantitative and qualitative primary research in English. Studies published outside the date range, not including barriers or enablers, or that were non-primary research were excluded. We assessed included publications for quality and extracted relevant data based on the 5As taxonomy: access, awareness, affordability, acceptance and activation. Results We included nine qualitative and seven quantitative studies from the 125 studies identified. Access barriers included scheduling difficulties, inconvenient opening hours, and logistical difficulties related to having multiple young children. Acceptance barriers included safety concerns. Insufficient knowledge about the importance of vaccine and timely vaccination and the perception of being shielded from infections because of seclusion from wider society were key awareness barriers. Competing priorities, such as work and housework, were the main affordability barriers. Mainstream religious leadership's support for vaccination was an enabler, although recent studies suggest their influence on vaccination behavior is decreasing and influence of anti-vaccination messages is growing. Discussion Barriers to vaccination among the UO were mainly logistical, with little religious framing. Safety and efficacy concerns were similar to those reported in the wider community. Decreasing influence of the traditionally pro-vaccine mainstream religious leadership and growing influence of anti-vaccination movements targeting the UO community are new phenomena that require close monitoring. Tailored interventions are required to protect the community and wider society against future VPD outbreaks. Systematic review registration PROSPERO: CRD42021273001.
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Lee JH, Shin E, Kim HK, Song WJ, Kwon HS, Kim TB, Cho YS. Exacerbation of Chronic Spontaneous Urticaria Following Coronavirus Disease 2019 (COVID-19) Vaccination in Omalizumab-Treated Patients. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2403-2410. [PMID: 37182571 PMCID: PMC10176887 DOI: 10.1016/j.jaip.2023.04.050] [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: 07/01/2022] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND The rapid development and rollout of vaccines against coronavirus disease 2019 (COVID-19) has led to more than half of the world's population being vaccinated to date. Real-world data have reported various adverse cutaneous reactions, including delayed-onset urticaria, which was highly ranked as a common manifestation across studies. However, the impact of these novel mRNA or viral vector COVID-19 vaccines on preexisting chronic spontaneous urticaria (CSU) remains largely unknown. OBJECTIVE To investigate the impact of COVID-19 vaccination on the clinical status of patients with relatively stable CSU who are undergoing omalizumab treatment and to identify risk factors for exacerbation. METHODS We conducted a questionnaire-based cross-sectional study in a tertiary hospital. Adult patients with relatively stable CSU under regular omalizumab treatments who had received at least one COVID-19 vaccination were included. RESULTS There were 105 study subjects who received 230 COVID-19 vaccinations between March and December 2021. Fifteen patients (14.3%) experienced aggravation of urticaria at least once after COVID-19 vaccination. The demographics and clinical characteristics of the patients were comparable regardless of the exacerbation of CSU. However, case-level analysis revealed that the presence of urticaria (vs none) before vaccination (odds ratio [OR] = 4.99; 95% CI, 1.57-15.82) and the development of systemic reactogenicity (OR = 4.57; 95% CI, 1.62-12.90) were associated with a higher risk for exacerbation. CONCLUSIONS The novel COVID-19 vaccination induced exacerbation in more than one-tenth of patients with well-controlled CSU. The establishment of a proper management strategy during COVID-19 vaccination is necessary for patients with CSU.
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Affiliation(s)
- Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Eunyong Shin
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun-Kyoung Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk-Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae-Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - You Sook Cho
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Gold MS, Amarasinghe A, Greenhawt M, Kelso JM, Kochhar S, Yu-Hor Thong B, Top KA, Turner PJ, Worm M, Law B. Anaphylaxis: Revision of the Brighton collaboration case definition. Vaccine 2023; 41:2605-2614. [PMID: 36435707 DOI: 10.1016/j.vaccine.2022.11.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
The Brighton Collaboration (BC) has formulated a number of case definitions which have primarily been applied to adverse events of special interest in the context of vaccine safety surveillance. This is a revision of the 2007 BC case definition for anaphylaxis. Recently, the BC definition has been widely used for evaluating reports of suspected anaphylaxis following COVID-19 vaccination. This has led to debate about the performance of the BC definition in comparison with those from the US National Institute of Allergy and Infectious Disease/Food Allergy Anaphylaxis Network (NIAID/FAAN) and the World Allergy Organization (WAO). BC convened an expert working group to revise the case definition based on their usual process of literature review and expert consensus. This manuscript presents the outcome of this process and proposes a revised case definition for anaphylaxis. Major and minor criteria have been re-evaluated with an emphasis on the reporting of observable clinical signs, rather than subjective symptoms, and a clearer approach to the ascertainment of levels of certainty is provided. The BC case definition has also been aligned with other contemporary and international case definitions for anaphylaxis.
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Affiliation(s)
- Michael S Gold
- Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
| | | | - Matthew Greenhawt
- Section of Allergy and Immunology, Children's Hospital Colorado, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - John M Kelso
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego CA, USA
| | - Sonali Kochhar
- Department of Global Health, University of Washington, Seattle, USA; Global Healthcare Consulting, India
| | - Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Karina A Top
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Paul J Turner
- National Heart & Lung Institute, Imperial College London, London, United Kingdom; University of Sydney, Sydney, Australia
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology and Allergy, Charité Universitätsmedizin, Berlin, Germany
| | - Barbara Law
- SPEAC, Brighton Collaboration, Independent Consultant, Vancouver, BC, Canada
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Judd A, Samarakoon U, Wolfson AR, Banerji A, Freeman EE, Blumenthal KG. Urticaria after COVID-19 vaccination and vaccine hesitancy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:958-960. [PMID: 36581074 PMCID: PMC9791784 DOI: 10.1016/j.jaip.2022.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/23/2022] [Accepted: 12/08/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Allen Judd
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass
| | - Upeka Samarakoon
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass
| | - Anna R Wolfson
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Aleena Banerji
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Esther E Freeman
- Harvard Medical School, Boston, Mass; Department of Dermatology, Massachusetts General Hospital, Boston, Mass
| | - Kimberly G Blumenthal
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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Kara A, Coskun A, Temel F, Özelci P, Topal S, Ates İ. Self-Reported Allergic Adverse Events Following Inactivated SARS-CoV-2 Vaccine (TURKOVAC™) among General and High-Risk Population. Vaccines (Basel) 2023; 11:vaccines11020437. [PMID: 36851314 PMCID: PMC9958953 DOI: 10.3390/vaccines11020437] [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: 12/17/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
TURKOVAC™ is a whole-virion inactivated COVID-19 vaccine which was developed and granted emergency use and conditional marketing authorization in December 2021 in Türkiye. The objective of this study is to assess the distribution and the severity of allergic adverse events following the administration of the vaccine as the primary or the booster dose in 15 provinces in Türkiye. In this cohort study, between February and May 2022, in the selected 15 provinces having an adequate number of health care personnel in the community health centers to conduct the study, 32,300 people having the first, the second, or the booster dose of the vaccine were invited to the survey. A total of 29,584 people voluntarily agreed to participate to the survey and were given a structured questionnaire after a minimum of 10 days following the vaccination. In our study, only 0.5% of the participants (142 persons) reported to experience any allergic reaction, and 12 of them (8.5%) reported to be given medical treatment in a health center. Male predominance (55.6%) was observed among participants reported to experience any allergic reaction. No hospitalization was recorded. Of the participants, 4.4% (1315 people) reported to have a history of allergy. The most reported allergens were drugs. Among the participants without a known history of allergy (n = 28,269), 0.4% of them (110 people) reported to experience an allergic reaction following the vaccination, and 5.4% of the allergic reactions (six people) were reported to be treated in a health center. The percentage of the participants given any medical treatment among the participants without a known history of allergy is 0.02%. No immediate or anaphylactic reaction was reported. Among the participants with a known history of allergy (n = 1315), 32 people (2.4% of them) reported to experience an allergic reaction following the vaccination, and 18.7% of the allergic reactions (six people) were reported to be prescribed a medical treatment. The percentage of the participants given any medical treatment among the participants with a known history of allergy is 0.4%. A known history of allergy increased the risk of having an allergic experience by approximately six times following vaccination. As a whole-virion inactivated SARS-CoV-2 vaccine, the TURKOVAC™ vaccine, with a low allergic reaction-related adverse event profile, can be an alternative to other COVID-19 vaccines.
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Affiliation(s)
- Ateş Kara
- Department of Pediatrics, Pediatric Infectious Disease Unit, Hacettepe University Faculty of Medicine, Health Institutes of Türkiye, Türkiye Vaccine Institute, Ankara 06100, Türkiye
- Correspondence:
| | - Aslihan Coskun
- Health Institutes of Türkiye, Türkiye Vaccine Institute, Ankara 06260, Türkiye
| | - Fehminaz Temel
- Türkiye Ministry of Health, General Directorate of Public Health, Department of Communicable Diseases and Early Warning, Field Epidemiology Unit, Ankara 06430, Türkiye
| | - Pervin Özelci
- Health Institutes of Türkiye, Türkiye Vaccine Institute, Ankara 06260, Türkiye
| | - Selmur Topal
- Türkiye Ministry of Health, General Directorate of Public Health, Department of Communicable Diseases and Early Warning, Field Epidemiology Unit, Ankara 06430, Türkiye
| | - İhsan Ates
- University of Health Science, Ankara City Hospital, Department of Internal Medicine, Ankara 06610, Türkiye
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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13
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Fithian EM, Warren C, Pappalardo AA, Thivalapill N, Long JR, Bilaver LA, Assa’ad A, Mahdavinia M, Sharma H, Gupta R. Racial, ethnic, and socioeconomic disparities in COVID-19 and influenza vaccination in pediatric food allergy. JOURNAL OF FOOD ALLERGY 2022; 4:172-180. [PMID: 37502300 PMCID: PMC10373577 DOI: 10.2500/jfa.2022.4.220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background Current coronavirus disease 2019 (COVID-19) and influenza vaccination-related knowledge, attitudes, and behaviors remain poorly understood among U.S. children with food allergy, and, particularly, those from non-Hispanic Black, Latinx, and lower-income backgrounds who bear a disproportionate burden by allergic disease. These data are especially relevant due to historical vaccine hesitancy in children with food allergy and an initial contraindication for those with severe allergic reactions to be vaccinated against COVID-19. Objective We sought to characterize COVID-19 and influenza vaccination-related knowledge, attitudes, and behaviors in a racially, ethnically, and socioeconomically diverse longitudinal cohort of caregiver-child dyads with immunoglobulin E-mediated food allergy. Methods We leveraged the National Institutes of Health supported FORWARD cohort, which consists of non-Hispanic White, non-Hispanic Black, and Hispanic/Latinx children diagnosed with food allergy to assess COVID-19 testing, vaccination, and influenza vaccine concern and utilization through administering a one-time institutional review board approved survey. Results Non-Hispanic Black participants were less likely than non-Hispanic White participants to be vaccinated (odds ratio [OR] 0.25 [95% confidence interval {CI}, 0.08-0.75]) or tested (OR 0.33 [95% CI, 0.13-0.85]) for COVID-19 and have the intention to vaccinate their children for influenza (OR 0.42 [95% CI, 0.18-0.98]). More than one-third of the participants reported that they believed that their child was at greater risk of complications from COVID-19 vaccination due to a food allergy. There were racial and/or ethnic disparities in the belief that COVID vaccines contain allergenic ingredients; more Hispanic/Latinx (37%) and Black (37%) than White (22%) participants reported this belief (p = 0.02). Conclusion The present findings of disparities in vaccination-related knowledge, attitudes, and behaviors across racial and/or ethnic, and household income strata suggested that initial reports of COVID-19 vaccination hesitancy within the population with food allergy may be further exacerbated by well-documented racial, ethnic, and socioeconomic differences in vaccine hesitancy, potentially leading to a greater infectious disease burden in these vulnerable populations. This highlights a need for targeted education and outreach among members of these communities who are living with food allergy.
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Affiliation(s)
- Eirene M. Fithian
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
| | - Christopher Warren
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
- Department of Preventive Medicine and Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University
| | - Andrea A. Pappalardo
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
- Department of Medicine and Pediatrics, University of Illinois at Chicago
| | - Neil Thivalapill
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
- Center for Food Allergy and Asthma Research, Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
| | - Jennifer R. Long
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
- Center for Food Allergy and Asthma Research; Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
| | - Lucy A. Bilaver
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
- Department of Pediatrics and Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University
| | - Amal Assa’ad
- Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati Department of Pediatrics
| | - Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Department of Internal Medicine, Rush University
| | - Hemant Sharma
- Division of Allergy and Immunology, George Washington University School of Medicine, Children’s National Hospital, and
| | - Ruchi Gupta
- From the Center for Food Allergy and Asthma Research; Ann and Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University
- Center for Food Allergy and Asthma Research; Institute for Public Health and Medicine, Northwestern Feinberg School of Medicine; Ann & Robert H. Lurie Children's Hospital of Chicago
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14
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Asperti C, Benanti G, Ramirez GA, Russo M, Vai B, Bramé B, Viapiana N, Nannipieri S, Cilona MB, Mazzetti M, Zuffada S, Di Mattei VE, Benedetti F, Dagna L, Yacoub MR. Interactions between Severe Allergy and Anxiety in Anti-SARS-CoV-2 Vaccinees. Vaccines (Basel) 2022; 10:vaccines10122047. [PMID: 36560457 PMCID: PMC9783305 DOI: 10.3390/vaccines10122047] [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: 10/29/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Severe drug allergy affects patient hesitancy to new treatments, posing unprecedented challenges to anti-SARS-CoV-2 vaccination campaigns. We aimed to analyze the psychological profile of vaccinees with a history of severe allergy in comparison to subjects with a milder allergy history. Patients attending a dedicated vaccination setting were administered an anonymized questionnaire including clinical data and the State-Trait Anxiety Inventory (STAI) scale (score range 20−80). Patients were also asked whether being in a protected setting affected their attitude toward vaccination. Data are expressed as median (interquartile range). We enrolled 116 patients (78% women), of whom 79% had a history of drug anaphylaxis. The median state anxiety score was 36.5 (30−47.2), while the trait anxiety score was 37 (32−48). State anxiety was higher in those with severe than mild allergy [39 (32−50) vs. 30 (25−37); p < 0.001], with the highest score found in a patient with previous drug anaphylaxis (42.5 [32−51.7]). More than 50% of patients reported that being in a protected setting had lowered their anxiety. Severe allergy is associated with a higher burden of situational anxiety in the setting of vaccination without affecting patient constitutional (trait) levels of anxiety. Vaccination in dedicated facilities might overcome issues related to hesitancy and improve patients’ quality of life.
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Affiliation(s)
- Chiara Asperti
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Giovanni Benanti
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Giuseppe A. Ramirez
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Marco Russo
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Benedetta Vai
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Barbara Bramé
- Nuovo Ospedale di Legnano, Uoc Medicina Generale, 20025 Legnano, Italy
| | - Naomi Viapiana
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Serena Nannipieri
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Maria Bernadette Cilona
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Martina Mazzetti
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Simone Zuffada
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valentina Elisabetta Di Mattei
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesco Benedetti
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Mona-Rita Yacoub
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Correspondence:
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15
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Parimi K, Gilkeson K, Creamer BA. COVID-19 vaccine hesitancy: Considerations for reluctance and improving vaccine uptake. Hum Vaccin Immunother 2022; 18:2062972. [PMID: 35436173 PMCID: PMC9897654 DOI: 10.1080/21645515.2022.2062972] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) pandemic during the fall of 2019 led to the rapid development of vaccines aimed at curbing viral infection, spread, and its potential eradication. A recent trend is an overall increase in vaccine hesitancy, leading to the World Health Organization citing this as a problem which needs to be addressed. With the development and approval of vaccines for COVID-19, this trend has quickened, leading to potential negative ramifications in the ability controlling COVID-19 spread. Here we describe reported examples in overall vaccine hesitancy prior to the emergence of COVID-19, as well as summarizing recent reports on vaccine hesitancy related to COVID-19 vaccines. Gaining a better understanding of the reasons individuals have, as well as potential methods for decreasing hesitancy in the future, will hopefully lead to a greater percentage of vaccinated individuals and aid in ending the current pandemic.
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Affiliation(s)
- Kaushal Parimi
- Thomas Jefferson Independent Day School, Joplin, MO, USA
| | - Kyle Gilkeson
- Department of Basic Sciences, College of Medicine, Kansas City University, Joplin, MO, USA
| | - Bradley A. Creamer
- Department of Basic Sciences, College of Medicine, Kansas City University, Joplin, MO, USA,CONTACT Bradley A. Creamer Department of Basic Sciences, Kansas City University, 2901 St. Johns Blvd, Joplin, MO64804, USA
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16
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Tostrud L, Thelen J, Palatnik A. Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature". Hum Vaccin Immunother 2022; 18:2138047. [PMID: 36345571 PMCID: PMC9746492 DOI: 10.1080/21645515.2022.2138047] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/26/2022] [Accepted: 10/15/2022] [Indexed: 11/09/2022] Open
Abstract
Vaccination has proven to be the most effective tool in controlling the COVID-19 pandemic. While pregnant individuals are considered to be a high-risk population and are more likely to experience adverse effects from COVID-19, vaccination rates among pregnant individuals are significantly lower than in the general population. The Health Belief Model (HBM), Theory of Planned Behavior (TPB), 3C model, 5C model, and 5A model have been used to assess vaccination hesitancy behaviors. In this paper, we review the use of each of these models to address vaccine hesitancy, with a focus on the pregnant population and the COVID-19 vaccine. The HBM, TPB, 3C model, and 5C model have demonstrated great versatility in their ability to evaluate, explain, and modify vaccine hesitancy and behavior. Up to date, the HBM and 3C models appear to be the most effective models to study and address vaccination hesitancy within the pregnant persons.
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Affiliation(s)
- Lauren Tostrud
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Julia Thelen
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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17
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De Gioia ER, Porqueddu A, Nebiaj O, Bianconi A, Conni A, Montalti M, Pandolfi P, Todeschini R, Fantini MP, Gori D. The Role of Needle Fear in Pediatric Flu Vaccine Hesitancy: A Cross-Sectional Study in Bologna Metropolitan Area. Vaccines (Basel) 2022; 10:1388. [PMID: 36146466 PMCID: PMC9506010 DOI: 10.3390/vaccines10091388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: vaccination is the most effective way to prevent influenza and reduce its complications. The main aim of the study is to assess a possible increase of parents'/caregivers' pediatric flu vaccination adherence due to a nasal administration as an alternative to injection in Bologna. (2) Methods: 169 parents/guardians of children who were joining the COVID-19 pediatric vaccination session in Bologna were interviewed. The results were summarized using descriptive statistics. A multiple logistic regression model was used to assess the determinants of the change in flu vaccine uptake if offered without injection administration. All analyses were conducted using STATA and R-Studio software. (3) Results: Only 29.0% of parents were informed about pediatric flu vaccination by pediatricians, and 32.5% heard about pediatric flu vaccination. Almost 72.2% of parents declared that they would not have their children vaccinated against influenza. Thus, 40.2% of them changed their opinion after being informed about the existence of a non-injective vaccine. Needle fear in children turned out to be a determinant of this opinion change (OR = 3.79; 95% CI = 1.63-9.43; p = 0.003). (4) Conclusions: the study has confirmed that needle fear is a determinant of vaccine hesitancy and that a different method of administration may increase parents'/guardians' adherence.
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Affiliation(s)
- Esther Rita De Gioia
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Adalisa Porqueddu
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Ornela Nebiaj
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Alessandro Bianconi
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Alice Conni
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Marco Montalti
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Paolo Pandolfi
- Department of Public Health, Bologna Local Health Authority, Via Gramsci, 12, 40124 Bologna, Italy
| | - Renato Todeschini
- Department of Public Health, Bologna Local Health Authority, Via Gramsci, 12, 40124 Bologna, Italy
| | - Maria Pia Fantini
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Davide Gori
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
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18
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Moosa AS, Wee YMS, Jaw MH, Tan QF, Tse WLD, Loke CY, Ee GLA, Ng CCD, Aau WK, Koh YLE, Tan NC. A multidisciplinary effort to increase COVID-19 vaccination among the older adults. Front Public Health 2022; 10:904161. [PMID: 35979453 PMCID: PMC9376249 DOI: 10.3389/fpubh.2022.904161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 vaccination significantly reduces the risk of infection and its associated morbidity and mortality. However, poor uptake of the COVID-19 vaccination was reported among the high-risk group of older people amidst emerging variants of concern. This community case study reports an outreach program in Singapore, COVE (COVID-19 Vaccination for the Elderly) initiated by healthcare workers in a cluster of primary care clinics. They assessed the vaccine hesitancy among these older persons, addressed their concerns and facilitated their vaccination appointment during a brief phone conversation. Method Twenty one thousand six hundred and sixty three unvaccinated adults aged ≥60 years were contacted by healthcare worker volunteers over two phases from June to October 2021. In phase I, they contacted adults aged above 70 years over 2 weeks. Adults who were uncontactable in phase I and those aged 60-69 years were sent SMS in phase II. Data were analyzed via descriptive data analysis. Results After phase 1, 65.5% (n = 5,646/8,617) of older adults had received at least one dose of the COVID-19 vaccine. The respondents expressed intention to vaccinate (39%, n = 3,390), requested to seek further information (25%, n = 2,138), reported access barrier (8%, n = 715), or were concerned of the vaccine adverse effects (3%, n = 288). Vaccination was refused by 24% (n = 2,086) of the respondents. Eventually 60.4% (n = 13,082/21,663) of them were vaccinated 3 months after COVE implementation. Conclusion The COVE program increased the COVID-19 vaccination uptake of older adults from 84.6 to 96.3%. A person-centric proactive approach by healthcare workers addressed vaccine hesitancy and optimized vaccination. The outreach scheduling of vaccination appointments is key in promoting vaccination uptake among older adults.
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Affiliation(s)
- Aminath S. Moosa
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Yi M. S. Wee
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Meng H. Jaw
- SingHealth Polyclinics, Singapore, Singapore
| | | | - Wan L. D. Tse
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | | | - Guan L. A. Ee
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Chee C. D. Ng
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
| | - Wai K. Aau
- SingHealth Polyclinics, Singapore, Singapore
| | | | - Ngiap C. Tan
- SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
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19
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Chiang V, Saha C, Yim J, Au EYL, Kan AKC, Hui KSH, Li TS, Lo WLW, Hong YD, Ye J, Ng C, Ko WWK, Ho CTK, Lau CS, Quan J, Li PH. The Role of the Allergist in Coronavirus Disease 2019 Vaccine Allergy Safety: A Pilot Study on a "Hub-and-Spoke" Model for Population-Wide Allergy Service. Ann Allergy Asthma Immunol 2022; 129:308-312.e1. [PMID: 35605815 PMCID: PMC9121691 DOI: 10.1016/j.anai.2022.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 02/06/2023]
Abstract
Background Hong Kong started its coronavirus disease 2019 (COVID-19) vaccination program in February 2021. A territory-wide Vaccine Allergy Safety (VAS) clinic was set up to assess individuals deemed at “higher risk” of COVID-19 vaccine-associated allergies. A novel “hub-and-spoke” model was piloted to tackle the overwhelming demand of services by allowing nonallergists to conduct assessment. Objective To evaluate the outcomes of the VAS hub-and-spoke model for allergy assessment. Methods Records of patients attending the VAS hub-and-spoke Clinics between March and August 2021 were reviewed (n = 2725). We studied the overall results between the Hub (allergist led) and Spoke (nonallergist led) Clinics. The Hub and the Hong Kong West Cluster Spoke Clinic were selected for subgroup analysis as they saw the largest number of patients (n = 1411). Results A total of 2725 patients were assessed under the VAS hub-and-spoke model. Overall, 2324 patients (85.3%) were recommended to proceed with vaccination. Allergists recommended significantly more patients for vaccination than nonallergists (odds ratio = 21.58; P < .001). Subgroup analysis revealed that 881 of 1055 (83.5%) patients received their first dose of COVID-19 vaccination safely after assessment. Among those recommended vaccination, more patients assessed by allergists received their first dose of vaccination (odds ratio = 4.18; P < .001). Conclusion The hub-and-spoke model has proven to be successful for the vaccination campaign. This study has illustrated the crucial role of allergists in countering vaccine hesitancy. Results from the study revealed considerable differences in outcomes between allergist-led and nonallergist-led clinics. Precise reasons for these differences warrant further evaluation. We are hopeful that the hub-and-spoke model can be similarly adapted for other allergist-integrative services in the future.
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Affiliation(s)
- Valerie Chiang
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Chinmoy Saha
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jackie Yim
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Elaine Y L Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Andy K C Kan
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kong Siu Harris Hui
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Tin Sum Li
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Wing Lam Whitney Lo
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yuh Dong Hong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jiaxi Ye
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Carmen Ng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Welchie W K Ko
- Department of Family Medicine and Primary Healthcare, Hong Kong West Cluster, Hospital Authority, Kowloon, Hong Kong
| | - Carmen T K Ho
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Chak Sing Lau
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jianchao Quan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Philip H Li
- Division of Rheumatology & Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong.
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20
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Corinti F, Pontillo D, Giansanti D. COVID-19 and the Infodemic: An Overview of the Role and Impact of Social Media, the Evolution of Medical Knowledge, and Emerging Problems. Healthcare (Basel) 2022; 10:732. [PMID: 35455910 PMCID: PMC9027783 DOI: 10.3390/healthcare10040732] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/25/2022] [Accepted: 04/12/2022] [Indexed: 12/28/2022] Open
Abstract
The infodemic is an important component of the cyber-risk in regard to the poor and uncontrolled dissemination of information related to the COVID-19 pandemic. The purpose of this study was to perform a narrative review based on three points of view to allow for an overall picture of this issue. The points of view focused on: (a) the volume of use of social media (a key element of the infodemic) and the position of international health domain bodies; (b) the evolution of scientific production in the life sciences; (c) emerging issues. The research methodology was based on Google and PubMed searches and a qualification process based on a standard checklist and an evaluation of eligibility based on parameters with five score levels applied by two experts (plus one in case of discrepancy). The three points of view stressed the key role of social media as a dissemination tool of the infodemic among citizens. The impact on citizens depends on various social factors and involves indirect (e.g., vaccine avoidance) and direct risks such as mental problems and the risk of suicide. The widespread diffusion of social media, conveyed by mobile technologies, also suggests their use as countermeasures, calibrated based on citizens’ level of both technological and health literacy. Effective and promising countermeasures in this direction are based both on initiatives of contact by apps or SMS and the collection of data based on surveys and finalized to the particular intervention. The review also suggests as further areas of in-depth research: (a) to combat high-level infodemic produced by scientific publications that are not yet official (preprint) or that have undergone peer review with bias/distortion; (b) focusing on the impact of the infodemic considering its spread in different languages.
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Affiliation(s)
- Francesca Corinti
- Facoltà di Medicina e Psicologia, Università Sapienza, 00185 Roma, Italy; (F.C.); (D.P.)
| | - Daniela Pontillo
- Facoltà di Medicina e Psicologia, Università Sapienza, 00185 Roma, Italy; (F.C.); (D.P.)
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21
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Maginot R, Esteves C, Kingsley K. Changing Perspectives on Pediatric Human Papillomavirus (HPV) Vaccination among Dental Students and Residents Reveals Recent Increase in Vaccine Hesitancy. Vaccines (Basel) 2022; 10:570. [PMID: 35455318 PMCID: PMC9029190 DOI: 10.3390/vaccines10040570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/02/2022] Open
Abstract
This study was a retrospective analysis of previously collected anonymous survey data regarding vaccine awareness, beliefs, and knowledge among dental (DMD) students and postgraduate (PG) residents. The protocol for this study was approved by the Institutional Review Board (IRB) as exempt. A total of 341 responses were collected from n = 293 DMD students and n = 48 PG residents. Although most respondents agreed that vaccines were necessary, safe, and effective, over the past 4 years (2017-2020) a growing percentage of respondents disagreed. In addition, although most respondents disagreed that there are too many required vaccines, vaccines can make you sick, or are dangerous, a growing percentage of respondents now agreed with these statements. Finally, although most respondents were aware of the HPV vaccine, recently a growing percentage of both students and residents reported they had insufficient information about this vaccine. These results provide novel insights into recent changes in attitudes and beliefs regarding vaccination among this population. Moreover, analysis of these shifts in attitudes and knowledge about HPV vaccination suggests that curricular integration of vaccine research and hesitancy may be needed to answer these questions in a supportive learning environment that fosters critical thinking and evidence-based practice and decision making.
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Affiliation(s)
- Rebecca Maginot
- Department of Advanced Education in Pediatric Dentistry, School of Dental Medicine, University of Nevada, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA;
| | - Carolina Esteves
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA;
| | - Karl Kingsley
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada, 1001 Shadow Lane, Las Vegas, NV 89106, USA
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22
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The COVID-19 Infodemic: Mechanism, Impact, and Counter-Measures—A Review of Reviews. SUSTAINABILITY 2022. [DOI: 10.3390/su14052605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The acceptability of appropriate SARS-CoV-2 pandemic measures including vaccinations is currently being hampered due to significant misinformation all over the globe, also known as the “infodemic” within the pandemic. We asked the following two research questions: (1) What is the current extent of the global infodemic preventing populations from receiving adequate healthcare including COVID-vaccinations? (2) Which are appropriate countermeasures to manage the infodemic in order to guarantee adequate healthcare in the SARS-CoV-2 pandemic? Pubmed and Cochrane Library were accessed on 29 October 2021 and searched for reviews and systematic reviews on “COVID-19” and “infodemic”. The literature identified was analyzed with methods of qualitative research focusing on (1) mechanism, (2) impact, and (3) countermeasures to confront the infodemic. The world-wide infodemic is being recognized as a multifaceted problem beyond health and human rights, extending into global political spheres such as societal cohesion and security. The mechanism of the COVID-19 infodemic involves specific factors related to the situation, sender, instrument, and recipient. Although freedom of expression and the right to seek, receive, and impart information through any media is a fundamental human right, the infodemic has a substantial impact on health, another fundamental human right, by causing stress, deception, violence, and harm. Mixed-synergistic pre-impact, trans-impact, and post-impact countermeasures can be taken; the most important is building and maintaining trust.
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23
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Jiang Y, Rubin L, Peng T, Liu L, Xing X, Lazarovici P, Zheng W. Cytokine storm in COVID-19: from viral infection to immune responses, diagnosis and therapy. Int J Biol Sci 2022; 18:459-472. [PMID: 35002503 PMCID: PMC8741849 DOI: 10.7150/ijbs.59272] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/05/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 outbreak is emerging as a significant public health challenge. Excessive production of proinflammatory cytokines, also known as cytokine storm, is a severe clinical syndrome known to develop as a complication of infectious or inflammatory diseases. Clinical evidence suggests that the occurrence of cytokine storm in severe acute respiratory syndrome secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is closely associated with the rapid deterioration and high mortality of severe cases. In this review, we aim to summarize the mechanism of SARS-CoV-2 infection and the subsequent immunological events related to excessive cytokine production and inflammatory responses associated with ACE2-AngII signaling. An overview of the diagnosis and an update on current therapeutic regimens and vaccinations is also provided.
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Affiliation(s)
- Yizhou Jiang
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Limor Rubin
- Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Tangming Peng
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Linlin Liu
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Xingan Xing
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
| | - Philip Lazarovici
- School of Pharmacy Institute for Drug Research, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Wenhua Zheng
- Center of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
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24
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Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South. Vaccines (Basel) 2021; 9:vaccines9111279. [PMID: 34835210 PMCID: PMC8621887 DOI: 10.3390/vaccines9111279] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/14/2021] [Accepted: 10/20/2021] [Indexed: 12/20/2022] Open
Abstract
Approximately 40% of Tennesseans are vaccinated fully, due mainly to higher vaccination levels within urban counties. Significantly lower rates are observed in rural counties. Surveys suggest COVID-19 vaccine hesitancy is entrenched mostly among individuals identifying as white, rural, Republican, and evangelical Christian. Rural counties represent 70 of the total 95 counties in Tennessee, and vaccine hesitancy signifies an immediate public health crisis likely to extend the COVID-19 pandemic. Tennessee is a microcosm of the pandemic’s condition in the Southern U.S. Unvaccinated communities are the greatest contributors of new COVID-19 infections, hospitalizations, and deaths. Rural Tennesseans have a long history of cultural conservatism, poor health literacy, and distrust of government and medical establishments and are more susceptible to misinformation and conspiracy theories. Development of novel strategies to increase vaccine acceptance is essential. Here, I examine the basis of COVID-19 following SARS-CoV-2 infection and summarize the pandemic’s extent in the South, current vaccination rates and efforts across Tennessee, and underlying factors contributing to vaccine hesitancy. Finally, I discuss specific strategies to combat COVID-19 vaccine hesitancy. We must develop novel strategies that go beyond financial incentives, proven ineffective toward vaccinations. Successful strategies for vaccine acceptance of rural Tennesseans could increase acceptance among unvaccinated rural U.S. populations.
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Yacoub MR, Cucca V, Asperti C, Ramirez GA, Della-Torre E, Moro M, Zandalasini C, Di Napoli D, Ambrosio A, Signorelli C, Colombo S, Beretta L, Ciceri F, Zangrillo A, Dagna L. Efficacy of a rational algorithm to assess allergy risk in patients receiving the BNT162b2 vaccine. Vaccine 2021; 39:6464-6469. [PMID: 34598820 DOI: 10.1016/j.vaccine.2021.09.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 02/02/2023]
Abstract
Among 6146 hospital employees, 118 subjects with severe allergic background were identified through a screening questionnaire and stratified into 3 groups (Low-risk (LR), Intermediate (IR) and High-risk (HR) group), based on their allergic anamnesis. Data reports on hypersensitivity reactions (HypR) have been collected in both allergic and non-allergic subjects. Seventeen patients (14%) in the allergic population had a HypR after the first, the second or both doses. Skin manifestations were the most frequent ones. Allergic events were more frequent in HR (35%) than IR (10%; p = 0.005) or LR (0%; p = 0.074) subjects. No patient had anaphylaxis. All patients completed the vaccination schedule. 13 HypR occurred in patients without severe allergic background (13/6028, 0,2%) including one (1/6148, 0.016% of total population) WAO grade-4 anaphylaxis. Our data suggest that BNT162b2 mRNA Covid-19 vaccine is relatively safe also in patients with severe allergic background; however, some precautions are required for high-risk patients.
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Affiliation(s)
- Mona-Rita Yacoub
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - Valentina Cucca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Giuseppe A Ramirez
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Emanuel Della-Torre
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Matteo Moro
- Medical Affairs Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Davide Di Napoli
- Medical Affairs Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alberto Ambrosio
- Medical Affairs Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Carlo Signorelli
- School of Hygiene and Public Health, Vita-Salute San Raffaele University, Milan, Italy
| | - Sergio Colombo
- Vita-Salute San Raffaele University, Milan, Italy; Anaesthesiology and Intensive Care Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luigi Beretta
- Vita-Salute San Raffaele University, Milan, Italy; Anaesthesiology and Intensive Care Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy; Haematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy; Anaesthesiology and Intensive Care Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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26
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Kelso JM, Ziegler JB. Maximizing the Potential of Vaccination. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3606-3607. [PMID: 34627534 PMCID: PMC8493059 DOI: 10.1016/j.jaip.2021.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/25/2022]
Affiliation(s)
- John M Kelso
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif.
| | - John B Ziegler
- School of Women's and Children's Health, University of NSW, Sydney, NSW, Australia; Department of Immunology & Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
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