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Prince M, Kim Y. Secondary Risk in COVID-19 Vaccination Intentions: A Theoretical Contribution to the Protection Motivation Paradigm. JOURNAL OF APPLIED SOCIAL SCIENCE 2023; 17:254-271. [PMID: 37162804 PMCID: PMC10158802 DOI: 10.1177/19367244231159594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This study presents an original model that features the emotion of fear of COVID-19 as a direct effect on vaccination intentions. A central research question addressed in the study is what roles do the emotion of fear of contracting COVID-19 and the threat posed by uptake of the COVID-19 vaccination play in levels of vaccination intention? The study used a structural equation model (SEM) and applied the SmartPLS 3.2.6 data analysis tool for model estimation and multivariate analysis variables. A key finding is that vaccination resistance is strongest when fear of COVID-19 is lower, and vaccination threat higher. Vaccination threat appraisal and vaccination intention were found to have a negative relationship. Response costs at higher levels lessen motivation for COVID-19 vaccination. Research implications include research-based targeting of differing segments by their primary fear, either fear of COVID-19 or of the preventative vaccine.
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Affiliation(s)
- Melvin Prince
- Southern Connecticut State University,
New Haven, USA
- Melvin Prince, Southern Connecticut State
University Business School, New Haven, CT 06515, USA.
| | - Young Kim
- Southern Connecticut State University,
New Haven, USA
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2
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Srivastav A, Lu PJ, Amaya A, Dever JA, Stanley M, Franks JL, Scanlon PJ, Fisher AM, Greby SM, Nguyen KH, Black CL. Prevalence of influenza-specific vaccination hesitancy among adults in the United States, 2018. Vaccine 2023; 41:2572-2581. [PMID: 36907734 PMCID: PMC10941755 DOI: 10.1016/j.vaccine.2023.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/17/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND The role of vaccine hesitancy on influenza vaccination is not clearly understood. Low influenza vaccination coverage in U.S. adults suggests that a multitude of factors may be responsible for under-vaccination or non-vaccination including vaccine hesitancy. Understanding the role of influenza vaccination hesitancy is important for targeted messaging and intervention to increase influenza vaccine confidence and uptake. The objective of this study was to quantify the prevalence of adult influenza vaccination hesitancy (IVH) and examine association of IVH beliefs with sociodemographic factors and early-season influenza vaccination. METHODS A four-question validated IVH module was included in the 2018 National Internet Flu Survey. Weighted proportions and multivariable logistic regression models were used to identify correlates of IVH beliefs. RESULTS Overall, 36.9% of adults were hesitant to receive an influenza vaccination; 18.6% expressed concerns about vaccination side effects; 14.8% personally knew someone with serious side effects; and 35.6% reported that their healthcare provider was not the most trusted source of information about influenza vaccinations. Influenza vaccination ranged from 15.3 to 45.2 percentage points lower among adults self-reporting any of the four IVH beliefs. Being female, age 18-49 years, non-Hispanic Black, having high school or lower education, being employed, and not having primary care medical home were associated with hesitancy. CONCLUSIONS Among the four IVH beliefs studied, being hesitant to receiving influenza vaccination followed by mistrust of healthcare providers were identified as the most influential hesitancy beliefs. Two in five adults in the United States were hesitant to receive an influenza vaccination, and hesitancy was negatively associated with vaccination. This information may assist with targeted interventions, personalized to the individual, to reduce hesitancy and thus improve influenza vaccination acceptance.
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Affiliation(s)
- Anup Srivastav
- Leidos Incorporated, Atlanta, GA, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Jill A Dever
- RTI International, District of Columbia, WA, USA.
| | | | | | - Paul J Scanlon
- Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
| | - Allison M Fisher
- Office of Health Communications, Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stacie M Greby
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kimberly H Nguyen
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Carla L Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Borah P, Hwang J. Trust in Doctors, Positive Attitudes, and Vaccination Behavior: The Role of Doctor-Patient Communication in H1N1 Vaccination. HEALTH COMMUNICATION 2022; 37:1423-1431. [PMID: 33685304 DOI: 10.1080/10410236.2021.1895426] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Although there is a wide variety of scientific evidence that demonstrates the benefits of vaccination on a multitude of diseases, vaccination rates remain low while misperceptions about vaccines are on the rise. The primary objective of the present study is to examine the role of doctor-patient communication and vaccination. We test the impact of doctor-patient communication on trust in doctors' vaccine recommendations as a mediator, to understand the mechanisms leading to positive vaccination attitudes, and ultimately leading to actual H1N1 vaccination behavior. We use data from a nationally representative U.S. sample from one of the Multimedia Audience Research Systems (MARS) data sets collected by Kantar Media. Our results demonstrate the crucial role of doctor-patient communication in building patients' trust in doctors, which in turn positively impact vaccination attitudes and H1N1 vaccination behavior. Unlike other preventive health measures, getting vaccines after a pandemic is a critical decision because these vaccines are previously unknown. Our finding implies that verified communication from the physician's office may be one of the effective strategies during or after a pandemic. Our findings have implications for public health organizations to incorporate effective vaccination communication and could have critical implications for the COVID-19 vaccination.
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Affiliation(s)
- Porismita Borah
- GTZN 224, Edward R. Murrow College of Communication, Washington State University
| | - Juwon Hwang
- School of Journalism and Mass Communication, University of Wisconsin-Madison
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MALONEY PATRICK, TIETJE LAUREN, RUNG ARIANE, BROYLES STEPHANIE, COUK JOHN, PETERS EDWARD, STRAIF-BOURGEOIS SUSANNE. The mediating effects of barriers to vaccination on the relationship between race/ethnicity and influenza vaccination status in a rural Southeastern Louisiana medical center. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E482-E491. [PMID: 36415290 PMCID: PMC9648542 DOI: 10.15167/2421-4248/jpmh2022.63.3.2687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/21/2022] [Indexed: 04/26/2023]
Abstract
Introduction Persistent disparities in influenza vaccination rates exist between racial/ethnic minorities and Whites. The mechanisms that define this relationship are under-researched. Methods Surveys assessing barriers to vaccination were administered to outpatients in a rural medical center in Southeastern Louisiana. Survey responses were matched to patient medical records. Likert-style statements were used to measure barriers to vaccination. A mediation analysis assessing the relationship between race and influenza vaccination mediated by vaccination barriers was conducted. Results The self-reported influenza vaccination rate in those surveyed was 40.4%. Whites (45.5%) were more likely than racial/ethnic minorities (36.3%) to report receipt of an influenza vaccination (p = 0.02). Racial/ethnic minorities reported significantly higher vaccination barrier scores (p < 0.01). The relationship between race/ethnicity and vaccination was mediated by vaccination barriers, when controlling for provider recommendation and having at least one comorbid medical condition (natural indirect effect [NIE] p-value = 0.02, proportion mediated = 0.71). Conclusions Barriers to vaccination mediates the relationship between race/ethnicity and vaccination status. Providers should focus on minimizing fears that the vaccine will cause illness and emphasize that the vaccine is safe and effective at preventing severe influenza-associated illness. Additional efforts should be made to improve accessibility of the influenza vaccine, including addressing costs of vaccination and expanding the number and types of settings where the vaccine is offered.
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Affiliation(s)
- PATRICK MALONEY
- University of Nebraska Medical Center, School of Public Health, Omaha, NE
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA
- Correspondence: Patrick Maloney, 984375 Nebraska Medical Center, MCPH Room 3031, Omaha, NE 68198-4375. - E-mail:
| | - LAUREN TIETJE
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA
| | - ARIANE RUNG
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA
| | - STEPHANIE BROYLES
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge, LA
| | - JOHN COUK
- Louisiana State University Health Care Services Division, New Orleans, LA
| | - EDWARD PETERS
- University of Nebraska Medical Center, School of Public Health, Omaha, NE
- Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA
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5
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Paramanathan P, Abbas M, Huda SA, Huda S, Mortazavi M, Taravati P. Comparing racial health disparities in pandemics a decade apart: H1N1 and COVID-19. Future Healthc J 2021. [PMID: 34888475 DOI: 10.7861/fhj.2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background and aims The Centers for Disease Control and Prevention has reported disproportionate health disparities with respect to disease for Blacks/African Americans (AAs) compared to Whites in the USA. In this paper, we identify and compare the factors involved in creating these disparities among these populations during the 2009 H1N1 and current COVID-19 pandemics. Methods We included studies describing health disparities towards Blacks/AAs in the USA during the H1N1 and COVID-19 pandemics. Only observational empirical studies with free full-text availability in English from PubMed, PubMed Central and Google Scholar were included. Results A total of 31 papers were included: 19 pertaining to the H1N1 pandemic and 12 to the COVID-19 pandemic. Qualitative analysis for health disparities resulted in 43 different factors, which were subdivided into nine overarching themes. Discussion The similarities that exist between the two pandemics indicate that there are many neglected issues in American healthcare that need to be addressed. The listed factors have led to disparities in screening and treating for disease resulting in disparities in infection rates, severity of illness and mortality. This calls for a change in healthcare dynamics to improve access to healthcare, remove any form of possible discrimination, and regain the lost trust with the Black/AA communities, repairing historical damage. Conclusions Effective utilisation of social media and faith-based centres to educate patients, implementation of new policies improving access to healthcare, and culture-sensitive education for healthcare providers are suggested to decrease health disparities and improve health outcomes across the USA.
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Affiliation(s)
- Prathayini Paramanathan
- All Saints University College of Medicine, Saint Vincent and the Grenadines, and clinical research coordinator, McMaster University, Canada
| | | | - Sajjad Ali Huda
- Avalon University School of Medicine, Curacao, and Canadian pharmacist, Kingston University, London, UK
| | | | | | - Parastoo Taravati
- Saint James School of Medicine, Saint Vincent and the Grenadines, and public health extern, Illinois Academy of Family Physicians, Chicago, USA
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6
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Paramanathan P, Abbas M, Huda SA, Huda S, Mortazavi M, Taravati P. Comparing racial health disparities in pandemics a decade apart: H1N1 and COVID-19. Future Healthc J 2021; 8:e722-e728. [PMID: 34888475 DOI: 10.7861/fhj.2021.0030] [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] [Indexed: 11/27/2022]
Abstract
Background and aims The Centers for Disease Control and Prevention has reported disproportionate health disparities with respect to disease for Blacks/African Americans (AAs) compared to Whites in the USA. In this paper, we identify and compare the factors involved in creating these disparities among these populations during the 2009 H1N1 and current COVID-19 pandemics. Methods We included studies describing health disparities towards Blacks/AAs in the USA during the H1N1 and COVID-19 pandemics. Only observational empirical studies with free full-text availability in English from PubMed, PubMed Central and Google Scholar were included. Results A total of 31 papers were included: 19 pertaining to the H1N1 pandemic and 12 to the COVID-19 pandemic. Qualitative analysis for health disparities resulted in 43 different factors, which were subdivided into nine overarching themes. Discussion The similarities that exist between the two pandemics indicate that there are many neglected issues in American healthcare that need to be addressed. The listed factors have led to disparities in screening and treating for disease resulting in disparities in infection rates, severity of illness and mortality. This calls for a change in healthcare dynamics to improve access to healthcare, remove any form of possible discrimination, and regain the lost trust with the Black/AA communities, repairing historical damage. Conclusions Effective utilisation of social media and faith-based centres to educate patients, implementation of new policies improving access to healthcare, and culture-sensitive education for healthcare providers are suggested to decrease health disparities and improve health outcomes across the USA.
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Affiliation(s)
- Prathayini Paramanathan
- All Saints University College of Medicine, Saint Vincent and the Grenadines, and clinical research coordinator, McMaster University, Canada
| | | | - Sajjad Ali Huda
- Avalon University School of Medicine, Curacao, and Canadian pharmacist, Kingston University, London, UK
| | | | | | - Parastoo Taravati
- Saint James School of Medicine, Saint Vincent and the Grenadines, and public health extern, Illinois Academy of Family Physicians, Chicago, USA
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Turner PJ, Larson H, Dubé È, Fisher A. Vaccine Hesitancy: Drivers and How the Allergy Community Can Help. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3568-3574. [PMID: 34242848 PMCID: PMC8416028 DOI: 10.1016/j.jaip.2021.06.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 02/07/2023]
Abstract
Vaccine hesitancy-defined by the World Health Organization (WHO) as a "delay in acceptance or refusal of vaccines despite availability of vaccination services"-is not a recent phenomenon. Historical records indicate that vaccine hesitancy existed by the 18th century in Europe and even resulted in violent riots. The drivers of vaccine hesitancy have evolved over the last 200 years but not, perhaps, as much as one might expect. More problematic are the means by which concerns over vaccine hesitancy are communicated by a new landscape of digital communication, generating what has been described as an "infodemic" in which an overabundance of information-both factual and misinformation-contributes to hesitancy. In this review, we discuss the background and current drivers of vaccine hesitancy and the evidence base for strategies to combat this. We highlight the important role the allergy/immunology community could have in working to mitigate vaccine hesitancy, particularly with respect to the current coronavirus disease 2019 (COVID-19) pandemic.
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Affiliation(s)
- Paul J Turner
- National Heart and Lung Institute, Imperial College London, London, UK.
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ève Dubé
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada; Université Laval, Faculty of Social Sciences, Quebec City, Quebec, Canada
| | - Allison Fisher
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Ga
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8
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Trent MJ, Salmon DA, MacIntyre CR. Using the health belief model to identify barriers to seasonal influenza vaccination among Australian adults in 2019. Influenza Other Respir Viruses 2021; 15:678-687. [PMID: 33586871 PMCID: PMC8404057 DOI: 10.1111/irv.12843] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/03/2021] [Accepted: 01/12/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Each year tens of thousands of Australians become ill with influenza, resulting in thousands of severe infections that require hospitalisation. However, only 40% of adults receive the annual influenza vaccine. We surveyed Australian adults to provide up to date, population-specific data on the predictors and barriers of seasonal influenza vaccination. METHODS We administered an online survey to a nationally representative sample of Australian adults. We designed survey questions using the theoretical constructs of the health belief model. Using simple and multivariable Poisson regression, we identified attitudes and beliefs associated with influenza vaccination in 2019. RESULTS Among 1,444 respondents, 51.7% self-reported influenza vaccination in 2019. We estimated vaccine coverage to be 44% for adults under 45, 46% for adults aged 45 to 64 and 77% for adults aged 65 and over. The strongest individual predictors of self-reported vaccination were believing the vaccine is effective at preventing influenza (APR = 3.71; 95% CI = 2.87-4.80), followed by recalling their doctor recommending the vaccine (APR = 2.70; 95% CI = 2.31-3.16). Common perceived barriers that predicted self-reported vaccination included believing the vaccine could give you influenza (APR = 0.59; 95% CI = 0.52-0.67), believing the vaccine can make you ill afterwards (APR = 0.68; 95% CI = 0.62-0.74) and preferring to develop immunity "naturally" (APR = 0.38; 95% CI = 0.32-0.45). CONCLUSION Although vaccine uptake in 2019 appears to be higher than previous years, there are perceived barriers which may limit uptake among Australians. Tailored interventions are needed to combat widespread influenza vaccine hesitancy, particularly among high-risk groups.
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Affiliation(s)
- Mallory J. Trent
- Biosecurity ProgramThe Kirby InstituteUniversity of New South WalesSydneyNSWAustralia
| | - Daniel A. Salmon
- Departments of International Health and Health, Behavior and SocietyInstitute for Vaccine SafetyBloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
| | - C. Raina MacIntyre
- Biosecurity ProgramThe Kirby InstituteUniversity of New South WalesSydneyNSWAustralia
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9
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Bianchi FP, Rizzo LA, De Nitto S, Stefanizzi P, Tafuri S. Influenza vaccination coverage among splenectomized patients: an Italian study on the role of active recall in the vaccination compliance. Hum Vaccin Immunother 2019; 15:2644-2649. [PMID: 31063019 PMCID: PMC6930075 DOI: 10.1080/21645515.2019.1599678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/04/2019] [Accepted: 03/14/2019] [Indexed: 11/07/2022] Open
Abstract
Patients with anatomical or functional hypo-/a-splenia have a 10- to 50-fold higher risk of developing severe infectious diseases than does the general population. Thus, it is recommended to adhere to a specific vaccination schedule, including receiving influenza vaccine. During 2014, Bari Policlinico General Hospital approved a specific protocol to ensure that vaccines are actively offered to all splenectomized patients during their hospitalizations. The aim of this study is to evaluate the efficacy of this active recall protocol for performing influenza vaccination in the years following splenectomy among patients still involved in a specific vaccination program carried out by the hospital's Hygiene department. From May 2014 to October 2016, 96 patients were involved in the vaccination program of the Hygiene department. In November 2017, 46/96 (48%) of patients received a specific invitation by phone to receive the annual influenza vaccine (intervention group), while 50/96 (52%) did not receive any such invitation (control group). At the end of the 2017 influenza season, 73/96 (76%; 95%CI = 66-84%) of patients reported having received the influenza vaccine; no differences were observed in the extent of vaccine coverage between the groups (intervention group = 80% vs. control group = 72%; p = 0.33). Older age, more recent splenectomy, hemo-lymphopathy and receiving the previous years' doses of influenza vaccine are associated with receiving influenza vaccination during the 2017 season. These data indicate how effective communication at the time of the vaccine counseling results in good adherence to the vaccination program even after several years. Indeed, vaccination should be an opportunity not only limited to the administration of the vaccine but also for providing patient care.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Letizia Alessia Rizzo
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Sara De Nitto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Nowak GJ, Cacciatore MA, Len-Ríos ME. Understanding and Increasing Influenza Vaccination Acceptance: Insights from a 2016 National Survey of U.S. Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040711. [PMID: 29642624 PMCID: PMC5923753 DOI: 10.3390/ijerph15040711] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 11/16/2022]
Abstract
Background: The percentage of adults in the U.S. getting seasonal influenza vaccination has not changed significantly since 2013 and remains far below the federal government's 70% target. Objective: This study assessed and identified characteristics, experiences, and beliefs associated with influenza vaccination using a nationally representative survey of 1005 U.S. adults 19 years old and older. Methods: The sample was drawn from the National Opinion Research Center's AmeriSpeak Panel, a probability-based panel designed to be representative of the U.S. household population. Results: Overall, 42.3% received an influenza vaccination in the past 12 months, with rates highest for non-Hispanic Whites and Blacks and those 65 years old and older. Hispanic respondents and those under 64 years old were much less likely to get an influenza vaccination. They were also less aware of the recommendation, less informed about influenza and the benefits of vaccination, and least confident in the vaccine. Conclusions: Increasing influenza vaccination coverage in the U.S. requires a greater focus on 19-64 year-olds, particularly those 50 to 64, Hispanics and continued focus on those with diabetes and asthma. Efforts need to increase awareness of influenza vaccination recommendations, foster a sense of being well informed about influenza vaccination benefits and the risks associated with non-vaccination, and increase confidence that there are meaningful benefits from receiving an influenza vaccination.
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Affiliation(s)
- Glen J Nowak
- Center for Health and Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
| | - Michael A Cacciatore
- Center for Health and Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
| | - María E Len-Ríos
- Center for Health and Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia, 120 Hooper Street, Athens, GA 30602, USA.
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11
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Nowak GJ, Shen AK, Schwartz JL. Using campaigns to improve perceptions of the value of adult vaccination in the United States: Health communication considerations and insights. Vaccine 2017; 35:5543-5550. [PMID: 28886947 DOI: 10.1016/j.vaccine.2017.08.064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/03/2017] [Accepted: 08/24/2017] [Indexed: 11/27/2022]
Abstract
Vaccines have much relevance and promise for improving adult health in the United States, but to date, overall use and uptake remain far below desired levels. Many adults have not received recommended vaccinations and many healthcare providers do not strongly and actively encourage their use with patients. This has led some public health and medical experts to conclude that adult vaccines are severely undervalued by the U.S. public and healthcare providers and to call for campaigns and communication-based efforts to foster increased appreciation, and in turn, higher adult immunization rates. A narrative integrative review that draws upon the vaccine valuation and health communication literatures is used to develop a framework to guide campaign and communication-based efforts to improve public, provider, and policymakers' assessment of the value of adult vaccination. The review does this by: (1) distinguishing social psychological value from economic value; (2) identifying the implications of social psychological value considerations for adult vaccination-related communication campaigns; and (3) using five core health communication considerations to illustrate how social psychological notions of value can be integrated into campaigns or communication that are intended to improve adult vaccination value perceptions and assessments, and in turn, motivate greater support for and uptake of recommended adult vaccines.
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Affiliation(s)
- Glen J Nowak
- Grady College Center for Health & Risk Communication, Grady College of Journalism and Mass Communication, University of Georgia, Athens, GA, United States; National Vaccine Program Office, U.S. Department of Health and Human Services, Washington, D.C., United States.
| | - Angela K Shen
- National Vaccine Program Office, U.S. Department of Health and Human Services, Washington, D.C., United States
| | - Jason L Schwartz
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States
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12
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Guthrie JL, Fisman D, Gardy JL. Self-rated health and reasons for non-vaccination against seasonal influenza in Canadian adults with asthma. PLoS One 2017; 12:e0172117. [PMID: 28207823 PMCID: PMC5312957 DOI: 10.1371/journal.pone.0172117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 01/31/2017] [Indexed: 12/02/2022] Open
Abstract
Introduction While seasonal influenza vaccination is recommended for individuals with asthma, uptake in this population is low. We examined how self-rated health impacts reasons for not being immunized against influenza in Canadian adults with asthma, focusing on those who have never been immunized. Methods We pooled four cycles of the Canadian Community Health Survey (cycles 3.1(2005), 2007/08, 2009/10 and 2011/12), grouping individuals by whether their reasons for not having been vaccinated were perceptual or technical. We used a multivariable logistic regression model, adjusted for confounders, to quantify the relationship between self-rated health and their reported reasons for not vaccinating. Results Among the 9,836 respondents, 84.4% cited perceptual barriers as a reason for not being vaccinated. After adjusting for socio-demographic characteristics and province of residence, we determined that reporting perceptual barriers was associated with self-rated health status, with the adjusted odds ratios ranging from 1.42 (95%CI: 0.97, 2.09) to 2.64 (95%CI: 1.74, 3.99) for fair and excellent health versus poor health, respectively. Each increase in self-rated health category was associated with greater odds of citing a perceptual rather than technical barrier as a reason for non-vaccination. Discussion Self-reported health influences people’s perception of the need for influenza vaccination. Viewing the results through the lens of the precaution adoption process model suggests that personalizing communication around both the risk of influenza and the effectiveness of the vaccine may improve uptake amongst adults with asthma.
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Affiliation(s)
- Jennifer L. Guthrie
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer L. Gardy
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Ackerson B, Hechter R, Sidell M, Sy LS, Slezak J, Chao C, Patel N, Tseng HF, Jacobsen S. Human papillomavirus vaccine series completion in boys before and after recommendation for routine immunization. Vaccine 2017; 35:897-902. [DOI: 10.1016/j.vaccine.2017.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/23/2016] [Accepted: 01/03/2017] [Indexed: 02/03/2023]
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Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016. PLoS One 2017; 12:e0170550. [PMID: 28125629 PMCID: PMC5268454 DOI: 10.1371/journal.pone.0170550] [Citation(s) in RCA: 692] [Impact Index Per Article: 98.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. OBJECTIVE This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. METHODS Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. RESULTS Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. CONCLUSION Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
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Affiliation(s)
- Philipp Schmid
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Dorothee Rauber
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Gianni Lidolt
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Marie-Luisa Denker
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
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