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Kimbugwe G, Vatrinet R, Mwanga JA, Kakuru R, Mpeirwe D, Logoose S, Opio K, Kambale M, Seeley J, Grais RF, Marquer C, Kaleebu P, Ssali A. Perceptions, attitudes, and willingness of healthcare and frontline workers to participate in an Ebola vaccine trial in Uganda. Vaccine 2024; 42:3002-3008. [PMID: 38565464 DOI: 10.1016/j.vaccine.2024.03.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/16/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Understanding the knowledge, perception and attitudes towards Ebola vaccines is an important factor in ensuring future use of these vaccines. A qualitative methods study embedded in an Ebola vaccine immunogenicity and safety trial (NCT04028349) was conducted to explore the knowledge and perceptions of healthcare (HCWs) and frontline workers (FLWs), about Ebola vaccines and their willingness to participate or recommend participation in Uganda. METHOD We carried out focus group discussions and semi-structured interviews before and after vaccination, with 70 HCWs and FLWs who consented to participate in the trial, and in the qualitative component, from August to September 2019. Data were analysed using thematic content analysis. RESULTS Respondents showed good knowledge about Ebola and the vaccines in general, and had wide access to information through several channels, including the study team. On prevention, particular attention was given to effective communication within health facilities. Misconceptions were mainly around route of transmission, animal origin and types of vaccines. Previous fears were based on rumours circulating in the community, mainly about the presence of the virus in the vaccine, side effects and intention to harm (e.g. by "the whites"), ultimately insisting on transparency, trust and involvement of local leaders. Acceptability of participation was motivated by the need to protect self and others, and the willingness to advance research. Majority were willing to recommend participation to their community. CONCLUSIONS Overall, information sharing leads to a better understanding and acceptance of vaccine trials and a positive vaccination experience can be a deciding factor in the acceptance of others. Particular attention should be paid to involving the community in addressing misconceptions and fears, while ensuring that participants have access to vaccination sites in terms of transport, and that they are properly accommodated at the study site including staying for a reasonable period of time.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Janet Seeley
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Pontiano Kaleebu
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda; Uganda Virus Research Institute, Entebbe, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Agnes Ssali
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom
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2
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Koyuncu A, Carter RJ, Musaazi J, Namageyo-Funa A, Carter VM, Lamorde M, Prybylski D, Apondi R, Bakyaita T, Boore AL, Homsy J, Brown VR, Kigozi J, Nabaggala MS, Nakate V, Nkurunziza E, Stowell DF, Walwema R, Olowo A, Jalloh MF. Public perceptions of Ebola vaccines and confidence in health services to treat Ebola, malaria, and tuberculosis: Findings from a cross-sectional household survey in Uganda, 2020. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001884. [PMID: 38113241 PMCID: PMC10729951 DOI: 10.1371/journal.pgph.0001884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/30/2023] [Indexed: 12/21/2023]
Abstract
Uganda used Ebola vaccines as part of its preparedness and response during the 2018-2020 10th Ebola virus disease (EVD) outbreak in neighboring Democratic Republic of the Congo (DRC). We evaluated the public's perceptions of Ebola vaccines and compared their confidence in health services to treat Ebola versus malaria and tuberculosis as part of a survey on Ebola knowledge, attitudes, and practices (KAP) conducted in March 2020. A cross-sectional household survey was implemented in six districts in Uganda using multi-stage cluster sampling to randomly select participants. The districts were purposively selected from districts classified by the government as at high- or low-risk for an EVD outbreak. We describe perceptions of Ebola vaccines and confidence in health services to treat Ebola, tuberculosis, and malaria. Modified Poisson regression modeling was used to identify the demographic correlates of these outcomes. Among 3,485 respondents, 18% were aware of Ebola vaccines. Of those, 92% agreed that the vaccines were needed to prevent Ebola. Participants aged 15-24 years were 4% more likely to perceive such need compared to those 60 years and older (adjusted prevalence ratio [aPR] 1.04, 95% confidence interval [CI] 1.0-1.08). The perceived need was 5% lower among participants with at least some secondary education compared to uneducated participants (aPR 0.95; 0.92-0.99). Overall, 81% of those aware of the vaccines believed that everyone or most people in their community would get vaccinated if offered, and 94% said they would likely get vaccinated if offered. Confidence in health services to treat Ebola was lower compared to treating malaria or tuberculosis (55% versus 93% and 77%, respectively). However, participants from the EVD high-risk districts were 22% more likely to be confident in health services to treat Ebola compared to those in low-risk districts (aPR: 1.22; 95% CI: 1.08, 1.38). Our findings suggest that intent to take an Ebola vaccine during an outbreak was strong, but more work needs to be done to increase public awareness of these vaccines. The public's high confidence in health services to treat other health threats, such as malaria and tuberculosis, offer building blocks for strengthening their confidence in health services to treat EVD in the event of an outbreak.
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Affiliation(s)
- Aybüke Koyuncu
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rosalind J. Carter
- National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Joseph Musaazi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Apophia Namageyo-Funa
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Victoria M. Carter
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mohammed Lamorde
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Dimitri Prybylski
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rose Apondi
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Amy L. Boore
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jaco Homsy
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Vance R. Brown
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Joanita Kigozi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Maria Sarah Nabaggala
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Vivian Nakate
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Emmanuel Nkurunziza
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Daniel F. Stowell
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Richard Walwema
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Apollo Olowo
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mohamed F. Jalloh
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Su Y, Zhang X, Zhang S. The impact of collective action dilemma on vaccine hesitancy: Evidence from China. Hum Vaccin Immunother 2023; 19:2256041. [PMID: 37747070 PMCID: PMC10521338 DOI: 10.1080/21645515.2023.2256041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Vaccine hesitancy has dramatically decreased the speed of vaccination and stalled global health development. While the factors influencing vaccine hesitancy and mitigation measures have been explored in depth by existing studies, research from the perspective of human interaction is lacking. Based on the theory of collective action, this paper analyzes how free riding behavior affects vaccine hesitancy and how the vaccine hesitancy caused by free riding behavior can be solved. Using 2,203 survey data sets from China, this paper examines the influence of the collective action dilemma - represented by free riding behavior - on COVID-19 vaccine hesitancy. The empirical results show that the existence of free riding behavior is an essential cause of vaccine hesitancy. Based on this conclusion, this paper discusses how to further alleviate the problem of vaccine hesitancy caused by collective action dilemmas by promoting cooperation. The findings of this paper may be helpful to promote various types of vaccines and further suggest that countries should assume the perspective of solving the collective action dilemma to achieve increased vaccination rates.
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Affiliation(s)
- Yiqing Su
- School of Public Policy and Management, Guangxi University, Nanning, China
| | - Xiaoting Zhang
- School of Public Policy and Management, Guangxi University, Nanning, China
| | - Shifei Zhang
- School of Public Policy and Management, Guangxi University, Nanning, China
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Doshi RH, Garbern SC, Kulkarni S, Perera SM, Fleming MK, Muhayangabo RF, Ombeni AB, Tchoualeu DD, Kallay R, Song E, Powell J, Gainey M, Glenn B, Mutumwa RM, Hans Bateyi Mustafa S, Earle-Richardson G, Gao H, Abad N, Soke GN, Fitter DL, Hyde TB, Prybylski D, Levine AC, Jalloh MF, Mbong EN. Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021. Front Public Health 2023; 11:1080700. [PMID: 37559741 PMCID: PMC10408297 DOI: 10.3389/fpubh.2023.1080700] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 06/19/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction During the 2018-2020 Ebola virus disease (EVD) outbreak in the eastern part of the Democratic Republic of the Congo (DRC), prevention and control measures, such as Ebola vaccination were challenging by community mistrust. We aimed to understand perceptions regarding Ebola vaccination and identify determinants of Ebola vaccine uptake among HCWs. Methods In March 2021, we conducted a cross-sectional survey among 438 HCWs from 100 randomly selected health facilities in three health zones (Butembo, Beni, Mabalako) affected by the 10th EVD outbreak in North Kivu, DRC. HCWs were eligible if they were ≥ 18 years and were working in a health facility during the outbreak. We used survey logistic regression to assess correlates of first-offer uptake (i.e., having received the vaccine the first time it was offered vs. after subsequent offers). Results Of the 438 HCWs enrolled in the study, 420 (95.8%) reported that they were eligible and offered an Ebola vaccine. Among those offered vaccination, self-reported uptake of the Ebola vaccine was 99.0% (95% confidence interval (CI) [98.5-99.4]), but first-offer uptake was 70.2% (95% CI [67.1, 73.5]). Nearly all HCWs (94.3%; 95% CI [92.7-95.5]) perceived themselves to be at risk of contracting EVD. The most common concern was that the vaccine would cause side effects (65.7%; 95% CI [61.4-69.7]). In the multivariable analysis, mistrust of the vaccine source or how the vaccine was produced decreased the odds of first-time uptake. Discussion Overall uptake of the Ebola vaccine was high among HCWs, but uptake at the first offer was substantially lower, which was associated with mistrust of the vaccine source. Future Ebola vaccination efforts should plan to make repeated vaccination offers to HCWs and address their underlying mistrust in the vaccines, which can, in turn, improve community uptake.
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Affiliation(s)
- Reena H. Doshi
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stephanie C. Garbern
- Department of Emergency Medicine, Brown University, Providence, RI, United States
| | - Shibani Kulkarni
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Monica K. Fleming
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | | | - Ruth Kallay
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | | | - Bailey Glenn
- James A. Ferguson Infectious Disease Program, Baltimore, MD, United States
| | | | | | - Giulia Earle-Richardson
- National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hongjiang Gao
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Neetu Abad
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gnakub Norbert Soke
- Division of Global Health Protection, Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of Congo
| | - David L. Fitter
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Terri B. Hyde
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Dimitri Prybylski
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Adam C. Levine
- International Medical Corps, Washington, DC, United States
- International Medical Corps, Goma, Democratic Republic of Congo
| | - Mohamed F. Jalloh
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eta Ngole Mbong
- International Medical Corps, Goma, Democratic Republic of Congo
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Huguet-Feixa A, Artigues-Barberà E, Sol J, Godoy P, Ortega Bravo M. Effects of the COVID-19 Pandemic on the Decision and Doubts About Vaccination in Catalonia: Online Cross-sectional Questionnaire. JMIR Form Res 2023; 7:e41799. [PMID: 36877561 PMCID: PMC9994466 DOI: 10.2196/41799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Hesitancy to get vaccinated during the COVID-19 pandemic may decrease vaccination coverage and facilitate the occurrence of local or global outbreaks. OBJECTIVE The objective of this study was to analyze the impact of the COVID-19 pandemic in Catalonia on 3 aspects: the decision to get vaccinated against COVID-19, changes in opinion about vaccination in general, and the decision to get vaccinated against other diseases. METHODS We performed an observational study with the population of Catalonia aged 18 years or over, obtaining information through a self-completed questionnaire in electronic format. Differences between groups were determined using the chi-square test, Mann-Whitney U test, or the Student t test. RESULTS We analyzed the answers from 1188 respondents, of which 870 were women, 47.0% (558/1187) had sons or daughters under the age of 14 years, and 71.7% (852/1188) had studied at university. Regarding vaccination, 16.3% (193/1187) stated that they had refused a vaccine on some occasion, 76.3% (907/1188) totally agreed with vaccines, 1.9% (23/1188) were indifferent, and 3.5% (41/1188) and 1.2% (14/1188) slightly or totally disagreed with vaccination, respectively. As a result of the pandemic, 90.8% (1069/1177) stated that they would get vaccinated against COVID-19 when they are asked, while 9.2% (108/1177) stated the opposite. A greater intention to get vaccinated was observed among women; people older than 50 years; people without children under 15 years of age; people with beliefs, culture, or family in favor of vaccination; respondents who had not previously rejected other vaccines, were totally in favor of vaccines, or had not increased their doubts about vaccination; and respondents who had not changed their decision about vaccines as a result of the pandemic. Finally, 30.3% (359/1183) reported an increase in their doubts regarding vaccination, and 13.0% (154/1182) stated that they had changed their decision about routinely recommended vaccines as a result of the pandemic. CONCLUSIONS The population studied was predominantly in favor of vaccination; however, the percentage of people specifically rejecting vaccination against COVID-19 was high. As a result of the pandemic, we detected an increase in doubts about vaccines. Although the final decision about vaccination did not primarily change, some of the respondents did change their opinion about routine vaccinations. This seed of doubt about vaccines may be worrisome as we aim to maintain high vaccination coverage.
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Affiliation(s)
- Agnes Huguet-Feixa
- Institut Catatà de la Salut, Primary Care Center Rambla Ferran, Lleida, Spain.,Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Lleida, Spain
| | - Eva Artigues-Barberà
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Lleida, Spain.,Institut Català de la Salut, Primary Care Center Balàfia-Pardinyes-Secà de Sant Pere, Lleida, Spain.,Faculty of Nursery and Physiotherapy, University of Lleida, Lleida, Spain
| | - Joaquim Sol
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Lleida, Spain.,Institut de Recerca Biomèdica, Department of Experimental Medicine, University of Lleida, Lleida, Spain.,Institut Catatà de la Salut, Primary Care, Lleida, Spain
| | - Pere Godoy
- Hospital Universitario Santa Maria., Gestió de Serveis Sanitaris., Departament de Salut, Lleida, Spain.,Centro de Investigación Biomédica en Red de Epidemiologia y Salud Publica, Instituto de Salud Carlos III, Madrid, Spain.,Institut de Recerca Biomèdica, Applied Epidemiology Research Group, University of Lleida, Lleida, Spain
| | - Marta Ortega Bravo
- Institut Catatà de la Salut, Primary Care Center Rambla Ferran, Lleida, Spain.,Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Lleida, Spain.,Faculty of Medicine, University of Lleida, Lleida, Spain
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6
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Wu L, Wang X, Li R, Huang Z, Guo X, Liu J, Yan H, Sun X. Willingness to Receive a COVID-19 Vaccine and Associated Factors among Older Adults: A Cross-Sectional Survey in Shanghai, China. Vaccines (Basel) 2022; 10:vaccines10050654. [PMID: 35632409 PMCID: PMC9146736 DOI: 10.3390/vaccines10050654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Older individuals have a high risk of morbidity and mortality due to COVID-19, and one of the most effective ways to prevent COVID-19 is vaccination. Little is known about older people’s willingness to receive a COVID-19 vaccine. Therefore, the objective of this study was to assess the acceptance of and factors influencing the intention to receive a COVID-19 vaccination among older adults in Shanghai, China. Methods: A cross-sectional study was conducted among older adults (≥60 years old) in Shanghai. Face-to-face interviews with a questionnaire were conducted in community health service centers, recording several parameters: demographic information, health-related factors; perceived likelihood, severity, and burden of COVID-19; perceived safety, effectiveness, necessity, and benefit of the COVID-19 vaccine, as well as their trust in the vaccine delivery system and doctors; willingness to receive a COVID-19 vaccination. Bivariate analysis between several survey items and the willingness to receive a COVID-19 vaccination was conducted using a chi-square test. Logistic regression was used to assess to what degree each variable affected the willingness to receive a COVID-19 vaccination. Results: Of the 1067 participants, 90.91% (970/1067) confirmed that they were willing to receive a COVID-19 vaccination. The participants were more likely to be willing to be vaccinated if they were immigrants (OR = 1.988, 95%CI = 1.062−3.717), had an education level of junior high school (OR = 2.724, 95%CI = 1.000−7.423) or high school or above (OR = 3.993, 95%CI = 1.576−10.119), and had a monthly income of CNY 3000−5000 (OR = 32.770, 95%CI = 1.144−6.711) or CNY >5000 (OR = 2.309, 95%CI = 1.003−5.319). The participants were also more likely to be willing to be vaccinated if they had received a pneumonia vaccination previously (OR = 2.138, 95%CI = 1.016−4.500), perceived the safety of the COVID-19 vaccine (OR = 1.508, 95%CI = 1.073−2.119), perceived the necessity of the COVID-19 vaccine (OR = 2.604, 95%CI = 1.946−3.484), or trusted the suggestions of doctors (OR = 1.706, 95%CI = 1.115−2.618). The participants were less likely to be willing to be vaccinated if they were aged ≥76 years (OR = 0.498, 95%CI = 0.264−0.939), reported a physical health condition of bad or below (OR = 0.229, 95% CI = 0.095−0.549), or were worried about the adverse effects of a COVID-19 vaccination (OR = 0.503, 95%CI = 0.364−0.695). Conclusions: Under the free vaccination policy for COVID-19, older adults have a high intention to be vaccinated to prevent COVID-19 in Shanghai, China. Widely publicizing the safety and necessity of COVID-19 vaccination is necessary.
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Affiliation(s)
- Linlin Wu
- Department of Immunization Program, Shanghai Municipal Center for Disease Prevention and Control, Shanghai 200336, China; (L.W.); (Z.H.); (X.G.); (J.L.); (H.Y.)
| | - Xiaolan Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China;
| | - Ruiping Li
- Department of Immunization Program, Fengxian District Municipal Center for Disease Prevention and Control, Shanghai 201499, China;
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Center for Disease Prevention and Control, Shanghai 200336, China; (L.W.); (Z.H.); (X.G.); (J.L.); (H.Y.)
| | - Xiang Guo
- Department of Immunization Program, Shanghai Municipal Center for Disease Prevention and Control, Shanghai 200336, China; (L.W.); (Z.H.); (X.G.); (J.L.); (H.Y.)
| | - Jiechen Liu
- Department of Immunization Program, Shanghai Municipal Center for Disease Prevention and Control, Shanghai 200336, China; (L.W.); (Z.H.); (X.G.); (J.L.); (H.Y.)
| | - Han Yan
- Department of Immunization Program, Shanghai Municipal Center for Disease Prevention and Control, Shanghai 200336, China; (L.W.); (Z.H.); (X.G.); (J.L.); (H.Y.)
| | - Xiaodong Sun
- Department of Immunization Program, Shanghai Municipal Center for Disease Prevention and Control, Shanghai 200336, China; (L.W.); (Z.H.); (X.G.); (J.L.); (H.Y.)
- Correspondence: ; Tel.: +86-021-6275-8710
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7
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Pham PN, Sharma M, Bindu KK, Zikomangane P, Nethery RC, Nilles E, Vinck P. Protective Behaviors Associated With Gender During the 2018-2020 Ebola Outbreak in Eastern Democratic Republic of the Congo. JAMA Netw Open 2022; 5:e2147462. [PMID: 35171261 PMCID: PMC8851299 DOI: 10.1001/jamanetworkopen.2021.47462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In 2018 to 2020, the Democratic Republic of the Congo experienced the world's second largest Ebola virus disease (EVD) outbreak, killing 2290 individuals; women were disproportionately infected (57% of all cases) despite no evidence of differential biological EVD risk. Understanding how gender norms may influence exposure to EVD, intensity, and prognosis as well as personal protective behaviors against the virus is important to disease risk reduction and control interventions. OBJECTIVE To assess whether men and women differ in personal protective behaviors (vaccine acceptance, health-seeking behaviors, physical distancing) and the mediating role of EVD information and knowledge, perceived disease risk, and social relations. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, multistage cluster survey study of 1395 randomly selected adults was conducted in the Ebola-affected regions of North Kivu from April 20, 2019, to May 10, 2019. Path analyses were conducted using structural equation modeling to examine associations among study variables. Statistical analysis was conducted from August 2019 to May 2020. MAIN OUTCOMES AND MEASURES The main behavioral outcomes of interest were (1) vaccine acceptance, (2) formal health care seeking, and (3) self-protective behaviors. The primary factor of interest was self-reported gender identity. We also assessed sociodemographic factors. RESULTS Among the study's 1395 participants, 1286 (93%) had Nande ethnicity and 698 (50%) were women; the mean (SD) age was 34.5 (13.1) years. Compared with female participants, male participants reported significantly higher levels of education, wealth, and mobile phone access. There were associations found between gender and all EVD preventive behavioral outcomes, with evidence for mediation through EVD knowledge and belief in rumors. Men reported greater EVD knowledge accuracy compared with women (mean [SE] score for men: 12.06 [0.13] vs women: 11.08 [0.16]; P < .001), and greater knowledge accuracy was associated with increases in vaccine acceptance (β = 0.37; P < .001), formal care seeking (β = 0.39; P < .001), and self-protective behaviors (β = 0.35; P < .001). Lower belief in rumors was associated with greater vaccine acceptance (β = -0.30; P < .001), and greater EVD information awareness was associated with increased adoption of self-protective behaviors (β = 0.23; P < .001). CONCLUSIONS AND RELEVANCE This survey study found gender differences in adopting preventive protective behaviors against EVD. These findings suggest that it is critical to design gender-sensitive communication and vaccination strategies, while engaging women and their community as a whole in any response to infectious disease outbreaks. Research on the potential link between gender and sociodemographics factors associated with disease risk and outcomes is needed.
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Affiliation(s)
- Phuong N. Pham
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Manasi Sharma
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kennedy Kihangi Bindu
- University Libre des Pays des Grands Lacs, Quartier Himbi, Goma, République Démocratique du Congo
| | - Pacifique Zikomangane
- University Libre des Pays des Grands Lacs, Quartier Himbi, Goma, République Démocratique du Congo
| | | | - Eric Nilles
- Harvard Medical School, Boston, Massachusetts
| | - Patrick Vinck
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Abdelmagid N, Checchi F, Roberts B. Public and health professional epidemic risk perceptions in countries that are highly vulnerable to epidemics: a systematic review. Infect Dis Poverty 2022; 11:4. [PMID: 34986874 PMCID: PMC8731200 DOI: 10.1186/s40249-021-00927-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/16/2021] [Indexed: 12/23/2022] Open
Abstract
Background Risk communication interventions during epidemics aim to modify risk perceptions to achieve rapid shifts in population health behaviours. Exposure to frequent and often concurrent epidemics may influence how the public and health professionals perceive and respond to epidemic risks. This review aimed to systematically examine the evidence on risk perceptions of epidemic-prone diseases in countries highly vulnerable to epidemics. Methods We conducted a systematic review using PRISMA standards. We included peer-reviewed studies describing or measuring risk perceptions of epidemic-prone diseases among the general adult population or health professionals in 62 countries considered highly vulnerable to epidemics. We searched seven bibliographic databases and applied a four-stage screening and selection process, followed by quality appraisal. We conducted a narrative meta-synthesis and descriptive summary of the evidence, guided by the Social Amplification of Risk Framework. Results Fifty-six studies were eligible for the final review. They were conducted in eighteen countries and addressed thirteen epidemic-prone diseases. Forty-five studies were quantitative, six qualitative and five used mixed methods. Forty-one studies described epidemic risk perceptions in the general public and nineteen among health professionals. Perceived severity of epidemic-prone diseases appeared high across public and health professional populations. However, perceived likelihood of acquiring disease varied from low to moderate to high among the general public, and appeared consistently high amongst health professionals. Other occupational groups with high exposure to specific diseases, such as bushmeat handlers, reported even lower perceived likelihood than the general population. Among health professionals, the safety and effectiveness of the work environment and of the broader health system response influenced perceptions. Among the general population, disease severity, familiarity and controllability of diseases were influential factors. However, the evidence on how epidemic risk perceptions are formed or modified in these populations is limited. Conclusions The evidence affords some insights into patterns of epidemic risk perception and influencing factors, but inadequately explores what underlies perceptions and their variability, particularly among diseases, populations and over time. Approaches to defining and measuring epidemic risk perceptions are relatively underdeveloped. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00927-z.
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Affiliation(s)
- Nada Abdelmagid
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Francesco Checchi
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bayard Roberts
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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9
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Wu L, Huang Z, Guo X, Liu J, Sun X. Acceptability of COVID-19 vaccine in the working-age population in Shanghai city: a cross-sectional study. Hum Vaccin Immunother 2021; 17:4038-4042. [PMID: 34324408 PMCID: PMC8828131 DOI: 10.1080/21645515.2021.1949951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/08/2021] [Accepted: 06/25/2021] [Indexed: 10/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is still an enormous threat to global health and the economy. Although China has adopted effective measures to control the outbreak, there is still a risk of local transmission from imported cases. Meanwhile, considering the high mortality rate and rapid spread of the disease, a safe and effective vaccine is urgently needed to control the pandemic. With COVID-19 vaccines becoming available to the population, it has become important to know about their acceptance in the population. This is important to enable high vaccination coverage rates and reflects the demand within the general population. An cross-sectional survey was conducted during October 2020 in Shanghai using a well-designed questionnaire, which aimed to evaluate the acceptability of COVID-19 vaccines and to identify the factors affecting its acceptability among working-age adults in Shanghai, China. We found that the acceptability of COVID-19 vaccines was high in work-age adults in Shanghai, China. The factors affecting the acceptability of vaccination identified in this study can provide guides to increase COVID-19 vaccine acceptability in future.
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Affiliation(s)
- Linlin Wu
- Departmen of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Zhuoying Huang
- Departmen of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Xiang Guo
- Departmen of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Jiechen Liu
- Departmen of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Xiaodong Sun
- Departmen of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
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10
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Forgie EME, Masumbuko Claude K, Hawkes MT. Perceptions of ebola virus disease among the bambuti hunter group: a mixed-methods study. Pathog Glob Health 2021; 116:244-253. [PMID: 34420499 DOI: 10.1080/20477724.2021.1970909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The second largest Ebola virus disease (EVD) epidemic occurred in the Democratic Republic of the Congo (DRC) from 2018-20. The Bambuti, a hunter population in the Ituri Forest of the DRC, may be vulnerable to the zoonotic spread of EVD due to their frequent handling of forest animals. We conducted five focus group discussions and surveyed 113 Bambuti and 91 Bantu (control group), to discern how the Bambuti perceived and responded to EVD. Thematic analysis of focus group discussions revealed three major themes: (1) deprivation and discrimination; (2) mistrust; and (3) epistemic dissonance with public health messages emphasizing risks posed by forest animals. In surveys, 98% of Bambuti were deprived using the multidimensional poverty index (versus 78% of Bantu controls, p < 0.0001) and 77% had no formal education (versus 29% of controls, p < 0.0001). Bambuti were more dependent on wild meat for survival (51% versus 32% of controls, p = 0.008) and more frequently opposed the implementation of a bushmeat ban (48% versus 19% of controls, p < 0.0001). Trust in government was similar among Bambuti and Bantu. Comprehensive EVD knowledge was poor overall, and lower among the Bambuti (2% versus 8% of controls, p = 0.041). Compliance with public health measures was associated with higher levels of education and trust in government but did not differ between Bambuti and Bantu survey respondents. Together, our findings point to a particular vulnerability of the Bambuti to the effects of EVD, attributable at least in part to multidimensional poverty.
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Affiliation(s)
- Ella M E Forgie
- Department of Anthropology, University of Alberta, Edmonton, Canada
| | - Kasereka Masumbuko Claude
- Department of Medicine, Université Catholique Du Graben, Butembo, Democratic Republic of the Congo.,Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Michael T Hawkes
- Department of Pediatrics, University of Alberta, Edmonton, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada.,Department of Global Health, School of Public Health, University of Alberta, Edmonton, Canada.,Distinguished Researcher, Stollery Science Lab, University of Alberta, Edmonton, Canada.,Member, Women and Children's Research Institute, University of Alberta, Edmonton, Canada
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11
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Wang MW, Wen W, Wang N, Zhou MY, Wang CY, Ni J, Jiang JJ, Zhang XW, Feng ZH, Cheng YR. COVID-19 Vaccination Acceptance Among Healthcare Workers and Non-healthcare Workers in China: A Survey. Front Public Health 2021; 9:709056. [PMID: 34409011 PMCID: PMC8364953 DOI: 10.3389/fpubh.2021.709056] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The coronavirus pneumonia is still spreading around the world. Much progress has been made in vaccine development, and vaccination will become an inevitable trend in the fight against this pandemic. However, the public acceptance of COVID-19 vaccination still remains uncertain. Methods: An anonymous questionnaire was used in Wen Juan Xing survey platform. All the respondents were divided into healthcare workers and non-healthcare workers. Multinomial logistic regression analyses were performed to identify the key sociodemographic, cognitive, and attitude associations among the samples of healthcare workers and non-healthcare workers. Results: A total of 2,580 respondents completed the questionnaire, including 1,329 healthcare workers and 1,251 non-healthcare workers. This study showed that 76.98% of healthcare workers accepted the COVID-19 vaccine, 18.28% workers were hesitant, and 4.74% workers were resistant. Among the non-healthcare workers, 56.19% workers received the COVID-19 vaccine, 37.57% workers were hesitant, and 6.24% workers were resistant. Among the healthcare workers, compared with vaccine recipients, vaccine-hesitant individuals were more likely to be female (AOR = 1.52, 95% CI: 1.12–2.07); vaccine-resistant individuals were more likely to live in the suburbs (AOR = 2.81, 95% CI: 1.44–3.99) with an income of 10,000 RMB or greater (AOR = 2.00, 95% CI: 1.03–3.90). Among the non-healthcare workers, vaccine-hesitant individuals were more likely to be female (AOR = 1.66, 95% CI: 1.31–2.11); vaccine-resistant individuals were also more likely to be female (AOR = 1.87, 95% CI: 1.16–3.02) and older than 65 years (AOR = 4.96, 95% CI: 1.40–7.62). There are great differences between healthcare workers and non-healthcare workers in their cognition and attitude toward vaccines. Conclusions: Our study shows that healthcare workers are more willing to be vaccinated than non-healthcare workers. Current vaccine safety issues continue to be a major factor affecting public acceptance, and to expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for non-healthcare workers.
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Affiliation(s)
- Ming-Wei Wang
- Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Wen Wen
- Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Nan Wang
- Department of Anesthesiology, The Second Hospital of Anhui Medical Unviersity, Hefei, China
| | - Meng-Yun Zhou
- Department of Molecular & Cellular Physiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Chun-Yi Wang
- Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jie Ni
- Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jing-Jie Jiang
- Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xing-Wei Zhang
- Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Zhan-Hui Feng
- Neurological Department, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yong-Ran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou, China
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12
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Truong J, Bakshi S, Wasim A, Ahmad M, Majid U. What factors promote vaccine hesitancy or acceptance during pandemics? A systematic review and thematic analysis. Health Promot Int 2021; 37:6318107. [PMID: 34244738 DOI: 10.1093/heapro/daab105] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Examine the factors that promote vaccine hesitancy or acceptance during pandemics, major epidemics and global outbreaks. A systematic review and thematic analysis of 28 studies on the Influenza A/H1N1 pandemic and the global spread of Ebola Virus Disease. We found seven major factors that promote vaccine hesitancy or acceptance: demographic factors influencing vaccination (ethnicity, age, sex, pregnancy, education, and employment), accessibility and cost, personal responsibility and risk perceptions, precautionary measures taken based on the decision to vaccinate, trust in health authorities and vaccines, the safety and efficacy of a new vaccine, and lack of information or vaccine misinformation. An understanding of participant experiences and perspectives toward vaccines from previous pandemics will greatly inform the development of strategies to address the present situation with the COVID-19 pandemic. We discuss the impact vaccine hesitancy might have for the introduction and effectiveness of a potential COVID-19 vaccine. In particular, we believe that skepticism toward vaccines can still exist when there are no vaccines available, which is contrary to contemporary conceptualizations of vaccine hesitancy. We recommend conducting further research assessing the relationship between the accessibility and cost of vaccines, and vaccine hesitancy.
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Affiliation(s)
- Judy Truong
- Research & Development, MaRS Discovery District, Toronto, Ontario, Canada
| | - Simran Bakshi
- BSc Undergraduate Science Program, University of Western Ontario, London, Ontario, Canada
| | - Aghna Wasim
- BSc Undergraduate Psychology Program, University of Toronto, Ontario, Canada
| | - Mobeen Ahmad
- Department of Internal Medicine, Abington Memorial Hospital/Abington-Jefferson Health, Abington, PA, USA
| | - Umair Majid
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Ontario, Canada
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13
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Haddow AD, Clarke SC. Inaccuracies in Google's Health-Based Knowledge Panels Perpetuate Widespread Misconceptions Involving Infectious Disease Transmission. Am J Trop Med Hyg 2021; 104:2293-2297. [PMID: 33901005 DOI: 10.4269/ajtmh.21-0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/12/2021] [Indexed: 11/07/2022] Open
Abstract
Google health-based Knowledge Panels were designed to provide users with high-quality basic medical information on a specific condition. However, any errors contained within Knowledge Panels could result in the widespread distribution of inaccurate health information. We explored the potential for inaccuracies to exist within Google's health-based Knowledge Panels by focusing on a single well-studied pathogen, Ebola virus (EBOV). We then evaluated the accuracy of those transmission modes listed within the Google Ebola Knowledge Panel and investigated the pervasiveness of any misconceptions associated with inaccurate transmission modes among persons living in Africa. We found that the Google Ebola Knowledge Panel inaccurately listed insect bites or stings as modes of EBOV transmission. Our scoping review found 27 articles and reports that revealed that 9 of 11 countries where misconceptions regarding insect transmission of EBOV have been reported are locations of current (i.e., Democratic Republic of Congo and Guinea) or previous EBOV outbreaks. We found reports that up to 26.6% (155/582) of study respondents in Democratic Republic of Congo believed mosquito bite avoidance would prevent EBOV; in other locations of previous large-scale EBOV outbreaks (e.g., Guinea), up to 61.0% (304/498) of respondents believed insects were involved in EBOV transmission. Our findings highlight the potential for errors to exist within the health information contained in Google's health-based Knowledge Panels. Such errors could perpetuate misconceptions or misinformation, leading to mistrust of health workers and aid agencies and in turn undermining public health education or outbreak response efforts.
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Affiliation(s)
- Andrew D Haddow
- 1Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Sarah C Clarke
- 2Darnall Medical Library, Walter Reed National Military Medical Center, Bethesda, Maryland
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14
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Petravić L, Arh R, Gabrovec T, Jazbec L, Rupčić N, Starešinič N, Zorman L, Pretnar A, Srakar A, Zwitter M, Slavec A. Factors Affecting Attitudes towards COVID-19 Vaccination: An Online Survey in Slovenia. Vaccines (Basel) 2021; 9:247. [PMID: 33808958 PMCID: PMC8002174 DOI: 10.3390/vaccines9030247] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/31/2022] Open
Abstract
While the problem of vaccine hesitancy is not new, it has become more pronounced with the new COVID-19 vaccines and represents an obstacle to resolving the crisis. Even people who would usually trust vaccines and experts now prefer to wait for more information. A cross-sectional online survey was conducted in Slovenia in December 2020 to find out the attitudes of the population regarding COVID-19 vaccination and the factors that affect these attitudes. Based on 12,042 fully completed questionnaires, we find that higher intention to get vaccinated is associated with men, older respondents, physicians and medical students, respondents who got the influenza vaccination, those who knew someone who had gotten hospitalised or died from COVID-19 and those who have more trust in experts, institutions and vaccines. Nurses and technicians were less likely to get vaccinated. In answers to an open question, sceptics were split into those doubting the quality due to the rapid development of the vaccine and those that reported personal experiences with side effects of prior vaccinations. Although the Slovenian population is diverse in its attitudes towards vaccination, the results are comparable to those found in other countries. However, there are potential limitations to the generalizability of the findings that should be addressed in future studies.
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Affiliation(s)
- Luka Petravić
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Rok Arh
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Tina Gabrovec
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Lucija Jazbec
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Nika Rupčić
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Nina Starešinič
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Lea Zorman
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Ajda Pretnar
- Faculty of Computer and Information Science, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Andrej Srakar
- Institute for Economic Research, 1000 Ljubljana, Slovenia;
| | - Matjaž Zwitter
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia; (R.A.); (T.G.); (L.J.); (N.R.); (N.S.); (L.Z.); (M.Z.)
| | - Ana Slavec
- InnoRenew CoE, Livade 6, 6310 Izola, Slovenia;
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15
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Wang J, Lyu Y, Zhang H, Jing R, Lai X, Feng H, Knoll MD, Fang H. Willingness to pay and financing preferences for COVID-19 vaccination in China. Vaccine 2021; 39:1968-1976. [PMID: 33714653 PMCID: PMC7914003 DOI: 10.1016/j.vaccine.2021.02.060] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 01/19/2023]
Abstract
Background The COVID-19 pandemic has caused significant diseases and economic burdens in the world. Vaccines are often considered as a cost-effective way to prevent and control infectious diseases, and the research and development of COVID-19 vaccines have been progressing unprecedently. It is needed to understand individuals’ willingness to pay (WTP) among general population, which provides information about social demand, access and financing for future COVID-19 vaccination. Objective To investigate individuals’ WTP and financing mechanism preference for COVID-19 vaccination during the pandemic period in China. Methods During March 1–18, 2020, we conducted a network stratified random sampling survey with 2058 respondents in China. The survey questionnaires included out-of-pocket WTP, financing mechanism preference as well as basic characteristics of the respondents; risk perception and impact of the COVID-19 pandemic; attitude for future COVID-19 vaccination. Multivariable Tobit regression was used to determine impact factors for respondents’ out-of-pocket WTP. Results The individuals’ mean WTP for full COVID-19 vaccination was CNY 254 (USD 36.8) with median of CNY 100 (USD 14.5). Most respondents believed that governments (90.9%) and health insurance (78.0%) needed to pay for some or full portions of COVID-19 vaccination, although 84.3% stated that individuals needed to pay. Annual family income, employee size in the workplace, and whether considering the COVID-19 pandemic in China in a declining trend affected respondents’ WTP significantly. Conclusion The findings demonstrated the individuals’ WTP for COVID-19 vaccination in China and their preferences for financing sources from individuals, governments and health insurance. And to suggest an effective and optimal financing strategy, the public health perspective with equal access to COVID-19 vaccination should be prioritized to ensure a high vaccination rate.
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Affiliation(s)
- Jiahao Wang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Yun Lyu
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Rize Jing
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Huangyufei Feng
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Maria Deloria Knoll
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China; Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China; Key Laboratory of Reproductive Health National Health Commission of the People's Republic of China, Beijing 100083, China.
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Wang J, Jing R, Lai X, Zhang H, Lyu Y, Knoll MD, Fang H. Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China. Vaccines (Basel) 2020; 8:vaccines8030482. [PMID: 32867224 PMCID: PMC7565574 DOI: 10.3390/vaccines8030482] [Citation(s) in RCA: 510] [Impact Index Per Article: 127.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 01/20/2023] Open
Abstract
Background: Faced with the coronavirus disease 2019 (COVID-19) pandemic, the development of COVID-19 vaccines has been progressing at an unprecedented rate. This study aimed to evaluate the acceptance of COVID-19 vaccination in China and give suggestions for vaccination strategies and immunization programs accordingly. Methods: In March 2020, an anonymous cross-sectional survey was conducted online among Chinese adults. The questionnaire collected socio-demographic characteristics, risk perception, the impact of COVID-19, attitudes, acceptance and attribute preferences of vaccines against COVID-19 during the pandemic. Multivariate logistic regression was performed to identify the influencing factors of vaccination acceptance. Results: Of the 2058 participants surveyed, 1879 (91.3%) stated that they would accept COVID-19 vaccination after the vaccine becomes available, among whom 980 (52.2%) wanted to get vaccinated as soon as possible, while others (47.8%) would delay the vaccination until the vaccine’s safety was confirmed. Participants preferred a routine immunization schedule (49.4%) to emergency vaccination (9.0%) or either of them (41.6%). Logistic regression showed that being male, being married, perceiving a high risk of infection, being vaccinated against influenza in the past season, believing in the efficacy of COVID-19 vaccination or valuing doctor’s recommendations could increase the probability of accepting COVID-19 vaccination as soon as possible, while having confirmed or suspected cases in local areas, valuing vaccination convenience or vaccine price in decision-making could hinder participants from immediate vaccination. Conclusion: During the pandemic period, a strong demand for and high acceptance of COVID-19 vaccination has been shown among the Chinese population, while concerns about vaccine safety may hinder the promotion of vaccine uptake. To expand vaccination coverage, immunization programs should be designed to remove barriers in terms of vaccine price and vaccination convenience, and health education and communication from authoritative sources are important ways to alleviate public concerns about vaccine safety.
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Affiliation(s)
- Jiahao Wang
- School of Public Health, Peking University, Beijing 100083, China; (J.W.); (R.J.); (X.L.); (H.Z.); (Y.L.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China
| | - Rize Jing
- School of Public Health, Peking University, Beijing 100083, China; (J.W.); (R.J.); (X.L.); (H.Z.); (Y.L.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China; (J.W.); (R.J.); (X.L.); (H.Z.); (Y.L.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100083, China; (J.W.); (R.J.); (X.L.); (H.Z.); (Y.L.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China
| | - Yun Lyu
- School of Public Health, Peking University, Beijing 100083, China; (J.W.); (R.J.); (X.L.); (H.Z.); (Y.L.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China
| | - Maria Deloria Knoll
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China
- Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Beijing 100083, China
- Correspondence: ; Tel.: +86-10-8280-5702
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Jalloh MF, Wallace AS, Bunnell RE, Carter RJ, Redd JT, Nur SA, Zeebari Z, Ekström AM, Nordenstedt H. Ebola vaccine? Family first! Evidence from using a brief measure on Ebola vaccine demand in a national household survey during the outbreak in Sierra Leone. Vaccine 2020; 38:3854-3861. [PMID: 32291102 PMCID: PMC10831169 DOI: 10.1016/j.vaccine.2020.03.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Vaccination against Ebolavirus is an emerging public health tool during Ebola Virus Disease outbreaks. We examined demand issues related to deployment of Ebolavirus vaccine during the 2014-2015 outbreak in Sierra Leone. METHODS A cluster survey was administered to a population-based sample in December 2014 (N = 3540), before any Ebola vaccine was available to the general public in Sierra Leone. Ebola vaccine demand was captured in this survey by three Likert-scale items that were used to develop a composite score and dichotomized into a binary outcome to define high demand. A multilevel logistic regression model was fitted to assess the associations between perceptions of who should be first to receive an Ebola vaccine and the expression of high demand for an Ebola vaccine. RESULTS The largest proportion of respondents reported that health workers (35.1%) or their own families (29.5%) should receive the vaccine first if it became available, rather than politicians (13.8%), vaccination teams (9.8%), or people in high risk areas (8.2%). High demand for an Ebola vaccine was expressed by 74.2% of respondents nationally. The odds of expressing high demand were 13 times greater among those who said they or their families should be the first to take the vaccine compared to those who said politicians should be the first recipients (adjusted odds ratio [aOR] 13.0 [95% confidence interval [CI] 7.8-21.6]). The ultra-brief measure of the Ebola vaccine demand demonstrated acceptable scale reliability (Cronbach's α = 0.79) and construct validity (single-factor loadings > 0.50). CONCLUSION Perceptions of who should be the first to get the vaccine was associated with high demand for Ebola vaccine around the peak of the outbreak in Sierra Leone. Using an ultra-brief measure of Ebola vaccine demand is a feasible solution in outbreak settings and can help inform development of future rapid assessment tools.
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Affiliation(s)
- Mohamed F Jalloh
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Aaron S Wallace
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Rebecca E Bunnell
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, USA
| | - Rosalind J Carter
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - John T Redd
- Center for Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Sophia A Nur
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, USA
| | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Jönköping International Business School, Jönköping, Sweden
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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18
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Jalloh MF, Wilhelm E, Abad N, Prybylski D. Mobilize to vaccinate: lessons learned from social mobilization for immunization in low and middle-income countries. Hum Vaccin Immunother 2019; 16:1208-1214. [PMID: 31464551 PMCID: PMC7227704 DOI: 10.1080/21645515.2019.1661206] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Creating and sustaining demand for immunization services is a global priority to ensure that vaccine-eligible populations are fully protected from vaccine-preventable diseases. Social mobilization remains a key health promotion strategy used by low- and middle-income countries (LMICs) to promote vaccination demand. In this commentary, we synthesize illustrative evidence on successful social mobilization efforts promoting the uptake of immunization services in select LMICs. The first example focuses on Sierra Leone’s routine immunization program during the Universal Child Immunization initiative in the late 1980s. We then give an example of India’s establishment of a social mobilization network in the early- to mid-2000s to support polio elimination in high-risk communities. Thirdly, we highlight the complexities of social mobilization in a humanitarian emergency during the 2017–2018 diphtheria outbreak among displaced Rohingyas in camps and settlements in Bangladesh. Lastly, we draw upon examples from the introduction of the human papillomavirus vaccine in several countries. We then critically examine recurring challenges faced when implementing social mobilization for immunization in LMICs and offer practical recommendations for improvement.
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Affiliation(s)
- Mohamed F Jalloh
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Elisabeth Wilhelm
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Neetu Abad
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Dimitri Prybylski
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
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19
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Kasereka MC, Hawkes MT. 'The cat that kills people:' community beliefs about Ebola origins and implications for disease control in Eastern Democratic Republic of the Congo. Pathog Glob Health 2019; 113:149-157. [PMID: 31387518 DOI: 10.1080/20477724.2019.1650227] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The current Ebola epidemic in Eastern Democratic Republic of Congo (DRC) has surpassed 1 700 deaths. Social resistance, a major barrier to control efforts, invites exploration of community beliefs around Ebola and its origins. We conducted a mixed-methods study, using four focus group discussions (FGDs) involving 20 participants, and a 19-item survey questionnaire, administered to a nonprobability sample of 286 community members throughout the outbreak zone. FGDs and surveys were conducted between 4 and 17 August 2018. FGDs revealed a widespread rumor early in the epidemic of two twins bewitched by their aunt after eating her cat, who developed bleeding symptoms and triggered the epidemic. However, this myth appeared to dissipate as the epidemic progressed and biomedical transmission became generally accepted. In our survey, 6% of respondents endorsed supernatural origins of Ebola. These respondents were more likely to believe that traditional medicine practitioners can cure Ebola. Wild animals were recognized as sources of Ebola by 53% and FGD participants commented that 'Ebola leaves the forest and hides in the hospital,' recognizing that zoonotic origins gave way to nosocomial transmission as the epidemic progressed. Taken together, our findings suggest that a dynamic syncretism of mythical and biomedical understanding of Ebola may have shaped transmission patterns. Mythical conceptions and fear of contagion may have fueled the 'underground' transmission of Ebola, as patients sought care from traditional healers, who are ill-equipped to deal with a highly contagious biohazard. A deeper understanding of beliefs around Ebola origins may illuminate strategies to engage communities in control efforts.
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Affiliation(s)
| | - Michael T Hawkes
- Department of Pediatrics, University of Alberta , Edmonton , Canada.,Department of Medical Microbiology and Immunology, University of Alberta , Edmonton , Canada.,School of Public Health, University of Alberta , Edmonton , Canada
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20
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Kasereka MC, Sawatzky J, Hawkes MT. Ebola epidemic in war-torn Democratic Republic of Congo, 2018: Acceptability and patient satisfaction of the recombinant Vesicular Stomatitis Virus - Zaire Ebolavirus Vaccine. Vaccine 2019; 37:2174-2178. [PMID: 30878249 DOI: 10.1016/j.vaccine.2019.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The current Ebola outbreak in Eastern Democratic Republic of the Congo (DRC) is the second largest in history and the first in which the recombinant Vesicular Stomatitis Virus - Zaire Ebolavirus (rVSV-ZEBOV) vaccine has been used at scale. We assessed side-effects, satisfaction, and attitudes toward the new vaccine. METHODS Cross-sectional survey questionnaire from a convenience sample of 90 vaccine recipients and 96 community controls in Eastern DRC. RESULTS Side-effects were reported in 75/90 (83%) vaccine recipients but only 5 (7%) and 4 (5%) reported arthralgia and rash, respectively. 76/90 (84%) vaccinees were classified as "promoters" (would recommend vaccine to others) and 6/90 (7%) as "detractors." 69/96 (72%) of unvaccinated community controls would wish to be vaccinated if supply were available. 153/186 (82%) would accept vaccination for family members. CONCLUSIONS The rVSV-ZEBOV vaccine was well tolerated, with high acceptability in the community during the current outbreak in the DRC.
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Affiliation(s)
| | | | - Michael T Hawkes
- Department of Pediatrics, University of Alberta, Edmonton, Canada; Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada; School of Public Health, University of Alberta, Edmonton, Canada.
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21
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Jalloh MF, Jalloh MB, Albert A, Wolff B, Callis A, Ramakrishnan A, Cramer E, Sengeh P, Pratt SA, Conteh L, Hajjeh R, Bunnell R, Redd JT, Ekström AM, Nordenstedt H. Perceptions and acceptability of an experimental Ebola vaccine among health care workers, frontline staff, and the general public during the 2014-2015 Ebola outbreak in Sierra Leone. Vaccine 2019; 37:1495-1502. [PMID: 30755367 DOI: 10.1016/j.vaccine.2019.01.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 01/09/2019] [Accepted: 01/22/2019] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Experimental Ebola vaccines were introduced during the 2014-2015 Ebola outbreak in West Africa. Planning for the Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) was underway in late 2014. We examined hypothetical acceptability and perceptions of experimental Ebola vaccines among health care workers (HCWs), frontline workers, and the general public to guide ethical communication of risks and benefits of any experimental Ebola vaccine. METHODS Between December 2014 and January 2015, we conducted in-depth interviews with public health leaders (N = 31), focus groups with HCWs and frontline workers (N = 20), and focus groups with members of the general public (N = 15) in Western Area Urban, Western Area Rural, Port Loko, Bombali, and Tonkolili districts. Themes were identified using qualitative content analysis. RESULTS Across all participant groups, not knowing the immediate and long-term effects of an experimental Ebola vaccine was the most serious concern. Some respondents feared that experimental vaccines may cause Ebola, lead to death, or result in other adverse events. Among HCWs, not knowing the level of protection provided by experimental Ebola vaccines was another concern. HCWs and frontline workers were motivated to help find a vaccine for Ebola to help end the outbreak. General public participants cited positive experiences with routine childhood immunization in Sierra Leone. DISCUSSION Our formative assessment prior to STRIVE's implementation in Sierra Leone helped identify concerns, motivations, and information gaps among potential participants of an experimental Ebola vaccine trial, at the time when an unprecedented outbreak was occurring in the country. The findings from this assessment were incorporated early in the process to guide ethical communication of risks and benefits when discussing informed consent for possible participation in the vaccine trial that was launched later in 2015.
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Affiliation(s)
- Mohamed F Jalloh
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | | | - Alison Albert
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brent Wolff
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amy Callis
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Emily Cramer
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Lansana Conteh
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Rana Hajjeh
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca Bunnell
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John T Redd
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anna Mia Ekström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Infectious diseases, Karolinska University Hospital, Sweden
| | - Helena Nordenstedt
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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22
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Health care worker vaccination against Ebola: Vaccine acceptance and employment duration in Sierra Leone. Vaccine 2019; 37:1101-1108. [PMID: 30685246 DOI: 10.1016/j.vaccine.2018.12.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/19/2018] [Accepted: 12/21/2018] [Indexed: 11/20/2022]
Abstract
Health care workers (HCW) are at high risk of Ebola virus disease (EVD) infection during epidemics and may contribute to onward transmission, and therefore HCW-targeted prophylactic vaccination strategies are being considered as interventions. To assess the feasibility of preventive HCW vaccination, we conducted a pilot survey on staff turnover and vaccine acceptance amongst 305 HCW in Freetown and Kambia districts of Sierra Leone. Multivariable logistic regression demonstrated which demographic and behavioural factors were associated with acceptance of a hypothetical new vaccine. We quantified the duration of employment of HCW, and used multivariable gamma regression to detect associations with duration of employment in current or any health care position. Finally, we simulated populations of HCW, to determine the likely future immunisation coverage amongst HCW based on our estimates of vaccine acceptance and employment duration. Most HCW we surveyed had a positive opinion of EVD vaccination (76.3%). We found that being a volunteer HCW (vs being on the government payroll) was associated with increased vaccine acceptance. We found that HCW have stable employment, with a mean duration of employment in the health sector of 10.9 years (median 8.0 years). Older age and being on the government payroll (vs volunteer HCW) were associated with a longer duration of employment in the health sector. Assuming a single vaccine campaign, with 76.3% vaccine acceptance, 100% vaccine efficacy and no waning of vaccine-induced protection, immunisation coverage was sustained over 50% until 6 years after a vaccination campaign. If vaccine-induced immunity wanes at 10% per year, then the immunisation coverage among HCW would fall below 50% after 3 years. Vaccinating HCW against EVD could be feasible as employment appeared stable and vaccine acceptance high. However, even with high vaccine efficacy and long-lasting immunity, repeated campaigns or vaccination at employment start may be necessary to maintain high coverage.
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Muniz Júnior RL, Godói IP, Reis EA, Garcia MM, Guerra-Júnior AA, Godman B, Ruas CM. Consumer willingness to pay for a hypothetical Zika vaccine in Brazil and the implications. Expert Rev Pharmacoecon Outcomes Res 2018; 19:473-482. [PMID: 30468095 DOI: 10.1080/14737167.2019.1552136] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
ABSTRACT Background: Zika virus is a newly emerging infection, associated with increasingly large outbreaks especially in tropical countries such as Brazil. A future Zika vaccine can contribute to decreasing the number of cases and associated complications. Information about consumers' willingness to pay (WTP) for a hypothetical Zika vaccine can help price setting discussions in the future in Brazil, starting with the private market. METHODS A cross-sectional study conducted among residents of Minas Gerais, Brazil, regarding their WTP for a hypothetical Zika Vaccine. The mean effective protection was 80%, with the possibility of some local and systemic side- effects. RESULTS 517 people were interviewed. However, 28 would not be vaccinated even if the vaccine was free. Most of the resultant interviewees (489) were female (58.2%), had completed high school (49.7%), were employed (71.2%), had private health insurance (52.7%), and did not have Zika (96.9%). The median individual maximum WTP for this hypothetical Zika vaccine (one dose) was US$31.34 (BRL100.00). CONCLUSION Such discussions regarding WTP can contribute to decision-making about prices once a Zika vaccine becomes available in Brazil alongside other ongoing programs to control the virus.
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Affiliation(s)
- Roberto Lúcio Muniz Júnior
- a College of Pharmacy - Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627 , Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901 , Brazil
| | - Isabella Piassi Godói
- b Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, sala 1023, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627 , Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901 , Minas Gerais , Brazil.,c SUS Collaborating Centre for Technology Assessment and Excellence in Health, sala 1042, Faculdade de Farmácia , Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901 , Brazil.,d Institute of Health and Biological Studies - Universidade Federal do Sul e Sudeste do Pará, Avenida dos Ipês , s/n, Cidade Universitária, Cidade Jardim, Marabá , Pará , Brazil
| | - Edna Afonso Reis
- e Department of Statistics - Exact Sciences Institute - Universidade Federal de Minas Gerais (UFMG) - Av. Presidente Antônio Carlos 6627 - Pampulha - CEP 31.270-901 - Belo Horizonte , Brazil
| | - Marina Morgado Garcia
- f Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , United Kington.,g Division of Clinical Pharmacology , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden
| | - Augusto Afonso Guerra-Júnior
- b Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, sala 1023, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627 , Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901 , Minas Gerais , Brazil.,c SUS Collaborating Centre for Technology Assessment and Excellence in Health, sala 1042, Faculdade de Farmácia , Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901 , Brazil
| | - Brian Godman
- f Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , United Kington.,g Division of Clinical Pharmacology , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.,h Health Economics Centre , Liverpool University Management School , Liverpool , UK.,i Department of Public Health Pharmacy and Management, School of Pharmacy , Sefako Makgatho Health Sciences University , Garankuwa , South Africa
| | - Cristina Mariano Ruas
- b Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, sala 1023, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627 , Campus Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901 , Minas Gerais , Brazil
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24
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Claude KM, Underschultz J, Hawkes MT. Ebola virus epidemic in war-torn eastern DR Congo. Lancet 2018; 392:1399-1401. [PMID: 30297137 DOI: 10.1016/s0140-6736(18)32419-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/14/2018] [Accepted: 09/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jack Underschultz
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Michael T Hawkes
- Department of Pediatrics, Department of Medical Microbiology and Immunology, and School of Public Health, University of Alberta, Edmonton T6G 1C9, AB, Canada.
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25
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Kpanake L, Sorum PC, Mullet É. Willingness to get vaccinated against Ebola: A mapping of Guinean people positions. Hum Vaccin Immunother 2018; 14:2391-2396. [PMID: 29923787 PMCID: PMC6284512 DOI: 10.1080/21645515.2018.1480236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To map the different personal positions of Guinean people regarding vaccination against Ebola. METHODS From January to April 2016, 304 adults in Guinea were presented with 48 vignettes depicting situations in which getting vaccinated would be possible. These situations varied as a function of the constructs of health-protective behavior theories. The participants indicated the likelihood they would get vaccinated in each case. RESULTS Seven qualitatively different positions were found: Always Vaccinate (38%), Never Vaccinate (25%), Hesitant (19%), Depends on Cost Only (7%), Depends on Neighbors' Attitude and Cost (5%), Mainly Depends on Risk (4%), and Mistrust of Cheap Vaccines (2%). CONCLUSION The diversity of Guinean people's positions implies that Ebola vaccination campaigns in Guinea, and probably in other sub-Saharan African countries, must not be "one size fits all," but must be multifaceted and tailored in design and implementation to match the diversity of these people's needs and views.
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26
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Walldorf JA, Cloessner EA, Hyde TB, MacNeil A. Considerations for use of Ebola vaccine during an emergency response. Vaccine 2017; 37:7190-7200. [PMID: 28890191 DOI: 10.1016/j.vaccine.2017.08.058] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/21/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
Abstract
Vaccination against Ebola virus disease is a tool that may limit disease transmission and deaths in future outbreaks, integrated within traditional Ebola outbreak prevention and control measures. Although a licensed Ebolavirus vaccine (EV) is not yet available, the 2014-2016 West African Ebola outbreak has accelerated EV clinical trials and given public health authorities in Guinea, Liberia, and Sierra Leone experience with implementation of emergency ring vaccination. As evidence supporting the use of EV during an outbreak response has become available, public health authorities in at-risk countries are considering how to integrate EV into future emergency Ebola responses and for prevention in high-risk groups, such as healthcare workers and frontline workers (HCW/FLWs), even before an EV is licensed. This review provides an overview of Ebola epidemiology, immunology, and evidence to inform regional and country-level decisions regarding EV delivery during an emergency response and to at-risk populations before a licensed vaccine is available and beyond. Countries or regions planning to use EV will need to assess factors such as the likelihood of a future Ebolavirus outbreak, the most likely species to cause an outbreak, the availability of a safe and effective EV (unlicensed or licensed) for the affected population, capacity to implement Ebola vaccination in conjunction with standard Ebola outbreak control measures, and availability of minimum essential resources and regulatory requirements to implement emergency Ebola vaccination. Potential emergency vaccination strategies for consideration include ring or geographically targeted community vaccination, HCW/FLW vaccination, and mass vaccination. The development of guidelines and protocols for Ebola vaccination will help ensure that activities are standardized, evidence-based, and well-coordinated with overall Ebola outbreak response efforts in the future.
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Affiliation(s)
- Jenny A Walldorf
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, United States.
| | - Emily A Cloessner
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, United States; Association of Schools and Programs of Public Health, 1900 M St NW Suite 710, Washington, DC 20036, United States.
| | - Terri B Hyde
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, United States.
| | - Adam MacNeil
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, United States.
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