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Sadak KT, Aremu TO, Buttar S, Ly DV, Weigel B, Neglia JP. The Feasibility and Acceptability of a Data Capture Methodology in Pediatric Cancer Patients Treated with Targeted Agents and Immunotherapies. Curr Oncol 2024; 31:693-703. [PMID: 38392045 PMCID: PMC10887547 DOI: 10.3390/curroncol31020051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/07/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
As childhood cancer treatments have improved to include new and innovative agents, the need for more advanced monitoring of their long-term effects and related research has increased. This has resulted in a need for evidence-based research methodologies for the longitudinal care of childhood cancer patients treated with targeted agents and immunotherapies. The rationale for this pilot study was to determine the feasibility and acceptability of a data capture methodology for pediatric, adolescent, and young adult cancer patients treated with targeted agents and immunotherapy as there is little research to inform this delivery of care. Data were collected from thirty-two patients and two providers for descriptive statistics and thematic analyses. Feasibility was characterized by expected participant attrition. Key drivers of acceptability were (1) providers' language and clarity of communication and (2) convenient participation requirements. Long-term follow-up research practices developed with input from key stakeholders, including patients, caregivers, and providers, can lead to acceptable and feasible research protocols that optimize successful participant recruitment. These evidence-based research practices can result in high participant satisfaction and can be implemented as program development initiatives across centers caring for childhood cancer survivors.
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Affiliation(s)
- Karim Thomas Sadak
- University of Minnesota Masonic Children’s Hospital, University of Minnesota Masonic Cancer Center, 420 Delaware St. SE—Mayo MMC 484, Minneapolis, MN 55455, USA; (T.O.A.); (S.B.); (D.V.L.); (B.W.); (J.P.N.)
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Sheng AY, Gottlieb M, Bautista JR, Trueger NS, Westafer LM, Gisondi MA. The role of emergency physicians in the fight against health misinformation: Implications for resident training. AEM EDUCATION AND TRAINING 2023; 7:S48-S57. [PMID: 37383831 PMCID: PMC10294217 DOI: 10.1002/aet2.10877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/21/2022] [Accepted: 11/01/2022] [Indexed: 06/30/2023]
Abstract
Emergency physicians on the frontlines of the COVID-19 pandemic are first-hand witnesses to the direct impact of health misinformation and disinformation on individual patients, communities, and public health at large. Therefore, emergency physicians naturally have a crucial role to play to steward factual information and combat health misinformation. Unfortunately, most physicians lack the communications and social media training needed to address health misinformation with patients and online, highlighting an obvious gap in emergency medicine training. We convened an expert panel of academic emergency physicians who have taught and conducted research about health misinformation at the Society for Academic Emergency Medicine (SAEM) Annual Meeting in New Orleans, LA, on May 13, 2022. The panelists represented geographically diverse institutions including Baystate Medical Center/Tufts University, Boston Medical Center, Northwestern University, Rush Medical College, and Stanford University. In this article, we describe the scope and impact of health misinformation, introduce methods for addressing misinformation in the clinical environment and online, acknowledge the challenges of tackling misinformation from our physician colleagues, demonstrate strategies for debunking and prebunking, and highlight implications for education and training in emergency medicine. Finally, we discuss several actionable interventions that define the role of the emergency physician in the management of health misinformation.
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Affiliation(s)
- Alexander Y. Sheng
- Department of Emergency MedicineBoston Medical CenterBostonMassachusettsUSA
- School of Medicine, Boston UniversityBostonMassachusettsUSA
- Department of Emergency MedicineAlpert Medical School at Brown UniversityRhode IslandProvidenceUSA
| | - Michael Gottlieb
- Emergency Ultrasound Division, Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
| | | | - N. Seth Trueger
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Lauren M. Westafer
- Department of Emergency Medicine, Department of Healthcare Delivery and Population ScienceUniversity of Massachusetts Chan Medical School–BaystateSpringfieldMassachusettsUSA
| | - Michael A. Gisondi
- The Precision Education and Assessment Research Lab, Department of Emergency MedicineStanford UniversityPalo AltoCaliforniaUSA
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Licata F, Romeo M, Riillo C, Di Gennaro G, Bianco A. Acceptance of recommended vaccinations during pregnancy: a cross-sectional study in Southern Italy. Front Public Health 2023; 11:1132751. [PMID: 37250080 PMCID: PMC10213683 DOI: 10.3389/fpubh.2023.1132751] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Background Vaccine administration is a recommended, safe, and effective measure to protect pregnant women against vaccine-preventable diseases (VPDs). Despite available guidance, maternal immunization rates for vaccination against influenza and with the reduced antigen content tetanus-diphtheria-acellular pertussis vaccine (Tdap) in Italy remain incredibly low. The primary goal of the study was to explore what Italian pregnant women knew about VPDs and immunization during pregnancy and what factors affected their decision to be vaccinated. Methods This cross-sectional study took place between October 2021 and April 2022 in the Southern part of Italy. All consecutive pregnant women, from those attending the selected facilities on randomly selected days, were approached to request participation. The inclusion criteria for participation were age ≥18 years, the ability to understand, speak, and read Italian, and being pregnant at any gestational age. The questionnaire, using a combination of checkboxes and free text answers, consisted of 32 items divided into five parts and lasted ~10 min. Results The results showed that 61% knew that the influenza vaccine is recommended and 48.7% knew that influenza could be risky during pregnancy; 74.1% wrongly reported that the Measles-Mumps-Rubella (MMR) vaccine is recommended during pregnancy. Seven out of 10 pregnant women believed that strong evidence supported the safety of vaccinations during pregnancy, and more than half (55.6%) thought they were at increased risk of severe illness with COVID-19. Women in the sample believed that vaccines received during pregnancy pose a risk of adverse events to the unborn child with a median value of 6 (IQR 3-9), on a scale ranging from 1 to 10. Similarly, the fear of contracting pertussis and influenza during pregnancy showed a median value of 6 (IQR 3-9) and 5 (IQR 3-8), respectively. Only 21.1% and 36.5% of women received influenza and Tdap vaccines during pregnancy. Conclusion Unrealistic risk perception with a negative attitude toward vaccines in pregnancy and a low percentage of vaccinated pregnant women confirm the urgency of training women to make informed choices to increase overall vaccine uptake.
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Wolynn T, Hermann C, Hoffman BL. Social Media and Vaccine Hesitancy: Help Us Move the Needle. Pediatr Clin North Am 2023; 70:329-341. [PMID: 36841600 DOI: 10.1016/j.pcl.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
With more than 75% of parents and pediatric caregivers getting their health-related information online, reaching families on social media is a powerful way to leverage the trust built in the examination room to address vaccine hesitancy. This article first reviews the ways the antivaccine movement has leveraged social media to expand its considerable influence, and why social media companies have failed to reduce antivaccine misinformation and disinformation. Next, it reviews the barriers to adoption of social media-based communication by pediatric health-care providers and concludes with action-oriented items to increase the adoption of this powerful tool.
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Affiliation(s)
- Todd Wolynn
- Kids Plus Pediatrics, 4070 Beechwood Boulevard, Pittsburgh, PA 15217, USA
| | - Chad Hermann
- Kids Plus Pediatrics, 4070 Beechwood Boulevard, Pittsburgh, PA 15217, USA
| | - Beth L Hoffman
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA; Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
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Attwell K, Hannah A. Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates. Int J Health Policy Manag 2022; 11:2660-2671. [PMID: 35397484 PMCID: PMC9818102 DOI: 10.34172/ijhpm.2022.6518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Vaccine hesitancy is a global problem with diverse local policy responses, from voluntaristic to coercive. Between 2015 and 2017, California, Australia, France, and Italy increased the coerciveness of their childhood vaccine regimes. Despite this apparent convergence, there is little evidence of imposition, policy learning, or diffusion - the drivers that are usually discussed in scholarly literature on policy convergence. The fact that the four governments were oriented across the political spectrum, with quite different political and institutional systems, further indicates an empirical puzzle. METHODS To better understand the drivers of enhanced vaccine mandates, a crucial issue during the coronavirus disease 2019 (COVID-19) global rollout, this article engages with four case studies assembled from qualitative analysis of semi-structured in-country interviews and document analysis between November 2018 and November 2020. Key informants had specific expert knowledge or played a role in the introduction or implementation of the new policies. Interview transcripts were coded inductively and deductively, augmented with extensive analysis of legal, policy, academic and media documents. RESULTS The case analysis identifies two key and interacting elements in government decisions to tighten vaccine mandates: functional and political pressures. Policy-makers in Italy and France were primarily driven by functional challenges, with their vaccination governance systems under threat from reduced population compliance. California and Australia did not face systemic threats to the functioning of their systems, but activists utilised local opportunities to heighten political pressure on decision makers. CONCLUSION In four recent cases of high-income jurisdictions making childhood vaccination policies more coercive, vaccine hesitancy alone could not explain why the policies arose in these jurisdictions and not others, while path dependency alone could not explain why some jurisdictions with mandates made them more coercive. Explanation lies in restrictive mandates being attractive for governments, whether they face systemic functional problems in vaccine governance, or political pressures generated by media and activists. Mandates can be framed as targeting whole populations or localised groups of refusers, and implemented without onerous costs or policy complexity.
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Affiliation(s)
- Katie Attwell
- Political Science and International Relations, School of Social Sciences, University of Western Australia, Perth, WA, Australia
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6
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Wang J, Wagner AL, Chen Y, Jaime E, Hu X, Wu S, Lu Y, Ruan Y, Pan SW. Would COVID-19 vaccination willingness increase if mobile technologies prohibit unvaccinated individuals from public spaces? A nationwide discrete choice experiment from China. Vaccine 2022; 40:7466-7475. [PMID: 34742594 PMCID: PMC8531240 DOI: 10.1016/j.vaccine.2021.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/06/2021] [Accepted: 10/01/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Achieving COVID-19 community protection (aka, herd immunity) in China may be challenging because many individuals remain unsure or are unwilling to be vaccinated. One potential means to increase COVID-19 vaccine uptake is to essentially mandate vaccination by using existing mobile technologies that can prohibit unvaccinated individuals from certain public spaces. The "Health Code" is a ubiquitous mobile phone app in China that regulates freedom of travel based on individuals' predicted risk of exposure to SARS-CoV-2. Green-colored codes indicate ability to travel unrestricted in low-risk regions; yellow-colored codes indicate prohibition from major public spaces and modes of public transportation. We examined the effects of a "Health Code"-based vaccine mandate on willingness to vaccinate for COVID-19 in China. METHODS In August 2020, an online discrete choice experiment (DCE) was conducted among adults living in China. Participants completed up to six DCE choice sets, each containing two hypothetical COVID-19 vaccination scenario choices and a "do not vaccinate" choice. Half of the choice sets had a "Health Code" attribute that associated the "do not vaccinate" choice with a yellow Health Code implying restricted travel. Weighted, mixed effects multinomial logit regression was used to estimate preference utilities and predicted choice probabilities. RESULTS Overall, 873 participants completed 4317 choice sets. Most participants attained at least college-level education (90.9%). 29.8% of participants were identified as vaccine hesitators (defined as being unsure or unwilling to receive a COVID-19 vaccination). With and without the "Health Code"-based vaccine mandate, there was an 8.6% (85% CI: 6.4% - 10.92%) and 17.3% (85% CI:13.1% - 21.6%) respective predicted probability that vaccine hesitators would choose "do not vaccinate" over a common vaccination scenario currently in China (i.e., free, domestic vaccine, 80% effectiveness, 10% probability of fever side-effects, administered in a large hospital, two doses). Corresponding predicted probabilities for people who did not express vaccine hesitancy was 0.3% (93% CI: 0.0% - 14.3%) and 3.5% (93% CI:2.3% - 4.8%). The "Health Code"-based mandate significantly increased willingness to vaccinate when vaccine efficacy was greater than 60%. CONCLUSION Among vaccine hesitators with higher educational attainment, willingness to vaccinate for COVID-19 appears to increase if mobile technology-based vaccine mandates prohibit unvaccinated individuals from public spaces and public transportation. However, such mandates may not increase willingness if perceived vaccine efficacy is low.
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Affiliation(s)
- Jing Wang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Ying Chen
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Etienne Jaime
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Xinwen Hu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Shiqiang Wu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Yihan Lu
- Ministry of Education Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Stephen W Pan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China.
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Affiliation(s)
- Jane Tuckerman
- From the Vaccine Uptake Group, Infection Immunity Theme, Murdoch Children’s Research Institute, Parkville
- Dentistry and Health Sciences, University of Melbourne, Parkville
| | - Jessica Kaufman
- From the Vaccine Uptake Group, Infection Immunity Theme, Murdoch Children’s Research Institute, Parkville
- Dentistry and Health Sciences, University of Melbourne, Parkville
| | - Margie Danchin
- From the Vaccine Uptake Group, Infection Immunity Theme, Murdoch Children’s Research Institute, Parkville
- Dentistry and Health Sciences, University of Melbourne, Parkville
- Department of General Medicine, Royal Children’s Hospital, Parkville
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Barton SM, Calhoun AW, Bohnert CA, Multerer SM, Statler VA, Bryant KA, Arnold DM, Felton HM, Purcell PM, Kinney MD, Parrish-Sprowl JM, Marshall GS. Standardized Vaccine-Hesitant Patients in the Assessment of the Effectiveness of Vaccine Communication Training. J Pediatr 2022; 241:203-211.e1. [PMID: 34699909 DOI: 10.1016/j.jpeds.2021.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To determine if training residents in a structured communication method elicits specific behaviors in a laboratory model of interaction with vaccine-hesitant parents. STUDY DESIGN Standardized patients portraying vaccine-hesitant parents were used to assess the effectiveness of training in the Announce, Inquire, Mirror, Secure (AIMS) Method for Healthy Conversations. Blinded pediatric residents were pseudorandomized to receive AIMS or control training and underwent pre- and post-training encounters with blinded standardized patients. Encounters were assessed by blinded raters using a novel tool. Participant confidence and standardized patient evaluations of the participants' general communication skills were assessed. RESULTS Ratings were available for 27 AIMS and 26 control participants. Statistically significant increases in post-training scores (maximum = 30) were detected in AIMS, but not in control, participants (median, 21.3 [IQR, 19.8-24.8] vs 18.8 [IQR, 16.9-20.9]; P < .001). Elements (maximum score = 6) with significant increases were Inquire (0.67 [IQR, 0-1.76] vs -0.33 [IQR, -0.67 to 0.33]; P < .001); Mirror (1.33 [IQR, 0 to 2] vs -0.33 [IQR, -0.92 to 0]; P < .001) and Secure (0.33 [IQR, 0 to 1.67] vs -0.17 [IQR, -0.67 to 0.33]; P = .017). Self-confidence increased equally in both groups. Standardized patients did not detect a difference in communication skills after training and between groups. Internal consistency and inter-rater reliability of the assessment tool were modest. CONCLUSIONS Standardized patients proved useful in studying the effectiveness of structured communication training, but may have been limited in their ability to perceive a difference between groups owing to the predetermined encounter outcome of vaccine refusal. AIMS training should be studied in real-world scenarios to determine if it impacts vaccine acceptance.
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Affiliation(s)
- Shanna M Barton
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Aaron W Calhoun
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Carrie A Bohnert
- Department of Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY
| | - Sara M Multerer
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Victoria A Statler
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Kristina A Bryant
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Daniel M Arnold
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Heather M Felton
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Patricia M Purcell
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - Matthew D Kinney
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY
| | - John M Parrish-Sprowl
- Department of Communication Studies, Global Health Communication Center, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Gary S Marshall
- Norton Children's Hospital, and University of Louisville School of Medicine, Louisville, KY.
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Do TVC, Thota Kammili S, Reep M, Wisnieski L, Ganti SS, Depa J. COVID-19 Vaccine Acceptance Among Rural Appalachian Healthcare Workers (Eastern Kentucky/West Virginia): A Cross-Sectional Study. Cureus 2021; 13:e16842. [PMID: 34513428 PMCID: PMC8410864 DOI: 10.7759/cureus.16842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction The success of a vaccination program is dependent on vaccine efficacy and the number of people vaccinated. Healthcare workers are the first to receive the COVID-19 vaccine based on CDC phase 1a recommendations and are a point of contact for information for patients, so they must be well-educated on common misconceptions about the vaccine. Objective To identify acceptance/refusal rates of COVID-19 vaccine, reasons for refusal, and to understand the impact of demographics, work environment, and comorbidities on vaccine acceptance. Methods A cross-sectional study of 1076 healthcare employees in Rural Appalachian utilizing electronic and paper-based 12 question surveys from December 10, 2020, through December 20, 2020, followed up to April 2021. Results Within our study, 52.3% of our healthcare workers would accept vaccination with higher age, male gender, physicians, and those who receive annual flu vaccines more likely to accept vaccination. The most common reason for refusal was unknown side effects (88.5%). The second reason for refusal at 33.5% was waiting for someone else to take the vaccine first. In February 2021, the percentage of our healthcare workers who were vaccinated was 48%, which then increased to 55% in March 2021. By April 2021, the vaccination percentage of our healthcare workers reached 59%. Conclusions In order to predict how the public percentage of vaccination would be, healthcare workers need to address concerns about side effects from the vaccines and encourage the public to get the vaccines since healthcare workers themselves had already received the vaccines and can educate the patients on how they did after getting the shots.
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Affiliation(s)
- Tuong Vi C Do
- Internal Medicine Residency Program, Appalachian Regional Healthcare, Harlan, USA
| | - Sanjana Thota Kammili
- Internal Medicine Residency Program, Appalachian Regional Healthcare, Whitesburg, USA
| | - Michael Reep
- Internal Medicine Residency Program, Appalachian Regional Healthcare, Harlan, USA
| | - Lauren Wisnieski
- Public Health and Research, Lincoln Memorial University, Harrogate, USA
| | | | - Jayaramakrishna Depa
- internal Medicine Residency Program, Appalachian Regional Healthcare, Harlan, USA
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Wolynn T, Hermann C. Shots heard round the world: better communication holds the key to increasing vaccine acceptance. Nat Immunol 2021; 22:1068-1070. [PMID: 34429551 DOI: 10.1038/s41590-021-00998-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Todd Wolynn
- Kids Plus Pediatrics, Pittsburgh, PA, USA.,Shots Heard Round the World, Pittsburgh, USA
| | - Chad Hermann
- Kids Plus Pediatrics, Pittsburgh, PA, USA. .,Shots Heard Round the World, Pittsburgh, USA.
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Tsui J, Vincent A, Anuforo B, Btoush R, Crabtree BF. Understanding primary care physician perspectives on recommending HPV vaccination and addressing vaccine hesitancy. Hum Vaccin Immunother 2021; 17:1961-1967. [PMID: 33439768 PMCID: PMC8189098 DOI: 10.1080/21645515.2020.1854603] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
HPV vaccination rates have improved in recent years, but remain suboptimal in the United States. Physician recommendation is associated with increased uptake; however, specific strategies used by physicians to recommend the vaccine and address hesitancy are underexplored. We iteratively conducted qualitative in-depth interviews with family medicine and pediatrics/adolescent medicine physicians recruited from four primary care settings (federally qualified health centers and hospital-affiliated practices) within a large academic-hospital system in New Jersey. Interviews aimed to understand factors influencing physician recommendations. Transcripts were analyzed iteratively using a team-based, thematic content analysis approach. All physicians reported strong support for HPV vaccination, intention to recommend for target age groups, and providing factsheets to parents. Many physicians used electronic medical records and/or the state immunization registry for monitoring vaccinations, but few were able to report their own clinic-level rates. The majority said they needed to overcome both hesitancy for at least 10-30% of parents and misinformation from the internet. Most cited having their own children vaccinated for HPV as a first-line strategy for addressing parental hesitancy. Other strategies included using data or professional authority to address safety concerns, linking HPV to cervical cancer, highlighting only needing two doses if vaccinated younger, and normalizing the vaccine. While our findings indicate physicians are knowledgeable about HPV vaccination and recommend it to parents, strategies to overcome parental hesitancy varied. Physician, clinic, and health-system-based strategies need to be adopted to overcome parental hesitancy for HPV vaccination.
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Affiliation(s)
- Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ashley Vincent
- Medical Student, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Bianca Anuforo
- Division of Nursing Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Rula Btoush
- Division of Nursing Science, Rutgers School of Nursing, Newark, NJ, USA
| | - Benjamin F Crabtree
- Division of Nursing Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson, Medical School, New Brunswick, NJ, USA
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Attwell K, Carlson S, Tchilingirian J, Harper T, McKenzie L, Roberts L, Rizzi M, Westphal D, Effler P, Hughes C, Swift V, Blyth CC. Coronavax: preparing community and government for COVID-19 vaccination: a research protocol for a mixed methods social research project. BMJ Open 2021; 11:e049356. [PMID: 34193501 PMCID: PMC8249174 DOI: 10.1136/bmjopen-2021-049356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Ahead of the implementation of a COVID-19 vaccination programme, the interdisciplinary Coronavax research team developed a multicomponent mixed methods project to support successful roll-out of the COVID-19 vaccine in Western Australia. This project seeks to analyse community attitudes about COVID-19 vaccination, vaccine access and information needs. We also study how government incorporates research findings into the vaccination programme. METHODS AND ANALYSIS The Coronavax protocol employs an analytical social media study, and a qualitative study using in-depth interviews with purposively selected community groups. Participant groups currently include healthcare workers, aged care workers, first responders, adults aged 65+ years, adults aged 30-64 years, young adults aged 18-29 years, education workers, parents/guardians of infants and young children (<5 years), parents/guardians of children aged 5-18 years with comorbidities and parents/guardians who are hesitant about routine childhood vaccines. The project also includes two studies that track how Australian state and Commonwealth (federal) governments use the study findings. These are functional dialogues (translation and discussion exercises that are recorded and analysed) and evidence mapping of networks within government (which track how study findings are used). ETHICS AND DISSEMINATION Ethics approval has been granted by the Child and Adolescent Health Service Human Research Ethics Committee (HREC) and the University of Western Australia HREC. Study findings will be disseminated by a series of journal articles, reports to funders and stakeholders, and invited and peer-reviewed presentations.
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Affiliation(s)
- Katie Attwell
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Samantha Carlson
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Jordan Tchilingirian
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Tauel Harper
- Faculty of Arts, Business, Law and Education, The University of Western Australia, Perth, Western Australia, Australia
| | - Lara McKenzie
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Leah Roberts
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Marco Rizzi
- School of Law, The University of Western Australia, Perth, Western Australia, Australia
| | - Darren Westphal
- Communicable Disease Control Directorate, Department of Health Government of Western Australia, Perth, Western Australia, Australia
| | - Paul Effler
- Communicable Disease Control Directorate, Department of Health Government of Western Australia, Perth, Western Australia, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Catherine Hughes
- Immunisation Foundation of Australia, Perth, Western Australia, Australia
| | - Valerie Swift
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, The University of Western Australia, Perth, Western Australia, Australia
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Di Giuseppe G, Pelullo CP, Della Polla G, Pavia M, Angelillo IF. Exploring the Willingness to Accept SARS-CoV-2 Vaccine in a University Population in Southern Italy, September to November 2020. Vaccines (Basel) 2021; 9:275. [PMID: 33803730 PMCID: PMC8003195 DOI: 10.3390/vaccines9030275] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 12/23/2022] Open
Abstract
Understanding whether members of the university population are willing to receive a future vaccination against COVID-19 and identifying barriers may help public health authorities to develop effective strategies and interventions to contain COVID-19. This cross-sectional study explored the willingness to accept a future SARS-CoV-2 vaccine in a university population in Southern Italy. The perceived risk level of developing COVID-19 was 6.5 and it was significantly higher among females, younger subjects, and those who agreed/strongly agreed that COVID-19 is a severe disease. Only 21.4% of respondents were not worried at all regarding the safety of the vaccine. Males, not being married/cohabitant, being a faculty member, those who perceived a lower risk of developing COVID-19, and those who did not need information regarding the vaccination against COVID-19 were significantly more likely to have no concern at all regarding the safety of the vaccine. The vast majority (84.1%) were willing to receive a future vaccine against COVID-19. Almost coherently with predictors of concern on the safety of the vaccine, being male, not being married/cohabitant, being a faculty member, not being concerned at all that COVID-19 vaccination might not be safe, and agreeing that COVID-19 can have serious health consequences were significant predictors of the willingness to receive the vaccine against COVID-19. A considerable proportion of the population had a positive willingness to receive the future COVID-19 vaccine, although some concerns have been expressed regarding the effectiveness and safety and public health activities seem necessary to achieve the rate that can lead to the protection of the community.
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Affiliation(s)
- Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy; (G.D.G.); (C.P.P.); (M.P.)
| | - Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy; (G.D.G.); (C.P.P.); (M.P.)
| | - Giorgia Della Polla
- Health Direction, Teaching Hospital of the University of Campania “Luigi Vanvitelli”, Via S. Maria di Costantinopoli 104, 80138 Naples, Italy;
| | - Maria Pavia
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy; (G.D.G.); (C.P.P.); (M.P.)
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy; (G.D.G.); (C.P.P.); (M.P.)
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Attwell K, Betsch C, Dubé E, Sivelä J, Gagneur A, Suggs LS, Picot V, Thomson A. Increasing vaccine acceptance using evidence-based approaches and policies: Insights from research on behavioural and social determinants presented at the 7th Annual Vaccine Acceptance Meeting. Int J Infect Dis 2021; 105:188-193. [PMID: 33578012 DOI: 10.1016/j.ijid.2021.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In 2019, the World Health Organization (WHO) flagged vaccine hesitancy as one of the top 10 threats to global health. The drivers of and barriers to under-vaccination include logistics (access to and awareness of affordable vaccines), as well as a complex mix of psychological, social, political, and cultural factors. INCREASING VACCINE UPTAKE There is a need for effective strategies to increase vaccine uptake in various settings, based on the best available evidence. Fortunately, the field of vaccine acceptance research is growing rapidly with the development, implementation, and evaluation of diverse measurement tools, as well as interventions to address the challenging range of drivers of and barriers to vaccine acceptance. ANNUAL VACCINE ACCEPTANCE MEETINGS Since 2011, the Mérieux Foundation has hosted Annual Vaccine Acceptance Meetings in Annecy, France that have fostered an informal community of practice on vaccination confidence and vaccine uptake. Mutual learning and sharing of knowledge has resulted directly in multiple initiatives and research projects. This article reports the discussions from the 7th Annual Vaccine Acceptance Meeting held September 23-25, 2019. During this meeting, participants discussed emergent vaccine acceptance challenges and evidence-informed ways of addressing them in a programme that included sessions on vaccine mandates, vaccine acceptance and demand, training on vaccine acceptance, and frameworks for resilience of vaccination programmes.
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Affiliation(s)
- Katie Attwell
- School of Social Science, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia.
| | - Cornelia Betsch
- University of Erfurt, Nordhäuser Str. 63, 99089, Erfurt, Germany.
| | - Eve Dubé
- Centre de Recherche du CHU de Québec-Université Laval, 2400 D'Estimauville, Quebec, QC, G1E 7G9, Canada.
| | - Jonas Sivelä
- Infectious Disease Control and Vaccinations, Finnish Institute for Health and Welfare (THL), Mannerheimintie 166, Helsinki, Finland.
| | - Arnaud Gagneur
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
| | - L Suzanne Suggs
- BeCHANGE Research Group, Institute of Public Health, Faculty of Communication Sciences, Università della Svizzera Italiana, via G. Buffi 13, Lugano, Switzerland; Swiss School of Public Health (SSPH+), Zurich, Switzerland; Institute for Global Health Innovation, Imperial College London, London, UK.
| | - Valentina Picot
- Scientific Conferences and Public Health Initiatives, Fondation Mérieux, 17 Rue Bourgelat, 69002, Lyon, France.
| | - Angus Thomson
- Sanofi Pasteur, 14 Espace Henry Vallee, 69007, Lyon, France.
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Hori A, Yoshii S, Isaka Y, Wada K. Factors associated with participation in an ongoing national catch-up campaign against rubella: a cross-sectional internet survey among 1680 adult men in Japan. BMC Public Health 2021; 21:292. [PMID: 33541317 PMCID: PMC7863504 DOI: 10.1186/s12889-021-10340-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/26/2021] [Indexed: 01/25/2023] Open
Abstract
Background Since 2019, aiming to eliminate periodic rubella outbreaks, the Japanese government has provided a rubella immunization program targeting men born in fiscal years 1972 to 1978, who lacked the opportunity to be vaccinated against rubella in childhood. This study aimed to explore the factors associated with participation in the rubella vaccination program among the first-year target population in 2019. Methods A total of 11,754 adult men in Japan born in fiscal years 1972 to1978 living in seven rubella epidemic areas (Tokyo, Chiba, Kanagawa, Saitama, Aichi, Osaka, and Fukuoka) were selected from a list of a survey agency and invited to complete an Internet questionnaire in March 2020. Recruitment ended when the participants reached 1680 individuals. Multivariable log binomial regression analyses were performed to explore the association between awareness of rubella prevention and rubella antibody testing in fiscal year 2019, adjusting for social characteristics. Results Of the 1680 men aged 41–47 years who completed the survey, approximately half (51.3%) said that they had received a voucher for the rubella antibody testing and vaccination program. One-quarter (25.9%) of the respondents had used the voucher for rubella antibody testing in 2019, and 6.0% had used the voucher for rubella vaccination in fiscal year 2019. Respondents who understood the government recommendation for rubella antibody testing and vaccination for men of their generation (odds ratio [OR]: 5.50; 95% confidence interval [CI]: 4.01–7.53), those with acquaintances who had undergone rubella testing (OR: 1.39; 95% CI: 1.22–1.59), and those who knew that about their lack of opportunity for rubella vaccination (OR: 1.33; 95% CI: 1.11–1.60) tended to undergo rubella antibody testing. Receiving the most recent seasonal influenza vaccination (OR: 1.26; 95% CI: 1.10–1.43) and being able to confirm a rubella vaccination history (OR: 1.28; 95% CI: 1.13–1.46) were also associated with rubella antibody testing. Conclusions The ongoing Japanese test-and-vaccinate rubella program has yet to achieve its participation rate goal for 2019. Further dissemination of the government recommendation to the population is necessary, along with improvements in the accessibility of the rubella vaccination program. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10340-8.
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Affiliation(s)
- Ai Hori
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8577, Japan
| | - Shiho Yoshii
- Department of Public Health, Faculty of Medicine, Graduate School of Medicine and Public Health, International University of Health and Welfare, 26-1 Akasaka-4chome Minato-ku, Tokyo, 107-8402, Japan
| | - Yukari Isaka
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8577, Japan
| | - Koji Wada
- Department of Public Health, Faculty of Medicine, Graduate School of Medicine and Public Health, International University of Health and Welfare, 26-1 Akasaka-4chome Minato-ku, Tokyo, 107-8402, Japan.
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Chevalier-Cottin EP, Ashbaugh H, Brooke N, Gavazzi G, Santillana M, Burlet N, Tin Tin Htar M. Communicating Benefits from Vaccines Beyond Preventing Infectious Diseases. Infect Dis Ther 2020; 9:467-480. [PMID: 32583334 PMCID: PMC7452969 DOI: 10.1007/s40121-020-00312-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
Despite immunisation being one of the greatest medical success stories of the twentieth century, there is a growing lack of confidence in some vaccines. Improving communication about the direct benefits of vaccination as well as its benefits beyond preventing infectious diseases may help regain this lost confidence. A conference was organised at the Fondation Merieux in France to discuss what benefits could be communicated and how innovative digital initiatives can used for communication. During this meeting, a wide range of indirect benefits of vaccination were discussed. For example, influenza vaccination can reduce hospitalisations and deaths in older persons with diabetes by 45% and 38%, respectively, but the link between influenza and complications from underlying chronic non-communicable diseases such as diabetes is frequently underestimated. Vaccination can reduce antimicrobial resistance (AMR), which is growing, by reducing the incidence of infectious disease (though direct and indirect or herd protection), by reducing the number of circulating AMR strains, and by reducing the need for antimicrobial use. Disease morbidity and treatment costs in the elderly population are likely to rise substantially, with the ageing global population. Healthy ageing and life-course vaccination approaches can reduce the burden of vaccine-preventable diseases, such as seasonal influenza and pneumococcal diseases, which place a significant burden on individuals and society, while improving quality of life. Novel disease surveillance systems based on information from Internet search engines, mobile phone apps, social media, cloud-based electronic health records, and crowd-sourced systems, contribute to improved awareness of disease burden. Examples of the role of new techniques and tools to process data generated by multiple sources, such as artificial intelligence, to support vaccination programmes, such as influenza and dengue, were discussed. The conference participants agreed that continual efforts are needed from all stakeholders to ensure effective, transparent communication of the full benefits and risks of vaccination.
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Affiliation(s)
| | - Hayley Ashbaugh
- Department of Epidemiology, UCLA Fielding School of Public Health, UCLA Fielding School of Public Health, South, Los Angeles, CA, USA
| | | | - Gaetan Gavazzi
- Geriatric Clinic, Grenoble-Alpes University Hospital, GREPI EA, Grenoble-Alpes University, 7408, Grenoble, France
| | | | - Nansa Burlet
- Global head Patient Insights Innovation, Sanofi Pasteur, Lyon, France
| | - Myint Tin Tin Htar
- Medical Development and Scientific/Clinical Affairs, Pfizer Inc., Paris, France
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Abstract
PURPOSE OF REVIEW In September 2019, the United States was at risk of losing measles elimination status due to several large-scale outbreaks resulting in more than 1200 confirmed cases across 31 states. This resurgence caps approximately 10 years of increasing incidence, marked by a highly publicized outbreak in 2015 associated with Disneyland when an infected traveler from the Philippines unknowingly spread the virus to susceptible park visitors and the recently ended large outbreak in undervaccinated Orthodox Jewish communities in New York City and Rockland counties. This review highlights current literature elucidating factors associated with current trends in measles epidemiology in the United States, the public health implications of current measles outbreaks and a path forward for addressing challenges contributing to the resurgence of measles in the United States and globally. RECENT FINDINGS AND SUMMARY As the most highly transmissible vaccine preventable disease, measles is especially sensitive to changes in herd immunity, the impact of vaccine refusal and globalization. Results highlight the confluence of these factors in current outbreaks, provide tools to predict outbreak risk, demonstrate the growing impact of misinformation and evaluate the impact of policy approaches for outbreak control and prevention.
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Napolitano F, Ali Adou A, Vastola A, Angelillo IF. Rotavirus Infection and Vaccination: Knowledge, Beliefs, and Behaviors among Parents in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101807. [PMID: 31117274 PMCID: PMC6571979 DOI: 10.3390/ijerph16101807] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/18/2019] [Accepted: 05/19/2019] [Indexed: 12/14/2022]
Abstract
This study was designed to investigate the knowledge, beliefs, and behaviors about rotavirus infection and its vaccination in a sample of parents in Naples, Italy. The survey was conducted between June and December 2018 among parents of children aged 3 months to 3 years. A total of 40.7% of the study subjects declared that they had heard about rotavirus infection and 60.8% and 59.2% were aware about the vaccination and of its availability in Italy. Parents with a child aged <1 year and those who reported the physicians as source of information were more likely to have heard about rotavirus infection and to know that the vaccination is available in Italy. More than half (56.4%) were worried that their children could have a rotavirus gastroenteritis and this was most likely to occur in those who have heard about rotavirus infection. Only 15.3% declared that they had immunized their children against rotavirus infection. Parents who considered it dangerous for their children to contract the rotavirus gastroenteritis, those who considered the rotavirus vaccine useful, and those who had received information by physicians were more likely to have vaccinated their children against the infection. More than half of the parents who did not immunize their children expressed their willingness to vaccinate them. Developing and implementing additional public education programs are needed for better knowledge toward rotavirus infection and vaccination and a high coverage among parents.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
| | - Abdoulkader Ali Adou
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
| | - Alessandra Vastola
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
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