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de Souza Amorim Matos CC, Couto MT, Oduwole EO, Shey Wiysonge C. Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital. Hum Vaccin Immunother 2024; 20:2298562. [PMID: 38196242 PMCID: PMC10793707 DOI: 10.1080/21645515.2023.2298562] [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: 07/03/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.
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Affiliation(s)
- Camila Carvalho de Souza Amorim Matos
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina, Araranguá, Brazil
| | - Marcia Thereza Couto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Elizabeth O. Oduwole
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, Universal Health Coverage/Communicable and Non-Communicable Diseases Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Gonzalez H, Patel MS, Pehlivanova M, Burke RV. Assessing Trust in Physician and Vaccine Hesitancy Among Hispanic/Latinx Parents. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:74-82. [PMID: 37438967 DOI: 10.1177/15404153231187379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Introduction: Representing the USA's largest ethnic/racial group, Hispanic/Latinx (HL) experience health challenges of proportional magnitude. This study investigates the prevalence of vaccine hesitancy among HL adults and trust in their child's pediatrician. Methods: HL parents of children who receive medical care at one of the largest Federally Qualified Health Centers in the United States completed a survey examining associations between physician trust, vaccine hesitancy, and demographics. Data were subjected to ANOVA via SAS9 version 9.0 (Cary, NC) and SPSS version 27 (Chicago, IL) software. Results: With a total of 500 surveys completed (51% response rate; 81% completion rate), the prevalence of vaccine hesitancy amounted to 15.4% (n = 77). Parents with university-level education displayed higher levels of trust and perceptions in favor of routine vaccination practices (p < .01). When medical visits were conducted in Spanish, parents exhibited lower levels of trust and were more vaccine-hesitant (p < .01). Conclusions: Vaccine literacy must be prioritized in early education to reach parents who may not achieve college degrees. Ensuring language concordance within patient-physician dyads may maximize the potential for vaccine uptake and physician trust.
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Affiliation(s)
- Hector Gonzalez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mona S Patel
- Department of General Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Marieta Pehlivanova
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rita V Burke
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Castro-Aguirre IE, Alvarez D, Contreras M, Trumbo SP, Mujica OJ, Salas Peraza D, Velandia-González M. The Impact of the Coronavirus Pandemic on Vaccination Coverage in Latin America and the Caribbean. Vaccines (Basel) 2024; 12:458. [PMID: 38793709 PMCID: PMC11125655 DOI: 10.3390/vaccines12050458] [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: 01/29/2024] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Routine vaccination coverage in Latin America and the Caribbean declined prior to and during the coronavirus pandemic. We assessed the pandemic's impact on national coverage levels and analyzed whether financial and inequality indicators, immunization policies, and pandemic policies were associated with changes in national and regional coverage levels. METHODOLOGY We compared first- and third-dose coverage of diphtheria-pertussis-tetanus-containing vaccine (DTPcv) with predicted coverages using time series forecast modeling for 39 LAC countries and territories. Data were from the PAHO/WHO/UNICEF Joint Reporting Form. A secondary analysis of factors hypothesized to affect coverages during the pandemic was also performed. RESULTS In total, 31 of 39 countries and territories (79%) had greater-than-predicted declines in DTPcv1 and DTPcv3 coverage during the pandemic, with 9 and 12 of these, respectively, falling outside the 95% confidence interval. Within-country income inequality (i.e., Gini coefficient) was associated with significant declines in DTPcv1 coverage, and cross-country income inequality was associated with declines in DTPcv1 and DTPcv3 coverages. Observed absolute and relative inequality gaps in DTPcv1 and DTPcv3 coverage between extreme country quintiles of income inequality (i.e., Q1 vs. Q5) were accentuated in 2021, as compared with the 2019 observed and 2021 predicted values. We also observed a trend between school closures and greater-than-predicted declines in DTPcv3 coverage that approached statistical significance (p = 0.06). CONCLUSION The pandemic exposed vaccination inequities in LAC and significantly impacted coverage levels in many countries. New strategies are needed to reattain high coverage levels.
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Affiliation(s)
- Ignacio E. Castro-Aguirre
- Comprehensive Family Immunization Unit, Pan American Health Organization, Washington, DC 20037, USA; (I.E.C.-A.); (D.A.)
| | - Dan Alvarez
- Comprehensive Family Immunization Unit, Pan American Health Organization, Washington, DC 20037, USA; (I.E.C.-A.); (D.A.)
| | - Marcela Contreras
- Comprehensive Family Immunization Unit, Pan American Health Organization, Washington, DC 20037, USA; (I.E.C.-A.); (D.A.)
| | - Silas P. Trumbo
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA
| | - Oscar J. Mujica
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, DC 20037, USA;
| | - Daniel Salas Peraza
- Comprehensive Family Immunization Unit, Pan American Health Organization, Washington, DC 20037, USA; (I.E.C.-A.); (D.A.)
| | - Martha Velandia-González
- Comprehensive Family Immunization Unit, Pan American Health Organization, Washington, DC 20037, USA; (I.E.C.-A.); (D.A.)
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Szőllősi GJ, Pataki J, Virágh A, Bányai G, Boruzs K, Bíró K, Dombrádi V. Influenza Vaccination Coverage among People with Self-Reported Cardiovascular Diseases-Findings from the Hungarian Implementation of the European Health Interview Survey. Vaccines (Basel) 2024; 12:360. [PMID: 38675742 PMCID: PMC11054540 DOI: 10.3390/vaccines12040360] [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: 02/27/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Worldwide, cardiovascular diseases are the leading cause of mortality. This has significant implications for public health. Influenza, a common infectious disease, poses an increased risk for individuals with chronic conditions, such as cardiovascular diseases. However, little is known about influenza vaccination coverage in this group. This study utilized data from the Hungarian implementation of the European Health Interview Survey to assess influenza vaccination coverage and its determinants among cardiovascular respondents from 2009 to 2019. The findings reveal a downward trend in the vaccination rates over the years (from 24% to 21%), despite the availability of free vaccination in Hungary for this high-risk population. The main factors influencing low influenza vaccine uptake were identified, as follows: young age, a lower level of education, good self-perceived health status, smoking, a lower frequency of medical visits, and not suffering from respiratory diseases. Addressing these disparities necessitates targeted vaccination strategies supported by enhanced education, better access to healthcare services, and the promotion of preventive healthcare measures. Improving vaccination coverage among patients with cardiovascular diseases is imperative for reducing influenza-related morbidity and mortality. This highlights the importance of comprehensive public health interventions and healthcare provider engagement in promoting vaccination among groups at increased risk.
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Affiliation(s)
- Gergő József Szőllősi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary
| | - Jenifer Pataki
- Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (J.P.); (A.V.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Anett Virágh
- Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (J.P.); (A.V.)
| | - Gábor Bányai
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Klára Boruzs
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Klára Bíró
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Viktor Dombrádi
- Patient Safety Department, Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, 1085 Budapest, Hungary;
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Hernandez Woodbine MJ, Fernández-Niño JA, Rodríguez-Villamizar LA, Rojas-Botero ML. COVID-19 vaccination plans in Latin America and the Caribbean: a multi-country comparative analysis of prioritization strategies. Public Health 2024; 228:162-170. [PMID: 38364676 DOI: 10.1016/j.puhe.2023.12.035] [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: 08/11/2023] [Revised: 12/02/2023] [Accepted: 12/28/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES This study aimed to synthesize and compare the prioritization strategies outlined in the national vaccination plans (NVPs) against Coronavirus Disease 2019 (COVID-19) developed by countries in the Latin America and Caribbean (LAC) region. STUDY DESIGN We conducted a comparative policy analysis based on COVID-19 NVPs. METHODS We conducted a search strategy in three stages to identify NVPs for COVID-19 across 41 countries/territories in the LAC region. Sources included official governmental repositories, complementary Google searches, and less formal documentation. We extracted key variables and conducted a comparative policy analysis based on the prioritization criteria and specific prioritization groups. RESULTS The study identified 52 NVPs for COVID-19, corresponding to 27 (65.8 %) out of 41 countries/territories in the LAC region. Official national websites yielded documents for 12 countries. All NVPs included frontline healthcare personnel in the first prioritization phase/stage, whilst some included residents of long-term healthcare facilities, adults aged 60 years or more, and people with disabilities. The decision criteria for prioritization were declared in 14 countries/territories. Ethical considerations declared in five NVPs included human welfare, equality, solidarity, equity, and social justice as values. CONCLUSION The early stages of vaccination rollout in LAC countries prioritized protection of the healthcare system and epidemiological risk for severe disease. Few countries included ethical considerations in their NVPs, and global inequities in vaccine access and distribution led to varied protections for vulnerable populations across LAC. This analysis highlights the need for improved emergency-response capacity, planning, and enhanced multilateral cooperation in the LAC region for future public health emergencies.
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Affiliation(s)
| | - J A Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia.
| | | | - M L Rojas-Botero
- Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
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Felzer JR, Montgomery A, LeMahieu AM, Finney Rutten LJ, Juhn YJ, Wi CI, Jacobson RM, Kennedy CC. Disparities in Influenza, Pneumococcal, COVID-19 Vaccine Coverage in High-Risk Adults 19 to 64 Years of Age in Southeastern Minnesota, 2010-2021. Chest 2024:S0012-3692(24)00145-4. [PMID: 38342164 DOI: 10.1016/j.chest.2024.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/17/2023] [Accepted: 01/24/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Despite effective vaccines against influenza, pneumococcus, and COVID-19, uptake has been suboptimal. RESEARCH QUESTION Although disparities in vaccination by race and ethnicity have been observed, what is the role of other sociodemographic in US vaccine uptake? STUDY DESIGN AND METHODS We conducted a population-based study using the Rochester Epidemiology Project (REP), a comprehensive medical records linkage system, to assess effects of sociodemographic factors including race, ethnicity, individual-level socioeconomic status (SES) via the housing-based socioeconomic status index, education, population density (urban or nonurban), and marital status with uptake of influenza, pneumococcal, and COVID-19 vaccination in high-risk adults. Adults at high risk of invasive pneumococcal disease residing in four counties in southeastern Minnesota who were 19 to 64 years of age were identified. Vaccination data were obtained from the Minnesota Immunization Information Connection and REP from January 1, 2010, through December 31, 2021. RESULTS We identified 45,755 residents. Most were White (82%), non-Hispanic (94%), married (56%), and living in an urban setting (81%), with three-quarters obtaining at least some college education (74%). Although 45.1% were up-to-date on pneumococcal vaccines, 60.1% had completed the primary COVID-19 series. For influenza and COVID-19, higher SES, living in an urban setting, older age, and higher education positively correlated with vaccination. Magnitude of differences in race, education, and SES widened with booster vaccines. INTERPRETATION This high-risk population is undervaccinated against preventable respiratory diseases, especially influenza and pneumococcus. Although national data reported improvement of disparities in COVID-19 vaccination uptake observed early in the pandemic, our data demonstrated gaps related to race, education level, SES, and age that widened with booster vaccines. Communities with high social vulnerabilities often show increased risk of severe disease outcomes, yet demonstrate lower uptake of preventive services. This highlights the need to understand better vaccine compliance and access in rural, lower SES, less-educated, Black, Hispanic, and younger populations, each of which were associated independently with decreased vaccination.
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Affiliation(s)
- Jamie R Felzer
- Division of Pulmonary & Critical Care, Mayo Clinic, Rochester, MN
| | | | - Allison M LeMahieu
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Lila J Finney Rutten
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Young J Juhn
- Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Chung-Il Wi
- Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Robert M Jacobson
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN; Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine
| | - Cassie C Kennedy
- Division of Pulmonary & Critical Care, Mayo Clinic, Rochester, MN; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN.
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Zanon IP, Campos JVF, de Castro YG, de Souza TGV, do Amarante VS, de Oliveira CSF, Nicolino RR, Silva ROS. Non-vaccination of dogs is linked to uncompleted COVID-19 vaccination protocols of owners. Prev Vet Med 2024; 222:106093. [PMID: 38103432 DOI: 10.1016/j.prevetmed.2023.106093] [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: 10/28/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
Despite the known importance of vaccines as one of the greatest achievements in medical science, vaccine hesitancy has been increasing in the last decade and has become a major threat to global health. The growth of vaccine hesitancy worldwide became more evident with the onset of COVID-19 and raised the fear that this hesitancy would also impact companion animal vaccination. This study aimed to characterize vaccine-hesitant groups regarding companion animals and human vaccinations, as well as to explore the possible association between vaccine hesitancy in pets and their owners. An anonymous online survey containing 27 closed questions was conducted, including questions about dog health, such as vaccination, neutering, and homeopathy use, as well as questions about the COVID-19 vaccination status of the owner and motivations for vaccinating or not vaccinating their pets. Most participants (81.5 %) reported receiving three or more doses of the COVID-19 vaccine. Not vaccinating against COVID-19 or having an incomplete vaccination protocol was associated with an increase in the age range of participants (odds ratio [OR] = 1.43), not having higher education (OR = 7.70), and being in extreme income ranges (less than two minimum wages [OR = 7.57] and more than 10 [OR = 5.20]). The use of homeopathy in humans (OR = 3.24) and dogs (OR = 3.74) was associated with non-vaccination against COVID-19. Owners who were not fully vaccinated against COVID-19 were almost six times more likely to not vaccinate their dogs (OR = 5.94). Non-vaccination of dogs was also associated with non-neutering (OR = 3.56), keeping the dog in contact with other dogs (OR = 2.09), and an increase in the number of dogs in the house increased the chance of not vaccinating the animals (OR = 1.30). The present study revealed a strong association between non-vaccination against COVID-19 and non-vaccination in companion dogs, raising the hypothesis that vaccination hesitancy is a growing challenge in veterinary medicine. In addition, the characteristics of Brazilians who are reluctant to be vaccinated against COVID-19 or immunize their companion animals are described here for the first time.
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Affiliation(s)
- Isabela Pádua Zanon
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - João Victor Ferreira Campos
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - Yasmin Gonçalves de Castro
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - Thayanne Gabryelle Viana de Souza
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - Victor Santos do Amarante
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - Camila Stefanie Fonseca de Oliveira
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - Rafael Romero Nicolino
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil
| | - Rodrigo Otávio Silveira Silva
- Department of Preventive Veterinary Medicine Federal University of Minas Gerais (UFMG), Antônio Carlos Avenue, 6627, Belo Horizonte, Zip-code: 31270-901 Minas Gerais, Brazil.
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Villena R, Safadi MA, Gentile Á, Pujadas M, De la Maza V, George S, Torres JP. Epidemiology of Meningococcal Disease in Four South American Countries and Rationale of Vaccination in Adolescents from the Region: Position Paper of the Latin American Society of Pediatric Infectious Diseases (SLIPE). Vaccines (Basel) 2023; 11:1841. [PMID: 38140244 PMCID: PMC10748232 DOI: 10.3390/vaccines11121841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 12/24/2023] Open
Abstract
Surveillance of meningococcal disease (MD) is crucial after the implementation of vaccination strategies to monitor their impact on disease burden. Adolescent vaccination could provide direct and indirect protection. Argentina, Brazil, and Chile have introduced meningococcal conjugate vaccines (MCV) into their National Immunization Programs (NIP), while Uruguay has not. Here, we analyze the epidemiology of MD and vaccination experience from these four South American countries to identify needs and plans to improve the current vaccination programs. METHODOLOGY Descriptive study of MD incidence rates, serogroup distribution, case fatality rates (CFR), and MCV uptakes during the period 2010-2021 in Argentina, Brazil, Chile, and Uruguay. Data were extracted from national surveillance programs, reference laboratories, NIPs, and Pubmed. RESULTS MD overall incidence from 2010 to 2021 have a decreasing trend in Argentina (0.37 [IQR = 0.20-0.61]), Brazil (0.59 [IQR = 0.54-1.22]), and Chile (0.45 [IQR = 0.40-0.77]), while a significant increase in Uruguay (0.47 [IQR = 0.33-0.69]) was found from 2016 to 2019. During the COVID-19 pandemic, all countries sharply reduced their MD incidence. The highest incidence rates were observed among infants, followed by children 1-4 years of age. No second peak was evident in adolescents. A reduction in serogroup C, W, and Y cases has occurred in Argentina, Brazil, and Chile after introduction of MCV, serogroup B becoming predominant in all four countries. Median CFR was 9.0%, 21%, 19.9%, and 17.9% in Argentina, Brazil, Chile, and Uruguay, respectively. Median uptake of MCV for Argentina and Brazil were 66.6% and 91.0% for priming in infants; 54.7% and 84.5% for booster in toddlers; and 47.5% and 53% for adolescents; while for Chile, 95.6% for toddlers. CONCLUSIONS Experience after the implementation of MCV programs in South America was successful, reducing the burden of MD due to the vaccine serogroups. High vaccine uptake and the inclusion of adolescents will be crucial in the post-pandemic period to maintain the protection of the population. The increase in the proportion of serogroup B cases emphasizes the importance of continuous surveillance to guide future vaccination strategies.
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Affiliation(s)
- Rodolfo Villena
- Department of Pediatrics, Hospital de Niños Exequiel González Cortés, Faculty of Medicine, Universidad de Chile, Santiago 8900085, Chile;
| | - Marco Aurelio Safadi
- Department of Pediatrics, School of Medical Sciences, Santa Casa de Sao Paulo, Sao Paulo 01224-001, Brazil;
| | - Ángela Gentile
- Department of Epidemiology, Hospital de Niños Ricardo Gutierrez, Faculty of Medicine, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires C1121, Argentina;
| | - Mónica Pujadas
- Department of Epidemiology and Pediatrics Infectious Diseases, Hospital Pereira Rossell, Faculty of Medicine, University of the Republic, Montevideo 11400, Uruguay;
| | - Verónica De la Maza
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago 7500539, Chile; (V.D.l.M.); (S.G.)
| | - Sergio George
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago 7500539, Chile; (V.D.l.M.); (S.G.)
| | - Juan Pablo Torres
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago 7500539, Chile; (V.D.l.M.); (S.G.)
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Urueña A, Machado R, Cunha J, López Colmano C, Rancaño C, Kfouri R, Pírez C, Bonvehí P, Calvo M, Cuadros R, Muñoz G, Rodríguez M, Torres J, Cahn F, Ballalai I. Opinions, Attitudes and Factors Related to SARS-CoV-2 Vaccine Uptake in Eight South American Countries. Vaccines (Basel) 2023; 11:1660. [PMID: 38005992 PMCID: PMC10675814 DOI: 10.3390/vaccines11111660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023] Open
Abstract
This article presents attitudes and practices regarding COVID-19 vaccination in the South American population. The study collected data from a self-administered survey distributed through social media platforms between February and April 2022 (N = 6555). The survey included questions related to participants' sociodemographic background, flu vaccination practices, sources of information about COVID-19, and opinions regarding pandemic management and vaccination against SARS-CoV-2. The respondents agreed with the statement that COVID-19 vaccines were necessary (86.4%), effective (79.8%), safe (79.1%), and should be mandatory (64%). Overall, 83.4% accepted vaccination and 12.3% refused it completely. Main rejection reasons were safety (65.8%) and efficacy (54.9%) issues, and rushed development and approvals (49.1%). Vaccine uptake was associated with being ≥60 years, being a healthcare worker, previous influenza vaccine uptake, adherence to preventive measures, the death of ≥1 close people from COVID-19, and being informed through mass media or health authorities' channels. Vaccine uptake inversely correlated with male gender, low educational level, and use of closed social networks for COVID-19 information purposes. This study provides valuable insights into COVID-19 vaccination attitudes and practices in South America that may be used to promote vaccine uptake in the region. Higher COVID-19 vaccination acceptance among people with previously acquired prevention habits reinforces the importance of routine health promotion strategies.
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Affiliation(s)
- Analía Urueña
- Centro de Estudios para la Prevención y Control de Enfermedades Transmisibles, Universidad Isalud, Venezuela 931, Ciudad Autónoma de Buenos Aires C1095AAS, Argentina
- Sociedad Argentina de Vacunología y Epidemiología (SAVE), Ciudad Autónoma de Buenos Aires, Argentina
| | - Ricardo Machado
- Sociedade Brasileira de Imunizações (Sbim), R. Luís Coelho, 308-Consolação, São Paulo 01309-000, SP, Brazil (I.B.)
| | - Juarez Cunha
- Sociedade Brasileira de Imunizações (Sbim), R. Luís Coelho, 308-Consolação, São Paulo 01309-000, SP, Brazil (I.B.)
| | - Clara López Colmano
- Sociedad Argentina de Vacunología y Epidemiología (SAVE), Ciudad Autónoma de Buenos Aires, Argentina
| | - Carolina Rancaño
- Sociedad Argentina de Vacunología y Epidemiología (SAVE), Ciudad Autónoma de Buenos Aires, Argentina
| | - Renato Kfouri
- Sociedade Brasileira de Imunizações (Sbim), R. Luís Coelho, 308-Consolação, São Paulo 01309-000, SP, Brazil (I.B.)
| | - Catalina Pírez
- Sociedad Uruguaya de Pediatría, Comité de Infectología y Vacunas, Lord Ponsonby 2410, Montevideo 11600, Uruguay
| | - Pablo Bonvehí
- Sociedad Argentina de Vacunología y Epidemiología (SAVE), Ciudad Autónoma de Buenos Aires, Argentina
- Servicio de Infectología, Hospital Universitario CEMIC, Dr. Ricardo Balbín 4459, Ciudad Autónoma de Buenos Aires C1430ABC, Argentina
| | - Mario Calvo
- Instituto de Medicina, Facultad de Medicina, Universidad Austral de Chile, Coronel Santiago Bueras 1003, Valdivia 5110566, Chile;
| | - Robinson Cuadros
- Asociación Internacional de Gerontología y Geriatría, Comité Latinoamericano y del Caribe, Carrera 7C Bis 139-17, Bogotá 110121, Colombia;
| | - Greta Muñoz
- Sociedad Ecuatoriana de Pediatría (SEP), Av. Naciones Unidas E2-17 e, Quito 170135, Ecuador
| | - Mónica Rodríguez
- Hospital Central, Instituto de Previsión Social, PCH9+4RX, Santísimo Sacramento, Asunción 1519, Paraguay
| | - Jaime Torres
- Sección de Enfermedades Infecciosas, Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas 1040, Venezuela
| | - Florencia Cahn
- Sociedad Argentina de Vacunología y Epidemiología (SAVE), Ciudad Autónoma de Buenos Aires, Argentina
| | - Isabella Ballalai
- Sociedade Brasileira de Imunizações (Sbim), R. Luís Coelho, 308-Consolação, São Paulo 01309-000, SP, Brazil (I.B.)
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10
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Yeskendir A, Gusmanov A, Zhussupov B. Parental attitudes, beliefs and behaviors toward childhood and COVID-19 vaccines: A countrywide survey conducted in Kazakhstan examining vaccine refusal and hesitancy. Vaccine 2023; 41:6548-6557. [PMID: 37648608 DOI: 10.1016/j.vaccine.2023.08.063] [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: 06/01/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Vaccination rates worldwide have declined in recent years. This decrease is primarily driven by vaccine hesitancy, which remains understudied in Central Asia, including Kazakhstan. Furthermore, there is great concern about parental hesitancy toward COVID-19 vaccines, as previous studies have focused on adult vaccine hesitancy. The current study was conducted by UNICEF and funded by USAID to explore the drivers of routine and COVID-19 immunization behaviors among parents and caregivers in Kazakhstan. METHODS Using a cross-sectional methodology, researchers conducted 3081 face-to-face interviews with parents and caregivers of children aged 0-17 years across cities and villages in Kazakhstan. A tablet-based questionnaire (CAPI) was utilized, collecting participants' data on sociodemographic characteristics, childhood and COVID-19 vaccination behaviors, and potential drivers. RESULTS Total of 239 participants (7.8%) were found to previously refuse vaccination due to their own beliefs. Stronger belief that vaccines are efficacious (AdjOR = 0.47), stronger belief that childhood vaccines are safe and danger of vaccine-preventable diseases is high (AdjOR = 0.73), firmer trust in societal factors (AdjOR = 0.77) and positive attitudes of family members toward immunization (AdjOR = 0.6) were significantly associated with parental refusal of childhood vaccines. The large proportion of respondents (N = 2,634, 85.6%) missed the COVID-19 vaccination of their child or were unwilling to get vaccinated. Stronger belief that COVID-19 vaccines are safe and efficacious (AdjsOR = 0.18), lacking important information about COVID-19 vaccines (AdjOR = 1.25) and parents being unvaccinated against COVID-19 (AdjOR = 2.3) were significant predictors of vaccine hesitancy. CONCLUSION This study revealed numerous socio-demographic and behavioral factors significantly associated with parental refusal of childhood vaccines and hesitancy toward COVID-19 vaccines. Many parents not refusing vaccination possessed negative attitudes towards vaccines. Potential changes in their attitudes and beliefs of parents were observed compared to findings from pre-COVID era. Continuous monitoring of parental hesitancy, proper interventions and education of healthcare workers are suggested to reduce parental vaccine hesitancy.
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Affiliation(s)
- Alua Yeskendir
- UNICEF Kazakhstan National Consultant on COVID-19 Vaccine C4D/Demand Generation Activities, Kazakhstan.
| | - Arnur Gusmanov
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan.
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Mudenda S, Meyer JC, Fadare JO, Ogunleye OO, Saleem Z, Matafwali SK, Daka V, Chabalenge B, Chama J, Mukosha M, Skosana P, Witika BA, Kalungia AC, Hamachila A, Mufwambi W, Godman B. COVID-19 vaccine uptake and associated factors among adolescents and youths: Findings and implications for future vaccination programmes. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002385. [PMID: 37729153 PMCID: PMC10511127 DOI: 10.1371/journal.pgph.0002385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023]
Abstract
Adolescents and youths are a key part of the population that needs to be protected against the coronavirus disease 2019 (COVID-19). This is because they are more likely to spread the virus to vulnerable individuals. In view of these concerns, this study investigated the uptake of COVID-19 vaccines and associated factors among adolescents and youths attending secondary schools in Zambia. This cross-sectional study was conducted among 1500 school-going adolescents in Lusaka from September 2022 to November 2022. Overall, 1409 participants took part giving a response rate of 94%. Only 29.2% (n = 411) of the participants were vaccinated against COVID-19 at the time of the study. Compared to their unvaccinated counterparts, vaccinated adolescents and youths scored higher for knowledge (66.2% vs 57.8%) and attitudes (76.7% vs 39.4%) regarding COVID-19 vaccines. Healthcare workers, family/friends and social media were key sources of information regarding the vaccine. Factors associated with increased vaccine uptake were positive attitudes (AOR = 33.62, 95% CI: 19.92-56.73), indicating it was stressful to follow COVID-19 preventive measures (AOR = 1.47, 95% CI: 1.09-1.99), participants in Grade 12 (AOR = 3.39, 95% CI: 1.94-5.91), Grade 11 (AOR = 2.59, 95% CI: 1.94-5.91), Grade 10 (AOR = 3.48, 95% CI: 1.98-6.11) and Grade 9 (AOR = 3.04, 95% CI: 1.74-5.32) compared to Grade 8. This study found a relatively low uptake of COVID-19 vaccines among adolescents and youths in Zambia. There is a need to provide adequate strategies to address knowledge and attitude gaps regarding COVID-19 vaccines to improve uptake and reduce future morbidity and mortality.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria
| | - Olayinka O. Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Scott K. Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene &Tropical Medicine, London, United Kingdom
| | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Billy Chabalenge
- Department of Medicines Control, Zambia Medicines Regulatory Authority, Lusaka, Zambia
| | - Jacob Chama
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
- HIV and Women’s Health Research Group, University Teaching Hospital, Lusaka, Zambia
| | - Phumzile Skosana
- Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Bwalya A. Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Aubrey C. Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Audrey Hamachila
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Webrod Mufwambi
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
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Pereira MAD, Arroyo LH, Gallardo MDPS, Arcêncio RA, Gusmão JD, Amaral GG, de Oliveira VC, Guimarães EADA. Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity. Rev Bras Enferm 2023; 76:e20220734. [PMID: 37729269 PMCID: PMC10506597 DOI: 10.1590/0034-7167-2022-0734] [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: 09/06/2022] [Accepted: 02/15/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais. METHODS an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals. RESULTS spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals. CONCLUSIONS the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.
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Affiliation(s)
| | | | | | | | - Josianne Dias Gusmão
- Secretaria de Estado da Saúde de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
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13
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Rivera T, Brustrom J, Vera Antelo M, Puertas EB, Rhoda DA, Velandia-Gonzalez M. Understanding COVID-19 Vaccine Acceptance among Latin American Health Workers: Implications for Designing Interventions. Vaccines (Basel) 2023; 11:1471. [PMID: 37766147 PMCID: PMC10536662 DOI: 10.3390/vaccines11091471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Health workers (HWs) have a key role in promoting vaccine acceptance. This study draws on the Behavioral and Social Drivers of Vaccination (BeSD) model and our team's investigation of vaccine hesitancy in a sample of 1197 HWs across 14 Caribbean countries in 2021. We conducted a cross-sectional Internet survey of 6718 HWs across 16 countries in Latin America in spring 2022, after the COVID-19 vaccine had recently become widely available in the region. The survey assessed HWs' attitudes regarding COVID-19 vaccines and vaccines in general. As a proxy measure of COVID-19 vaccine acceptance, we used the willingness to recommend the COVID-19 vaccine to eligible people. Ninety-seven percent of respondents were COVID-19 vaccine acceptant. Although nearly all respondents felt that the COVID-19 vaccine was safe and effective, 59% expressed concerns about potential adverse effects. Despite uniformly high acceptance of the COVID-19 vaccine overall and across Latin American subregions, acceptance differed by sex, HW profession, and COVID-19 history. Social processes, including actions and opinions of friends, family, and colleagues; actions and opinions of religious leaders; and information seen on social networks shaped many respondents' opinions of vaccines, and the magnitude of these effects differed across both demographic and geographic subgroups. Information campaigns designed for HWs should underscore the importance of vaccine safety. Messages should be tailored to specific audiences according to the information source each is most likely to consult and trust.
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Affiliation(s)
- Tamara Rivera
- Comprehensive Immunization Program, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
| | - Jennifer Brustrom
- Biostat Global Consulting, 330 Blandford Drive, Worthington, OH 43085, USA
| | - Maite Vera Antelo
- Comprehensive Immunization Program, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
| | - E Benjamin Puertas
- Human Resources for Health Unit, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
| | - Dale A Rhoda
- Biostat Global Consulting, 330 Blandford Drive, Worthington, OH 43085, USA
| | - Martha Velandia-Gonzalez
- Comprehensive Immunization Program, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
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14
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Chandeying N, Thongseiratch T. Systematic review and meta-analysis comparing educational and reminder digital interventions for promoting HPV vaccination uptake. NPJ Digit Med 2023; 6:162. [PMID: 37644090 PMCID: PMC10465590 DOI: 10.1038/s41746-023-00912-w] [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: 02/28/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
Global Human papillomavirus (HPV) vaccination rates remain low despite available WHO-approved vaccines. Digital interventions for promoting vaccination uptake offer a scalable and accessible solution to this issue. Here we report a systematic review and meta-analysis examining the efficacy of digital interventions, comparing educational and reminder approaches, for promoting HPV vaccination uptake (HVU). This study also identifies factors influencing the effectiveness of these interventions. We searched PubMed, PsycInfo, Web of Science, and the Cochrane Library from each database's inception to January 2023. Three raters independently evaluate the studies using a systematic and blinded method for resolving disagreements. From 1929 references, 34 unique studies (281,280 unique participants) have sufficient data. Client reminder (OR, 1.41; 95% CI, 1.23-1.63; P < 0.001), provider reminder (OR, 1.39; 95% CI, 1.11-1.75; P = 0.005), provider education (OR, 1.18; 95% CI, 1.05-1.34; P = 0.007), and client education plus reminder interventions (OR, 1.29; 95% CI, 1.04-1.59; P = 0.007) increase HVU, whereas client education interventions do not (OR, 1.08; 95% CI, 0.92-1.28; P = 0.35). Digital intervention effectiveness varies based on participants' gender and the digital platform used. Interventions targeting male or mixed-gender participants demonstrate greater benefit, and reminder platforms (SMS, preference reminders, or electronic health record alerts) are more effective in increasing HVU. Digital interventions, particularly client and provider reminders, along with provider education, prove significantly more effective than client education alone. Incorporating digital interventions into healthcare systems can effectively promote HPV vaccination uptake. Reminder interventions should be prioritized for promoting HVU.
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Affiliation(s)
- Nutthaporn Chandeying
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Therdpong Thongseiratch
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
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15
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Gonçalves BA, Matos CCDSA, Ferreira JVDS, Itagyba RF, Moço VR, Couto MT. COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review. CAD SAUDE PUBLICA 2023; 39:e00041423. [PMID: 37556613 PMCID: PMC10494688 DOI: 10.1590/0102-311xpt041423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.
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16
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Oliveira GCCFD, Arroyo LH, Vimieiro AM, Gusmão JD, Oliveira VCD, Guimarães EADA. Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230030. [PMID: 37377251 DOI: 10.1590/1980-549720230030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/14/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE To analyze the spatial behavior of hepatitis A, measles, mumps, and rubella (MMR), and varicella vaccination coverage in children and its relationship with socioeconomic determinants in the state of Minas Gerais. METHODS This ecological study investigated records of doses administered to children, extracted from the Immunization Information System of 853 municipalities in Minas Gerais, in 2020. We analyzed the vaccination coverage and socioeconomic factors. Spatial scan statistics were used to identify spatial clusters and measure the relative risk based on the vaccination coverage indicator and the Bivariate Moran Index, and thus detect socioeconomic factors correlated with the spatial distribution of vaccination. We used the cartographic base of the state and its municipalities and the ArcGIS and SPSS software programs. RESULTS Hepatitis A (89.0%), MMR (75.7%), and varicella (89.0%) showed low vaccination coverage. All vaccines analyzed had significant clusters. The clusters most likely to vaccinate their population were mainly located in the Central, Midwest, South Central, and Northwest regions, while the least likely were in the North, Northeast, and Triângulo do Sul regions. The municipal human development index, urbanization rate, and gross domestic product were spatially dependent on vaccination coverage. CONCLUSIONS The spatial behavior of hepatitis A, MMR, and varicella vaccination coverage is heterogeneous and associated with socioeconomic factors. We emphasize that vaccination records require attention and should be continuously monitored to improve the quality of information used in services and research.
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Limbu YB, Gautam RK. The determinants of COVID-19 vaccination intention: a meta-review. Front Public Health 2023; 11:1162861. [PMID: 37377544 PMCID: PMC10291626 DOI: 10.3389/fpubh.2023.1162861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background A large number of systematic reviews have been published that synthesized various determinants of COVID-19 vaccination intention (CVI). However, they reported inconsistent evidence. Therefore, we conducted a meta-review (systematic review of systematic reviews) to provide a comprehensive synthesis of factors influencing CVI. Methods This meta-review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, Web of Science, and CINAHL were searched for systematic reviews published from 2020 to 2022 that examined the determinants of CVI. AMSTAR-2 critical appraisal tool was used to ensure the quality of included reviews, and ROBIS tool was used to evaluate the risk of bias. Results Globally, the average rate of COVID-19 vaccination intention was 56.97%. We identified 21 main determinants of CVI: socio-demographic, geographical location, social, political, government role, study timeline, attitude, perceived severity, perceived susceptibility, perceived benefits, perceived barriers, self-efficacy and perceived behavioral control, norms, trust, conspiracy theory/propaganda/misinformation, knowledge, information and communication, vaccination recommendation, vaccination history, history of COVID-19 infection, and health status and well-being. Conclusions These results suggest that COVID-19 vaccination intention is a complex process and is affected by numerous multidimensional factors. Therefore, integrated communication strategies and multifaceted interventions may be effective for improving vaccination intention against COVID-19.
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Affiliation(s)
- Yam B. Limbu
- Montclair State University, Montclair, NJ, United States
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18
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Van Espen M, Dewachter S, Holvoet N. COVID-19 vaccination willingness in peri-urban Tanzanian communities: Towards contextualising and moving beyond the individual perspective. SSM Popul Health 2023; 22:101381. [PMID: 36936725 PMCID: PMC10014502 DOI: 10.1016/j.ssmph.2023.101381] [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: 06/22/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
With only 5.1% of the population fully vaccinated against COVID-19, Tanzania has one of the lowest vaccination rates in the world and after two years of changing policies regarding the disease, the country struggles to get its vaccination campaign on the rails. In this study, we identify the determinants of COVID-19 vaccination willingness in two villages of the Mvomero district in Eastern Tanzania. Based on survey data, we performed univariate analyses to assess differences in vaccination intention for various social groups, and built a four-dimensional multivariate ordered logistic regression model that comprises respondents' personal and socioeconomic characteristics, the channels through which they get their information, their attitudes and perceptions towards COVID-19, and their social network embeddedness. Only 37.0% of the respondents indicated that they would be willing to get vaccinated against COVID-19. Vaccination willingness differed significantly according to gender, age, educational attainment and religion; with men, the elderly, people with post-secondary education and Catholics and Muslims more likely to accept a vaccine. Predictors of vaccination willingness were gender, age, social media and informal contacts as information sources, perceived effectiveness of the vaccine and of alternative medicine, fear of side effects, a general dislike of vaccines, and the proportion of vaccinated people and the highest value of trust in international organisations in one's network. Although people's attitudes and perceptions have the largest share of the explanatory value, our model shows that all four of our model's building blocks were imperative in explaining vaccination willingness. Therefore, our paper presents a compelling case for the inclusion of respondents' social embeddedness as a common dimension for exploratory models of vaccination willingness.
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Affiliation(s)
- Marie Van Espen
- Institute of Development Policy, University of Antwerp, Department of Agricultural Economics, Ghent University, Belgium
| | - Sara Dewachter
- Institute of Development Policy, University of Antwerp, Belgium
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19
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Ballalai I, Dawson R, Horn M, Smith V, Bekkat-Berkani R, Soumahoro L, Vicic N. Understanding barriers to vaccination against invasive meningococcal disease: a survey of the knowledge gap and potential solutions. Expert Rev Vaccines 2023; 22:457-467. [PMID: 37144283 DOI: 10.1080/14760584.2023.2211163] [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: 05/06/2023]
Abstract
INTRODUCTION Invasive meningococcal disease (IMD) is a leading cause of life-threatening bacterial meningitis and septicemia. Evidence points to a knowledge gap among parents, teenagers, and healthcare providers (HCPs) regarding IMD and available vaccines, including those against the highly prevalent serogroup B. AREAS COVERED An online survey was conducted between March 27 and April 12, 2019, to gather insights into the knowledge that parents/guardians have about IMD vaccines. The children were aged 2 months-10 years in Australia, Brazil, Germany, Greece, Italy, and Spain, 5-20 years in the UK, and 16-23 years in the US. The findings were discussed in the context of the available literature and solutions were proposed to minimize the knowledge gap and the barriers to vaccination against IMD. EXPERT OPINION The survey demonstrated that parents have a good understanding of IMD but a limited understanding of the different serogroups and vaccines. The available literature highlighted multiple barriers to IMD vaccine uptake; these may be reduced through education of HCPs, clear recommendations to parents by HCPs, the use of technology, and disease-awareness initiatives that engage parents through physical and digital channels. Further studies are warranted to assess the impact of the COVID-19 pandemic on IMD vaccination.
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Affiliation(s)
| | - Rob Dawson
- Meningitis Research Foundation, Bristol, UK
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20
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Kuan-Mahecha MA, Rahman S, Martínez-Rivera P, Lamb MM, Asturias EJ. Differences in parental vaccine confidence and attitudes by health system in Guatemala and their impact on immunization timeliness. Vaccine 2023; 41:3099-3105. [PMID: 37061374 DOI: 10.1016/j.vaccine.2023.03.064] [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: 11/25/2021] [Revised: 02/11/2023] [Accepted: 03/29/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVE The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. METHODS A cross-sectional survey was conducted in parents 6-18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. RESULTS Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). CONCLUSIONS In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series.
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Affiliation(s)
| | - Sabrina Rahman
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | | | - Molly M Lamb
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA; Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
| | - Edwin J Asturias
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA; Center for Global Health, Colorado School of Public Health, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Department of Infectious Diseases and Epidemiology, Children's Hospital Colorado, Aurora, CO, USA.
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Guzman-Holst A, Petrozzi V, Velez C, Gupta V, Ochoa TJ, Juliao P. Knowledge, Attitudes, and Practices Concerning Maternal Immunization Among Pregnant/Postpartum Women and Health Care Professionals in Peru. Infect Dis Ther 2023; 12:1151-1173. [PMID: 36966229 PMCID: PMC10039770 DOI: 10.1007/s40121-023-00788-z] [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: 12/08/2022] [Accepted: 02/27/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION For pregnant women, vaccination with inactivated influenza vaccine (IIV) and tetanus, diphtheria, acellular pertussis vaccine (Tdap) is recommended. In Peru, uptake is nonetheless low. A study was conducted to identify factors affecting maternal vaccination coverage. The study's primary objectives were to describe the knowledge, attitudes, and practices regarding maternal immunization among pregnant/postpartum women and health care professionals (HCPs). The secondary objective was to determine the vaccination coverage and the impact of Ministry of Health (MOH) recommendations. METHODS An observational multicenter, cross-sectional survey study was conducted from February 1, 2021 to June 30, 2021 in five cities in Peru. Two surveys were conducted to assess knowledge, attitudes, and practices concerning maternal immunization: one among pregnant/postpartum women and one among HCPs. RESULTS Participants were 668 pregnant/postpartum women with a mean age of 29.6 years and 219 HCPs-mostly midwives (46.6%) and obstetricians/gynecologists (44.7%). Of the pregnant/postpartum women, 66.9% knew that, in general, vaccinations are given for prevention, and 98.5% believed vaccines are important. Nonetheless, 69.6% of pregnant/postpartum women had poor or moderate knowledge of maternal vaccination. Disease knowledge of influenza (89.1%) and tetanus (87.0%) was high, while knowledge of pertussis (37.7%) was low. Women agreed/strongly agreed that they would get vaccinated with Tdap if a doctor (96.3%), midwife (88.9%), or nurse (72.0%) recommended it. Of the HCPs, 81.3% routinely recommended Tdap vaccination for pregnant women. CONCLUSIONS To enhance vaccine acceptance in pregnant women in Peru, we must improve knowledge of the diseases, MOH recommendations, and benefits of the offered vaccinations. HCPs could provide this vaccination knowledge and information along with their vaccination recommendation as the pregnant/postpartum women indicated they would take the vaccines if recommended by their HCPs. Our findings are important for the successful implementation of maternal immunization programs in Peru.
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Affiliation(s)
| | | | | | - Vinay Gupta
- JSS Medical Research Asia Pacific Private Limited, Faridabad, India
| | - Theresa J Ochoa
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
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22
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Nichol B, McCready JL, Steen M, Unsworth J, Simonetti V, Tomietto M. Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review. PLoS One 2023; 18:e0282525. [PMID: 36862698 PMCID: PMC9980804 DOI: 10.1371/journal.pone.0282525] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Vaccination during pregnancy has been repeatedly demonstrated to be safe and effective in protecting against infection and associated harms for the mother, developing baby, and subsequent infant. However, maternal vaccination uptake remains low compared to the general population. OBJECTIVES An umbrella review to explore the barriers and facilitators to Influenza, Pertussis and COVID-19 vaccination during pregnancy and within 2 years after childbirth, and to inform interventions to encourage uptake (PROSPERO registration number: CRD42022327624). METHODS Ten databases were searched for systematic reviews published between 2009 and April 2022 exploring the predictors of vaccination or effectiveness of interventions to improve vaccination for Pertussis, Influenza, or COVD-19. Both pregnant women and mothers of infants under two years were included. Barriers and facilitators were organised using the WHO model of determinants of vaccine hesitancy through narrative synthesis, the Joanna Briggs Institute checklist assessed review quality, and the degree of overlap of primary studies was calculated. RESULTS 19 reviews were included. Considerable overlap was found especially for intervention reviews, and the quality of the included reviews and their primary studies varied. Sociodemographic factors were specifically researched in the context of COVID-19, exerting a small but consistent effect on vaccination. Concerns around the safety of vaccination particularly for the developing baby were a main barrier. While key facilitators included recommendation from a healthcare professional, previous vaccination, knowledge around vaccination, and communication with and support from social groups. Intervention reviews indicated multi-component interventions involving human interaction to be most effective. CONCLUSION The main barriers and facilitators for Influenza, Pertussis and COVID-19 vaccination have been identified and constitute the foundation for policy development at the international level. Ethnicity, socioeconomic status, concerns about vaccine safety and side effects, and lack of healthcare professionals' recommendations, are the most relevant factors of vaccine hesitancy. Adapting educational interventions to specific populations, person-to-person interaction, healthcare professionals' involvement, and interpersonal support are important strategies to improve uptake.
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Affiliation(s)
- Bethany Nichol
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jemma Louise McCready
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mary Steen
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - John Unsworth
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Valentina Simonetti
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Visiting Professor, University of Bari “Aldo Moro”, Bari, Italy
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23
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Matta MG, Pulido L, Herrera-Paz JJ, Picco JM, Wolff S, Tse G, Garcia-Zamora S. Influenza and pneumococcal vaccine prescription for adults during COVID-19 first wave in three regions of Argentina. Vaccine 2023; 41:1541-1544. [PMID: 36725429 PMCID: PMC9885296 DOI: 10.1016/j.vaccine.2023.01.056] [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: 10/03/2022] [Revised: 12/15/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
Immunizations for influenza and pneumococcus are effective interventions in reducing morbidity and mortality. The objective of this study was to describe the vaccination rates in volunteers from three regions of Argentina during the COVID-19 pandemic. In 2020, 3853 adults were surveyed, 61.6 % were females, 45 % were aged between 40 and 60 and 18.6 % were > 60 years old. The commonest comorbidities were hypertension (12.9 %), dyslipidemia (8.5 %), and smokers or former smokers (9.2 %). The global influenza vaccination rate was 37.7 %, pneumococcal vaccination 24.7 %, and both 17.8 %. Multivariable regression showed that the vaccination rate increased with age and the presence of comorbidities. However, in the subgroup with indications for both vaccines, 71.7 % had the influenza vaccine, 59 % had the pneumococcal vaccine, and 28.3 % received neither. Our study suggests that influenza and pneumococcal vaccine percentages in high-risk patients in Argentina remain sub-optimal. Immunizations with proven reductions in morbimortality could have also been relegated during the COVID pandemic.
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Affiliation(s)
- María Gabriela Matta
- Pharmacology Department, School of Medicine, FASTA University, Mar del Plata, Argentina
| | - Laura Pulido
- Department of Pulmonology, Sanatorio Americano, Rosario, Argentina
| | | | - José M Picco
- Wolff Cardiology and Sport Medicine Institute, Mendoza, Argentina
| | - Sebastian Wolff
- Wolff Cardiology and Sport Medicine Institute, Mendoza, Argentina
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China; Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, United Kingdom
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24
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Hromatko I, Mikac U, Tadinac M. Intention to Vaccinate against COVID-19 among Young Adults: The Role of Conspiratorial Thinking. Vaccines (Basel) 2023; 11:vaccines11020321. [PMID: 36851199 PMCID: PMC9965982 DOI: 10.3390/vaccines11020321] [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: 12/21/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
The anti-scientific and anti-vaccine movements gained momentum amidst the health and socio-economic crisis brought about by the COVID-19 pandemic. These widespread pseudoscientific beliefs and the endorsement of conspiracy theories likely contributed to the COVID-19 vaccine hesitancy. The aim of this study was to explore which variables best differentiated between groups of vaccinated (n = 289), vaccine-hesitant (n = 106), and vaccine-refusing (n = 146) young adults. The study was conducted online at the beginning of the mass vaccination campaign in Croatia when the vaccine just became available for younger and non-vulnerable members of the general population. The demographic variables, COVID-19 anxiety, and conspiratorial thinking regarding COVID-19 were entered into the discriminant analysis. The function explaining 89.2% of the group differences, mostly between the vaccinated and vaccine-refusing, was largely defined by conspiratorial thinking regarding COVID-19 (0.852), followed by variables with substantially less discriminative power, including COVID-19 anxiety (0.423; lower in the vaccine-refusing group), political orientation (0.486; vaccine-refusing leaning less to the left), financial and educational status (0.435 and 0.304, respectively; both lower in the vaccine-refusing group), and religiosity (0.301; higher in the vaccine-refusing group). These results confirm that among young adults, the decision to vaccinate against COVID-19 might be heavily influenced by one's proclivity to engage in conspiratorial thinking.
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Skinner NA, Sanders K, Lopez E, Sotz Mux MS, Abascal Miguel L, Vosburg KB, Johnston J, Diamond-Smith N, Kraemer Diaz A. Barriers to COVID-19 vaccine acceptance to improve messages for vaccine uptake in indigenous populations in the central highlands of Guatemala: a participatory qualitative study. BMJ Open 2023; 13:e067210. [PMID: 36707110 PMCID: PMC9884572 DOI: 10.1136/bmjopen-2022-067210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION As of July 2022, a little over one-third of Guatemalans were fully vaccinated. While COVID-19 vaccination rates are not officially reported nationally by racial/ethnic groups, non-governmental organisations and reporters have observed that COVID-19 vaccination rates are especially low among high-risk Indigenous populations. We conducted one of the first studies on COVID-19 vaccine acceptance in Indigenous populations in the Central Highlands of Guatemala, which aimed to better understand the barriers to COVID-19 vaccine uptake and how to improve vaccine promotional campaigns. METHODS In November 2021, we conducted eight focus group discussions (FGDs) with 42 Indigenous men and women and 16 in-depth interviews (IDIs) with community health workers, nurses and physicians in Chimaltenango and Sololá. Using a participatory design approach, our qualitative analysis used constant comparative methods to understand the inductive and deductive themes from the FGD and IDI transcripts. RESULTS We found three major overarching barriers to vaccination within the sampled population: (1) a lack of available easily understandable, linguistically appropriate and culturally sensitive COVID-19 vaccine information; (2) vaccine access and supply issues that prevented people from being vaccinated efficiently and quickly; and (3) widespread misinformation and disinformation that prey on people's fears of the unknown and mistrust of the medical establishment and government. CONCLUSION When developing COVID-19 vaccine messages, content should be culturally relevant, appropriate for low-literacy populations and in the languages that people prefer to speak. Promotional materials should be in multiple modalities (print, radio and social media) and also have specific Maya cultural references (dress, food and concepts of disease) to ensure messaging connects with intended targets. This study supports the need for more robust research into best practices for communicating about COVID-19 vaccines to marginalised communities globally and suggests that policy makers should invest in targeted local solutions to increase vaccine uptake.
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Affiliation(s)
- Nadine Ann Skinner
- Stanford Center for Health Education, Stanford University School of Medicine, Stanford, California, USA
| | - Kelly Sanders
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Emily Lopez
- Maya Health Alliance Wuqu' Kawoq, Tecpan, Guatemala
| | | | - Lucía Abascal Miguel
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Kathryn B Vosburg
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Jamie Johnston
- Stanford Center for Health Education, Stanford University School of Medicine, Stanford, California, USA
| | - Nadia Diamond-Smith
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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26
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Analysis of Socio-demographic, Economic and Individual Reasons for COVID-19 Vaccination Hesitancy in Ecuador: A Nationwide Longitudinal Study. J Community Health 2023; 48:467-479. [PMID: 36652158 PMCID: PMC9845833 DOI: 10.1007/s10900-023-01188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
The current outbreak of SARS-Cov-2, a virus responsible for COVID-19, has infected millions and caused a soaring death toll worldwide. Vaccination represents a powerful tool in our fight against the transmission of SARS-CoV-2. Ecuador is one of the Latin American countries most impacted by COVID-19. Despite free COVID-19 vaccines, Ecuadorians still hesitate to get vaccinated. A multivariate binary logistic regression was used to analyze data from the Ecuadorian National Institute of Statistics and Censuses. This study investigated socio-demographics, economic, and individual reasons associated with a person having "no intention" to receive COVID-19 vaccine across the study period of October 2021 to March 2022. The survey revealed an increase of unvaccinated people having no intention of COVID-19 vaccination from 57.4% (October-December 2021) to 72.9% (January-March 2022). COVID-19 vaccine hesitancy was dependent on factors like sex, age and ethnicity. Socio-economic characteristics and education level were not found to be statistically significant in lack of vaccine intention, but most vaccination hesitancy was due to distrust in the COVID-19 vaccine. People who believed that the vaccine could be unsafe because of possible side effects represented half of the surveyed participants, a proportion that barely diminished during the progress of the vaccination campaign across October-December 2021 (57.04%) and January-March 2022 (49.59%) periods. People who did not believe that the vaccine was effective enough increased from 11.47 to 18.46%. Misbeliefs about effectiveness and safety of vaccines should be considered in the implementation of public health initiatives of communication, education and intervention to improve vaccination campaigns.
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Searles M, Jose Ronquillo Mora Y, Carlo L, Heydari N, Takyiwaa Y, Borbor-Cordova MJ, Campagna CD. Zika virus knowledge and vaccine acceptance among undergraduate students in Guayaquil, Ecuador. Vaccine X 2022; 13:100258. [PMID: 36686399 PMCID: PMC9850025 DOI: 10.1016/j.jvacx.2022.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 11/17/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose Zika virus (ZIKV) was declared a Public Health Emergency of International Concern (PHEIC) in 2016. Concerns surrounding the effects of ZIKV persist today and several vaccine candidates are currently in various stages of development worldwide. There is limited research on ZIKV vaccine acceptability worldwide, and little research specific to Latin American countries. This research aims to identify the general beliefs and acceptance of a potential ZIKV vaccine in the undergraduate population at Escuela Superior Politécnica del Litoral (ESPOL) in Guayaquil, Ecuador. Methods Between January and November 2019, 429 undergraduate students at ESPOL responded anonymously to a ZIKV vaccine survey. Frequencies, percentages, simple correspondence analysis, and bivariate inferential analyses were conducted using Kendall's tau-b test. Tests explored associations between likelihood of receiving a ZIKV vaccine and demographic, ZIKV information seeking, ZIKV psychosocial variables, and ZIKV information source variables. Results Among the eligible participants, 241 (56.2%) were willing to receive a ZIKV vaccine if one was made commercially available. Most students were male (61.5%), age 20-25 (63.3%), and of mixed (Mestizo) race (95.3%). Results provided insight into student's knowledge on ZIKV, revealed television as the most common information source, and found most students were willing to receive a ZIKV vaccine were one to become available. Bivariate results revealed most respondents reported feeling neutral or likely to receive a ZIKV vaccine regardless of their agreeability with ZIKV information seeking behavior and psychosocial variables. Conclusions This study provides insight into ZIKV knowledge among ESPOL university students and reveals most respondents obtained ZIKV related information from television. The most common reason for not wanting to receive a hypothetical ZIKV vaccine was vaccine hesitancy. Likelihood of receiving a ZIKV vaccine was associated with several information seeking behavior and psychosocial variables. Public health campaigns should focus on comprehensive ZIKV education efforts in this population.
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Affiliation(s)
- Madison Searles
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA
| | - Ysai Jose Ronquillo Mora
- Facultad de Ingeniería Marítima y Ciencias del Mar, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Lorena Carlo
- Department of Health Informatics, School of Health Professions, Rutgers University, Piscataway, NJ, 08854, USA,Facultad de Ingeniería Electricidad y Computación, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Naveed Heydari
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA
| | - Yaa Takyiwaa
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA,College of Medicine, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Mercy J Borbor-Cordova
- Facultad de Ingeniería Marítima y Ciencias del Mar, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador,Pacific International Center for Disaster Risk Reduction (-RRD), ESPOL, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, Guayaquil, Ecuador
| | - Christina D Campagna
- Institute for Global Health and Translational Science, State University of New York Upstate Medical University, 505 Irving Avenue Suite 4200, Syracuse, NY, 13210, USA,Department of Public Health and Preventive Medicine, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA,Corresponding author.
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Andrade-Guerrero F, Tapia A, Andrade V, Vásconez-González J, Andrade-Guerrero J, Noroña-Calvachi C, Izquierdo-Condoy JS, Yeager J, Ortiz-Prado E. False Contraindications for Vaccinations Result in Sub-Optimal Vaccination Coverage in Quito, Ecuador: A Cross-Sectional Study. Vaccines (Basel) 2022; 11:vaccines11010060. [PMID: 36679905 PMCID: PMC9861379 DOI: 10.3390/vaccines11010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/15/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Vaccination coverage in Ecuador has decreased since 2013, falling short of the World Health Organization's vaccination goal. There are several causes for this deficiency in coverage, one of these are lost vaccination opportunities, which are caused when a patient without contraindications postpones, or for other reasons fails to receive a recommended immunization. The objective of this study was to determine the state of knowledge regarding vaccination contraindications among the Metropolitan District of Quito health personnel to assess missed vaccination opportunities. Through this cross-sectional descriptive study, health personnel were surveyed online and asked 18 clinical scenarios which were created to evaluate their knowledge of the true contraindications of vaccination, and measure missed opportunities. A total of 273 surveys were collected; 74% belonged to the public health system, and the rest represented by private practitioners. Of those surveyed, 98.2% of health personnel had improperly denied vaccination at least once. We specifically found vaccinations were incorrectly denied more frequently in cases where the hypothetical patient presented mild or moderate fever cases. The use of corticosteroids, autoimmune diseases, and egg allergy were also incorrectly denied (89%, 71.4%, 72.9%, and 58.6%, respectively). Among the health personnel surveyed, there is an apparent lack of knowledge of the true contraindications of vaccination and differences in knowledge about contraindications according to personnel in charge of administering immunization to children. Our preliminary results suggest that lack of education related to side effects could be biasing medical professionals' decisions, causing them to unnecessarily delay or deny vaccinations, which likely contributes to explaining low overall vaccination coverage in Quito, the capital city of Ecuador.
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Affiliation(s)
- Felipe Andrade-Guerrero
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
| | - Adriana Tapia
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
| | - Vinicio Andrade
- Department of Pediatrics, Metropolitano Hospital, Quito 170137, Ecuador
| | - Jorge Vásconez-González
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
| | | | | | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
- Health Management and Research Area, Universidad Internacional Iberoamericana, Arecibo 00613, Puerto Rico
| | - Justin Yeager
- Grupo de Investigación en Medio Ambiente y Salud BIOMAS, Quito 170137, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
- Correspondence:
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Abascal Miguel L, Lopez E, Sanders K, Skinner NA, Johnston J, Vosburg KB, Kraemer Diaz A, Diamond-Smith N. Evaluating the impact of a linguistically and culturally tailored social media ad campaign on COVID-19 vaccine uptake among indigenous populations in Guatemala: a pre/post design intervention study. BMJ Open 2022; 12:e066365. [PMID: 36523220 PMCID: PMC9748511 DOI: 10.1136/bmjopen-2022-066365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate the impact of culturally and linguistically tailored informational videos delivered via social media campaigns on COVID-19 vaccine uptake in Indigenous Maya communities in Guatemala. METHODS Our team designed a series of videos utilising community input and evaluated the impact using a pre-post intervention design. In-person preintervention surveys were collected from a sample of respondents in four rural municipalities in Guatemala in March 2022. Facebook, Instagram and browser ads were flooded with COVID-19 vaccine informational videos in Spanish, Kaqchikel and Kiche for 3 weeks. Postintervention surveys were conducted by telephone among the same participants in April 2022. Logistic regression models were used to estimate the OR of COVID-19 vaccine uptake following exposure to the intervention videos. RESULTS Preintervention and postintervention surveys were collected from 1572 participants. The median age was 28 years; 63% (N=998) identified as women, and 36% spoke an Indigenous Mayan language. Twenty-one per cent of participants (N=327) reported watching the intervention content on social media. At baseline, 89% (N=1402) of participants reported having at least one COVID-19 vaccine, compared with 97% (N=1507) in the follow-up. Those who reported watching the videos had 1.78 times the odds (95% CI 1.14 to 2.77) of getting vaccinated after watching the videos compared with those who did not see the videos when adjusted by age, community, sex and language. CONCLUSION Our findings suggest that culturally and linguistically tailored videos addressing COVID-19 vaccine misinformation deployed over social media can increase vaccinations in a rural, indigenous population in Guatemala, implying that social media content can influence vaccination uptake. Providing accurate, culturally sensitive information in local languages from trusted sources may help increase vaccine uptake in historically marginalised populations.
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Affiliation(s)
| | - Emily Lopez
- Wuqu' Kawoq, Maya Health Alliance, Tecpan, Guatemala
| | - Kelly Sanders
- Institute for Global Health Sciences, UCSF, San Francisco, California, USA
| | - Nadine Ann Skinner
- Stanford Center for Health Education, Stanford University School of Medicine, Stanford, California, USA
| | - Jamie Johnston
- Stanford Center for Health Education, Stanford University School of Medicine, Stanford, California, USA
| | - Kathryn B Vosburg
- Institute for Global Health Sciences, UCSF, San Francisco, California, USA
| | | | - Nadia Diamond-Smith
- Institute for Global Health Sciences, UCSF, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
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Osur JO, Chengo R, Muinga E, Kemboi J, Sidibe M, Rarieya M. Determinants of COVID-19 vaccine behaviour intentions among the youth in Kenya: a cross-sectional study. Arch Public Health 2022; 80:159. [PMID: 35733196 PMCID: PMC9217729 DOI: 10.1186/s13690-022-00904-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/22/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction COVID-19 has become a public health concern globally with increased numbers of cases of the disease and deaths reported daily. The key strategy for the prevention of COVID-19 disease is to enhance mass COVID-19 vaccination. However, mass vaccination faces challenges of hesitation to acceptance of the vaccine in the community. The youth may not be among the vulnerable population to severe COVID-19 disease but are highly susceptible to contracting the virus and spreading it. The aim of the study was to assess COVID-19 vaccine youth behavior intentions and their determinants in Kenya. Methods The study used a mixed method design, employing a cross-sectional survey and focused group discussions across 47 counties in Urban, Peri-Urban and Rural settings of Kenya. The interviewees were youths aged 18–35, registered in online platforms/peer groups that included Shujaaz, Brck Moja, Aiffluence, Y Act and Heroes for Change. Quantitative data was collected using Google forms. A total of 665 interviews were conducted. Quantitative data was analysed using STATA version 16. In this paper we report quantitative study findings. Results The findings of the study indicated that only 42% of the youth were ready to be vaccinated, with 52% adopting a wait and see approach to what happens to those who had received the vaccine and 6% totally unwilling to be vaccinated. The determinants of these behavior intentions included: the perceived adverse effects of the vaccine on health, inadequate information about the COVID-19 vaccine, conflicting information about COVID-19 vaccine from the social media, religious implications of the vaccine, impact of education level on understanding of the vaccine, perceived risk of contracting the COVID-19 disease, efficacy of the COVID-19 vaccine, COVID-19 affecting women than men and trust in the ministry of health to lead COVID-19 interventions. Significantly it was found that hesitancy is higher among females, protestants and those with post-secondary education. Lack of information and concerns around vaccine safety and effectiveness were main cause of COVID-19 vaccine hesitancy. Social media was the major source of information contributing to hesitancy. Other contributors to hesitancy included low trust in the MoH and belief that mass vaccination is not helpful. Conclusion Vaccine hesitancy remains high among the youth but the causes of it are modifiable and health systems need to have evidence based engagements with the youth to reduce vaccine hesitancy.
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Castrejon MM, Leal I, de Jesus Pereira Pinto T, Guzmán-Holst A. The impact of COVID-19 and catch-up strategies on routine childhood vaccine coverage trends in Latin America: A systematic literature review and database analysis. Hum Vaccin Immunother 2022; 18:2102353. [PMID: 36084255 DOI: 10.1080/21645515.2022.2102353] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Globally, an estimated 23 million children missed vaccination in 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. We analyzed vaccination coverage trends and catch-up strategies/recommendations implemented in Latin America during the pandemic. We performed a national administrative database analysis and a systematic literature review to evaluate vaccination coverage data and identify catch-up strategies for missed vaccinations in selected countries in Latin America (Argentina, Brazil, Chile, Colombia, Mexico and Peru). Data were extracted from national health ministry vaccination coverage and supranational databases to identify coverage of rotavirus (RV), pentavalent/hexavalent, measles, Bacillus Calmette-Guérin (BCG) and pneumococcal conjugate vaccines (PCV) at country level before and during the COVID-19 pandemic. A systematic literature review of published papers was conducted to identify vaccination catch-up strategies published in January 2020-June 2021. National administrative database-reported data showed that vaccination coverage trends were declining prior to 2020. The change in vaccination coverage before and during the COVID-19 pandemic ranged from 2.5% to -11.5% (RV), -3.0% to -11.0% (measles), 1.5% to -7.5% (PCV), 9.0% to -14.0% (pentavalent/hexavalent), and 3.0% to -18.5% (BCG). Among 696 identified studies, 14 studies were included in this review. Catch-up vaccination strategies included prioritizing routine vaccinations as per the national immunization schedule. Overall vaccination coverage declined by varying degrees among the countries investigated. This trend was observed prior to 2020, suggesting multifactorial reasons for declining vaccination rates in Latin America.
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Affiliation(s)
- María M Castrejon
- Scientific and Medical Affairs in Emerging Markets, GSK, Ciudad de Panamá, Panamá
| | - Ingrid Leal
- Regional Publications - Global Medical, GSK, Ciudad de Panamá, Panamá
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Eiden AL, Barratt J, Nyaku MK. Drivers of and barriers to routine adult vaccination: A systematic literature review. Hum Vaccin Immunother 2022; 18:2127290. [PMID: 36197070 DOI: 10.1080/21645515.2022.2127290] [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: 12/15/2022] Open
Abstract
We performed a systematic literature review in PubMed and Embase (2016-2021) to investigate the drivers of and barriers to routine vaccination in adults aged 50 and older globally. A thematic assessment identified three categories across 61 publications: sociodemographic, health-related, and attitudinal. The most common sociodemographic determinants (factors identified in studies; n = 47) associated with vaccination uptake were economic status, age, education, and household composition, which had mixed effects on vaccine uptake. For health-related determinants (n = 27), individuals with comorbidities and health care consumption were the most common factors, both increased vaccine uptake. The most common attitudinal factors (n = 42) were self-efficacy, provider or other's recommendations, and vaccine-preventable disease awareness; across studies, all attitude factors had a positive effect, unlike the sociodemographic and health status categories. Findings suggest that patient and provider awareness and education campaigns are effective ways to increase uptake of routine vaccinations in older adults.
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Affiliation(s)
- Amanda L Eiden
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
| | - Jane Barratt
- International Federation on Ageing, Toronto, Ontario, Canada
| | - Mawuli K Nyaku
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
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Silva IDAG, de Sá ACMGN, Prates EJS, Malta DC, Matozinhos FP, da Silva TMR. Vaccination against human papillomavirus in Brazilian schoolchildren: National Survey of School Health, 2019. Rev Lat Am Enfermagem 2022; 30:e3834. [PMID: 36449928 PMCID: PMC9699524 DOI: 10.1590/1518-8345.6296.3834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE to analyze the prevalence of schoolchildren vaccinated against human papillomavirus (HPV) and the reasons related to non-vaccination. METHOD cross-sectional study, with data from the 2019 National Survey of School Health. The sample consisted of 160,721 students aged 13 to 17 years. The prevalence and confidence intervals (95%CI) of vaccinated adolescents were estimated according to location, sex, and administrative dependence of the school. The differences between the strata were evaluated with the Chi-square test. Adjusted prevalence ratios (aPR) and 95%CI were estimated with the Poisson regression model. RESULTS most of the students were vaccinated (62.9%), and the prevalence of girls (76.1%) was higher than that of boys (49.1%). The most prevalent reason for not vaccinating was "did not know they had to take" (46.8%), with the highest aPR in public schoolchildren in Brazil (1.6; 95%CI 1.5;1.7), from the Northeast region (1.2; 95%CI 1.1;1.2), and in students from private schools in the Northeast regions (1.1; 95%CI 1.1;1.2) and North (1.3; 95%CI 1.2;1.4). CONCLUSION one out of every two Brazilian schoolchildren was vaccinated against HPV. Misinformation was a recurring reason for non-vaccination. The North and Northeast regions had the highest prevalence of non-vaccinated people, observed mainly in adolescents from public schools. HIGHLIGHTS (1) 63% of Brazilian schoolchildren reported having been vaccinated against human papillomavirus (HPV).(2) In Brazil, in 2019, the prevalence of immunized girls was higher than that of boys.(3) Misinformation and fear are reasons for hesitating vaccination.(4) Social and health inequalities may reflect upon HPV vaccination.(5) Achieving the goal of 80% in HPV vaccination coverage is a challenge in Brazil.
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Affiliation(s)
- Isabella de Alcântara Gomes Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | | | - Elton Junio Sady Prates
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Tércia Moreira Ribeiro da Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
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Arrieta A, García-Prado A, Sarmiento JP, Paz Castro C. Identifying early adopters of COVID-19 vaccines in Latin America. Vaccine 2022; 40:7158-7166. [PMID: 36328886 PMCID: PMC9584855 DOI: 10.1016/j.vaccine.2022.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 05/26/2022] [Accepted: 10/15/2022] [Indexed: 01/27/2023]
Abstract
COVID-19 vaccine hesitancy is currently-one of the main obstacles to worldwide herd immunity and socioeconomic recovery. Because vaccine coverage can vary between and within countries, it is important to identify sources of variation so that policies can be tailored to different population groups. In this paper, we analyze the results from a survey designed and implemented in order to identify early adopters and laggers in six big cities located in Argentina, Colombia, Chile, Ecuador, Peru, and Dominican Republic. We find that trust in government and science, accurate knowledge about the value of vaccination and vaccine effects, and perceived risk of getting sick is associated with a higher probability to get vaccinated. We also identify potential laggers such as women and populations with high education but low knowledge about vaccines. We discuss specific strategies to promote vaccination among these populations groups as well as more general strategies designed to gain trust. These findings are specific to the context of Latin America insofar as the underlying factors associated with the choice to be vaccinated vary significantly by location and in relation to individual-level factors.
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Affiliation(s)
- Alejandro Arrieta
- Florida International University, USA,Corresponding author at: 11200 SW 8th Street, AHC5-450, Miami, FL 33199, Estados Unidos
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Al-Kassab-Córdova A, Silva-Perez C, Maguiña JL. Spatial distribution, determinants and trends of full vaccination coverage in children aged 12-59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey. BMJ Open 2022; 12:e050211. [PMID: 36368757 PMCID: PMC9660560 DOI: 10.1136/bmjopen-2021-050211] [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: 11/13/2022] Open
Abstract
OBJECTIVE To assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12-59 months between 2010 and 2019 in Peru. DESIGN, SETTING AND ANALYSIS A cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran's I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic. OUTCOME MEASURE FVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age. PARTICIPANTS A total of 5 751 and 14 144 children aged 12-59 months from 2010 and 2019 DHSs, respectively, were included. RESULTS FVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified. CONCLUSIONS Although FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.
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Affiliation(s)
- Ali Al-Kassab-Córdova
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Claudia Silva-Perez
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Jorge L Maguiña
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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Grigera J. Adding Insult to Injury: The COVID-19 Crisis Strikes Latin America. DEVELOPMENT AND CHANGE 2022; 53:1335-1361. [PMID: 36712584 PMCID: PMC9874821 DOI: 10.1111/dech.12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This article takes on the task of historicizing the global crisis that unfolded after the outbreak of COVID-19, focusing on its particular dynamics in Latin America. It proposes a distinction between a first phase - an unmitigated crisis that lasted until the end of 2020 - and a second phase in the period since then, that is defined by managed crisis and lukewarm economic recovery. The first phase showed a profoundly fragmented local state response, the breakdown of capital's 'normal' capacity for reproduction, and a disarticulation of the world order. As of 2021, a different kind of crisis has been evident: the response has been more emphatic and more effective in re-establishing accumulation and a weak and fragile international order, but at a cost to legitimacy whose full extent is yet to unfold.
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Bates BR, Villegas-Botero A, Costales JA, Moncayo AL, Tami A, Carvajal A, Grijalva MJ. COVID-19 Vaccine Hesitancy in Three Latin American Countries: Reasons Given for Not Becoming Vaccinated in Colombia, Ecuador, and Venezuela. HEALTH COMMUNICATION 2022; 37:1465-1475. [PMID: 35164624 DOI: 10.1080/10410236.2022.2035943] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although vaccines have been developed to prevent COVID-19, vaccine hesitancy is a significant barrier for vaccination programs. Most research on COVID-19 vaccine hesitancy has blamed misinformation and misstated concerns about effectiveness, safety, and side effects of these vaccines. The preponderance of these studies has been performed in the Global North. Although Latin American has been substantially and negatively impacted by COVID-19, few studies have examined COVID-19 vaccine hesitancy there. We explored reasons volunteered for COVID-19 vaccine hesitancy from a sample of 1,173 Colombians, Ecuadorians, and Venezuelans. Overall, COVID-19 vaccine hesitancy in these three countries is higher than desirable, but most people who are COVID-19 vaccine hesitant offered one reason or fewer. The reasons offered are diverse, including myths and exaggerations, but also individual-level contraindications for vaccination and structural barriers. Because of the diversity of reasons, single-issue mass campaigns are unlikely to bring about large shifts in COVID-19 vaccine hesitancy in Colombia, Ecuador, and Venezuela. Our data suggest that interpersonal communication, particularly in Ecuador, and addressing structural concerns, particularly in Venezuela, are likely to have the greatest impact on vaccine uptake.
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Affiliation(s)
- Benjamin R Bates
- School of Communication Studies, Scripps College of Communication, Ohio University
- Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University
| | | | - Jaime A Costales
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador
| | - Ana L Moncayo
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador
| | - Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Facultad de Ciencias de la Salud, Universidad de Carabobo
| | - Ana Carvajal
- Postgrado de Infectología del Hospital Universitario de Caracas, Universidad Central de Venezuela (Jubilada)
- Facultad de Medicina, Universidad Central de Venezuela
| | - Mario J Grijalva
- Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador
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Nogueira-Rodrigues A, Flores MG, Macedo Neto AO, Braga LAC, Vieira CM, de Sousa-Lima RM, de Andrade DAP, Machado KK, Guimarães APG. HPV vaccination in Latin America: Coverage status, implementation challenges and strategies to overcome it. Front Oncol 2022; 12:984449. [PMID: 36387151 PMCID: PMC9645205 DOI: 10.3389/fonc.2022.984449] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022] Open
Abstract
Cervical cancer remains a leading cause of morbidity and mortality amongst females in Latin America (LATAM). Cervical cancer is a preventable disease and HPV vaccination is a main key strategy towards its elimination. This study analyzes HPV vaccine implementation current status and the main barriers to achieve adequate coverage in the region. Data from the nineteen sovereign states of LATAM (comprised of all Portuguese and Spanish-speaking nations located south of the United States) were collected, including year of HPV vaccine implementation, gender and age targets, the number of doses included in the public program and coverage by dose. Sixteen out of the 19 evaluated countries have already implemented HPV vaccination programs. However, despite its proven efficacy and safety, HPV vaccine uptake in LATAM has been lower than expected. There is an evident decline in adhesion, mainly regarding the second dose. Several reasons are probably involved, of note: limited knowledge of HPV and HPV vaccine, misguided safety concerns, high cost, cultural barriers, and the Covid19 pandemic. Proper strategies to overcome these barriers are needed to ensure successful uptake. Effective policies are: adopting the one dose schedule, delivering the vaccine on both health center and schools, and advising health professionals to recommend the vaccine. Further research regarding HPV vaccine hesitancy in Latin America is needed.
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Affiliation(s)
- Angélica Nogueira-Rodrigues
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizontel, Brazil
- *Correspondence: Angélica Nogueira-Rodrigues,
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Garcini LM, Ambriz AM, Vázquez AL, Abraham C, Sarabu V, Abraham C, Lucas-Marinelli AK, Lill S, Tsevat J. Vaccination for COVID-19 among historically underserved Latino communities in the United States: Perspectives of community health workers. Front Public Health 2022; 10:969370. [PMID: 36330116 PMCID: PMC9623251 DOI: 10.3389/fpubh.2022.969370] [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: 06/14/2022] [Accepted: 09/30/2022] [Indexed: 01/25/2023] Open
Abstract
A critical step to reduce the spread of COVID-19 is vaccination. We conducted a mixed methods project that used online surveys and focus groups with 64 Community Health Workers and Promotor/as (CHW/Ps) located near the U.S.-Mexico border to identify barriers and facilitators to COVID-19 vaccination among Latino communities that have been historically underrepresented and medically underserved. Overall, personal barriers to vaccination included mistrust of manufacturers and administrators as well as fear of: becoming infected from the vaccine, discrimination/stigmatization from healthcare professionals administering the vaccine, exploitation/manipulation by the government or health authorities, and having personal information mishandled. Environmental and community barriers included being undocumented and fear-inducing myths and beliefs. Additional barriers included limited information and logistics pertaining to vaccination access. Targeted efforts are needed to overcome barriers in a culturally and contextually sensitive manner to prevent harm and reduce risk of infection among communities that have been historically underrepresented.
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Affiliation(s)
- Luz M. Garcini
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,Department of Psychiatry and Behavioral Sciences, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,Baker Institute Center for the United States and Mexico, Rice University, Houston, TX, United States,*Correspondence: Luz M. Garcini
| | - Arlynn M. Ambriz
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | | | - Cristina Abraham
- Department of Sciences, University of Texas at San Antonio, San Antonio, TX, United States
| | - Vyas Sarabu
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ciciya Abraham
- Department of Sciences, University of Texas at San Antonio, San Antonio, TX, United States
| | | | - Sarah Lill
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Joel Tsevat
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States,Department of Population Health and Internal Medicine, Dell Medical School, University of Texas, Austin, TX, United States
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Contreras-Pérez ME, Diaz-Martinez J, Langwerden RJ, Hospital MM, Morris SL, Wagner EF, Campa AL. Preliminary Analysis of COVID-19 Vaccination Factors among Native and Foreign-Born Hispanic/Latine Adults Residing in South Florida, U.S.A. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13225. [PMID: 36293803 PMCID: PMC9603465 DOI: 10.3390/ijerph192013225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
This study explored barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among Hispanic/Latine individuals. Hispanic/Latine is a broad social construct that encompasses people from heterogeneous countries and cultures. In the U.S., foreign-born Hispanics/Latines tend to have better health outcomes than U.S.-born individuals. Thus, the study examined whether nativity is a significant factor in COVID-19 vaccine hesitancy. Binary logistic regression and linear regression analyses were employed and revealed that, regardless of nativity, Hispanic/Latine participants face similar barriers and find similar sources of information trustworthy. Controlling for age and race, vaccination rates or perceived likelihood of getting vaccinated did not differ between the two groups. The two groups significantly differed in specific motivators for vaccination: foreign-born Hispanic/Latine individuals were more motivated to get the vaccine to keep themselves, their families, and their community safe, and more often believed vaccination is needed for life to return to normal. Study results provide important insights into similarities and differences in barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among native and foreign-born Hispanic/Latine individuals.
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Affiliation(s)
- María Eugenia Contreras-Pérez
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
- School of Social Work, Florida International University, Miami, FL 33199, USA
| | - Janet Diaz-Martinez
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
- Department of Biostatistics, Florida International University, Miami, FL 33199, USA
- Caridad Center, Boynton Beach, FL 33472, USA
| | - Robbert J. Langwerden
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
| | - Michelle M. Hospital
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
- Department of Biostatistics, Florida International University, Miami, FL 33199, USA
| | - Staci L. Morris
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
- School of Social Work, Florida International University, Miami, FL 33199, USA
| | - Eric F. Wagner
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
- School of Social Work, Florida International University, Miami, FL 33199, USA
| | - Adriana L. Campa
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA
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El Hajj MS, Al‐Ziftawi N, Stewart D, Al‐Khater DMAY. Community pharmacists' participation in adult vaccination: A cross-sectional survey based on the theoretical domains framework. Br J Clin Pharmacol 2022; 89:773-786. [PMID: 36098619 PMCID: PMC9538350 DOI: 10.1111/bcp.15529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES This study aims to assess Qatar community pharmacists' practices in advocating and promoting adult vaccination and to characterize and quantify potential determinants of participation in adult vaccination as vaccine administrators, based on the theoretical domains framework (TDF). METHODS A cross-sectional survey of a randomly selected sample of community pharmacists in Qatar was conducted using a self-administered validated questionnaire. Items in the questionnaire on potential determinants of participation in adult vaccination were based on TDF. TDF items were subjected to principal components analysis. RESULTS In total, 271 respondents completed the questionnaire (67.7%). Most respondents (83.5%) did not have any previous training in vaccination administration and were not involved in any vaccine-related advocacy activities (78.9%). Principal components analysis of TDF items gave eight components: pharmacists' perceived knowledge and skills (median score of 22, interquartile range [IQR] 17-26, possible range: 7-35); perceived confidence (16; IQR 12-20, possible range: 5-25); perceived external support (9; IQR 7-11, possible range: 3-15); professional role identity (38; IQR 33-42, possible range: 11-55); emotions (10; IQR 9-12, possible range: 3-15); perceived consequences (22; IQR 18-24, possible range: 6-30); perceived usefulness (16; IQR 14-18, possible range: 4-20); and behaviour control (6; IQR 4-8, possible range: 2-10). CONCLUSION Pharmacists' perceived knowledge, skills, confidence and behavioural control are potentially important factors to address to facilitate participation in vaccination administration in Qatar. Along with providing vaccination training to community pharmacists, there is a need to change the current pharmacy practice structure to improve managerial and government support for and to equip pharmacies with resources for this role.
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Affiliation(s)
| | | | - Derek Stewart
- College of Pharmacy, QU HealthQatar UniversityDohaQatar
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Mapping global acceptance and uptake of COVID-19 vaccination: A systematic review and meta-analysis. COMMUNICATIONS MEDICINE 2022; 2:113. [PMID: 36101704 PMCID: PMC9465145 DOI: 10.1038/s43856-022-00177-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 08/25/2022] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
The COVID-19 pandemic exit strategies depend on widespread acceptance of COVID-19 vaccines. We aim to estimate the global acceptance and uptake of COVID-19 vaccination, and their variations across populations, countries, time, and sociodemographic subgroups.
Methods
We searched four peer-reviewed databases (PubMed, EMBASE, Web of Science, and EBSCO) for papers published in English from December 1, 2019 to February 27, 2022. This review included original survey studies which investigated acceptance or uptake of COVID-19 vaccination, and study quality was assessed using the Appraisal tool for Cross-Sectional Studies. We reported the pooled acceptance or uptake rates and 95% confidence interval (CI) using meta-analysis with a random-effects model.
Results
Among 15690 identified studies, 519 articles with 7,990,117 participants are eligible for meta-analysis. The global acceptance and uptake rate of COVID-19 vaccination are 67.8% (95% CI: 67.1–68.6) and 42.3% (95% CI: 38.2–46.5), respectively. Among all population groups, pregnant/breastfeeding women have the lowest acceptance (54.0%, 46.3–61.7) and uptake rates (7.3%, 1.7–12.8). The acceptance rate varies across countries, ranging from 35.9% (34.3–37.5) to 86.9% (81.4–92.5) for adults, and the lowest acceptance is found in Russia, Ghana, Jordan, Lebanon, and Syria (below 50%). The acceptance rate declines globally in 2020, then recovers from December 2020 to June 2021, and further drops in late 2021. Females, those aged < 60 years old, Black individuals, those with lower education or income have the lower acceptance than their counterparts. There are large gaps (around 20%) between acceptance and uptake rates for populations with low education or income.
Conclusion
COVID-19 vaccine acceptance needs to be improved globally. Continuous vaccine acceptance monitoring is necessary to inform public health decision making.
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Alarcón-Braga EA, Hernandez-Bustamante EA, Salazar-Valdivia FE, Valdez-Cornejo VA, Mosquera-Rojas MD, Ulloque-Badaracco JR, Rondon-Saldaña JC, Zafra-Tanaka JH. Acceptance towards COVID-19 vaccination in Latin America and the Caribbean: A systematic review and meta-analysis. Travel Med Infect Dis 2022; 49:102369. [PMID: 35680058 PMCID: PMC9169427 DOI: 10.1016/j.tmaid.2022.102369] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Vaccination represents an important strategy to mitigate COVID-19 related morbidity and mortality by protecting against severe forms of the disease and reducing hospitalization and death rates. In this sense, the objective of this study is to estimate the prevalence of Vaccination Intention (VI) against COVID-19 in Latin America and Caribbean (LAC). METHODS We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention to vaccines against COVID-19 in LAC countries. The Clopper-Pearson method was used to estimate 95% Confidence Intervals. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. A subgroup analysis by study location and a sensitivity analysis were developed. RESULTS Nineteen cross-sectional studies were included. Five meta-analyzes were performed according to the target population of the included studies. The VI in the general population of LAC was 78.0% (95%CI: 74.0%-82.0%). The VI for non-pregnant women was 78.0% (95%CI: 58.0%-99.0%), for elderly population was 63.0% (95%CI: 59.0%-69.0%), for pregnant women was 69.0% (95%CI: 61.0%-76.0%) and for health-personnel was 83.0% (95% CI: 71.0%-96.0%). The sensitivity analysis for general population meta-analysis that included only low risk of bias studies showed a 77.0% VI (95%CI: 73.0%-82.0%) and for non-pregnant women, 85.0% VI (95%CI: 79.0%-90.0%). CONCLUSION Despite the high prevalence of VI in general population found in our study, VI prevalence from elderly people and pregnant women are lower than other population groups and overall population.
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Affiliation(s)
- Esteban A Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
| | - Enrique A Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru; Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Farley E Salazar-Valdivia
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Valeria A Valdez-Cornejo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Melany D Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Juan R Ulloque-Badaracco
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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Schwalb A, Armyra E, Méndez-Aranda M, Ugarte-Gil C. COVID-19 in Latin America and the Caribbean: Two years of the pandemic. J Intern Med 2022; 292:409-427. [PMID: 35411985 PMCID: PMC9115176 DOI: 10.1111/joim.13499] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Worldwide, nations have struggled during the coronavirus disease 2019 (COVID-19) pandemic. However, Latin America and the Caribbean faced an unmatched catastrophic toll. As of March 2022, the region has reported approximately 15% of cases and 28% of deaths worldwide. Considering the relatively late arrival of SARS-CoV-2, several factors in the region were determinants of the humanitarian crisis that ensued. Pandemic unpreparedness, fragile healthcare systems, forthright inequalities, and poor governmental support facilitated the spread of the virus throughout the region. Moreover, reliance on repurposed and ineffective drugs such as hydroxychloroquine and ivermectin-to treat or prevent COVID-19-was publicised through misinformation and created a false sense of security and poor adherence to social distancing measures. While there were hopes that herd immunity could be achieved after the region's disastrous first peak, the emergence of the Gamma, Lambda, and Mu variants made this unattainable. This review explores how Latin America and the Caribbean fared during the first 2 years of the pandemic, and how, despite all the challenges, the region became a global leader in COVID-19 vaccination, with 63% of its population fully vaccinated.
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Affiliation(s)
- Alvaro Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,London School of Hygiene and Tropical Medicine, London, UK
| | - Eleonora Armyra
- Health Innovation Lab, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Melissa Méndez-Aranda
- Facultad de Ciencias y Filosofía, Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - César Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,London School of Hygiene and Tropical Medicine, London, UK.,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Baklouti M, Ben Ayed H, Maamri H, Ketata N, Yaich S, Karray R, Jdidi J, Mejdoub Y, Kassis M, Feki H, Dammak J. Prevalence and Factors Affecting Willingness to Accept or Refuse Vaccination against COVID-19 among Healthcare Professionals in Southern Tunisia. Hosp Top 2022:1-10. [PMID: 35975838 DOI: 10.1080/00185868.2022.2111287] [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: 10/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic continues to spread throughout the world causing serious morbidity and mortality. Health care professionals (HCP) are on the front line in the face of this pandemic and are identified as priorities for COVID-19 vaccination. This study aimed to estimate the acceptability rate of the COVID-19 vaccination among HCP and to identify their predisposing factors. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire including a randomized sample of HCP in Southern Tunisia, on March-April 2021. Results: Among 300 participants, the COVID-19 vaccine acceptability rate was 65.3%. Factors independently associated with vaccine acceptability were age groups <30 years [Adjusted Odds Ratio (AOR)=4.36; p = 0.002)], urbanity of residence (AOR = 3.44; p = 0.027), medical professional category (AOR = 2.69; p = 0.023) and caring for coronavirus infected patients (AOR = 2.32; p = 0.047). Belief that COVID-19 vaccination is important to work safely as a health care provider (AOR = 3.26; p = 0.013), should be available for all HCP (AOR = 17.98; p = 0.004) and has been quickly developed before it has been thoroughly vetted and tested for efficacy and safety (AOR = 5.88; p < 0.01) were independently associated with willingness to accept vaccine. Planning to get a COVID-19 vaccine for the next years and recommending it to the family were independent predictive factors of accepting COVID-19 vaccine ((AOR = 6.88; p < 0.001) and (AOR = 25.03; p < 0.001), respectively).Conclusion: The acceptance rate of vaccination against COVID-19 among Tunisian HCP is still low in South Tunisian hospitals. Socio-demographic, cultural and professional factors predisposing to the vaccination willingness were highlighted. Combating the vaccine hesitancy of HCP through enhancing sensibilization campaigns is essential to promote vaccination in general population.
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Affiliation(s)
- Mouna Baklouti
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Houda Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Hanen Maamri
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Nouha Ketata
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Sourour Yaich
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Raouf Karray
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Jihene Jdidi
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Yosra Mejdoub
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Mondher Kassis
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Habib Feki
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Jamel Dammak
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
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Dib F, Mayaud P, Renaudie C, Launay O, Chauvin P. Determinants of human papillomavirus (HPV) vaccine uptake among girls in France: A population-based telephone survey. Hum Vaccin Immunother 2022; 18:2083894. [PMID: 35766886 PMCID: PMC9621050 DOI: 10.1080/21645515.2022.2083894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction The uptake of human papillomavirus (HPV) vaccination in France remains low. The aim of this study was to identify factors associated with the uptake of the HPV vaccine in girls aged 11–14 years in France. Methods We conducted a telephone survey among a quota sample of 1102 mothers of 11-14-year-old daughters residing in mainland France, using the French Survey Questionnaire for the Determinants of HPV Vaccine Hesitancy (FSQD-HPVH). The dependent variable was the uptake of at least one dose of the HPV vaccine in the daughter. The independent variables included the FSQD-HPVH item variables, the Global Vaccine Confidence Index item variables, the daughter’s age, and the mother’s socioeconomic status. Results Overall, 38.6% of the mothers indicated that their daughter received at least one dose of the HPV vaccine. The multivariate analysis revealed that agreeing with the statement that doctors/health care providers believe vaccinating girls against HPV was a good idea, and having asked questions to the attending doctor about HPV vaccines were associated with a higher HPV vaccine uptake (OR = 4.99 , 95% CI [2.09–11.89]; and OR = 3.44, 95% CI [2.40–4.92]). Mother’s belief that her daughter was too young to be vaccinated against HPV (OR = 0.16 , 95% CI [0. 09–0.29]) and lower daughter’s age (OR = 0.17 , 95% CI [0.10–0.28] for girls aged 11 compared to those aged 14) were found strongly inversely associated with HPV vaccination, followed by agreeing with the statement that the HPV vaccine was unsafe (OR = 0.42 , 95% CI [0.26–0.67]), identifying as true the statement that HPV was very rare (OR = 0.49 , 95% CI [0.31–0.77]), and the mother’s refusal of own vaccination (OR = 0.57 , 95% CI [0.40–0.80]). Conclusion We have identified important determinants associated with HPV vaccine uptake in France. Interventions designed to improve HPV vaccine uptake should be tailored to address these determinants.
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Affiliation(s)
- Fadia Dib
- REIVAC; Assistance Publique- Hôpitaux de Paris, Hôpital CochinINSERM CIC 1417, F-CRIN, I, Paris, France.,INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Odile Launay
- REIVAC; Assistance Publique- Hôpitaux de Paris, Hôpital CochinINSERM CIC 1417, F-CRIN, I, Paris, France.,Université de Paris, Faculté de médecine Paris Descartes, Paris, France
| | - Pierre Chauvin
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, Paris, France
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47
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Tampi M, Carrasco-Labra A, O'Brien KK, Velandia-González M, Brignardello-Petersen R. Systematic review on reducing missed opportunities for vaccinations in Latin America. Rev Panam Salud Publica 2022; 46:e65. [PMID: 35747470 PMCID: PMC9211032 DOI: 10.26633/rpsp.2022.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives To estimate the prevalence of missed opportunities for vaccination (MOV) in Latin America and the effect of interventions targeting health systems, health workers, patients, and communities on MOV. Methods Searches were conducted in MEDLINE, EMBASE, CINAHL, and LILACS electronic databases and relevant organizations were contacted, including the Pan American Health Organization (PAHO), to identify studies meeting eligibility criteria. A pair of reviewers identified 27 randomized and non-randomized studies quantifying the effectiveness of any intervention for reducing MOV and 5 studies assessing the rate of MOV in Latin America. Results are reported narratively when criteria to pool results were not met, and the certainty of this evidence was assessed using the GRADE approach. Results Evidence suggests the rate of MOV in Latin America ranged from 5% to 37% with a pooled estimate of 17% (95% CI [9, 32]) (low certainty) and that monetary incentives to healthcare teams, training for healthcare teams on how to communicate with patients, and educational interventions for caregivers probably reduce MOV (moderate to very low certainty). Conclusions There is insufficient evidence supporting the implementation of any intervention as policy based only on the potential reduction of MOV without considering several factors, including costs, feasibility, acceptability, and equity.
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Affiliation(s)
- Malavika Tampi
- University of Michigan School of Dentistry Ann ArborMichigan United States of America University of Michigan School of Dentistry, Ann Arbor, Michigan, United States of America
| | - Alonso Carrasco-Labra
- University of Pennsylvania PhiladelphiaPennsylvania United States of America University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Kelly K O'Brien
- American Dental Association ChicagoIllinois United States of America American Dental Association, Chicago, Illinois, United States of America
| | - Martha Velandia-González
- Pan American Health Organization Washington, D.C. United States of America Pan American Health Organization, Washington, D.C., United States of America
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48
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Périères L, Séror V, Boyer S, Sokhna C, Peretti-Watel P. Reasons given for non-vaccination and under-vaccination of children and adolescents in sub-Saharan Africa: A systematic review. Hum Vaccin Immunother 2022; 18:2076524. [PMID: 35709342 PMCID: PMC9481092 DOI: 10.1080/21645515.2022.2076524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
To achieve the full benefits of vaccination, it is key to understand the underlying causes of low vaccination by researching the barriers to vaccination at a local level. This systematic literature review aims to identify the reasons given by community members for the non-vaccination and under-vaccination of children and adolescents in sub-Saharan Africa. PubMed, Web of Science, PsycINFO, African Index Medicus, and African Journals Online databases were searched to identify articles published between 2010 and 2020. A total of 37 articles were included. As 17 studies did not report the reasons for non-vaccination and under-vaccination separately, we considered these two outcomes as “incomplete vaccination”. The most common reasons for incomplete vaccination were related to caregiver’s time constraints, lack of knowledge regarding vaccination, the unavailability of vaccines/personnel in healthcare facilities, missed opportunities for vaccination, caregiver’s fear of minor side effects, poor access to vaccination services, and caregiver’s vaccination beliefs.
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Affiliation(s)
| | - Valérie Séror
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Sylvie Boyer
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Cheikh Sokhna
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Patrick Peretti-Watel
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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49
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Caycho-Rodríguez T, Ventura-León J, Valencia PD, Vilca LW, Carbajal-León C, Reyes-Bossio M, White M, Rojas-Jara C, Polanco-Carrasco R, Gallegos M, Cervigni M, Martino P, Palacios DA, Moreta-Herrera R, Samaniego-Pinho A, Lobos Rivera ME, Buschiazzo Figares A, Puerta-Cortés DX, Corrales-Reyes IE, Calderón R, Pinto Tapia B, Arias Gallegos WL, Petzold O. What Is the Support for Conspiracy Beliefs About COVID-19 Vaccines in Latin America? A Prospective Exploratory Study in 13 Countries. Front Psychol 2022; 13:855713. [PMID: 35602688 PMCID: PMC9120924 DOI: 10.3389/fpsyg.2022.855713] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022] Open
Abstract
Conspiracy theories about COVID-19 began to emerge immediately after the first news about the disease and threaten to prolong the negative impact of the COVID-19 pandemic by limiting people's willingness of receiving a life-saving vaccine. In this context, this study aimed to explore the variation of conspiracy beliefs regarding COVID-19 and the vaccine against it in 5779 people living in 13 Latin American countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela) according to sociodemographic variables such as gender, age, educational level and source of information about COVID-19. The study was conducted during the COVID-19 pandemic between September 15 and October 25, 2021. The Spanish-language COVID-19 Vaccine Conspiracy Beliefs Scale (ECCV-COVID) and a sociodemographic survey were used. The results indicate that, in most countries, women, people with a lower educational level and those who receive information about the vaccine and COVID-19 from family/friends are more supportive of conspiracy ideas regarding the COVID-19 vaccine. In the case of age, the results vary by country. The analysis of the responses to each of the questions of the ECCV-COVID reveals that, in general, the countries evaluated are mostly in some degree of disagreement or indecision regarding conspiratorial beliefs about COVID-19 vaccines. The findings could help open further study which could support prevention and treatment efforts during the COVID-19 pandemic.
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Affiliation(s)
| | - José Ventura-León
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Pablo D Valencia
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de Mexico, Tlalnepantla de Baz, Mexico
| | - Lindsey W Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | | | - Mario Reyes-Bossio
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Michael White
- Facultad de Ciencias Humanas y Educación, Universidad Peruana Unión, Lima, Peru
| | - Claudio Rojas-Jara
- Facultad de Ciencias de la Salud, Departamento de Psicología, Universidad Católica del Maule, Talca, Chile
| | | | - Miguel Gallegos
- Facultad de Ciencias de la Salud, Departamento de Psicología, Universidad Católica del Maule, Talca, Chile
- Programa de Pós-Graduação em Psicología, Pontificia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Mauricio Cervigni
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
- Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento, Universidad Adventista del Plata, Consejo Nacional de Investigaciones Científicas y Técnicas, Rosario, Argentina
| | - Pablo Martino
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | | | | | - Antonio Samaniego-Pinho
- Carrera de Psicología, Facultad de Filosofía, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Marlon Elías Lobos Rivera
- Escuela de Psicología, Facultad de Ciencias Sociales, Universidad Tecnológica de El Salvador, San Salvador, El Salvador
| | | | | | - Ibraín Enrique Corrales-Reyes
- Servicio de Cirugía Maxilofacial, Hospital General Universitario Carlos Manuel de Céspedes, Universidad de Ciencias Médicas de Granma, Bayamo, Cuba
| | - Raymundo Calderón
- Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad del Valle de Mexico, Mexico City, Mexico
| | - Bismarck Pinto Tapia
- Carrera de Psicología, Universidad Católica Boliviana San Pablo, La Paz, Bolivia
| | | | - Olimpia Petzold
- Lone Star College-Conroe Center, Conroe, TX, United States
- Psychosomatic and Psycho-Oncological Research Unit, Université Libre de Bruxelles, Brussels, Belgium
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Puertas EB, Velandia-Gonzalez M, Vulanovic L, Bayley L, Broome K, Ortiz C, Rise N, Vera Antelo M, Rhoda DA. Concerns, attitudes, and intended practices of Caribbean healthcare workers concerning COVID-19 vaccination: A cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2022; 9:100193. [PMID: 35136868 PMCID: PMC8812828 DOI: 10.1016/j.lana.2022.100193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Caribbean has a long history of being a global leader in immunization, and one factor contributing to this success has been the commitment of healthcare workers in promoting the benefits of vaccines. Healthcare workers play a critical role in building trust between the public and the immunization program and are generally cited as the most trusted source of information on vaccination. Healthcare workers themselves, therefore, must be confident in vaccination as a public health good and able to transmit this confidence to those who trust them. However, just as with the general public, healthcare workers develop confidence at different rates and may be susceptible to misinformation about vaccines. METHODS During April and May 2021, the Pan American Health Organization (PAHO) conducted a mixed-methods survey to assess vaccination attitudes, opinions, and reasoning of 1197 healthcare workers across 14 Caribbean countries. FINDINGS Seventy-seven percent of respondents expressed clear intention to be vaccinated for COVID-19 as soon as possible. Intention to be vaccinated as soon as possible was expressed by lower proportions of nurses (66%) and allied health professionals (62%) than physicians (85%) and by younger respondents than older ones (64% vs. 85%, respectively; p < 0.001 for all these comparisons). Across 32 questions about attitudes and opinions, vaccine hesitancy was consistently expressed by higher proportions of nurses and allied health professionals than physicians and by younger respondents than older ones. INTERPRETATION Insights from the survey are helping PAHO address healthcare worker concerns with informative messages and supporting countries in policy development to increase vaccine confidence and coverage among Caribbean healthcare workers. FUNDING This work has been sponsored by the World Health Organization/Pan American Health Organization, the Government of Germany and The Gavi Alliance.
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Affiliation(s)
- E Benjamin Puertas
- Pan American Health Organization, Office of the Subregional Program Coordination, Caribbean, Bridgetown, Barbados
| | - Martha Velandia-Gonzalez
- Pan American Health Organization, Family, Health Promotion and Life Course Department, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Lauren Vulanovic
- Pan American Health Organization, Family, Health Promotion and Life Course Department, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Lisa Bayley
- Pan American Health Organization, Office of the Subregional Program Coordination, Caribbean, Bridgetown, Barbados
| | - Karen Broome
- Pan American Health Organization, Office of the Subregional Program Coordination, Caribbean, Bridgetown, Barbados
| | - Claudia Ortiz
- Pan American Health Organization, Family, Health Promotion and Life Course Department, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Nina Rise
- Pan American Health Organization, Office of the Subregional Program Coordination, Caribbean, Bridgetown, Barbados
| | - Maite Vera Antelo
- Pan American Health Organization, Family, Health Promotion and Life Course Department, Comprehensive Family Immunization Unit, Washington, DC, USA
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