1
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Benedict Kpozehouen E, Macintyre CR, Tan TC. Determinants of uptake of influenza, zoster and pneumococcal vaccines in patients with cardiovascular diseases. Vaccine 2024; 42:3404-3409. [PMID: 38704255 DOI: 10.1016/j.vaccine.2024.04.031] [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: 04/30/2023] [Revised: 02/13/2024] [Accepted: 04/09/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Globally, cardiovascular disease (CVD) is the leading cause of death and illness. Vaccine-preventable infections may increase acute coronary vascular disease events and the risk of complications. Low vaccine coverage has been reported among adults at high risk of complications from vaccine-preventable infections. There is a gap in research evidence around determinants of uptake of vaccines among adults with CVD. This study examined the uptake of influenza, pneumococcal and zoster vaccines and the determinants of uptake of the vaccines among cardiac patients. METHOD A prospective cross-sectional study was carried out among hospitalised cardiac patients through an interviewer-administered questionnaire. Descriptive statistics were used to investigate self-reported uptake of influenza, pneumococcal and zoster vaccines. Univariate and multivariate analyses of participants' social demographic and clinical characteristics were conducted to identify factors for receiving influenza vaccine. RESULTS Low vaccination rates among 104 participants were found for influenza (45.2%), pneumococcal (13.5%) and zoster (5.8%) vaccines. The most common reason for not receiving influenza vaccine was concern about side effects. Lack of awareness about the pneumococcal and zoster vaccines was the main reason for the poor uptake of these vaccines. Australia-born participants were more likely to receive influenza vaccine than overseas-born participants. Working-age participants and, interestingly, people living with a current smoker were less likely to receive influenza vaccine. CONCLUSION Influenza, pneumococcal and zoster vaccine uptake among cardiac patients was low. Encouraging physician recommendations for vaccination for cardiac patients under 65 years of age and addressing vaccination challenges among people from culturally and linguistically diverse backgrounds and pharmacy, workplace, and hospital vaccination may help increase vaccination uptake among cardiac patients.
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Affiliation(s)
| | | | - Timothy C Tan
- Department of Cardiology, Blacktown Hospital, NSW 2148, Australia; Western Sydney University, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Australia
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2
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Alghalyini B, Garatli T, Hamoor R, Ibrahim L, Elmehallawy Y, Hamze D, Abbara Z, Zaidi ARZ. Hesitance and Misconceptions about the Annual Influenza Vaccine among the Saudi Population Post-COVID-19. Vaccines (Basel) 2023; 11:1595. [PMID: 37896998 PMCID: PMC10610791 DOI: 10.3390/vaccines11101595] [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: 07/31/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: Vaccination is a cornerstone of public health strategy for mitigating the morbidity and mortality associated with seasonal influenza. However, vaccine hesitancy and misconceptions pose significant barriers to this effort, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the transfer of COVID-19 vaccine hesitancy to the influenza vaccine and to identify misconceptions about the influenza vaccine among the Saudi population in the post-COVID-19 era. (2) Methods: A web-based, cross-sectional study was conducted between February and June 2023 using a questionnaire adapted from the Adult Vaccine Hesitancy Scale (aVHS). The questionnaire was disseminated to 589 Saudi residents, aged 18 and above, with access to digital devices. Data were analyzed via logistic regression analysis to determine the associations between vaccine hesitancy, knowledge of influenza, and baseline characteristics. (3) Results: This study found that 37.7% of respondents exhibited vaccine hesitancy, while 56.7% demonstrated good knowledge about influenza. There was a significant relationship between nationality and vaccine hesitancy (p-value > 0.05), with non-Saudi respondents exhibiting higher hesitancy. Logistic regression analysis revealed significant associations between vaccine hesitancy, age, and nationality. Meanwhile, participants with higher educational qualifications showed greater knowledge about influenza. (4) Conclusions: The findings highlight an important crossover of COVID-19 vaccine hesitancy to influenza vaccines. This study underscores the need for targeted public health interventions to address misconceptions about the influenza vaccine, particularly among certain demographic groups, in order to improve influenza vaccine uptake in the post-COVID era.
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Affiliation(s)
| | | | | | | | | | | | | | - Abdul Rehman Zia Zaidi
- Department of Family & Community Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; (B.A.); (T.G.); (R.H.); (L.I.); (Y.E.); (D.H.); (Z.A.)
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3
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The Vaccine Hesitancy Profiles and Determinants of Seasonal Influenza among Chinese Community Healthcare Workers: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10091547. [PMID: 36146625 PMCID: PMC9505772 DOI: 10.3390/vaccines10091547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/04/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022] Open
Abstract
This paper is an evaluation of seasonal influenza vaccination hesitancy (IVH) and its determinants among community HCWs in Chongqing, a city in southwest China. Methods: A cross-sectional survey of 1030 community HCWs with direct or indirect patient contact was conducted from July to September 2021 using a self-administered electronic questionnaire. Possible factors for IVH among community HCWs were investigated by multivariable logistic regression to yield adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Overall, 46.2% of community HCWs were vaccinated in the 2020–2021 season, while 65.8% of community HCWs had IVH. “Don’t know the coverage in China” (OR: 1.46, 95% CI: 1.01–2.11; 40-year-old group OR: 3.02, 95% CI: 1.92–4.76), “complacency” (OR: 4.55, 95% CI: 3.14–6.60) were positively related with having IVH. The community HCWs that had a history of influenza vaccination (OR: 0.67 95% CI: 0.48–0.95) and groups with confidence and convenience (OR: 0.08, 95% CI: 0.06–0.12; OR: 0.34, 95% CI: 0.23–0.52, respectively) were more likely to completely accept vaccination. Conclusions: Measures such as improving the awareness and knowledge of influenza and vaccination and expanding the free vaccination policy, combined with improving the convenience of the vaccination service, will promote increased seasonal influenza vaccination-coverage in community HCWs in Chongqing.
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Matsuda A, Asayama K, Obara T, Yagi N, Ohkubo T. Effectiveness of Influenza Vaccination among Children in Satellite Cities of a Metropolitan Area in Tokyo, Japan during the 2014/2015-2018/2019 Season. TOHOKU J EXP MED 2022; 258:69-78. [PMID: 35831118 DOI: 10.1620/tjem.2022.j057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ayako Matsuda
- Center for Public Health Informatics, National Institute of Public Health
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Tohoku Institute for Management of Blood Pressure.,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University
| | | | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven
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5
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Liu M, Cui T, Wang Q, Han Y, Han Y, Yang L, Shi N, Yi Y, Jin H. Using an extended protection motivation theory to explain vaccine hesitancy: a cross-sectional study among Chinese adults. Hum Vaccin Immunother 2022; 18:2026136. [PMID: 35103578 PMCID: PMC8993063 DOI: 10.1080/21645515.2022.2026136] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Vaccine hesitancy was listed as one of the top 10 issues threatening global health in 2019. The objectives of this study were to (a) use an extended protection motivation theory (PMT) with an added trust component to identify predictors of vaccine hesitancy and (b) explore the predictive ability of vaccine hesitancy on vaccination behavior. Methods We conducted an online questionnaire from February 9 to April 9, 2021, in China. The target population was Chinese residents aged 18 and over. A total of 14,236 responses were received. Structural equation modeling was used to test the extended PMT model hypotheses. Results A total of 10,379 participants were finally included in this study, of whom 52.0% showed hesitancy toward vaccination. 2854 (27.5%) participants reported that they got flu shots in the past year, and 2561 (24.7%) participants were vaccinated against COVID-19. 2857 (27.5%) participants engaged in healthcare occupation. The model explained 85.7% variance of vaccine hesitancy. Self-efficacy was the strongest predictor, negatively associated with vaccine hesitancy (β = −0.584; p < .001). Response efficacy had a negative effect on vaccine hesitancy (β = −0.372; p < .001), while threat appraisal showed a positive effect (β = 0.104; p < .001). Compared with non-health workers, health workers showed more vaccine hesitancy, and response efficacy was the strongest predictor (β = −0.560; p < .001). Vaccine hesitancy had a negative effect on vaccination behavior (β = −0.483; p < .001), and the model explained 23.4% variance of vaccination behavior. Conclusions This study demonstrates that the extended PMT model is efficient in explaining vaccine hesitancy. However, the predictive ability of vaccine hesitancy on vaccination behavior is limited.
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Affiliation(s)
- Minqi Liu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Tingting Cui
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Qiang Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Ying Han
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Yue Han
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Liuqing Yang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Naiyang Shi
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Youqin Yi
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
| | - Hui Jin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education School of Public Health Southeast University Nanjing, PR China.,Department of Epidemiology and Health Statistics, School of Public Health, Southeast University Nanjing, PR China
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6
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Hook SA, Hansen AP, Niesobecki SA, Meek JI, Bjork JKH, Kough EM, Peterson MS, Schiffman EK, Rutz HJ, Rowe AJ, White JL, Peel JL, Biggerstaff BJ, Hinckley AF. Evaluating public acceptability of a potential Lyme disease vaccine using a population-based, cross-sectional survey in high incidence areas of the United States. Vaccine 2021; 40:298-305. [PMID: 34895785 DOI: 10.1016/j.vaccine.2021.11.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/09/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lyme disease incidence is increasing, despite current prevention options. New Lyme disease vaccine candidates are in development, however, investigation of the acceptability of a Lyme disease vaccine among potential consumers is needed prior to any vaccine coming to market. We conducted a population-based, cross-sectional study to estimate willingness to receive a potential Lyme disease vaccine and factors associated with willingness. METHODS The web-based survey was administered to a random sample of Connecticut, Maryland, Minnesota, and New York residents June-July 2018. Survey-weighted descriptive statistics were conducted to estimate the proportion willing to receive a potential Lyme disease vaccine. Multivariable multinomial logistic regression models were used to quantify the association of sociodemographic characteristics and Lyme disease vaccine attitudes with willingness to be vaccinated. RESULTS Surveys were completed by 3313 respondents (6% response rate). We estimated that 64% of residents were willing to receive a Lyme disease vaccine, while 30% were uncertain and 7% were unwilling. Compared to those who were willing, those who were uncertain were more likely to be parents, adults 45-65 years old, non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. Those who were unwilling were also more likely to be non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. In addition, the unwilling had low confidence in vaccines in general, had low perceived risk of contracting Lyme disease, and said they would not be influenced by a positive recommendation from a healthcare provider. DISCUSSION Overall, willingness to receive a Lyme disease vaccine was high. Effective communication by clinicians regarding safety and other vaccine parameters to those groups who are uncertain will be critical for increasing vaccine uptake and reducing Lyme disease incidence.
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Affiliation(s)
- Sarah A Hook
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - AmberJean P Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Jenna K H Bjork
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Erin M Kough
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Molly S Peterson
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | | | - Heather J Rutz
- Maryland Department of Health, 201 W. Preston Street, 3rd Floor, Baltimore, MD 21201, USA.
| | - Adam J Rowe
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L White
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L Peel
- Colorado State University, Environmental Health Building, 350 W. Lake St., Fort Collins, CO 80523, USA.
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
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7
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Influenza Vaccination During COVID-19 in a Rural Community: A Cross-sectional Survey. J Community Health 2021; 47:226-231. [PMID: 34647201 PMCID: PMC8514004 DOI: 10.1007/s10900-021-01036-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/19/2022]
Abstract
Vaccination behavior is an informative metric for assessing flu seasons and is especially important to understand for the 2020–2021 flu season, which coincided with the COVID-19 pandemic. This study aimed to estimate flu vaccine behavior and assess vaccine perceptions during the pandemic season. Using a cross-sectional descriptive study design, we conducted an online survey to assess vaccination behavior and perceptions of both COVID-19 and the flu. Patients were identified as recently seen by providers in an academic internal medicine practice (n = 827) and surveys were distributed as messages in the Epic electronic medical record system. We found that 88.3% of respondents (188/206) had received their flu vaccination for the season at the time of their survey response in December 2020–February 2021. Of those that had not yet received the flu vaccine, only 13.6% indicated they planned on getting one. 12.5% of respondents said they had changed their flu vaccine plans due to the COVID-19 pandemic. Looking at differences from past season’s behavior, more individuals switched to getting the flu vaccine than those that switched to not getting the vaccine this season. The most frequently cited reasons for not receiving the flu vaccination were concerns about side effects and not being in a priority group. Changes in flu vaccination behavior from previous seasons represent a net positive in the direction of vaccine acceptance. Barriers to vaccination were identified and results from this study provide more information on vaccine perceptions, beliefs, and behavior, which can benefit future vaccination programs.
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8
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Lytle KL, Collins SP, Feldstein LR, Baughman AH, Brown SM, Casey JD, Erickson HL, Exline MC, Files DC, Gibbs KW, Ginde AA, Gong MN, Grijalva CG, Khan A, Lindsell CJ, Peltan ID, Prekker ME, Rice TW, Shapiro NI, Steingrub JS, Stubblefield WB, Tenforde MW, Womack KN, Patel MM, Self WH. Influenza vaccine acceptance and hesitancy among adults hospitalized with severe acute respiratory illnesses, United States 2019-2020. Vaccine 2021; 39:5271-5276. [PMID: 34376307 DOI: 10.1016/j.vaccine.2021.07.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Understanding patient factors associated with not being vaccinated is essential for successful implementation of influenza vaccination programs. METHODS We enrolled adults hospitalized with severe acute respiratory illness at 10 United States (US) hospitals during the 2019-2020 influenza season. We interviewed patients to collect data about influenza vaccination, sociodemographic characteristics, and vaccine perceptions. RESULTS Among 679 participants, 264 (38.9%) reported not receiving influenza vaccination. Among those not vaccinated, 135 (51.1%) reported choosing not to receive a vaccine because of perceived ineffectiveness (36.7%) or risk (14.4%) of influenza vaccination. Sociodemographic factors associated with not being vaccinated included no medical insurance (aOR = 6.42; 95% CI: 2.52-16.38) and being non-White or Hispanic (aOR = 1.54, 95% CI: 1.02-2.32). CONCLUSIONS Optimizing uptake of influenza vaccination in the US may be improved by educational programs regarding vaccine safety and effectiveness and enhancing vaccine access, particularly among non-White and Hispanic Americans and those without medical insurance.
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Affiliation(s)
- Kelsey L Lytle
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sean P Collins
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Samuel M Brown
- Intermountain Medical Center and University of Utah, Salt Lake City, UT, USA
| | | | - Heidi L Erickson
- Hennepin County Medical Center and the University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - D Clark Files
- Wake Forest School of Medicine, Winston Salem North Carolina, USA
| | - Kevin W Gibbs
- Wake Forest School of Medicine, Winston Salem North Carolina, USA
| | - Adit A Ginde
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Michelle N Gong
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Akram Khan
- Oregon Health & Sciences University, Portland, OR, USA
| | | | - Ithan D Peltan
- Intermountain Medical Center and University of Utah, Salt Lake City, UT, USA
| | - Matthew E Prekker
- Hennepin County Medical Center and the University of Minnesota Medical School, Minneapolis, MN, USA
| | - Todd W Rice
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Mark W Tenforde
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Manish M Patel
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wesley H Self
- Vanderbilt University Medical Center, Nashville, TN, USA.
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9
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The protection motivation theory for predict intention of COVID-19 vaccination in Iran: a structural equation modeling approach. BMC Public Health 2021; 21:1165. [PMID: 34140015 PMCID: PMC8209774 DOI: 10.1186/s12889-021-11134-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/24/2021] [Indexed: 12/27/2022] Open
Abstract
Background Many efforts are being made around the world to discover the vaccine against COVID-19. After discovering the vaccine, its acceptance by individuals is a fundamental issue for disease control. This study aimed to examine COVID-19 vaccination intention determinants based on the protection motivation theory (PMT). Methods We conducted a cross-sectional study in the Iranian adult population and surveyed 256 study participants from the first to the 30th of June 2020 with a web-based self-administered questionnaire. We used Structural Equation Modeling (SEM) to investigate the interrelationship between COVID-19 vaccination intention and perceived susceptibility, perceived severity, perceived self-efficacy, and perceived response efficacy. Results SEM showed that perceived severity to COVID-19 (β = .17, p < .001), perceived self-efficacy about receiving the COVID-19 vaccine (β = .26, p < .001), and the perceived response efficacy of the COVID-19 vaccine (β = .70, p < .001) were significant predictors of vaccination intention. PMT accounted for 61.5% of the variance in intention to COVID-19 vaccination, and perceived response efficacy was the strongest predictor of COVID-19 vaccination intention. Conclusions This study found the PMT constructs are useful in predicting COVID-19 vaccination intention. Programs designed to increase the vaccination rate after discovering the COVID-19 vaccine can include interventions on the severity of the COVID-19, the self-efficacy of individuals receiving the vaccine, and the effectiveness of the vaccine in preventing infection.
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10
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Social norms and vaccine uptake: College students' COVID vaccination intentions, attitudes, and estimated peer norms and comparisons with influenza vaccine. Vaccine 2021; 39:2060-2067. [PMID: 33741191 PMCID: PMC7965606 DOI: 10.1016/j.vaccine.2021.03.018] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 11/29/2022]
Abstract
Background Vaccination may be critical to curtailing the spread of the SARS-CoV-2 virus responsible for the COVID-19 pandemic, but herd immunity can only be realized with high vaccination coverage. There is a need to identify empirically supported strategies to increase uptake, especially among young adults as this subpopulation has shown relatively poor adherence to physical distancing guidelines. Social norms – estimates of peers’ behavior and attitudes – are robust predictors of health behaviors and norms-based intervention strategies may increase COVID vaccine uptake, once available. This study examined the extent that vaccination intentions and attitudes were associated with estimated social norms as an initial proof-of-concept test. Method In November of 2020, 647 undergraduate students (46.21% response rate) completed online surveys in which they reported intentions to get COVID and influenza vaccines, perceived importance of these vaccines for young adults, and estimated social norms regarding peers’ vaccination behaviors and attitudes. Results Students reported significantly greater intentions to get a COVID vaccine (91.64%) than an influenza vaccine (76.04%), and perceived COVID vaccination as significantly more important than influenza vaccination. The sample generally held strong intentions to receive a COVID vaccine and thought that doing so was of high importance, but participants, on average, perceived that other young adults would be less likely to be vaccinated and would not think vaccination was as important. Multiple regression models indicated that estimated social norms were positively associated with participants’ own intentions and perceived importance of getting a COVID vaccine. Conclusions These significant associations highlight the potential value in developing and testing norms-based intervention strategies, such as personalized normative feedback, to improve uptake of forthcoming COVID vaccines among young adults.
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11
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Wu MJ, Chung JR, Kim SS, Jackson ML, Jackson LA, Belongia EA, McLean HQ, Gaglani M, Reis M, Beeram M, Martin ET, Monto AS, Nowalk MP, Zimmerman R, Santibanez TA, Singleton JA, Patel M, Flannery B. Influenza vaccination coverage among persons seeking outpatient medical care for acute respiratory illness in five states in the United States, 2011-2012 through 2018-2019. Vaccine 2021; 39:1788-1796. [PMID: 33597114 DOI: 10.1016/j.vaccine.2021.01.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND In the United States (U.S.), annual influenza vaccination has been recommended for all persons aged ≥6 months with the Healthy People 2020 coverage target of 70%. However, vaccination coverage has remained around 42-49% during the past eight influenza seasons. We sought to quantify influenza vaccination coverage and factors associated with vaccination in persons seeking outpatient medical care for an acute respiratory illness (ARI). METHODS We enrolled outpatients aged ≥6 months with ARI from >50 U.S. clinics from 2011 to 2012 through 2018-2019 influenza seasons and tested for influenza with molecular assays. Vaccination status was based on documented receipt of the current season's influenza vaccine. We estimated vaccination coverage among influenza-negative study participants by study site, age, and season, and compared to state-level influenza coverage estimates in the general population based on annual immunization surveys. We used multivariable logistic regression to examine factors independently associated with receipt of influenza vaccines. RESULTS We enrolled 45,424 study participants with ARI who tested negative for influenza during the study period. Annual vaccination coverage among influenza-negative ARI patients and the general population in the participating states averaged 55% (range: 47-62%), and 52% (range: 46-54%), respectively. Among enrollees, coverage was highest among adults aged ≥65 years (82%; range, 80-85%) and lowest among adolescents aged 13-17 years (38%; range, 35-41%). Factors significantly associated with non-vaccination included non-White race, no college degree, exposure to cigarette smoke, absence of high-risk conditions, and not receiving prior season influenza vaccine. CONCLUSIONS Influenza vaccination coverage over eight seasons among outpatients with non-influenza respiratory illness was slightly higher than coverage in the general population but 15% lower than national targets. Increased efforts to promote vaccination especially in groups with lower coverage are warranted to attain optimal health benefits of influenza vaccine.
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Affiliation(s)
- Michael J Wu
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jessie R Chung
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sara S Kim
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michael L Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Lisa A Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | | | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Manjusha Gaglani
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, TX, United States
| | - Michael Reis
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, TX, United States
| | - Madhava Beeram
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, TX, United States
| | - Emily T Martin
- University of Michigan and Henry Ford Health System, Ann Arbor, MI, United States
| | - Arnold S Monto
- University of Michigan and Henry Ford Health System, Ann Arbor, MI, United States
| | - Mary Patricia Nowalk
- University of Pittsburgh Schools of the Health Sciences and UPMC, Pittsburgh, PA, United States
| | - Richard Zimmerman
- University of Pittsburgh Schools of the Health Sciences and UPMC, Pittsburgh, PA, United States
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Manish Patel
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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