COVID-19 vaccine literacy and vaccine hesitancy among pregnant women and mothers of young children in Japan

Validation of a questionnaire for evaluating vaccine literacy in adulthood vaccination: A pilot study from Zhejiang province, China

This study aimed to validate a tool for assessing vaccine literacy (VL) in adult vaccination under the Chinese context. A pilot study on adult's VL was conducted in 2023 in Huzhou city of Zhejiang province, China. A self-designed questionnaire, specific for the self-assessment of three domains (functional, interactive, and critical), as well as the vaccination knowledge and acceptance was applied. Validation process of the questionnaire was conducted through the investigation of a panel of experts, principal component analysis (factors whose cumulative explanation proportion of variance > 80% were selected) and Cronbach's α coefficient test (>0.7 was acceptable). Correlation coefficient analysis for VL domains, vaccination knowledge and acceptance were also implemented, and r value as well as its significance were calculated. For the validation of the questionnaire, the mean scores for reliability, comprehensibility, efficiency, sensitivity of each question of functional and interactive/critical VL ranged from 3.86 (sensitivity of interactive/critical VL) to 4.26 (comprehensibility of functional VL). Cronbach's α coefficient was 0.8223 with functional VL, 0.8916 for interactive VL and 0.9061 for critical VL. The scores of functional VL, interactive VL and critical VL were 3.36, 3.06 and 2.91, respectively. The mean score of vaccine knowledge was 5.80. The positive response rate of receiving influenza vaccine, pneumococcal vaccine and herpes-zoster vaccine was 36.5% (73/200), 23.00% (46/200) and 11.66% (19/163). The VL score of all domains, the individual's vaccine knowledge and the vaccine acceptance were all significantly correlated to the high education degree (r = 0.37 for functional VL, r = 0.35 for interactive VL, r = 0.30 for critical VL, r = 0.28 for vaccine knowledge, r = 0.42 for vaccine acceptance). The VL questionnaire was shown to be a valid and reliable tool for measuring VL among Chinese adults. It was recommended that the VL questionnaire should be validated in larger and more diverse samples, exploring the impact of interventions to improve VL and assessing the relationship between VL and vaccination behavior over time.

Vaccination decisions and social capital in Japan

The COVID-19 vaccines played a pivotal role in safeguarding many people. Yet, vaccine hesitancy remained a significant barrier to increasing coverage rates, as many high-income countries faced prolonged vaccine refusal campaigns. In Japan, vaccine doses were administered under a reservation system accessible via a website and by phone. Achieving a high vaccination coverage for a vaccine that was offered at no financial cost was surprisingly difficult in Japan as well. In many countries, vaccine hesitancy during the pandemic has been closely related to people's trust in their governments given governments' controversial social distancing mandates. In Japan, lockdowns were voluntary, and vaccinations were also not mandated. As there were no significant political conflicts about the government's policies, vaccination acceptance was influenced by more basic tenets, and we focus here on social capital, defined as cohesive links that enable a society to function effectively. Social capital, in this context, refers to community trust, collaboration, and engagement that create social bonds between individuals and society. Using a uniquely large survey, administered repeatedly through the years of the pandemic, we mostly find support, for the hypothesis that social capital matters for the vaccination decision; and that it matters even once we control for institutional trust (especially trust in the medical system). However, this general association between trust in other community members, belief in the willingness of community members to engage in reciprocal assistance, and belief in the more general willingness of the community to support individuals, were all associated differently with the vaccination decision, and with the views expressed about the vaccinations. From a policy perspective, this suggests that intra-community trust (i.e., bonding social capital), is important even in contexts when trust in governmental is not a significant concern.

COVID-19 Vaccine Literacy Among Black Pregnant and Postpartum Women in the USA

BACKGROUND

Black pregnant and postpartum women in the USA are disproportionately affected by the COVID-19 pandemic yet have low vaccination coverage rates. Low levels of vaccine literacy contribute vaccine hesitancy and low vaccination rates, especially in racialized populations that face multiple dimensions of systemic racism and inequalities in access to quality health information and services. Guided by the Public Health Critical Race Praxis, we examined COVID-19 vaccine literacy and information sources among Black pregnant and postpartum women.

METHODS

We conducted semi-structured in-depth interviews with 22 Black pregnant and postpartum women living in Greater Philadelphia from November 2022 to May 2023. Interviews were transcribed and thematically analyzed using NVivo version 14.

RESULTS

Participants' mean age was 33.5 years; 17 had a college or graduate degree. Six women had Medicaid coverage during pregnancy; eight women received at least one form of public assistance during the pandemic. Four themes were identified: (1) perceptions of vaccine safety and efficacy, (2) vaccination information sources, (3) drivers of mistrust in vaccine information and hesitancy, and (4) participants' recommendation for improving COVID-19 vaccine literacy.

CONCLUSION

Efforts to address inequities in COVID-19 outcomes must include the provision of accurate health information addressing the specific concerns of marginalized populations through trusted sources. Due to the importance of health care providers as trusted sources of COVID-19 and vaccine information, there is a need for such information provision to take an empathetic and person-centered approach that focuses on the specific concerns of Black pregnant and postpartum persons.

Association between adults' vaccine literacy and their intention to recommend older family members for influenza vaccine

OBJECTIVE

Seasonal influenza vaccine is effective to reduce the risk of hospitalization and death in vulnerable older persons, but the coverage of influenza vaccine remains low in these population in China. This study thus aimed to investigate how adults' vaccine literacy affects their intention to recommend influenza vaccination to older family members in China.

METHODS

A cross-sectional survey was performed in China during October 7 to 16, 2023 through a web-based questionnaire. The participants' influenza vaccine literacy (IVL) was quantitatively assessed using an adapted scale, and bivariate analyses were undertaken to evaluate variable associations among the participants. Multivariable logistic regression and mediation effect model were used to analyze the target factors.

RESULTS

3027 valid respondents were included in our survey, 89.6 % of them were willing to recommend their older family members for influenza vaccine. Participants with higher IVL scores were more likely to recommend influenza vaccination (OR = 1.553, P < 0.01). In addition, participants who were living with their older family members, received annual influenza vaccinations, or whose older family members had infected influenza within the past six months, were also more likely to do so. Of note, despite of a higher level of vaccine literacy, healthcare works were more reluctant to recommend vaccination for older family members (OR = 0.496, P < 0.05).

CONCLUSION

High level of vaccine literacy is positively correlated to adults' intention to recommend influenza vaccination for older family members. We should take educational interventions of vaccine literacy among adults, and thus promoting influenza vaccination coverage among the older population.

Understanding COVID-19 Vaccine Hesitancy among the General Population in Japan from Public Health Ethical Perspectives: Findings from a Narrative Review

Japan has been reported as a country with high levels of vaccine hesitancy. However, a lack of comprehensive reviews studying factors for vaccine hesitancy for the COVID-19 vaccines in the Japanese context from the perspective of ethical controversy exists. Using a narrative review method, we reviewed factors associated with vaccine hesitancy to the COVID-19 vaccines and examined issues related to ethical controversy among the Japanese population. Factors associated with vaccine hesitancy include concerns about vaccine safety, suspicion of vaccine inefficacy, mistrust of the government, and low perceived threat. Factors associated with vaccine acceptance include environmental factors, factors related to Japanese cultural values, including collectivism and social norms, and positive attitudes toward information provided by authorities. Unique backgrounds in Japan are historical events such as the anti-HPV vaccine campaigns, the accessible medical system fostering high expectations of zero risk, and cultural factors of caring social norms influencing vaccine acceptance. Ethical controversies arise from preferences and practices at the individual or national level around individual rights versus public health benefits. Healthcare professionals and public health experts should continue dialoguing with the critical mass, practitioners, and policymakers, considering the ethical dilemmas surrounding individual rights and public health benefits. Insights obtained from this study indicate the need to develop tailored strategies to enhance vaccine acceptance while respecting individual autonomy within the Japanese context.

Bibliometric and visual analyses of vaccine literacy research from 1982 to 2023

Vaccine literacy (VL) is an important part of health literacy (HL), which is of great significance in reducing vaccine hesitancy and improving vaccine coverage rate. We aimed to perform a bibliometric analysis of VL research conducted from 1982 to 2023 to evaluate its current status and prospects. All relevant publications were retrieved from the Web of Science Core Collection database and the Scopus database. The Bibliometrix R-package and VOSviewer software were used to analyze the publication outputs, countries, organizations, authors, journals, cited publications, and keywords. In total, 1,612 publications were included. The number of articles published on VL generally showed an increasing trend. The United States was in a leading position among all countries and had the closest connections with other countries and organizations. Its in-depth study of vaccine hesitancy provided a good foundation for VL research. Harvard University was the most productive organization. Bonaccorsi G was the most productive and cited author. VACCINES was the most productive journal. Research topics primarily revolved around vaccination, HL, vaccine hesitancy, and COVID-19 vaccine. In conclusion, the current research on the conceptual connotation and influencing factors of VL is insufficiently deep and should be further improved in the future to distinguish it from HL in a deeper manner. More tools for measuring VL need to be developed, such as those applicable to different populations and vaccines. The more complex relationship between VL, vaccine hesitancy and vaccination needs to be further explored. Gender differences deserve further investigation.

Vaccine-induced reduction of COVID-19 clusters in school settings in Japan during the epidemic wave caused by B.1.1.529 (Omicron) BA.2, 2022

Clusters of COVID-19 in high-risk settings, such as schools, have been deemed a critical driving force of the major epidemic waves at the societal level. In Japan, the vaccination coverage among students remained low up to early 2022, especially for 5-11-year-olds. The vaccination of the student population only started in February 2022. Given this background and considering that vaccine effectiveness against school transmission has not been intensively studied, this paper proposes a mathematical model that links the occurrence of clustering to the case count among populations aged 0-19, 20-59, and 60+ years of age. We first estimated the protected (immune) fraction of each age group either by infection or vaccination and then linked the case count in each age group to the number of clusters via a time series regression model that accounts for the time-varying hazard of clustering per infector. From January 3 to May 30, 2022, there were 4,722 reported clusters in school settings. Our model suggests that the immunity offered by vaccination averted 226 (95% credible interval: 219-232) school clusters. Counterfactual scenarios assuming elevated vaccination coverage with faster roll-out reveal that additional school clusters could have been averted. Our study indicates that even relatively low vaccination coverage among students could substantially lower the risk of clustering through vaccine-induced immunity. Our results also suggest that antigenically updated vaccines that are more effective against the variant responsible for the ongoing epidemic may greatly help decrease not only the incidence but also the unnecessary loss of learning opportunities among school-age students.

A scoping review of global COVID-19 vaccine hesitancy among pregnant persons

Uptake of the COVID-19 vaccine among pregnant persons is lower than the general population. This scoping review explored pregnant people's attitudes towards the COVID-19 vaccine, reasons for vaccine hesitancy, and whether attitudes about COVID-19 vaccines differ by country of origin. A scoping review was conducted across PubMed, Embase, CINHAL, and Scopus. Inclusion criteria were articles published in English from 2019-2022 focused on attitudes towards COVID-19 vaccination among pregnant persons. Data analysis was done via the 5Cs framework for vaccine hesitancy: Constraints, Complacency, Calculation, Confidence, and Collective Responsibility. 44 articles were extracted. A lack of confidence in vaccine safety was the most prevalent theme of hesitancy among pregnant persons. This was largely driven by a lack of access to information about the vaccine as well as mistrust of the vaccine and medical professionals. Meanwhile, vaccine acceptance was mostly driven by a desire to protect themselves and their loved ones. Overall, COVID-19 vaccine hesitancy among pregnant persons continues to be high. Vaccine hesitancy is primarily driven by fear of the unknown side effects of the vaccine on pregnant persons and their fetuses along with a lack of information and medical mistrust. Some differences can be seen between high income and low- and middle-income countries regarding vaccine hesitancy, showing that a single solution cannot be applied to all who are vaccine hesitant. General strategies, however, can be utilized to reduce vaccine hesitancy, including advocating for inclusion of pregnant persons in clinical trials and incorporating consistent COVID-19 vaccine counseling during prenatal appointments.

COVID-19 vaccine acceptance and associated factors among pregnant and lactating women attending maternity care clinics in refugee camps in Jordan

BACKGROUND

Despite the advantages of vaccination in preventing maternal and fetal problems, there were many concerns in the medical community regarding vaccine safety for pregnant women, and this has put obstetricians in a challenging situation when it comes to advising their pregnant patients on whether to obtain the vaccine.

AIM

This study was performed to define the level of acceptance of COVID-19 vaccination and assess the impact of COVID-19 attitudes and knowledge on vaccine acceptance between pregnant and lactating Syrian women who are seeking prenatal care services at the clinics in Azraq refugee camp in Jordan.

METHOD

A quantitative, cross-sectional study utilizing a non-probability convenience sample. A validated and reliable self-administered questionnaire consisting of four sections was used.

RESULTS

A total of 412 pregnant/lactating women was recruited The acceptance rate of the COVID-19 vaccine among participants was 86.5%. There was a significant positive moderate association between respondents' attitudes and knowledge around the COVID-19 vaccine and their acceptance of the vaccine (r = .468, p < .001, r = .357, p < .001), respectively.

CONCLUSION

To effectively mitigate the COVID-19 pandemic and achieve collective protection, decision-makers must intensify the efforts in promoting the importance of maternal vaccination, especially in vulnerable communities that suffer the most from pandemic outcomes.

COVID-19 vaccine hesitancy among adults in India: A primary study based on health behavior theories and 5C psychological antecedents model

Despite the significant success of India's COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models-the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, "perceived benefits", "confidence" and "collective responsibility" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a 'negative attitude towards the vaccine' showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of 'negative attitudes towards the vaccine' and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.

Perspectives in the Development of Tools to Assess Vaccine Literacy

Vaccine literacy (VL) is the ability to find, understand, and evaluate vaccination-related information to make appropriate decisions about immunization. The tools developed so far for its evaluation have produced consistent results. However, some dimensions may be underestimated due to the complexity of factors influencing VL. Moreover, the heterogeneity of methods used in studies employing these tools hinders a comprehensive understanding of its role even more. To overcome these limitations, a path has been sought to propose new instruments. This has necessitated updating earlier literature reviews on VL and related tools, exploring its relationship with vaccine hesitancy (VH), and examining associated variables like beliefs, attitudes, and behaviors towards immunization. Based on the current literature, and supported by the re-analysis of a dataset from an earlier study, we propose a theoretical framework to serve as the foundation for creating future assessment tools. These instruments should not only evaluate the psychological factors underlying the motivational aspect of VL, but also encompass knowledge and competencies. The positioning of VL in the framework at the intersection between sociodemographic antecedents and attitudes, leading to behaviors and outcomes, explains why and how VL can directly or indirectly influence vaccination decisions by countering VH and operating at personal, as well as at organizational and community levels.

Pandemic antecedents - Exploring predictivity and relationships between COVID-19 vaccine uptake and influenza, shingles, and HPV vaccination

BACKGROUND

A wealth of extant research focuses on identifying barriers to, and predictors of, COVID-19 vaccination. In addition to treating COVID-19 vaccination and related experiences as antecedents, this study analyzes the relationships between COVID-19 vaccination experiences and intent to receive the flu, shingles, and HPV vaccines.

METHOD

Analyses were performed on the responses from U.S. survey panel of 1,024 participants (n = 1,024), 530 (51.8 %) who received at least a dose of the COVID-19 vaccine and 494 (48.2 %) who had not. Descriptive and inferential statistics identify participant demographic characteristics, prior vaccination behavior, vaccination intentions, risk behavior assessment, vaccination attitudes and beliefs, and the predictivity of COVID-19 vaccination, when treated as an antecedent.

RESULTS

Receiving a first dose of the COVID-19 vaccine interacted with receiving a past influenza vaccine, predicting the future intention to receive a COVID-19 vaccine or booster. Vaccine hesitancy in parents is significantly related to vaccination behaviors for themselves and their children. Analyses also showed differences between the vaccinated group (VG) and the unvaccinated group (UVG) on hesitancy, beliefs, and attitudes toward the COVID-19 vaccine.

CONCLUSION

Experience with COVID-19 vaccination and the relationship of those experiences with other vaccinations provide useful insight on leveraging vaccine uptake. Healthcare professionals should improve the COVID-19 vaccination experience and use vaccination appointments to promote other vaccinations. Research should continue to compare vaccination experiences and how they may persuade or dissuade vaccination intent for other vaccinations.

Validation of the questionnaire "Pregnancy Vaccine Hesitancy Scale (pVHS)" toward COVID-19 vaccine for Malaysian pregnant women

Background

Pregnancy is one of the risks for severe COVID-19 infection, and receiving a vaccination is one of the effective methods to reduce disease severity. However, COVID-19 vaccine hesitancy among pregnant women remains an issue. This study aims to develop and validate the pregnancy Vaccine Hesitancy Scale (pVHS) toward COVID-19 vaccine for Malaysian pregnant women.

Method

An 8-item Malay language pregnancy Vaccine Hesitancy Scale (pVHS-M) for COVID-19 was adapted from the adult Vaccine Hesitancy Scale and validated using Exploratory Factor Analysis. Six expert panels were involved in content validity, and ten pregnant women were involved in face validity. A cross-sectional study on 200 pregnant women was conducted between October 2022 and March 2023 at the Obstetrics and Gynaecology Clinic, Universiti Sains Malaysia, Kelantan.

Result

The item-level content validity index is 1.00, demonstrating good relevance of the eight items used to assess COVID-19 vaccine hesitancy. The item-level face validity index obtained is 0.99, indicating that the items were clear and comprehensible. The Cronbach alpha score was 0.944, with factor loadings ranging from 0.79 to 0.89.

Conclusion

The pVHS-M demonstrated good internal consistency, indicating that it is a valid and reliable tool for assessing COVID-19 vaccine hesitancy among pregnant women.

Perspectives on childhood coronavirus disease vaccination in Japan and influencing factors

BACKGROUND

To support parental decision-making it is important to understand parents' perspectives on vaccination for their children and the factors that contribute to their vaccine hesitancy. There have been relatively few studies in this area in Japan, particularly with longitudinal and mixed methodologies.

METHODS

We used an explanatory sequential mixed methods approach to describe longitudinal changes in vaccine acceptance and to explore factors associated with parental coronavirus 2019 (COVID-19) vaccine hesitancy. We recruited parents who had children aged 6 months to 11 years old from five facilities in Japan. Two cross-sectional online surveys and semi-structured online interviews were conducted. Logistic regression analysis was used to explore factors associated with parents' vaccine hesitancy for their children, and thematic analysis was used to analyze the interview data.

RESULTS

In total, 134 parents responded to both online surveys and, of those, 10 participated in interviews. Acceptance rates of COVID-19 vaccination for their children were 19.4% (26/134) at the first survey and 11.2% (15/134) at the second survey. Integration of the data identified that the main factors for vaccine hesitancy included vaccine safety, vaccine effectiveness, government policy, and recommendations from people close to parents.

CONCLUSIONS

Readily available and more balanced information, and community-wide support from people close to parents and familiar health-care providers are likely to provide better support for parents' decision-making. Further investigation is required on how to provide information in an easily understood manner.

COVID-19 vaccine literacy: A scoping review

To address vaccine hesitancy, specific self-rated tools have been developed to assess vaccine literacy (VL) related to COVID-19, including additional variables, such as beliefs, behavior, and willingness to be vaccinated. To explore the recent literature a search was performed selecting articles published between January 2020 and October 2022: 26 papers were identified using these tools in the context of COVID-19. Descriptive analysis showed that the levels of VL observed in the studies were generally in agreement, with functional VL score often lower than the interactive-critical dimension, as if the latter was stimulated by the COVID-19-related infodemic. Factors associated with VL included vaccination status, age, educational level, and, possibly, gender. Effective communication based on VL when promoting vaccination is critical to sustaining immunization against COVID-19 and other communicable diseases. The VL scales developed to date have shown good consistency. However, further research is needed to improve these tools and develop new ones.

Lessons learned from COVID-19 vaccination implementation: How psychological antecedents of vaccinations mediate the relationship between vaccine literacy and vaccine hesitancy

BACKGROUND

Enhancing the public's vaccine literacy is critical for curbing vaccine hesitancy and enhancing society's pandemic preparedness, particularly in an era of infodemic. Evidence on vaccine literacy as an influencing factor of hesitancy is scarce. Lessons could be learned from COVID-19 vaccination implementation. Taking the COVID-19 vaccines as an example, the current study aimed to examine the relationship between vaccine literacy and hesitancy and the mediating role of psychological antecedents of vaccination on the relationship.

METHODS

A baseline online questionnaire survey among the general public in China based on quota sampling was conducted in April 2021 to measure participants' vaccine literacy, psychological antecedents of vaccination, COVID-19 vaccination status, and vaccine hesitancy. A follow-up online survey tracked the updated COVID-19 vaccination status among those who hadn't taken COVID-19 vaccines at the baseline survey. Structural equation modeling has been applied to examine the direct and indirect effect of vaccine literacy on vaccine hesitancy. Time-to-event analysis was used to explore the effect of vaccine hesitancy on vaccination behavior.

RESULTS

Lower vaccine hesitancy was associated with higher vaccine literacy. The "3Cs" psychological antecedents were important mediators between vaccine literacy and vaccine hesitancy. The pathway between critical/interactive vaccine literacy and vaccine hesitancy through the "3Cs" psychological antecedents played a more important role. Time-to-event analysis showed participants with a higher vaccine hesitancy were prone to have a longer delay in vaccination.

CONCLUSIONS

Improving the public's ability to obtain and evaluate vaccination information can fix the public's psychological determinants of vaccination, reducing vaccine hesitancy and promoting vaccination. Governments need to put more effort into guiding and regulating the media to disseminate evidence-based information, rectifying misinformation, and improving the public's vaccine literacy through education, especially the public's capability to critically discern mixed information.

Who chooses alternative sources of information about childhood vaccinations? A cross-sectional study

Introduction

Vaccine hesitancy can lead to problematic outcomes in terms of public health. A factor playing a fundamental role in this dynamic is the source of information considered by parents in the decision-making progress that leads to the acceptance or refusal of childhood vaccinations. This study aims to investigate the sources of information considered by the parents of children attending primary and secondary schools in two large Italian cities and to identify predictors that led to choosing alternative sources of information.

Methods

An online questionnaire was administered to the parents of students attending elementary, middle, and high schools in Rome and Turin. Two validated tools were used: the Parent Attitudes about Childhood Vaccines Survey and the Vaccine Health Literacy of adults in Italian. Sources of information about vaccinations, trust toward the healthcare system, hesitancy and attitudes about COVID-19 vaccinations, were also investigated. A multivariable logistic regression model was built to identify predictors of the preferred sources of information on the topic.

Results

Totally, 2,301 answers to the survey were collected from June to October 2021. Of these, 1,127 came from parents in Rome (49%) and 1,174 from parents based in Turin (51%) with a mean age of 47.7 years (±6.4). The majority of the respondents were mothers (81%), married (73%), with two or more children (70.5%). The multivariable logistic regression model results showed that fathers were more inclined than mothers to use alternative sources of information (OR 1.48, 95% CI 1.29-2.00). Moreover, a higher level of vaccine hesitancy was a strong predictor for choosing alternative sources of information (OR 2.45, 95% CI 1.73-3.46). The HLVa-it scores show that parents with a lower Vaccine Literacy (VL) were more inclined to use alternative sources of information.

Discussion

Addressing health literacy issues and changing the official forms of communication could help improving vaccine acceptance. This study shows the importance of rebuilding a trusting relationship between patients and health care providers, which is fundamental in the fight against vaccine hesitancy.

Dilemmas and options for COVID-19 vaccination in children

Over 16 million children have been detected positive for the coronavirus disease 2019 (COVID-19) in the United States since the outbreak of the pandemic. In general, children infected with severe acute respiratory syndrome coronavirus type 2 tend to have lighter symptoms than adults. However, in some cases, the infection can develop into severe forms, such as multisystem inflammatory syndrome in children. Moreover, long-term public health preventive interventions have had some negative effects on the physical and mental health of children. Given the important role that vaccination plays in reducing severe illness and mortality, it is essential for the efficient implementation of vaccination in the pediatric population. Nevertheless, parental distrust of vaccination, especially with regard to its safety and efficacy, hinders this process. Herein, we comprehensively summarize the available data on the safety and effectiveness of COVID-19 vaccine in children. The results show that the currently approved COVID-19 vaccine is safe and effective for children. Although two doses of vaccine in children seem insufficient to prevent Omicron infection, the booster dose provides enhanced protection against infection and severe illness. Most importantly, the bivalent vaccine has been approved for use in the pediatric population to extend the immune response to currently circulating Omicron variant. And the immune protection afforded to newborns after maternal vaccination appears to last only 6 months. Therefore, in the current situation where the rate of virus mutation is accelerating and the COVID-19 pandemic is still severe, it is crucial to extend vaccine protection to children over 6 months of age to weave a tighter safety net.

Vaccination as a social practice: towards a definition of personal, community, population, and organizational vaccine literacy

BACKGROUND

A comprehensive and agreed-upon definition of vaccine literacy (VL) could support the understanding of vaccination and help policy-makers and individuals make informed decisions about vaccines.

METHODS

To shed some light on this debate and provide clarity, a scoping review was conducted to collect, summarize, and analyse available definitions of VL. Based on the findings of the scoping review, a new and comprehensive definition was proposed by a panel of experts.

RESULTS

Fifty-three articles were included, and two of them appeared to be the milestones around which the other definitions were grouped. The new definition proposed by the panel of experts included not only the personal perspective, but also the community, population, and organizational perspectives. Moreover, due to the increasing complexity of the social context with respect to the ability to navigate, understand, and use information and services, the definition of organizational vaccine literacy and the attributes of a vaccine literate healthcare organization have been proposed.

CONCLUSION

The new definition can contribute to the overall paradigm of health literacy and its distinct component of vaccine literacy, possibly improving the implementation of public health strategies to allow vaccination to be understood as a social practice by the entire community. This study describes the conceptual foundations, the competencies, and the civic orientation to be considered when developing measurement tools devoted to assessing VL at the different levels and in different contexts.

Assessing Doubts, Knowledge, and Service Appreciation among Pregnant Women Who Received the COVID-19 Vaccination in an Italian Research Hospital: A Cross-Sectional Study

The COVID-19 pandemic is considered one of the deadliest pandemics in history. Pregnant women are more susceptible to developing serious diseases during COVID-19 than their non-pregnant peers. Pregnant women often express doubt about accepting the vaccination, especially in regard to their security and safety. This study aims to investigate the appreciation of the vaccination offer, and if there are any determinants impacting vaccine hesitancy. A questionnaire was administered to a sample of pregnant women who had just received their immunization against COVID-19 at the vaccination service of a teaching hospital in Rome, from October 2021 to March 2022. A high appreciation of the vaccination services was found, both for the logistic organization and the healthcare personnel, with mean scores above 4 out of 5. The degree of pre-vaccinal doubt was low (41%) or medium (48%) for the largest part of the sample, while the degree of COVID-19 vaccine knowledge was high for 91% of the participants. Physicians were the most decisive information source for the vaccination choice. Our results highlighted that a supportive approach could increase appreciation and improve the setting of vaccinations. Healthcare professionals should aim for a more comprehensive and integrated role of all figures.

Cognitive and Cultural Factors That Affect General Vaccination and COVID-19 Vaccination Attitudes

The development of COVID-19 vaccines is a major scientific accomplishment that has armed communities worldwide with powerful epidemic control tools. Yet, COVID-19 vaccination efforts in the US have been marred by persistent vaccine hesitancy. We used survey methodology to explore the impact of different cognitive and cultural factors on the public's general vaccination attitudes, attitudes towards COVID-19 vaccines, and COVID-19 vaccination status. The factors include information literacy, science literacy, attitudes towards science, interpersonal trust, public health trust, political ideology, and religiosity. The analysis suggests that attitudes towards vaccination are influenced by a multitude of factors that operate in a complex manner. General vaccination attitude was most affected by attitudes towards science and public health trust and to a lesser degree by information literacy, science literacy, and religiosity. Attitudes towards COVID-19 vaccines were most affected by public health trust and to a lesser extent by general trust, ideology and attitudes towards science. Vaccination status was most influenced by public health trust. Possible mediating effects of correlated variables in the model need to be further explored. The study underscores the importance of understanding the relationship between public health trust, literacies, and sociocultural factors.