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Bussink-Voorend D, Hautvast JLA, Wiersma T, Akkermans R, Hulscher MEJL. Developing a practical tool for measuring parental vaccine hesitancy: A people-centered validation approach in Dutch. Hum Vaccin Immunother 2025; 21:2466303. [PMID: 39957364 PMCID: PMC11834527 DOI: 10.1080/21645515.2025.2466303] [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: 10/02/2024] [Revised: 01/28/2025] [Accepted: 02/10/2025] [Indexed: 02/18/2025] Open
Abstract
Vaccine hesitancy (VH) about routine childhood vaccinations drives falling vaccine uptake rates. This is a major public health challenge and therefore important to monitor uniformly. The challenge is that different methods are used to measure VH and that, in non-English language, there may not be an unequivocal translation of VH terminology. We aimed to develop and validate a method to assess VH in a simple and self-reported manner, with a mixed-methods study using a people-centered approach with a diverse group of parents and illustrated in Dutch. In the quantitative part, parents were asked to rate experienced vaccine hesitancy on a 10-point Likert scale, using five differently worded Dutch translations for VH. We analyzed internal consistency with Cronbach's alpha and correlation with the short parental attitudes about childhood vaccination (PACV-5) scale. A total of 532 parents participated in the survey. We found that the five worded alternatives measured the same construct, indicated by a Cronbach's alpha of 0.95. The wording resembling 'doubt' showed highest correlation with the PACV-5 score (coefficient -0.525, p < .001). In the qualitative part of this study, we conducted cognitive interviews with 12 lower educated parents to evaluate the comprehensibility and interpretation of the question and VH translations. The findings reinforced and added to the quantitative findings that 'doubt' is the preferred wording. Based on the integrated results, we developed the Vaccine Hesitancy Assessment (VHA) tool. We encourage its use for monitoring purposes at the time of decision-making as this may provide a window of opportunity for decision-support interventions.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud Institute for Health Sciences, Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeannine L. A. Hautvast
- Radboud Institute for Health Sciences, Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tim Wiersma
- Radboud Institute for Health Sciences, Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Reinier Akkermans
- IQ Health Science Department, Radboud University Medical Center, Nijmegen, The Netherlands
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Gavaruzzi T, Ceccarelli A, Nanni C, Vignali C, Colonnello V, Caserotti M, Riccò M, Gori D. Knowledge and Attitudes Regarding Respiratory Syncytial Virus (RSV) Prevention: A Systematic Review. Vaccines (Basel) 2025; 13:159. [PMID: 40006706 PMCID: PMC11861692 DOI: 10.3390/vaccines13020159] [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: 11/22/2024] [Revised: 01/27/2025] [Accepted: 02/02/2025] [Indexed: 02/27/2025] Open
Abstract
Background: New strategies for respiratory syncytial virus (RSV) prevention are available and are in development, but their acceptance is crucial to their effectiveness. Objectives: This systematic review aims to summarize current quantitative and qualitative evidence regarding knowledge and attitudes relating to RSV prevention. Methods: Six databases (PubMed, Scopus, APA PsycArticles; APA PsycInfo; CINAHL Complete; Psychology and Behavioral Sciences Collection) and two preprint repositories (medRxiv and Preprints) were searched up until 23 December 2024 (PROSPERO: CRD42024602351). Results: Sixty-one articles were included, focusing on vaccination for the elderly and adults at risk (n = 10) or pregnant people (n = 24, of which 8 also examined preferences for maternal vs. infant immunization) and infant immunization (n = 27, of which 16 focused on palivizumab, with 6 focusing on adherence to its monthly administration). Eighteen articles assessed attitudes in healthcare professionals. Overall, findings showed limited knowledge and awareness of RSV but generally positive attitudes towards prevention strategies and moderate to high intentions and uptake rates. Protection against the disease and perceived severity promoted acceptance, whereas concerns about side effects hindered it. Maternal vaccination was more acceptable than infant immunization. Conclusions: Attitudes towards RSV prevention options were generally favorable. Should more options become available, preferences may depend on which options are available, their characteristics, and how they are framed and presented. These insights highlight the importance of education on RSV grounded in decision-making literature, while recognizing the likely favorable reception of preventive measures across target age-populations.
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Affiliation(s)
- Teresa Gavaruzzi
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Andrea Ceccarelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (A.C.); (C.V.); (D.G.)
| | | | - Carloalberto Vignali
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (A.C.); (C.V.); (D.G.)
| | - Valentina Colonnello
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Marta Caserotti
- Department of Developmental Psychology and Socialization, University of Padova, 35131 Padova, Italy;
| | - Matteo Riccò
- AUSL–IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (A.C.); (C.V.); (D.G.)
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Abu-Farha RK, Khabour OF, Gharaibeh L, Elrahal YM, Alzoubi KH, Nassar R, Harahsheh MM, Binsaleh AY, Shilbayeh SA. Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2025; 35:68-80. [PMID: 38620051 PMCID: PMC12002394 DOI: 10.1080/09603123.2024.2342018] [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: 03/06/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024]
Abstract
This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.
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Affiliation(s)
- Rana K. Abu-Farha
- Clinical Pharmacy and Therapeutics Department, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Lobna Gharaibeh
- Biopharmaceutics and Clinical Pharmacy Department, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Yusra M. Elrahal
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Razan Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Meaad M Harahsheh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Ammena Y. Binsaleh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sireen A. Shilbayeh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Aguinaga-Ontoso I, Guillen-Aguinaga S, Guillen-Aguinaga L, Alas-Brun R, Guillen-Aguinaga M, Onambele L, Aguinaga-Ontoso E, Rayón-Valpuesta E, Guillen-Grima F. The Impact of COVID-19 on DTP3 Vaccination Coverage in Europe (2012-2023). Vaccines (Basel) 2024; 13:6. [PMID: 39852785 PMCID: PMC11768563 DOI: 10.3390/vaccines13010006] [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: 11/17/2024] [Revised: 12/11/2024] [Accepted: 12/13/2024] [Indexed: 01/26/2025] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted routine child immunization efforts, threatening to reverse progress in controlling vaccine-preventable diseases. MATERIALS AND METHODS We analyzed the impact of COVID-19 on DTP3 vaccination in Europe by comparing trends before and after the pandemic using time series data from 2000 to 2023. Employing joinpoint regression, chi-square tests, and segmented regression analysis, we assessed DTP3 vaccination trends and coverage changes. RESULTS The findings revealed significant regional disparities across Europe. Statistical models indicated reductions in DTP3 coverage in countries such as Ireland, Sweden, and Switzerland, whereas Ukraine and San Marino showed improvements. CONCLUSIONS There are variations in the effect of COVID-19 on DTP3 coverage rates, indicating the need for targeted public health strategies to address vaccine hesitancy, logistical barriers, and systemic inequities.
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Affiliation(s)
- Ines Aguinaga-Ontoso
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain; (I.A.-O.)
- Healthcare Research Institute of Navarra (IdiSNA), 31008 Pamplona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 46980 Madrid, Spain
| | - Sara Guillen-Aguinaga
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain; (I.A.-O.)
- San Juan Primary Health Care Center, Navarra Health Service, 31008 Pamplona, Spain
| | | | - Rosa Alas-Brun
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain; (I.A.-O.)
| | | | - Luc Onambele
- School of Health Sciences, Catholic University of Central Africa, Yaoundé 1110, Cameroon;
| | - Enrique Aguinaga-Ontoso
- Department of Sociosanitary Sciences, University of Murcia, 30003 Murcia, Spain;
- Department of Preventive Medicine, Virgen de la Arrixaca University Clinical Hospital, 30003 Murcia, Spain
| | | | - Francisco Guillen-Grima
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain; (I.A.-O.)
- Healthcare Research Institute of Navarra (IdiSNA), 31008 Pamplona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 46980 Madrid, Spain
- Department of Preventive Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
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Sartori AL, Buffarini R, Machado da Silva A, Amaral de Andrade Leão O, Ramos Flores T, Dâmaso Bertoldi A, Curi Hallal P, Freitas da Silveira M. Child COVID-19 vaccine uptake among participants of the 2015 Pelotas (Brazil) Birth Cohort Study. Vaccine 2024; 42:126105. [PMID: 38991916 DOI: 10.1016/j.vaccine.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To analyze COVID-19 vaccine uptake in children and to investigate factors associated with two outcomes variables: (a) not even beginning; (b) not completing the COVID-19 vaccine series. METHODS We used data of children aged 6-7 years from the 2015 Pelotas c Birth Cohort Study. COVID-19 vaccination status was collected from immunization cards and National Immunization Program Information System. Adjusted analyses were performed using a hierarchical model to identify factors associated with the two study outcomes. RESULTS Among 3867 children, 20.7 % (95 % CI, 19.5 %-22.0 %) did not even begin the 2-dose primary COVID-19 vaccine series, and 28.2 % (95 % CI, 26.6 %-29.8 %) did not complete the series with the second dose. Children not even beginning the COVID-19 vaccine series were more likely to have a White mother, not to have obesity, to have a history of COVID-19 infection, to have received non-recommended drugs for COVID-19, to be afraid of needles, and to have an incomplete diphtheria-tetanus-pertussis (DTP) and poliovirus immunization schedule. Not completing the 2-dose series was associated with lower maternal age and education, mother's self-identification as White or Brown, lower household income, lack of access to health services, not having completed the DTP and poliovirus immunization schedule and living with a person with a history of infection with COVID-19. CONCLUSION The results highlight a vaccine-hesitant parents' group who chose not beginning the COVID-19 vaccine series of their children and, another group of parents who failure to complete the child's series due to difficulty accessing health services.
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Affiliation(s)
- Ana Lucia Sartori
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil; Institute of Health Sciences, Federal University of Mato Grosso, 1200 Alexandre Ferronato Avenue, 78550-728, Sinop, MT, Brazil.
| | - Romina Buffarini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil; Postgraduate Program in Health Sciences, Federal University of Rio Grande, General Osório Street, 96200-400 Rio Grande, RS, Brazil.
| | - Aline Machado da Silva
- Pelotas Municipal Health Department, 1764 Lobo da Costa Street, 96020-360 Pelotas, RS, Brazil.
| | - Otávio Amaral de Andrade Leão
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil; Department of Health and Kinesiology, University of Illinois Urbana-Champaign, 1206 S 4th St, 61820, Urbana/Champaign, Champaign, IL, USA.
| | - Thaynã Ramos Flores
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil.
| | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil.
| | - Pedro Curi Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil; Department of Health and Kinesiology, University of Illinois Urbana-Champaign, 906 S. Goodwin, 61801-3841, Urbana/Champaign, Champaign, IL, USA.
| | - Mariângela Freitas da Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, 3rd floor, 96020-220 Pelotas, RS, Brazil.
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