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Hoyt J, Okello G, Bange T, Kariuki S, Jalloh MF, Webster J, Hill J. RTS,S/AS01 malaria vaccine pilot implementation in western Kenya: a qualitative longitudinal study to understand immunisation barriers and optimise uptake. BMC Public Health 2023; 23:2283. [PMID: 37980467 PMCID: PMC10657022 DOI: 10.1186/s12889-023-17194-2] [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: 07/07/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Malaria is a significant public health threat in sub-Saharan Africa, particularly among children. The RTS,S/AS01 malaria vaccine reduces the risk and severity of malaria in children. RTS,S/AS01 was piloted in three African countries, Ghana, Kenya and Malawi, to assess safety, feasibility and cost-effectiveness in real-world settings. A qualitative longitudinal study was conducted as part of the feasibility assessment. This analysis explores RTS,S/AS01 vaccination barriers and identifies potential motivators among caregivers in three sub-counties in western Kenya. METHODS A cohort of 63 caregivers with a malaria vaccine eligible child was interviewed at three time points over 24 months. A sub-set of 11 caregivers whose eligible children were either partially or non-vaccinated were selected for this sub-analysis. The 5A Taxonomy for root causes of under-vaccination was used to organise the inductively-coded data into categories (awareness, acceptance, access, affordability, and activation) and identify the factors influencing uptake across caregivers. A trajectory analysis was conducted to understand changes in factors over time within each caregiver experience. Caregiver narratives are used to illustrate how the factors influencing uptake were interrelated and changed over time. RESULTS Lack of awareness, previous negative experiences with routine childhood immunisations and the burden of getting to the health facility contributed to caregivers initially delaying uptake of the vaccine. Over time concerns about vaccine side effects diminished and anticipated vaccination benefits strongly motivated caregivers to vaccinate their children. Persistent health system barriers (e.g., healthcare provider strikes, vaccine stockouts, negative provider attitudes) meant some children missed the first-dose eligibility window by aging-out. CONCLUSIONS Caregivers in this study believed the RTS,S/AS01 to be effective and were motivated to have their children vaccinated. Despite these positive perceptions of the malaria vaccine, uptake was substantially hindered by persistent health system constraints. Negative provider attitudes emerged as a powerful deterrent to attending immunisation services and hampered uptake of the vaccine. Strategies that focus on improving interpersonal communication skills among healthcare providers are needed.
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Affiliation(s)
- Jenna Hoyt
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - George Okello
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Kenya Medical Research Institute/Centre for Global Health Research, Kisumu, Kenya
| | - Teresa Bange
- Kenya Medical Research Institute/Centre for Global Health Research, Kisumu, Kenya
| | - Simon Kariuki
- Kenya Medical Research Institute/Centre for Global Health Research, Kisumu, Kenya
| | - Mohamed F Jalloh
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jayne Webster
- Disease Control Department, London School of Tropical Medicine and Hygiene, London, UK
| | - Jenny Hill
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Bwanali AN, Lubanga AF, Mphepo M, Munthali L, Chumbi GD, Kangoma M. Vaccine hesitancy in Malawi: a threat to already-made health gains. Ann Med Surg (Lond) 2023; 85:5291-5293. [PMID: 37811119 PMCID: PMC10552950 DOI: 10.1097/ms9.0000000000001198] [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: 06/05/2023] [Accepted: 08/05/2023] [Indexed: 10/10/2023] Open
Abstract
Malawi faces a growing concern about vaccine hesitancy. This threatens to undermine significant strides in the fight against infectious diseases in the country. Vaccine hesitancy in Malawi is driven by multiple factors. This short communication discusses the extent of vaccine hesitancy in Malawi and its main drivers according to SAGE's (Strategic Advisory Group of Expert) 3Cs (confidence, complacency and convenience) model of vaccine hesitancy. As an escalating health concern, it is imperative to address it urgently. It is imperative to address it urgently through comprehensive and sustainable awareness campaigns that should aim to increase acceptance and demand for vaccines.
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Affiliation(s)
- Akim N. Bwanali
- Clinical Research Education and Management Services Limited (CREAMS)
- Kamuzu University of Health Sciences, Blantyre, Malawi
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
| | - Adriano F. Lubanga
- Clinical Research Education and Management Services Limited (CREAMS)
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
| | - Mzati Mphepo
- Clinical Research Education and Management Services Limited (CREAMS)
| | | | | | - Melina Kangoma
- Kamuzu Central Hospital, Ministry of Health (MoH), Lilongwe
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Barrow A, Afape AO, Cham D, Azubuike PC. Uptake and determinants of childhood vaccination status among children aged 0-12 months in three West African countries. BMC Public Health 2023; 23:1093. [PMID: 37280553 DOI: 10.1186/s12889-023-15863-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/10/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Vaccination has long been recognized as one of the most effective ways to reduce child mortality. It has played a significant role, particularly for children, and is considered a major achievement and relevant in preventing childhood diseases worldwide. This study looks at the uptake and determinants of childhood vaccination status among children under the age of one year, for Gambia, Sierra Leon, and Liberia. METHOD Data from 2019 to 20 Demographic and Health Survey (DHS) data from Gambia, Sierra Leone, and Liberia were pooled for the analysis used in this study. Data were obtained from a total weighted sample of 5,368 children aged 0-12 months through a stratified two-stage cluster sampling approach. A multivariable logistic regression model was used to assess the predictors of childhood vaccination uptake at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs). RESULTS The weighted sample pooled prevalence of full vaccination among children under 12 months of age was 15.1% for males and 15.0% for females. After controlling for confounders in the regression model, factors that were found to be associated with vaccination status include children whose mothers attended postnatal care (PNC) visits had higher odds of being fully vaccinated (aOR = 1.23, 95% CI = 1.03-1.46), while children whose fathers had primary education (aOR = 0.67, 95% CI = 0.48-0.96), children whose households never watched TV (aOR = 0.68, 95% CI = 0.56-0.82) and children whose mothers attended 1-3 antenatal care (ANC) visits (aOR = 0.59, 95% CI = 0.45-0.79) had lower odds of being fully vaccinated. CONCLUSION Childhood vaccination uptake was low among children under 12 months of age in these countries. Hence, there is a need to promote the uptake of vaccination across these three West African countries especially among rural dwellers.
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Affiliation(s)
- Amadou Barrow
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia.
- Department of Epidemiology, University of Florida, Gainesville, United States of America.
| | | | - Dalanda Cham
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia
- Epidemiology & Disease Control Unit, Ministry of Health, Kotu, The Gambia
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Getachew T, Negash A, Degefa M, Lami M, Balis B, Debela A, Gemechu K, Shiferaw K, Nigussie K, Bekele H, Oljira A, Eyeberu A, Dessie Y, Alemu A, Sertsu A. COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in eastern Ethiopia using the health belief model: multicentre cross-sectional study. BMJ Open 2023; 13:e070551. [PMID: 36958789 PMCID: PMC10039978 DOI: 10.1136/bmjopen-2022-070551] [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] [Received: 11/26/2022] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE Immunization is still one of the best ways to reduce viral-related morbidity and mortality . Therefore, this study aimed to assess COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in Eastern Ethiopia. METHOD A multicentred facility-based cross-sectional study design was utilised. The systematic random sampling technique was used to select 420 study participants. The characteristics of individuals were described using descriptive statistical analysis such as frequency, median and IQR. Mean was used for health belief model components. The association was assessed using bivariate and multivariable logistic regression and described by the OR along with a 95% CI. Finally, a p-value<0.05 in the adjusted analysis was used to declare a significant association. OUTCOME MEASURE COVID-19 vaccine acceptance and associated factors. RESULT A total of 412 adult clients were interviewed, with a response rate of 98.1%. Of the total study participants, 225 (54.6%; 95% CI: 50.0% to -59.7%) were willing to accept the COVID-19 vaccine. Age≥46 (adjusted OR, AOR=3.64, 95% CI: 1.35- to 9.86), college and above level of education (AOR=2.50, 95% CI: 1.30- to 4.81), having health insurance (AOR=1.79, 95% CI: 1.11- to 2.87) and experiencing chronic disease (AOR=1.96, 95% CI: 1.02- to 3.77) were predictor variables. Also, components of the health belief model were significantly associated with COVID-19 vaccine acceptance. CONCLUSION COVID-19 vaccine acceptance among the adult population was low compared to other study. Factors associated with COVID-19 vaccine acceptance were age, college and above level of education, having a chronic disease, having health insurance, perceived susceptibility, perceived severity, perceived benefit and perceived barrier.Improving awareness about COVID-19 among all sections of the population is crucial to improving vaccine acceptability.
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Affiliation(s)
- Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- Haramaya University School of Nursing and Midwifery, Dire Dawa, Dire Dawa, Ethiopia
| | - Meron Degefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Magarsa Lami
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debela
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Haramaya, Oromia, Ethiopia
| | - Kasiye Shiferaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | | | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Oromia, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Oromia, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Abdulhamid I, Usmael N, Shaweno T. Willingness to Accept COVID-19 Vaccine and Associated Factors Among Adult Household Members in Dire Dawa City Administration, East Ethiopia. Patient Prefer Adherence 2022; 16:2977-2988. [PMID: 36345291 PMCID: PMC9636885 DOI: 10.2147/ppa.s380393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/26/2022] [Indexed: 01/25/2023] Open
Abstract
Background COVID-19 vaccine is a vital strategy to prevent and control this pandemic. This will depend principally on people's acceptance of COVID-19 vaccine. We aimed to determine the willingness to accept COVID vaccine among adult household members of Dire Dawa city administration. Methods A community-based cross-sectional study was conducted among randomly selected 634 adult household members in the Dire Dawa city administration during January 16-31/2022. Data were collected using face-to-face interview. Extent of willingness was estimated using participants' self-report. Bivariate and multivariate logistic regression models were fitted, and statistical significance was set at p-value <0.05. Results The estimated willingness to accept COVID-19 vaccine was 28.4% (95% CI 25.1, 31.5) in the study setting. The odds of willingness to accept COVID-19 vaccine was higher for household members living without at least one chronic disease (AOR 1.7, 95% CI 1.10, 2.70), who had good knowledge score (AOR 2.3, 95% CI 1.31, 2.18) and positive attitude score (AOR 5.5, 95% CI 2.1, 14.5) compared to their counterparts, respectively. The estimated willingness to accept COVID-19 vaccine among household members with good knowledge score was 47.4 (95% CI 42.1, 52.7) and 15.5 (95% CI 8.7, 22.2) among those with poor knowledge. Nearly, 90% of the study participants had limited knowledge about COVID 19 vaccine. Conclusion The estimated willingness to accept COVID-19 vaccine in the study setting is very low and far from the set target to be reached by the end of 2022. Being free from chronic disease, and having good knowledge and positive attitude about COVID-19 vaccine were the main drivers for willingness. Public awareness directed to increase knowledge about COVID-19 vaccine and attitude change strategies should be scaled up to increase the COVID-19 vaccine uptake. Moreover, those individuals with chronic diseases need special attention.
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Affiliation(s)
| | - Nejib Usmael
- Dire Dawa Administration Regional Health Bureau, Dire Dawa, Ethiopia
| | - Tamrat Shaweno
- Africa Centers for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
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Perceived Vaccine Availability and the Uptake of Measles Vaccine in Sudan: The Mediating Role of Vaccination Hesitancy. Vaccines (Basel) 2022; 10:vaccines10101674. [PMID: 36298539 PMCID: PMC9611017 DOI: 10.3390/vaccines10101674] [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: 08/29/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate whether measles vaccine uptake can be predicted directly or indirectly by parental perceptions about the availability of measles vaccine services with parental hesitancy towards the measles vaccine as a potential mediator. This was a community-based cross-sectional study conducted at Omdurman locality in Khartoum state, Sudan in February 2019. The study population included parents/guardians having at least one child aged 2-3 years old. Mediation analysis was conducted using two models, the ordinary least squares path analysis and multiple logistic regression. These models considered perceived vaccine accessibility and availability as independent factors, vaccine uptake as dependent factors, and vaccine hesitancy (PACV scores) as a mediator. A total of 495 responded and the mean age of the mothers who participated in the study was 31.1 (SD = 5.73). Half of the respondents (50.1%) completed university education and nearly three-quarters of the respondents (74.7%) were housewives. After controlling for the other factors, including the mother's age and the number of children, parental perception about the accessibility and availability of the measles vaccine influences the uptake of the measles vaccine indirectly through the mediation effect of measles vaccine hesitancy. We suggest that intervening in measles vaccine hesitancy in addition to measles vaccination access issues will have a positive impact on the uptake and coverage of the measles vaccine in Sudan.
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Olu-Abiodun O, Abiodun O, Okafor N. COVID-19 vaccination in Nigeria: A rapid review of vaccine acceptance rate and the associated factors. PLoS One 2022; 17:e0267691. [PMID: 35544545 PMCID: PMC9094528 DOI: 10.1371/journal.pone.0267691] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/13/2022] [Indexed: 11/18/2022] Open
Abstract
Vaccine acceptance among a large population of people can determine the successful control of the COVID-19 pandemic. We aimed to assess the COVID-19 vaccine acceptance rate and to identify the predicting factors to the non-acceptance of the vaccine in Nigeria up to date. In line with this, PubMed, Web of Science, Cochrane Library, and Embase databases were searched for relevant articles between January 2020 and November 2021 in this rapid review. Ten articles with 9,287 individuals met the inclusion criteria and formed the basis for the final COVID-19 acceptance estimates. A total of ten peer-reviewed articles were reviewed. The vaccine acceptance rate ranged from 20.0% to 58.2% among adults across the six geopolitical zones of the country. Non-acceptance of the vaccine was found to be a result of propaganda, adverse effect concerns, and conspiracy theories. National, community, and individual-level interventions need to be developed to improve the COVID-19 vaccine acceptance rate in the country. Greater efforts could be put in place to address the issues of concern leading to the unwillingness of the people to receive the COVID-19 vaccine. Also, as the pandemic is unfolding, emerging evidence needs to be synthesized and updated.
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Affiliation(s)
- Oluwatosin Olu-Abiodun
- Department of Community Health Nursing, School of nursing Sciences, Babcock University, Ilishan, Ogun State, Nigeria
| | - Olumide Abiodun
- Department of Community Medicine, School of Clinical Sciences, Babcock University, Ilishan, Ogun State, Nigeria
- * E-mail:
| | - Ngozi Okafor
- Department of Community Health Nursing, School of nursing Sciences, Babcock University, Ilishan, Ogun State, Nigeria
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Sahile AT, Mulugeta B, Hadush S, Fikre EM. COVID-19 Vaccine Acceptance and its Predictors among College Students in Addis Ababa, Ethiopia, 2021: A Cross-Sectional Survey. Patient Prefer Adherence 2022; 16:255-263. [PMID: 35136350 PMCID: PMC8817737 DOI: 10.2147/ppa.s348132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The coronavirus disease pandemic disrupted the normal social and economic activities of the people resulting in over 3 million deaths worldwide. Piece of literature depicted that predictors of vaccine acceptance are complex, multiple, and vary depending on the type of vaccine involved. OBJECTIVE The study aimed at assessing the COVID-19 acceptance and its predictors among college students in Addis Ababa, Ethiopia, 2021. METHODS A multi-center-institutional-based cross-sectional study was conducted among 407 participants from three institutions in Addis Ababa selected based on a simple random sampling method from May 01 to July 30, 2021. A self-administered structured questionnaire was used for the collection of data, after which informed consent was obtained from all the included study participants. Descriptive statistics was used for the summarization of the data. Binary (bivariate and multivariate) logistic regression was applied for the identification predictors of vaccine acceptance with their respective 95% confidence interval and less than 5% p-value for the ascertainment of presence of association. RESULTS The level of vaccine acceptance was 39.8% (95% CI: 35.0-44.7%). Being male (AOR: 0.463, 95% CI: 0.284-0.755, P < 0.001), living with children under the age of five (AOR: 2.295; 95% CI: 1.416-3.721, P < 0.05), living with an elderly (AOR: 1.609, 95% CI: 1.016-2.548, P < 0.05) and having had poor knowledge (AOR: 2.187, 95% CI: 1.391-3.438, P < 0.001) were predictors significantly associated with an increased level of vaccine acceptance. CONCLUSION AND RECOMMENDATION The level of vaccine acceptance among college students in Ethiopia was lower than necessary to achieve herd immunity. Sex, living with under-five children, and elderly, and knowledge were predictors of COVID-19 acceptance. Concerned bodies were suggested to work over the identified predictors of vaccine acceptance in the study settings.
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Affiliation(s)
| | - Betesida Mulugeta
- Department of Public Health, Universal Medical and Business College, Addis Ababa, Ethiopia
| | - Semhal Hadush
- Department of Public Health, Universal Medical and Business College, Addis Ababa, Ethiopia
| | - Endashew Mulate Fikre
- Department of HIV/AIDS Prevention, Addis Ababa City Health Bureau, Addis Ababa, Ethiopia
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Sabahelzain MM, Moukhyer M, van den Borne B, Bosma H. Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan. Vaccines (Basel) 2022; 10:vaccines10020205. [PMID: 35214664 PMCID: PMC8875338 DOI: 10.3390/vaccines10020205] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 12/10/2022] Open
Abstract
Vaccine uptake is one of the indicators that has been used to guide immunization programs. This study aimed to evaluate whether measles vaccine uptake is predicted by measles vaccine hesitancy. A community-based cross-sectional study was conducted in urban districts in Khartoum state in February 2019. Measles vaccine uptake among children was measured as either fully vaccinated or partially/not vaccinated. The Parent Attitudes about Childhood Vaccines (PACV) scale was used to measure measles vaccine hesitancy. Multivariate logistic regression was run to identify the predictors of measles vaccination uptake, controlling for sociodemographic variables, and the adjusted odds ratios (aORs) with 95% CI were calculated. The receiver operator characteristic (ROC) curve was created, and the area under the curve (AUC) for the PACV was computed. Data were collected from 495 participants. We found that measles vaccine hesitancy (PACV scores) predicts the uptake of measles vaccine after controlling for other potential social confounders, such as the mother’s age and the number of children (aOR 1.055; 95% CI 1.028–1.028). Additionally, the ROC for the PACV yielded an area under the curve (AUC 0.686 (95% CI 0.620–0.751; p < 0.001)). Our findings show that measles vaccine hesitancy in Sudan directly influences the uptake of the measles vaccine. Addressing the determinants of vaccine hesitancy through communication strategies will improve vaccine uptake.
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Affiliation(s)
- Majdi M. Sabahelzain
- Department of Public Health, School of Health Sciences, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Mohamed Moukhyer
- Department of Research and Development, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia;
- Department of Emergency Medical Services, Faculty of Applied Medical Sciences, Jazan University, Jizan 45142, Saudi Arabia
- Public Health Programmes, School of Medicine, University of Limerick, V94 PX58 Limerick, Ireland
| | - Bart van den Borne
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
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Sabahelzain MM, Moukhyer M, Bosma H, van den Borne B. Determinants of Measles Vaccine Hesitancy among Sudanese Parents in Khartoum State, Sudan: A Cross-Sectional Study. Vaccines (Basel) 2021; 10:vaccines10010006. [PMID: 35062667 PMCID: PMC8780692 DOI: 10.3390/vaccines10010006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
Determinants of vaccine hesitancy are not yet well understood. This study aims to assess measles vaccine hesitancy and characterize its determinants among Sudanese parents in Omdurman in Khartoum State. A community-based cross-sectional quantitative study was conducted in Khartoum State in February 2019. The Parent Attitudes about Childhood Vaccination (PACV) was used to measure measles vaccine hesitancy. Questions about the sociodemographic characteristics of the family, the perception of the parents about the measles vaccine, and the parental exposure to information were asked. Proportions of vaccine hesitancy and coefficients of linear regression were computed. Five hundred parents were recruited for the study. We found that a significant proportion of participants (about 1 in 5 parents) had hesitations regarding the measles vaccine. Significant predictors of measles vaccine hesitancy were parental exposure to anti-vaccination information or materials (β = −0.478, p-value < 0.001), the parents’ perception of the effectiveness of measles vaccines (β = 0.093, p-value = 0.020), the age of the mother (β = 0.112, p-value = 0.017), the birth rank of the child (β = −0.116, p-value = 0.015), and the total number of the children in the family (β = 0.098, p-value = 0.013). Vaccination access issues were the common justification for parental vaccination hesitancy. Our findings indicate that investment in vaccine communication as well as addressing access issues might be an effective intervention for improving measles vaccine acceptance and, ultimately, measles vaccine coverage.
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Affiliation(s)
- Majdi M. Sabahelzain
- Department of Public Health, School of Health Sciences, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands;
- Correspondence:
| | - Mohamed Moukhyer
- Education Development and Quality Unit, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
- Public Health Programmes, School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands;
| | - Bart van den Borne
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands;
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Horn S, Chapman GB, Chouhan K. Doctor recommendations and parents' HPV vaccination intentions in Kenya: A randomized survey. Prev Med Rep 2021; 25:101659. [PMID: 34917466 PMCID: PMC8666573 DOI: 10.1016/j.pmedr.2021.101659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023] Open
Abstract
The causal effect of a doctor’s recommendation for Human Papillomavirus (HPV) vaccination on parents’ decisions in low-resource settings is not well understood. This study investigates how doctors’ endorsement of the HPV vaccine communicated through a public health poster affects parents’ decisions to vaccinate their daughters in Kenya. In January and February 2021, 600 parents of daughters eligible for the HPV vaccine but not yet vaccinated were recruited and completed a randomized survey. Participants saw a poster from a national campaign about HPV vaccination and either nothing further (Control) or an additional poster containing an HPV vaccine recommendation from a female (FDR) or male doctor (MDR). Primary outcomes are intentions to vaccinate and perceived safety of the HPV vaccine. Both recommendation arms increased the likelihood that participants reported the highest levels of vaccine intentions compared to control (FDR: 33.7% p = 0.01; MDR: 30.5%, p = 0.05, compared to Control (22.4%)) and safety perceptions (FDR: 24.2%. p = 0.09; MDR: 28.0%, p = 0.01, compared to Control (17.1%)) but there was no statistically significant increase in the likelihood to report above moderate vaccine intentions (FDR: 72.6%, p = 0.76; MDR: 72.5%, p = 0.77, compared to Control (71.4%)) or safety perceptions (FDR: 68.9%, p = 0.91; MDR: 75.0%, p = 0.17, compared to Control (68.6%)). We find no differential treatment effect by the recommending doctor’s gender. In conclusion, our results suggest that visual communication of a doctor’s support for the HPV vaccine can strengthen above-moderate intentions and safety perceptions but may not be enough to persuade the vaccine hesitant to vaccinate.
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Affiliation(s)
- Samantha Horn
- Department of Social and Decision Sciences, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States
- Corresponding author.
| | - Gretchen B. Chapman
- Department of Social and Decision Sciences, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States
| | - Kriti Chouhan
- Busara Center for Behavioral Economics, 5th Floor, Daykio Plaza, Lane, Ngong Ln, Nairobi, Kenya
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Abstract
PURPOSE OF REVIEW We reviewed the literature about parental vaccine hesitancy, focusing on publications from October 2019 to April 2021 to describe patterns and causes of hesitancy and interventions to address hesitancy. RECENT FINDINGS Recent studies expand understanding of the prevalence of vaccine hesitancy globally and highlight associated individual and contextual factors. Common concerns underlying hesitancy include uncertainty about the need for vaccination and questions about vaccine safety and efficacy. Sociodemographic factors associated with parental vaccine hesitancy vary across locations and contexts. Studies about psychology of hesitancy and how parents respond to interventions highlight the role of cognitive biases, personal values, and vaccination as a social contract or norm. Evidence-based strategies to address vaccine hesitancy include presumptive or announcement approaches to vaccine recommendations, motivational interviewing, and use of immunization delivery strategies like standing orders and reminder/recall programs. A smaller number of studies support use of social media and digital applications to improve vaccination intent. Strengthening school vaccine mandates can improve vaccination rates, but policy decisions must consider local context. SUMMARY Vaccine hesitancy remains a challenge for child health. Future work must include more interventional studies to address hesitancy and regular global surveillance of parental vaccine hesitancy and vaccine content on social media.
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Affiliation(s)
- Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
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13
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McAbee L, Tapera O, Kanyangarara M. Factors Associated with COVID-19 Vaccine Intentions in Eastern Zimbabwe: A Cross-Sectional Study. Vaccines (Basel) 2021; 9:1109. [PMID: 34696215 PMCID: PMC8538260 DOI: 10.3390/vaccines9101109] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
Vaccines are one of the most effective public health strategies to protect against infectious diseases, yet vaccine hesitancy has emerged as a global health threat. Understanding COVID-19 knowledge and attitudes and their association with vaccine intentions can help the targeting of strategies to increase vaccination uptake and achieve herd immunity. The goal of this study was to assess COVID-19 knowledge, attitudes, and behaviors, and identify factors associated with COVID-19 vaccine intentions among heads of households in Manicaland Province, Zimbabwe. A cross-sectional survey was conducted in May 2021 among 551 randomly selected households. Data were collected on socio-demographic characteristics, and knowledge, attitudes, and behaviors regarding COVID-19 and the vaccines. More than half (55.7%) of the respondents reported intending to vaccinate themselves or their households. Multivariate logistic regression indicated that the likelihood of vaccine intentions was most strongly associated with confidence in vaccine safety. Additionally, the odds of intending to get vaccinated were significantly higher among heads of households who were male, had a higher level of education, and identified vaccination and face mask usage as prevention measures. Among perceived motivators to vaccinate, recommendations from the World Health Organization and availability of the vaccine free of charge increased the likelihood of vaccine intentions, while country of vaccine manufacturer posed a barrier to vaccine intentions. As the vaccine rollout in Zimbabwe continues, efforts to increase COVID-19 vaccination coverage and achieve herd immunity should target females and less educated populations and be tailored to address concerns about vaccine safety and country of manufacturer.
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Affiliation(s)
- Lauren McAbee
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - Oscar Tapera
- SADTAP Health Research Institute, Harare 00263, Zimbabwe;
| | - Mufaro Kanyangarara
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
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14
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Adeyanju GC, Engel E, Koch L, Ranzinger T, Shahid IBM, Head MG, Eitze S, Betsch C. Determinants of influenza vaccine hesitancy among pregnant women in Europe: a systematic review. Eur J Med Res 2021; 26:116. [PMID: 34583779 PMCID: PMC8477621 DOI: 10.1186/s40001-021-00584-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/12/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pregnant women are at high risk for severe influenza. However, maternal influenza vaccination uptake in most World Health Organization (WHO) European Region countries remains low, despite the presence of widespread national recommendations. An influenza vaccination reduces influenza-associated morbidity and mortality in pregnancy, as well as providing newborns with protection in their first months. Potential determinants of vaccine hesitancy need to be identified to develop strategies that can increase vaccine acceptance and uptake among pregnant women. The primary objective of the systematic review is to identify the individual determinants of influenza vaccine hesitancy among pregnant women in Europe, and how to overcome the hesitancy. METHODS Databases were searched for peer-reviewed qualitative and quantitative studies published between 2009 and 2019 inclusive. Databases included PubMed via MEDLINE, Cochrane Central Register for Controlled Trials, PsycINFO, SAGE Journals, Taylor and Francis and Springer nature. These covered themes including psychology, medicine, and public health. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, 11 studies were eligible and analyzed for significant determinants of influenza vaccine hesitancy among pregnant women in Europe. RESULTS The most commonly reported factors were psychological aspects, for example concerns about safety and risks to mother and child, or general low risk perception of becoming ill from influenza. Doubts about the effectiveness of the vaccine and a lack of knowledge about this topic were further factors. There was also influence of contextual factors, such as healthcare workers not providing adequate knowledge about the influenza vaccine or the pregnant lady stating their antivaccine sentiment. CONCLUSION Health promotion that specifically increases knowledge among pregnant women about influenza and vaccination is important, supporting a valid risk judgment by the pregnant lady. The development of new information strategies for dialogue between healthcare providers and pregnant women should form part of this strategy.
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Affiliation(s)
- Gbadebo Collins Adeyanju
- Centre for Empirical Research in Economics and Behavioural Science (CEREB), University of Erfurt, Erfurt, Germany.
- Media and Communication Science, University of Erfurt, Erfurt, Germany.
| | - Elena Engel
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Laura Koch
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Tabea Ranzinger
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | | | - Micheal G Head
- Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sarah Eitze
- Centre for Empirical Research in Economics and Behavioural Science (CEREB), University of Erfurt, Erfurt, Germany
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Centre for Empirical Research in Economics and Behavioural Science (CEREB), University of Erfurt, Erfurt, Germany
- Media and Communication Science, University of Erfurt, Erfurt, Germany
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