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Amdisen L, Pedersen L, Abildgaard N, Benn CS, Rørth M, Cronin-Fenton D, Sørup S. The coverage of influenza vaccination and predictors of influenza non-vaccination in Danish cancer patients: A nationwide register-based cohort study. Vaccine 2024; 42:1690-1697. [PMID: 38350769 DOI: 10.1016/j.vaccine.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Influenza vaccination is recommended and provided free-of-charge to Danish citizens aged ≥65 years and to individuals with acquired immunodeficiency. We aimed to estimate influenza vaccination coverage and investigate predictors of influenza non-vaccination in Danish cancer patients. METHODS A nationwide cohort study of all Danish citizens aged ≥18 years with an incident cancer diagnosis between 2002 and 2017. Using national registries, we assessed information on influenza vaccination and potential predictors of influenza non-vaccination. We estimated adjusted prevalence ratios (aPR) of influenza non-vaccination for patients aged <65 years and ≥65 years. RESULTS We observed 269,863 patients during 840,876 influenza vaccination seasons. The influenza vaccination coverage was 14 % for cancer patients <65 years and 51 % for those ≥65 years. No influenza vaccination in the previous season was associated with non-vaccination in the current season (<65 years: aPR = 2.75, 95 %CI = 2.71-2.80; ≥65 years: aPR = 5.15, 95 %CI = 5.10-5.21). Haematological cancer patients receiving chemotherapy had lower vaccination prevalence compared with those not receiving chemotherapy. CONCLUSIONS The influenza vaccination coverage was low among cancer patients. Influenza non-vaccination in the previous season was the strongest predictor of not receiving influenza vaccination in the current season. Haematological cancer patients on current chemotherapy had lower vaccination prevalence than those not currently receiving chemotherapy.
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Affiliation(s)
- Lau Amdisen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
| | - Lars Pedersen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Niels Abildgaard
- Hematology Research Unit, Department of Hematology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christine Stabell Benn
- Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark,; Danish Institute of Advanced Science, University of Southern Denmark, Odense, Denmark
| | - Mikael Rørth
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Deirdre Cronin-Fenton
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Signe Sørup
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
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Salo H, Sakalauskaitè M, Lévy-Bruhl D, Lindstrand A, Valentiner-Branth P, Wichmann O, Puumalainen T. Prices of paediatric vaccines in European vaccination programmes. Vaccine X 2023; 15:100392. [PMID: 37779660 PMCID: PMC10539658 DOI: 10.1016/j.jvacx.2023.100392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To compare the vaccine prices per vaccinated child under 18 and vaccine funding and procurement systems in the national vaccination programmes (NVPs) in Europe. Methods The on-line survey targeted to NVP managers collected data referred to the information available on 31 December 2016. The prices of vaccines were categorised into three groups. The price per child 1) fully vaccinated comprised all vaccines and doses offered in the NVP; 2) vaccinated with standard vaccines comprised the vaccines included in the NVP in all countries; 3) vaccinated with recent vaccines comprised the pneumococcal conjugate, human papillomavirus and rotavirus vaccines. Results In the 23 out of 32 countries that answered the survey, 17 funded the vaccines by taxes and six by social insurance. 18 countries procured the vaccines through public tenders or negotiations. Five countries purchased the vaccines by healthcare providers and reimbursed from the health insurance system.In the countries with vaccine procurement through public tenders the price per child vaccinated with standard vaccines ranged from €59 to €117 when using pentavalent and from €98 to €220 when using hexavalent vaccines. The mean price per child vaccinated with recent vaccines was €130 for the countries that offered pneumococcal conjugate and human papillomavirus vaccines and €142 for the countries that in addition included rotavirus vaccine.In the countries that purchased the vaccines by healthcare providers and reimbursed from the health insurance system the price per child vaccinated with standard vaccines ranged from €136 to €427. Conclusions The vaccine prices differ notably in Europe. Prices were lower in countries where vaccines in the NVP were tax-funded and nationally or regionally procured. Improved procurement systems could lead to substantial savings or possibilities to introduce more vaccines into the NVP.
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Affiliation(s)
- Heini Salo
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Milda Sakalauskaitè
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Daniel Lévy-Bruhl
- Santé Publique France, Agence Nationale de Santé Publique, Saint-Maurice cedex, France
| | | | - Palle Valentiner-Branth
- Department of Infectious Disease Epidemiology and Prevention, Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | | | - Taneli Puumalainen
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department for Safety, Security and Health, Ministry of Social Affairs and Health, Helsinki, Finland
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3
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Scarso S, Marchetti G, Russo ML, D’Angelo F, Tosti ME, Bellini A, De Marchi C, Ferrari C, Gatta A, Caminada S, Papaevgeniou N, Dalma N, Karnaki P, Marceca M, Declich S. Access to Vaccination for Newly Arrived Migrants: Developing a General Conceptual Framework for Understanding How to Improve Vaccination Coverage in European Countries. Int J Public Health 2023; 68:1605580. [PMID: 37609078 PMCID: PMC10440383 DOI: 10.3389/ijph.2023.1605580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
Objectives: Access to vaccination for newly arrived migrants (NAMs) is a relevant concern that requires urgent attention in EU/EEA countries. This study aimed to develop a General Conceptual Framework (GCF) for understanding how to improve vaccination coverage for NAMs, by characterizing and critically analyzing system barriers and possible strategies to increase vaccination. Methods: A theoretical conceptualization of the GCF was hypothesized based on conceptual hubs in the immunization process. Barriers and solutions were identified through a non-systematic desktop literature review and qualitative research. The GCF guided the activities and facilitated the integration of results, thereby enriching the GCF with content. Results: The study explores the vaccination of NAMs and proposes strategies to overcome barriers in their vaccination process. It introduces a framework called GCF, which consists of five interconnected steps: entitlement, reachability, adherence, achievement, and evaluation of vaccination. The study also presents barriers and solutions identified through literature review and qualitative research, along with strategies to enhance professionals' knowledge, improve reachability, promote adherence, achieve vaccination coverage, and evaluate interventions. The study concludes by recommending strategies such as proximity, provider training, a migrant-sensitive approach, and data collection to improve vaccination outcomes for NAMs. Conclusion: Ensuring equitable access to healthcare services, including vaccination, is crucial not only from a humanitarian perspective but also for the overall public health of these countries.
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Affiliation(s)
- Salvatore Scarso
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Giulia Marchetti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Laura Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Franca D’Angelo
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Maria Elena Tosti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Arianna Bellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Caterina Ferrari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Nikoletta Papaevgeniou
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Nadia Dalma
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Pania Karnaki
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Silvia Declich
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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Lawlor R, Wilsdon T, Rémy-Blanc V, Nogal AÁ, Pana A. A review of the sustainability of vaccine funding across Europe and implications for post-COVID policymaking. Health Policy 2022; 126:956-969. [PMID: 36008177 PMCID: PMC9364713 DOI: 10.1016/j.healthpol.2022.08.004] [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: 03/28/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Approaches to routine vaccine funding and the underlying budget-setting process vary greatly across European countries. The ongoing COVID-19 pandemic has put enormous pressure on healthcare systems, affecting resilience of the overall vaccine ecosystem. METHODS This article reviews how vaccine budgets are structured across 8 European countries (England, Finland, France, Germany, Italy, Norway, Romania, and Spain). First a literature review of the landscape was undertaken, followed by expert interviews to review the findings and consider policy principles to secure prioritisation and sustainability of routine vaccination budgets post-COVID. RESULTS The organisation of budgets and vaccine spending varies greatly across Europe. In 2/8 countries (France and Germany) vaccine spending is subsumed into a wider healthcare budget. In 2/8 countries (Italy and Romania) the budget differentiates public health and prevention spending from other areas of healthcare, though there is no standalone vaccine budget. In 4/8 countries (England, Finland, Norway and Spain) there is a standalone vaccine budget, however this may not cover all elements needed for immunisation delivery and is not always transparent. CONCLUSION Ensuring adequate and dynamic country vaccine budgets, with horizon scanning approaches like in England and Finland, or flexible vaccines expenditures like Germany, would greatly help the timely availability of public funding for new vaccines and strengthen vaccines supply security in Europe through a more virtuous European vaccine ecosystem.
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Affiliation(s)
- Ryan Lawlor
- Life Sciences, Charles River Associates, London, UK.
| | - Tim Wilsdon
- Life Sciences, Charles River Associates, London, UK
| | | | | | - Adrian Pana
- Bucharest University of Economic Studies, Romania
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An Independent Study to Compare Compliance, Attitudes, Knowledge, and Sources of Knowledge about Pneumococcal Vaccinations among an Italian Sample of Older Adults. Vaccines (Basel) 2022; 10:vaccines10040490. [PMID: 35455239 PMCID: PMC9030078 DOI: 10.3390/vaccines10040490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Streptococcus pneumoniae is one of the leading causes of pneumoniae deaths, especially among elderly individuals, with the vaccine being the primary prevention instrument. However, information on national vaccine coverage among the elderly population is scarce and sparse. Methods: A survey involved a representative sample of Italians older than 65 years (n = 600), who agreed to participate in the study through a phone interview. Participants’ self-reported pneumococcal vaccination status, vaccine literacy, information source, and risk perception related to the infection and to vaccines-adverse reactions were assessed. Results: The reported vaccination status is very low (11.2%), with respondents largely uninformed about vaccination opportunities. The results also show that the predominant (and most effective) source of information is healthcare providers, with vaccine hesitancy being positively linked to risk perception related to disease and negatively linked to risk perception of vaccine adverse reactions. Conclusions: This study suggests the need to collect data to systematically monitor vaccination coverage and calls for information campaigns to improve elderly literacy to increase vaccination uptake.
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Soares P, Rocha JV, Moniz M, Gama A, Laires PA, Pedro AR, Dias S, Leite A, Nunes C. Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2021. [PMID: 33810131 DOI: 10.3390/vaccines9030300.pmid:33810131;pmcid:pmc8004673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
It is critical to develop tailored strategies to increase acceptability of the COVID-19 vaccine and decrease hesitancy. Hence, this study aims to assess and identify factors associated with COVID-19 vaccine hesitancy in Portugal. We used data from a community-based survey, "COVID-19 Barometer: Social Opinion", which includes data regarding intention to take COVID-19 vaccines, health status, and risk perception in Portugal from September 2020 to January 2021. We used multinomial regression to identify factors associated with intention to delay or refuse to take COVID-19 vaccines. COVID-19 vaccine hesitancy in Portugal was high: 56% would wait and 9% refuse. Several factors were associated with both refusal and delay: being younger, loss of income during the pandemic, no intention of taking the flu vaccine, low confidence in the COVID-19 vaccine and the health service response during the pandemic, worse perception of government measures, perception of the information provided as inconsistent and contradictory, and answering the questionnaire before the release of information regarding the safety and efficacy of COVID-19 vaccines. It is crucial to build confidence in the COVID-19 vaccine as its perceived safety and efficacy were strongly associated with intention to take the vaccine. Governments and health authorities should improve communication and increase trust.
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Affiliation(s)
- Patricia Soares
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - João Victor Rocha
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Marta Moniz
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Gama
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Pedro Almeida Laires
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Pedro
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Sónia Dias
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Andreia Leite
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Carla Nunes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
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7
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Soares P, Rocha JV, Moniz M, Gama A, Laires PA, Pedro AR, Dias S, Leite A, Nunes C. Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2021; 9:300. [PMID: 33810131 PMCID: PMC8004673 DOI: 10.3390/vaccines9030300] [Citation(s) in RCA: 363] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 01/21/2023] Open
Abstract
It is critical to develop tailored strategies to increase acceptability of the COVID-19 vaccine and decrease hesitancy. Hence, this study aims to assess and identify factors associated with COVID-19 vaccine hesitancy in Portugal. We used data from a community-based survey, "COVID-19 Barometer: Social Opinion", which includes data regarding intention to take COVID-19 vaccines, health status, and risk perception in Portugal from September 2020 to January 2021. We used multinomial regression to identify factors associated with intention to delay or refuse to take COVID-19 vaccines. COVID-19 vaccine hesitancy in Portugal was high: 56% would wait and 9% refuse. Several factors were associated with both refusal and delay: being younger, loss of income during the pandemic, no intention of taking the flu vaccine, low confidence in the COVID-19 vaccine and the health service response during the pandemic, worse perception of government measures, perception of the information provided as inconsistent and contradictory, and answering the questionnaire before the release of information regarding the safety and efficacy of COVID-19 vaccines. It is crucial to build confidence in the COVID-19 vaccine as its perceived safety and efficacy were strongly associated with intention to take the vaccine. Governments and health authorities should improve communication and increase trust.
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Affiliation(s)
- Patricia Soares
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - João Victor Rocha
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Marta Moniz
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Gama
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Pedro Almeida Laires
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Pedro
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Sónia Dias
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Andreia Leite
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Carla Nunes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
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Affiliation(s)
- Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
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9
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Janković S. Childhood vaccination in the twenty-first century: Parental concerns and challenges for physicians. ARHIV ZA FARMACIJU 2019. [DOI: 10.5937/arhfarm1906452j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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