1
|
Vigezzi GP, Maggioni E, Bert F, de Vito C, Siliquini R, Odone A. Who is (not) vaccinated? A proposal for a comprehensive immunization information system. Hum Vaccin Immunother 2024; 20:2386739. [PMID: 39103249 DOI: 10.1080/21645515.2024.2386739] [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: 06/28/2024] [Accepted: 07/27/2024] [Indexed: 08/07/2024] Open
Abstract
The role of immunization in public health is crucial, offering widespread protection against infectious diseases and underpinning societal well-being. However, achieving optimal vaccination coverage is impeded by vaccine hesitancy, a significant challenge that necessitates comprehensive strategies to understand and mitigate its effects. We propose the integration of Population Health Management principles with Immunization Information Systems (IISs) to address vaccine hesitancy more effectively. Our approach leverages systematic health determinants analysis to identify at-risk populations and tailor interventions, thereby promoting vaccination coverage and public health responses. We call for the development of an enhanced version of the Italian National Vaccination Registry, which aims to facilitate real-time tracking of individuals' vaccination status while improving data accuracy and interoperability among healthcare systems. This registry is designed to overcome current barriers by ensuring robust data protection, addressing cultural and organizational challenges, and integrating behavioral insights to foster informed public health campaigns. Our proposal aligns with the Italian National Vaccination Prevention Plan 2023-2025 and emphasizes proactive, evidence-based strategies to increase vaccination uptake and contrast the spread of vaccine-preventable diseases. The ultimate goal is to establish a data-driven, ethically sound framework that enhances public health outcomes and addresses the complexities of vaccine hesitancy within the Italian context and beyond.
Collapse
Affiliation(s)
- Giacomo Pietro Vigezzi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elena Maggioni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Fabrizio Bert
- Department of Public Health and Pediatrics Sciences, University of Torino, Torino, Italy
| | - Corrado de Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Roberta Siliquini
- Department of Public Health and Pediatrics Sciences, University of Torino, Torino, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Medical Direction, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
2
|
Jiang M, Yan X, Jiang W, Ma H, Zhou S, Ying X. From both sides of the needle: Understanding effective interventions for facilitating non-national immunization program vaccine decision making in China. Hum Vaccin Immunother 2024; 20:2389578. [PMID: 39171499 PMCID: PMC11346547 DOI: 10.1080/21645515.2024.2389578] [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: 06/17/2024] [Revised: 07/17/2024] [Accepted: 08/04/2024] [Indexed: 08/23/2024] Open
Abstract
Vaccination decisions are influenced by various psychological and practical factors. In China, non-National Immunization Program (non-NIP) vaccines, which are voluntary and self-paid, add uncertainty and autonomy to the decision-making process. Effective communication between providers and recipients is crucial but understudied. This study aims to integrate their perspectives, identify strategies for facilitating vaccination decisions, and analyze their mechanisms. From July to December 2023, semi-structured interviews were conducted with 17 caregivers and 12 vaccination providers across five Chinese provinces. Participants shared their experiences and decision-making processes regarding non-NIP vaccines. The Behaviour Change Wheel framework guided the analysis, utilizing iterative coding and directed content analysis. Thirteen Behavior Change Techniques were identified, with feedback, monitoring, and environmental restructuring being the most common. Key intervention functions included Persuasion, Education, and Training. We further mapped how these interventions influence non-NIP vaccine decisions. Capability was enhanced through education and effective communication, providing necessary knowledge and skills. Opportunity was increased via infrastructural improvements and societal support, making vaccines more accessible and endorsed by the community. Motivation was driven by clear communication of vaccination benefits and risks, reinforced by societal norms through public health messaging. By understanding the mechanisms influencing vaccination behaviors and interacting with stakeholders, tailored strategies can be developed. Healthcare providers can enhance service accessibility and offer evidence-based guidance with reminders, monitoring, and incentives to ensure compliance. For recipients, reliable information, sustained engagement, timely communication, and motivational opportunities are essential. A multi-dimensional approach involving multiple stakeholders is crucial for promoting non-NIP vaccine uptake.
Collapse
Affiliation(s)
- Mingzhu Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Xuanxuan Yan
- School of Public Health, Fudan University, Shanghai, China
| | - Weixi Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Haifeng Ma
- School of Public Health, Fudan University, Shanghai, China
| | - Sijuan Zhou
- School of Public Health, Fudan University, Shanghai, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, Shanghai, China
| |
Collapse
|
3
|
Qu S, Zhou M, Campy KS, He W. Predictors of parental acceptance to live attenuated influenza vaccine for children. Hum Vaccin Immunother 2024; 20:2356343. [PMID: 38835204 PMCID: PMC11155699 DOI: 10.1080/21645515.2024.2356343] [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: 02/11/2024] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
To determine the influencing factors of Chinese parents' intention and behavior for children to receive live attenuated influenza vaccine during the 2022-2023 influenza season. A theoretical model was developed and included seven constructs, and structural equation modeling was used to test 11 hypotheses. From October 2022 to December 2023, a survey was conducted across 38 medical institutions in four Chinese cities and their subordinate districts, counties, and rural areas. Parents who accompanied their children for vaccinations were selected through a randomization process based on their child's medical card numbers. Measures were taken to minimize method bias, including a diverse geographical representation and random sampling. The survey resulted in the collection of 936 valid responses, exceeding the recommended sample size for structural equation model analysis and providing robust statistical inferences. During the study period, 936 respondents were included in the study. Perceived ease of use was verified to be a predictor of perceived usefulness and perceived value. Perceived usefulness was verified as a predictor of perceived value and behavioral intention. Knowledge was a significant antecedent of perceived value and risk perception of influenza disease. Risk perception of influenza disease was proved to be a significant predictor of perceived value and self-reported vaccination behavior. Perceived value significantly affected behavioral intention, and behavioral intention significantly affected self-reported vaccination behavior. Six demographic variables significantly moderate the theoretical models. The low vaccination coverage of live attenuated influenza vaccine (LAIV) among children in China suggests a need for a deeper understanding of the factors that influence vaccination rates. Particularly, effective strategies are necessary from policymakers and practitioners to elevate childhood LAIV coverage.
Collapse
Affiliation(s)
- Shujuan Qu
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhou
- School of Business Administration, Hunan University of Technology and Business, Changsha, China
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kathryn S. Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Wei He
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
4
|
Rosado-Santiago C, Pérez-Guerra CL, Vélez-Agosto NM, Colón-Burgos C, Marrero-Santos KM, Partridge SK, Lockwood AE, Young C, Waterman SH, Paz-Bailey G, Cardona-Gerena I, Rivera A, Adams LE, Wong JM. Perceptions of dengue risk and acceptability of a dengue vaccine in residents of Puerto Rico. Hum Vaccin Immunother 2024; 20:2323264. [PMID: 38599678 PMCID: PMC11008542 DOI: 10.1080/21645515.2024.2323264] [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: 11/08/2023] [Accepted: 02/22/2024] [Indexed: 04/12/2024] Open
Abstract
Dengvaxia is the first dengue vaccine recommended in the United States (U.S.). It is recommended for children aged 9-16 y with laboratory-confirmed previous dengue infection and living in areas where dengue is endemic. We conducted focus groups with parents and in-depth interviews with key informants (i.e. practicing pediatricians, physicians from immunization clinics, university researchers, and school officials) in Puerto Rico (P.R.) to examine acceptability, barriers, and motivators to vaccinate with Dengvaxia. We also carried out informal meetings and semi-structured interviews to evaluate key messages and educational materials with pediatricians and parents. Barriers to vaccination included lack of information, distrust toward new vaccines, vaccine side effects and risks, and high cost of/lack of insurance coverage for laboratory tests and vaccines. Motivators included clear information about the vaccine, a desire to prevent future dengue infections, the experience of a previous dengue infection or awareness of dengue fatality, vaccine and laboratory tests covered by health insurance, availability of rapid test results and vaccine appointments. School officials and parents agreed parents would pay a deductible of $5-20 for Dengvaxia. For vaccine information dissemination, parents preferred an educational campaign through traditional media and social media, and one-on-one counseling of parents by healthcare providers. Education about this vaccine to healthcare providers will help them answer parents' questions. Dengvaxia acceptability in P.R. will increase by addressing motivators and barriers to vaccination and by disseminating vaccine information in plain language through spokespersons from health institutions in P.R.
Collapse
Affiliation(s)
- Coral Rosado-Santiago
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Carmen L. Pérez-Guerra
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Nicole M. Vélez-Agosto
- Department of Clinical Psychology, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Claudia Colón-Burgos
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Karla M. Marrero-Santos
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susanna K. Partridge
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Amy E. Lockwood
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Cathy Young
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steve H. Waterman
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Gabriela Paz-Bailey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | | | - Angel Rivera
- Puerto Rico Department of Health, San Juan, PR, USA
- Immunization Program, Puerto Rico Department of Health, San Juan, PR, USA
| | - Laura E. Adams
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Joshua M. Wong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| |
Collapse
|
5
|
Hansen BT, Winje BA, Stålcrantz J, Greve-Isdahl M. Predictors of maternal pertussis vaccination acceptance among pregnant women in Norway. Hum Vaccin Immunother 2024; 20:2361499. [PMID: 38847213 PMCID: PMC11164220 DOI: 10.1080/21645515.2024.2361499] [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: 03/13/2024] [Accepted: 05/25/2024] [Indexed: 06/12/2024] Open
Abstract
Maternal vaccination against pertussis is safe and provides effective protection against pertussis for the newborn, but the vaccine coverage rate remains generally low. Norway is currently planning for introduction of routine maternal pertussis vaccination. To assess maternal pertussis vaccination acceptance among pregnant Norwegian women, we surveyed women at 20-40 weeks gestation in 2019. Among the 1,148 pregnant women participating in this cross-sectional study, 73.8% reported they would accept pertussis vaccination during pregnancy if it was recommended, 6.9% would not accept and 19.2% were undecided. Predictors for low likelihood of accepting pertussis vaccination during pregnancy included low confidence in health authorities and in maternal pertussis vaccination safety and effectiveness, low awareness and adherence to influenza vaccination during pregnancy, and low awareness of pertussis vaccination. The major reasons reported for not accepting or being undecided about maternal pertussis vaccination were lack of information on vaccine safety for both mother and child. Most women reported that they would consult their general practitioner or a midwife for information if they were offered maternal pertussis vaccination. General practitioners and midwives were also regarded as the most trustworthy sources of information if the women were in doubt about accepting vaccination. We conclude that information addressing safety concerns and raising awareness about maternal pertussis vaccination could increase acceptance of maternal pertussis vaccination. Our findings highlight the pivotal role of the antenatal and primary health care services in providing such information to pregnant women.
Collapse
Affiliation(s)
- Bo T. Hansen
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
| | - Brita A. Winje
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Jeanette Stålcrantz
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
| | - Margrethe Greve-Isdahl
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
6
|
Dube E, Trottier ME, Greyson D, MacDonald NE, Meyer SB, MacDonald SE, Driedger SM, Witteman HO, Ouakki M, Gagnon D. Use of narratives to enhance childhood vaccine acceptance: Results of an online experiment among Canadian parents. Hum Vaccin Immunother 2024; 20:2379093. [PMID: 39044701 PMCID: PMC11271131 DOI: 10.1080/21645515.2024.2379093] [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: 05/01/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/25/2024] Open
Abstract
Identifying effective interventions to promote children's vaccination acceptance is crucial for the health and wellbeing of communities. Many interventions can be implemented to increase parental awareness of the benefits of vaccination and positively influence their confidence in vaccines and vaccination services. One potential approach is using narratives as an intervention. This study aims to evaluate the effects of a narrative-based intervention on parents' attitudes and vaccination intentions. In a pre-post experiment, 2,000 parents of young children recruited from an online pan-Canadian panel were randomly exposed to one of the three videos presenting narratives to promote childhood vaccination or a control condition video about the importance and benefits of physical activity in children. Pre-post measures reveal a relatively modest but positive impact of the narratives on parents' attitudes and intention to vaccinate their child(ren). The results also suggest that narratives with more emotional content may be more effective in positively influencing vaccine attitudes than the more factual narrative. Using narratives to promote vaccination can positively influence parents' views and intentions toward childhood vaccines, but research is still required to identify the best components of such interventions.
Collapse
Affiliation(s)
- Eve Dube
- Department of Anthropology, Laval University, Quebec, Quebec, Canada
| | - Marie-Eve Trottier
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Noni E. MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samantha B. Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University, University of Alberta, Edmonton, Alberta, Canada
| | - S. Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Holly O. Witteman
- Department of Family Medicine, Laval University, Quebec, Quebec, Canada
| | - Manale Ouakki
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Dominique Gagnon
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| |
Collapse
|
7
|
Willis DE, Moore R, Selig JP, Shafeek Amin N, Li J, Watson D, Brimberry RK, McElfish PA. Pediatric HPV vaccination: Provider recommendations matter among hesitant parents. Vaccine 2024; 42:126166. [PMID: 39079809 PMCID: PMC11401755 DOI: 10.1016/j.vaccine.2024.126166] [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: 03/26/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/15/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. HPV-associated diseases are preventable with vaccination, but HPV vaccine coverage remains below other vaccines recommended during childhood and adolescence. We examined correlates of pediatric HPV vaccination among parents who have reported hesitancy toward the HPV vaccine. In addition to sociodemographic correlates, we investigated the relationships between the social process of healthcare provider recommendations and pediatric HPV vaccination. METHODS We utilized phone survey data (N = 2201) collected in October 2022 via random digit dialing of Arkansan adults-Black and Hispanic respondents were oversampled for adequate representation. The survey was provided in English and Spanish. The analysis focused on a subsample of parents of children ages 9 to 17 years who reported HPV vaccine hesitancy (n = 201). Analyses include descriptive statistics, bivariate logistic regression, and multivariate logistic regression with Full Information Maximum Likelihood estimation. RESULTS A third (32.96%) of vaccine-hesitant parents reported their child(ren) had received at least one dose of the HPV vaccine. Only half (50.93%) of vaccine-hesitant parents received a healthcare provider recommendation to vaccinate their child(ren) between the ages of 9 and 17 against HPV. Adjusted odds of pediatric HPV vaccination were four times greater when vaccine-hesitant parents received a healthcare provider's recommendation (OR = 4.67; 95% CI[1.89, 11.55]) compared to when they had not. Pediatric HPV vaccination for parents whose provider did not recommend the HPV vaccine was not significantly different from those with no provider. CONCLUSION Healthcare provider recommendations are important for promoting HPV vaccination even among parents who are vaccine hesitant. Additional research is needed to understand why pediatric HPV vaccine recommendations are not made more often or consistently, particularly among vaccine-hesitant populations. This study demonstrates support for the growing body of research on hesitant adopters.
Collapse
Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - Neveen Shafeek Amin
- School of Human Inquiry, University of Arkansas at Little Rock, 2801 S. University Ave., Little Rock, AR 72204, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - Donya Watson
- South Arkansas Regional Hospital, 706 West Grove St., El Dorado, AR 71730, USA
| | - Ronald K Brimberry
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| |
Collapse
|
8
|
Santibanez TA, Black CL, Zhou T, Srivastav A, Singleton JA. Parental hesitancy about COVID-19, influenza, HPV, and other childhood vaccines. Vaccine 2024; 42:126139. [PMID: 39019662 DOI: 10.1016/j.vaccine.2024.07.040] [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: 03/06/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Some public health professionals have expressed concern that the COVID-19 pandemic has increased vaccine hesitancy about routine childhood vaccines; however, the differential prevalence of vaccine hesitancy about specific vaccines has not been measured. METHODS Data from the National Immunization Survey-Child COVID-19 Module (NIS-CCM) were analyzed to assess the proportion of children ages 6 months-17 years who have a parent with hesitancy about: COVID-19, influenza, human papillomavirus (HPV) (for children ≥ 9 years) vaccines, and "all other childhood shots." Interviews from October 2022 through April 2023 were analyzed. RESULTS The percentage of children with a vaccine-hesitant parent varied by vaccine. 55.9% of children had a parent hesitant about COVID-19 vaccine, 30.9% hesitant about influenza vaccine, 30.1% hesitant about HPV vaccine, and 12.2% had a parent hesitant about other vaccines such as measles, polio, and tetanus. CONCLUSION The study findings suggest that differential interventions and communications to parents be used to educate about COVID-19, influenza, HPV, and routine childhood vaccinations because the hesitancy levels differ widely.
Collapse
Affiliation(s)
- Tammy A Santibanez
- National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, Atlanta, GA 30329, USA.
| | - Carla L Black
- National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, Atlanta, GA 30329, USA.
| | - Tianyi Zhou
- National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, Atlanta, GA 30329, USA; Eagle Health Analytics, 5835 Peachtree Corners East, Suite B, Peachtree Corners, GA 30092, USA.
| | - Anup Srivastav
- National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, Atlanta, GA 30329, USA; Eagle Health Analytics, 5835 Peachtree Corners East, Suite B, Peachtree Corners, GA 30092, USA.
| | - James A Singleton
- National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, Atlanta, GA 30329, USA.
| |
Collapse
|
9
|
MacKay H, Gretton JD, Chyderiotis S, Elliott S, Howarth A, Guo C, Mastroianni A, Kormos C, Leifer J, Conway L, Morrissey MD. Confidence and barriers: Analysis of factors associated with timely routine childhood vaccination in Canada during the COVID-19 pandemic. Vaccine 2024; 42:126236. [PMID: 39217774 DOI: 10.1016/j.vaccine.2024.126236] [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: 02/29/2024] [Revised: 08/09/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
Routine childhood vaccination is a crucial component of public health in Canada and worldwide. To facilitate catch-up from the global decline in routine vaccination caused by the COVID-19 pandemic, and toward the ongoing pursuit of coverage goals, vaccination programs must understand barriers to vaccine access imposed or exacerbated by the pandemic. We conducted a regionally representative online survey in January 2023 including 2036 Canadian parents with children under the age of 18. We used the COM-B model of behaviour to examine factors influencing vaccination timeliness during the pandemic. We assessed Capability with measures of vaccine understanding and decision difficulty, and Motivation with a measure of vaccine confidence. Opportunity was assessed through parents' self-reported experience with barriers to vaccination. Twenty-four percent of surveyed parents reported having missed or delayed one of their children's scheduled routine vaccinations since the beginning of the pandemic, though most parents reported having either caught up or the intention to catch up soon. In the absence of opportunity barriers, motivation was associated with timely vaccination for children aged 0-4 years (aOR = 1.81, 95 % CI: 1.14-2.84). However, experience with one or more opportunity barriers, particularly clinic closures and difficulties getting an appointment, eliminated this relationship, suggesting perennial and new pandemic-associated barriers are a critical challenge to vaccine coverage goals in Canada.
Collapse
Affiliation(s)
- Harry MacKay
- Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada; Impact Canada, Impact & Innovation Unit, Privy Council Office, Canada
| | - Jeremy D Gretton
- Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada
| | - Sandra Chyderiotis
- Vaccination Behaviour and Confidence, Centre for Immunization Surveillance and Programs, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, Canada
| | - Stephanie Elliott
- Vaccination Behaviour and Confidence, Centre for Immunization Surveillance and Programs, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, Canada
| | - Ana Howarth
- Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, Canada
| | - Catherine Guo
- Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada
| | - Angela Mastroianni
- Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada; Impact Canada, Impact & Innovation Unit, Privy Council Office, Canada
| | - Christine Kormos
- Impact Canada, Impact & Innovation Unit, Privy Council Office, Canada
| | - Jessica Leifer
- Impact Canada, Impact & Innovation Unit, Privy Council Office, Canada
| | - Lauryn Conway
- Impact Canada, Impact & Innovation Unit, Privy Council Office, Canada
| | - Mark D Morrissey
- Behavioural Science Office, Centre for Surveillance, Integrated Insights, and Risk Assessment, Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Canada.
| |
Collapse
|
10
|
Melchinger H, Winters M, Christie S, Arias N, Lirman L, Abeyesekera S, Thomson A, Omer SB. Determinants of undervaccination of routine childhood immunization in Argentina: A cross-sectional study. Vaccine 2024; 42:126235. [PMID: 39182313 DOI: 10.1016/j.vaccine.2024.126235] [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: 05/23/2024] [Revised: 07/19/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
Routine childhood immunization is one of the most effective methods of preventing infectious diseases in children. In Argentina, there has been a decline in routine immunization coverage since 2015, with very little evidence to date on underlying drivers of this steady decline. We administered an online nationwide behavioral insights survey in Argentina between July 1-25, 2022, targeting parents with at least one child under the age of 12 years. Our survey included 1504 parents, 7% (n = 111) of whom did not or only partially vaccinated their children. We found that, compared to the youngest parents (aged 18-24), older parents were less likely to under-vaccinate their children (e.g., 30-34 year-old parents: adjusted Odds Ratio (aOR): 0.31, 95% Confidence Interval (CI) 0.16-0.57). Parents who undervaccinated their children were more likely to take vaccination advice from parent and wellness social media influencers (parent influencers: aOR 2.51, 95% CI 1.46-4.31), and were less likely to trust the social media accounts of official health organizations (aOR 0.82, 95% CI 0.70-0.96). Furthermore, these parents had heightened concerns about routine immunizations, including the number of vaccines given to children and potential for adverse side effects. When asked whether they knew enough to make a vaccine decision for their children, parents who undervaccinated their children were more likely to report that they did not know enough about vaccines or the vaccination schedule to make a decision. These results offer important insights into parental concerns surrounding routine childhood immunization and suggest potential drivers of - and solutions to - the decline in routine immunization seen in Argentina since 2015.
Collapse
Affiliation(s)
- Hannah Melchinger
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, United States
| | - Maike Winters
- Yale Institute for Global Health, Yale University, New Haven, CT 06511, United States
| | - Sarah Christie
- Yale School of Medicine, Yale University, New Haven, CT 06511, United States
| | | | | | | | | | - Saad B Omer
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, United States.
| |
Collapse
|
11
|
Fisher KA, Singh S, Stone RT, Nguyen N, Crawford S, Mazor KM. Primary care providers' views of discussing COVID-19 vaccination with vaccine hesitant patients: A qualitative study. PATIENT EDUCATION AND COUNSELING 2024; 127:108369. [PMID: 38996575 DOI: 10.1016/j.pec.2024.108369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/19/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE To describe primary care providers' (PCPs) perspectives on discussing COVID-19 vaccination with their patients. METHODS All PCPs from 11 primary care clinics at 3 health systems were invited to participate. Focus groups were conducted between December 2021-January 2022, and were recorded and transcribed. Participants were asked about their experience communicating about the COVID-19 vaccine. Themes and subthemes were inductively identified using thematic analysis. RESULTS 40 PCPs participated. All PCPs viewed discussing COVID-19 vaccination as high priority. Strategies for promoting COVID-19 vaccination included influencing what people think and feel, building trust and leveraging their relationship with patients, and practical strategies such as on-site vaccination. Most strategies aimed at influencing what people think and feel and leveraging relationships were viewed as generally ineffective. On-site vaccine availability was identified as the most influential factor. PCPs expressed frustration by their interactions with vaccine hesitant patients, leading them to truncate their communication with these patients. CONCLUSIONS Despite using a broad range of strategies, most PCPs were unable to change the strongly held beliefs among the most vaccine hesitant patients that were often informed by misinformation and mistrust. PRACTICE IMPLICATIONS Promising strategies for promoting vaccination include social/relational (expressing empathy) and practical (on-site COVID-19 vaccine availability).
Collapse
Affiliation(s)
- Kimberly A Fisher
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Sonal Singh
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA; Department of Family and Community Medicine, UMass Chan Medical School, Worcester, MA 01655, USA.
| | | | - Ngoc Nguyen
- Meyers Health Care Institute, A Joint Endeavor of the UMass Chan Medical School, Reliant Medical Group, and Fallon Health, Worcester, MA 01605, USA.
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Kathleen M Mazor
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA.
| |
Collapse
|
12
|
Sorrentino M, Belpiede A, Fiorilla C, Mercogliano M, Triassi M, Palladino R. Logistic and organizational barriers to herpes zoster vaccination in europe: A systematic review. Vaccine X 2024; 20:100544. [PMID: 39206078 PMCID: PMC11350440 DOI: 10.1016/j.jvacx.2024.100544] [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: 04/29/2024] [Revised: 06/17/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Background The Herpes Zoster (HZ) poses a significant public health threat, leading to morbidity and occasional mortality in unvaccinated adults aged 50 and older. With over 95 % of individuals in this age group globally having prior exposure to Varicella-Zoster Virus, a substantial portion of the world's population is susceptible to developing HZ. Without vaccination, individuals reaching 85 years face a 50 % lifetime risk of HZ. Organizational and logistical barriers further hinder vaccination efforts, involving complexities in cost management, demanding vaccine storage requirements, supply limitations, distribution challenges, absence of a streamlined status collection system, and healthcare system deficiencies. Methods A systematic review was conducted on the studies that examined the logistical and organizational barriers to HZ vaccination among frail and older adults, aligning with the PRISMA guidelines. Eligibility criteria focus on English studies in Europe, excluding pediatric or irrelevant populations. Rayyan AI was used for data extraction, and bias was assessed using the AXIS tool. Results After excluding 841 based on titles and abstracts, 22 publications were selected. A thorough analysis identified 4 studies meeting inclusion criteria, conducted between 2009 and 2022, unveiling several barriers on HZ vaccination: challenges with healthcare professionals, obstacles related to patients' perceptions and knowledge, difficulties in accessibility, structural issues, social dynamics. Conclusions The study represents a comprehensive examination, emphasizing the need for targeted interventions to overcome these barriers. The findings underscore the urgency of addressing these challenges to enhance vaccination rates and mitigate the public health burden associated with HZ.
Collapse
Affiliation(s)
| | | | - Claudio Fiorilla
- Department of Public Health, University Federico II – Naples, Italy
| | | | - Maria Triassi
- Department of Public Health, University Federico II – Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
| | - Raffale Palladino
- Department of Public Health, University Federico II – Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
| |
Collapse
|
13
|
Halilova JG, Fynes-Clinton S, Addis DR, Rosenbaum RS. Predictors of Change in Vaccination Decisions Among the Vaccine Hesitant: Examining the Roles of Age and Intolerance of Uncertainty. Ann Behav Med 2024:kaae053. [PMID: 39269193 DOI: 10.1093/abm/kaae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Vaccine hesitancy and resistance pose significant threats to controlling pandemics and preventing infectious diseases. In a group of individuals unvaccinated against the disease caused by the SARS-CoV-2 coronavirus (COVID-19), we investigated how age, intolerance of uncertainty (IU), and their interaction affected the likelihood of having changed one's vaccination decision a year later. We hypothesized that higher IU would increase the likelihood of becoming vaccinated, particularly among individuals of younger age. We predicted that this effect would remain significant, even after controlling for delay discounting and trust in science. PURPOSE The goal of this research was to understand the factors influencing changes in vaccination decisions among the vaccine hesitant. METHODS In a larger longitudinal study, ~7,500 participants from Prolific.co completed demographic and vaccination status questions, a delay discounting task, and the Intolerance of Uncertainty Scale in June-August 2021. Approximately 3,200 participants completed a follow-up survey in July-August 2022, answering questions about vaccination status, reasons for vaccination decision, and trust in science. We analyzed data from 251 participants who initially had no intention of getting vaccinated and completed the follow-up survey; 38% reported becoming vaccinated in the intervening year. RESULTS Data were analyzed using multilevel logistic regression. Over and above other factors related to vaccination decisions (delay discounting, trust in science), younger participants were more likely to change their decision and become vaccinated a year later, especially if they had higher IU, confirming our predictions. Primary reasons for becoming vaccinated were necessity and seeking protection against the virus. CONCLUSIONS These findings highlight the complex interplay between age, uncertainty, and vaccination decisions, and inform health policies by suggesting the need for tailoring interventions to specific concerns in different age groups.
Collapse
Affiliation(s)
- Julia G Halilova
- Department of Psychology and Centre for Integrative and Applied Neuroscience, York University, 4700 Keele St., Toronto, Ontario, M3J 1P3, Canada
| | - Samuel Fynes-Clinton
- Baycrest Health Sciences, Rotman Research Institute, 3560 Bathurst St, North York, ON M6A 2E1, Canada
| | - Donna Rose Addis
- Baycrest Health Sciences, Rotman Research Institute, 3560 Bathurst St, North York, ON M6A 2E1, Canada
- Department of Psychology, University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
- Department of Psychology, The University of Auckland, 34 Princes Street, Auckland CBD, Auckland 1010, New Zealand
| | - R Shayna Rosenbaum
- Department of Psychology and Centre for Integrative and Applied Neuroscience, York University, 4700 Keele St., Toronto, Ontario, M3J 1P3, Canada
- Baycrest Health Sciences, Rotman Research Institute, 3560 Bathurst St, North York, ON M6A 2E1, Canada
| |
Collapse
|
14
|
Kaufman J, Overmars I, Fong J, Tudravu J, Devi R, Volavola L, Vodonaivalu L, Jenkins K, Leask J, Seale H, Mohamed Y, Joshi K, Datt H, Sagan S, Dynes M, Hoq M, Danchin M. Training health workers and community influencers to be Vaccine Champions: a mixed-methods RE-AIM evaluation. BMJ Glob Health 2024; 9:e015433. [PMID: 39251236 DOI: 10.1136/bmjgh-2024-015433] [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: 02/26/2024] [Accepted: 08/22/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION Increasing trust and confidence in vaccines is a global priority, as countries have grappled with delivering COVID-19 vaccines, maintaining routine childhood vaccination rates and introducing new vaccines. Community-based vaccine promotion interventions are commonly implemented, but effectiveness evidence is limited. In 2022, supported by the Australian Government and in partnership with Fiji's Ministry of Health and UNICEF, we codesigned, delivered and comprehensively evaluated a vaccine education and communication training programme for health workers and community influencers to promote COVID-19 and routine immunisation. METHODS The Vaccine Champions programme included three phases: (1) codesign with Fiji stakeholders; (2) vaccine education and communication training for Vaccine Champions and (3) support for Champions to deliver community vaccine discussion sessions over 6 months.The RE-AIM framework evaluation measured programme reach, effectiveness, adoption, implementation and maintenance. Mixed-methods data were collected through interviews, surveys and field notes, integrating qualitative and quantitative data to triangulate findings. Primary outcomes included Champions' knowledge, communication self-efficacy, trust in COVID-19 vaccines, programme satisfaction and community members' intention to vaccinate. RESULTS We trained 35 Champions (27/35 female), including health workers, faith and community influencers. Half had a health background (17/35). Champions conducted 54 discussion sessions, reaching 1717 community members. Most Champions (22/35) conducted at least 1 session, with 16 running 3 or more. Champions who did not run sessions reported barriers like lack of confidence and competing duties. Training increased Champions' communication self-efficacy and trust in COVID-19 vaccines. Community member intention to vaccinate increased from 41% (394/960) to 83% (822/991) before and after a session. The programme was well received with interest in continued engagement. CONCLUSION Training health workers and community Vaccine Champions can promote vaccine confidence. Programmes require government support and engagement for sustainability. Robust evaluation frameworks are needed to build the evidence base.
Collapse
Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- The University of Melbourne Department of Paediatrics, Parkville, Victoria, Australia
| | - Isabella Overmars
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - James Fong
- Republic of Fiji Ministry of Health, Suva, Rewa, Fiji
| | | | - Rachel Devi
- Republic of Fiji Ministry of Health, Suva, Rewa, Fiji
| | | | - Luisa Vodonaivalu
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Kylie Jenkins
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Julie Leask
- School of Public Health, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Yasmin Mohamed
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | | | | | | | - Michelle Dynes
- UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- The University of Melbourne Department of Paediatrics, Parkville, Victoria, Australia
| |
Collapse
|
15
|
Nuss H, Privor-Dumm L, Ukachukwu C, Hall LL. Building and Sustaining Flu Vaccine Acceptance and Trust in the Black Community through Partnerships with Churches, Salons, and Barbershops. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02141-7. [PMID: 39240452 DOI: 10.1007/s40615-024-02141-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 06/21/2024] [Accepted: 08/17/2024] [Indexed: 09/07/2024]
Abstract
Despite the benefits of flu vaccines, Black adults continue to experience lower vaccination rates in the United States. Contributing factors include lack of access to health care and trusted information about vaccines. The National Minority Quality Forum's Center for Sustainable Health Care Quality and Equity collaborated with church pastors, barbers, and hair stylists to disseminate a survey to their communities to assess barriers/facilitators to flu vaccine uptake. The population (n = 262) was mostly Black (93%), female (77%), between the age of 50-64 (39%) and vaccinated (73%). The most common reasons cited by respondents for being vaccinated were personal health, a habit of getting the shot, and a desire not to spread it to others. Among the unvaccinated (27%), the most common reasons for not vaccinating were lack of perceived need, concern the shot would make them sick, and that they do not normally get vaccinated. Vaccine knowledge and trust in health care providers' recommendations was higher amongst vaccinated individuals. Amongst the unvaccinated, trust was lower and there was a stronger belief that the vaccine would not prevent illness. Age was also associated with the likelihood of being vaccinated and greater vaccine knowledge and trust in provider recommendations. Unvaccinated individuals, particularly those under 54 years of age, did not hold strong distrust, attitudes were more neutral, and concern for others was moderate, suggesting an opportunity to target younger age groups. This study highlights the importance of trusted community messengers in conveying targeted messages on the safety and effectiveness of the flu vaccine.
Collapse
Affiliation(s)
- Henry Nuss
- New Orleans School of Public Health, LSU Health, Behavioral Community Health Sciences, New Orleans, LA, USA.
| | - Lois Privor-Dumm
- Johns Hopkins Bloomberg School of Public Health, International Vaccine Access Center, Baltimore, MD, USA
| | - Chinonso Ukachukwu
- Center for Sustainable Health Care Quality and Equity, National Minority Quality Forum, Washington, DC, USA
| | - Laura Lee Hall
- Center for Sustainable Health Care Quality and Equity, National Minority Quality Forum, Washington, DC, USA
| |
Collapse
|
16
|
Barr EA, Celniker JB, Ballantyne N. Advancing Vaccine Uptake in People With HIV: A Call for Research on Trust and Intellectual Humility in Health Care. J Assoc Nurses AIDS Care 2024; 35:456-459. [PMID: 39042495 PMCID: PMC11346704 DOI: 10.1097/jnc.0000000000000482] [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] [Indexed: 07/25/2024]
Abstract
ABSTRACT This article addresses the challenge of vaccine hesitancy among people with HIV (PWH), emphasizing the need for research on the potential impact of trust and intellectual humility in health care. It underscores the complexity of vaccine acceptance in PWH and the urgency of addressing hesitancy in PWH ahead of a future HIV vaccine. The article identifies trust in health care providers as a critical factor influencing vaccine uptake and proposes that providers who demonstrate intellectual humility-openly recognizing the limits of their knowledge-might enhance patient trust. The role of nurses is spotlighted because of their social positioning in the patient experience. The article advocates for interventions tailored to PWH's unique experiences and attitudes. Such strategies are essential for improving vaccine uptake and, consequently, public health outcomes.
Collapse
Affiliation(s)
- Emily A. Barr
- Emily A. Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, is an Assistant Professor at the University of Texas Health Science Center at Houston at the Cizik School of Nursing, Houston, Texas, USA. Jared B. Celniker, PhD, is Research Director at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA. Nathan Ballantyne, PhD, is Associate Professor of Philosophy, Cognition, and Culture at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA
| | - Jared B. Celniker
- Emily A. Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, is an Assistant Professor at the University of Texas Health Science Center at Houston at the Cizik School of Nursing, Houston, Texas, USA. Jared B. Celniker, PhD, is Research Director at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA. Nathan Ballantyne, PhD, is Associate Professor of Philosophy, Cognition, and Culture at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA
| | - Nathan Ballantyne
- Emily A. Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, is an Assistant Professor at the University of Texas Health Science Center at Houston at the Cizik School of Nursing, Houston, Texas, USA. Jared B. Celniker, PhD, is Research Director at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA. Nathan Ballantyne, PhD, is Associate Professor of Philosophy, Cognition, and Culture at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA
| |
Collapse
|
17
|
Ellingson MK, Brewer NT. Mental health and lower adolescent HPV vaccine coverage. Lancet Public Health 2024; 9:e642-e643. [PMID: 39214634 DOI: 10.1016/s2468-2667(24)00190-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Mallory K Ellingson
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
| |
Collapse
|
18
|
Carter A, Klinner C, Young A, Strnadová I, Wong H, Vujovich-Dunn C, Newman CE, Davies C, Skinner SR, Danchin M, Hynes S, Guy R. "I Thought It Was Better to Be Safe Than Sorry": Factors Influencing Parental Decisions on HPV and Other Adolescent Vaccinations for Students with Intellectual Disability and/or Autism in New South Wales, Australia. Vaccines (Basel) 2024; 12:922. [PMID: 39204045 PMCID: PMC11359071 DOI: 10.3390/vaccines12080922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/26/2024] [Accepted: 08/10/2024] [Indexed: 09/03/2024] Open
Abstract
The uptake of human papilloma virus (HPV) and other adolescent vaccinations in special schools for young people with disability is significantly lower than in mainstream settings. This study explored the factors believed to influence parental decision making regarding vaccine uptake for students with intellectual disability and/or on the autism spectrum attending special schools in New South Wales, Australia, from the perspective of all stakeholders involved in the program. Focus groups and interviews were conducted with 40 participants, including parents, school staff, and immunisation providers. The thematic analysis identified two themes: (1) appreciating diverse parental attitudes towards vaccination and (2) educating parents and managing vaccination questions and concerns. While most parents were described as pro-vaccination, others were anti-vaccination or vaccination-hesitant, articulating a marked protectiveness regarding their child's health. Reasons for vaccine hesitancy included beliefs that vaccines cause autism, concerns that the vaccination may be traumatic for the child, vaccination fatigue following COVID-19, and assumptions that children with disability will not be sexually active. Special school staff regarded the vaccination information pack as inadequate for families, and nurses described limited educational impact resulting from minimal direct communication with parents. More effective communication strategies are needed to address vaccine hesitancy among parents with children with disability.
Collapse
Affiliation(s)
- Allison Carter
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
- Australian Human Rights Institute, UNSW Sydney, Sydney, NSW 2052, Australia
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Christiane Klinner
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
| | - Alexandra Young
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
| | - Iva Strnadová
- School of Education, UNSW Sydney, Sydney, NSW 2052, Australia;
- Disability Innovation Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Horas Wong
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW 2050, Australia;
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia;
| | | | - Christy E. Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia;
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia; (C.D.); (S.R.S.)
- Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW 2050, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia; (C.D.); (S.R.S.)
| | - Margie Danchin
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Sarah Hynes
- Health Protection NSW, Sydney, NSW 2065, Australia;
| | - Rebecca Guy
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia; (C.K.); (A.Y.); (R.G.)
| |
Collapse
|
19
|
Sallam M, Athamneh RY, Alkhazaleh R, Alzayadneh L, Jaradat L, Majali T, Obeidat S, Shhab A, Hallit S, Barakat M, Mahafzah A. Attitude towards cholera vaccination and its related factors in Jordan amid the 2022 Middle East outbreak. BMC Public Health 2024; 24:2237. [PMID: 39152391 PMCID: PMC11330065 DOI: 10.1186/s12889-024-19768-0] [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: 02/06/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND An outbreak of cholera was reported in the Middle East by the second half of 2022. Raising public awareness and vaccination against cholera represent critical factors in the preventive efforts. The current study aimed to assess the knowledge of cholera and attitude towards its vaccination among a sample of the general public residing in Jordan. METHODS An online self-administered questionnaire was distributed to the residents in Jordan using a snowball convenience-based sampling approach. The questionnaire based on previously published studies included items to evaluate sociodemographic variables, knowledge about cholera symptoms, transmission, and prevention and the willingness to accept cholera vaccination. Additionally, four items based on the validated 5 C scale in Arabic were included to assess the psychological factors influencing attitude to cholera vaccination. RESULTS The final study sample comprised 1339 respondents, of whom 1216 (90.8%) heard of cholera before the study. Among those who heard of cholera, and on a scale from 0 to 20, the overall mean cholera Knowledge score (K-score) was 12.9 ± 3.8. In multivariate analysis, being over 30 years old and occupation as healthcare workers or students in healthcare-related colleges were significantly associated with a higher K-score compared to younger individuals and students in non-healthcare-related colleges. Overall, the acceptance of cholera vaccination if cases are recorded in Jordan, and if the vaccine is safe, effective, and provided freely was reported among 842 participants (69.2%), while 253 participants were hesitant (20.8%) and 121 participants were resistant (10.0%). In linear regression, the significant predictors of cholera vaccine acceptance were solely the three psychological factors namely high confidence, low constraints, and high collective responsibility. CONCLUSIONS In this study, the identified gaps in cholera knowledge emphasize the need to enhance educational initiatives. Although cholera vaccine acceptance was relatively high, a significant minority of the respondents exhibited vaccination hesitancy or resistance. The evident correlation between the psychological determinants and attitudes toward cholera vaccination emphasizes the need to consider these factors upon designing public health campaigns aimed at cholera prevention. The insights of the current study highlight the importance of addressing both knowledge gaps and psychological barriers to optimize cholera control strategies.
Collapse
Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, University Hospital, Queen Rania Al-Abdullah Street-Aljubeiha, P.O. Box: 13046, Amman, Jordan.
| | - Rabaa Y Athamneh
- Department of Medical Laboratories Sciences, Faculty of Allied Medical Sciences, Zarqa University, Zarqa, Jordan
| | | | | | - Laila Jaradat
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Tala Majali
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Sarah Obeidat
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Aseel Shhab
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
20
|
Vashist K, Yankey D, Elam-Evans LD, Mu Y, Valier MR, Pingali C, Hill HA, Santibanez TA, Singleton JA. Changes in vaccine hesitancy among parents of children aged 6 months - 17 Years, National Immunization Surveys, 2019-2022. Vaccine 2024; 42:125989. [PMID: 38806351 DOI: 10.1016/j.vaccine.2024.05.037] [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: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Vaccine hesitancy (VH) has been a major contributor to large outbreaks of vaccine-preventable diseases globally, including in the United States. METHODS Data from the 2019-2022 National Immunization Surveys were analyzed to assess parental hesitancy toward routine vaccination of their children aged 6 months -17 years. Joinpoint regression was employed to investigate trends in VH from 2019 to 2022 nationally overall and among socio-demographic subgroups. Using logistic regression, the difference between the prevalence of VH before and after the authorization of the COVID-19 vaccine for children aged 6 months-4 years, 5-11 years, and 12-17 years was computed. Both unadjusted and adjusted estimates were reported. VH was also compared within each socio-demographic subgroup with a reference level, at two-time points- before and after the authorization of the COVID-19 vaccine for each age group. RESULTS Overall, VH remained around 19.0 % from Q2 2019 to Q3 2022. Parents of non-Hispanic Black children had the largest average quarterly decrease in VH (β = -0.55; p < 0.05 by test for trend). After the authorization of the COVID-19 vaccine for children aged 6 months to 4 years, the adjusted percentage of children having parents that reported VH decreased by 2.2 (95 % CI: -3.9, -0.6) percentage points (pp) from 21.6 % to 19.4 %. Conversely, for children aged 5-11 years, VH increased by 1.2 (95 % CI: 0.2, 2.3) pp, from 19.8 % to 21.0 %. VH among parents of non-Hispanic Black children decreased after the authorization of the COVID-19 vaccine for adolescents aged 12-17 years but remained significantly higher compared to parents of non-Hispanic White children before and after authorization of the COVID-19 vaccine for all age groups. DISCUSSION About 1 in 5 children had parents reporting VH from 2019 to 2022. Parental VH increased after the authorization of the COVID-19 vaccine for children aged 5-11 years and declined for children aged 6 months-4 years.
Collapse
Affiliation(s)
- Kushagra Vashist
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - David Yankey
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurie D Elam-Evans
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yi Mu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Madeleine R Valier
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Cassandra Pingali
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Holly A Hill
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
21
|
Li Z, Feng L, Long J, Xiong Y, Li T, Jiang B, Yang S, Fu L, Shi Z, Zhao Y, Qi L. Increasing Influenza Vaccination Rates among Patients with Type 2 Diabetes Mellitus in Chongqing, China: A Cross-Sectional Analysis Using Behavioral and Social Drivers Tools. Vaccines (Basel) 2024; 12:898. [PMID: 39204024 PMCID: PMC11360589 DOI: 10.3390/vaccines12080898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/31/2024] [Accepted: 08/04/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Influenza vaccination is essential for type 2 diabetes mellitus (T2DM) patients due to their higher risks of severe complications and mortality from influenza. This study investigated the willingness of T2DM patients in Chongqing, China, to receive the influenza vaccination during the 2023/2024 season, using behavioral and social drivers (BeSD) tools to improve vaccination uptake in this high-risk group. METHODS A multi-stage sampling method was used to select participants, and face-to-face surveys were conducted in community health centers between March 1 and May 1, 2023. Binary logistic regression was used to analyze the factors influencing vaccination willingness, and standardized scores identified barriers and drivers. RESULTS Among 1672 T2DM patients, 11.7% had been vaccinated during the 2022/2023 season, and 59.6% were willing to receive the vaccination in the 2023/2024 season. Higher willingness was associated with ethnic minorities (odds ratio [OR], 3.18, 95% confidence interval [CI]: 1.58-6.39), being unemployed individuals (OR 2.69, 95% CI: 1.60-4.52), higher monthly household income per capita (OR 2.72, 95% CI: 1.65-4.50), having diabetes complications (OR 1.76, 95% CI: 1.23-2.51), sufficient vaccine knowledge (OR 1.87, 95% CI: 1.48-2.37), and previous vaccination (OR 7.75, 95% CI: 4.83-12.44). Concerning BeSDs, fear of infecting friends or family members and trust in vaccine efficacy were the predominant drivers, while high vaccine costs were the greatest barrier. CONCLUSIONS Future strategies should focus on improving vaccine knowledge, supporting healthcare workers and peer recommendations, and enhancing vaccination policies. Key interventions such as health education among high-risk groups, such as unemployed individuals, advocacy campaigns, pay-it-forward strategies, and policies for free vaccination could improve coverage in Chongqing.
Collapse
Affiliation(s)
- Zhourong Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China; (Z.L.); (J.L.); (Y.X.); (T.L.)
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (S.Y.); (L.F.); (Y.Z.)
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; (L.F.); (B.J.)
| | - Jiang Long
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China; (Z.L.); (J.L.); (Y.X.); (T.L.)
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing 400799, China
| | - Yu Xiong
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China; (Z.L.); (J.L.); (Y.X.); (T.L.)
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing 400799, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China; (Z.L.); (J.L.); (Y.X.); (T.L.)
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing 400799, China
| | - Binshan Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; (L.F.); (B.J.)
| | - Shuang Yang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (S.Y.); (L.F.); (Y.Z.)
| | - Lin Fu
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (S.Y.); (L.F.); (Y.Z.)
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar;
| | - Yong Zhao
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (S.Y.); (L.F.); (Y.Z.)
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China; (Z.L.); (J.L.); (Y.X.); (T.L.)
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing 400799, China
- Infectious Disease Control and Prevention, Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China
| |
Collapse
|
22
|
Coursey K, Muralidhar K, Srinivas V, Jaykrishna P, Begum F, Ningaiah N, Lee SJ, Madhivanan P. Acceptability of HPV vaccination for cervical cancer prevention amongst emerging adult women in rural Mysore, India: a mixed-methods study. BMC Public Health 2024; 24:2139. [PMID: 39112938 PMCID: PMC11304586 DOI: 10.1186/s12889-024-19485-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 07/15/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND India has the highest number of estimated deaths from cervical cancer globally, with most cases attributed to Human papillomavirus (HPV). The World Health Organization recommends primary HPV vaccination for girls ages 9-14, with catch-up vaccination for young women ≥ 15 if feasible. India authorized a new, inexpensive HPV vaccine in 2022; given anticipated vaccine expansion, we conducted a mixed-methods study exploring acceptability of HPV catch-up vaccination for young emerging adult women in rural Mysore, India. METHODS Between September 2022-April 2023, participants were recruited with assistance from community health workers. In the qualitative phase, gender-stratified, audio-recorded focus group discussions (FGDs) were conducted in Kannada with emerging adults ages 18-26. FGDs were transcribed, translated, and analyzed using rapid approach to identify key HPV vaccination attributes. In the quantitative phase, a conjoint analysis was conducted to assess the impact of seven vaccination attributes on likelihood to vaccinate (LTV). Women ages 18-26 ranked LTV in eight hypothetical vaccination scenarios, and the relative impact of each attribute on LTV was calculated. All participants received education about cervical cancer, HPV, and HPV vaccination. RESULTS Fifty-two young adults (female = 31, male = 21) participated in seven FGDs, and 101 women participated in the conjoint analysis. Average age of the 153 participants was 22.5 years, 66.7% had married, and all had completed high school. Only 17.9% had heard of cervical cancer, and 2.7% knew of the HPV vaccine. FGDs identified seven HPV vaccination attributes: cost, vaccination location, family support, peer influence, dose number, side effects, and risk of acquiring HPV. In the conjoint analysis, all attributes except dose number significantly impacted LTV. Family support (impact score = 19.37, p < 0.0001) and peer influence (impact score = 18.01, p < 0.0001) had the greatest influence, followed by cost (impact score = 16.64, p < 0.0001) and HPV risk (impact score = 12.31, p < 0.0001). Vaccination location (government centers preferred) and side effects were also significant. CONCLUSION Participants had poor knowledge of cervical cancer and HPV. Social attributes (family support, peer influence) had greatest impacts on LTV, and future studies should explore family-based interventions and peer education. Providing free vaccines at government centers through India's national immunization program would maximize catch-up HPV vaccination for rural young women.
Collapse
Affiliation(s)
- Kate Coursey
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
| | - Kiranmayee Muralidhar
- Public Health Research Institute of India, Mysore, Karnataka, 570020, India
- JSS Academy of Higher Education and Research, Mysuru, Karnataka, 570004, India
| | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, 570020, India
| | | | - Fazila Begum
- Public Health Research Institute of India, Mysore, Karnataka, 570020, India
| | | | - Sung-Jae Lee
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, 570020, India
- Department of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Mel & Enid, Tucson, AZ, 85724, USA
| |
Collapse
|
23
|
Ceccarelli A, Soro G, Reali C, Biguzzi E, Farneti R, Frassineti V, Angelini R, Belloli GL, Gori D, Montalti M. The Influence of Altitude, Urbanization, and Local Vaccination Centers on Vaccine Uptake within an Italian Health District: An Analysis of 15,000 Individuals Eligible for Vaccination. Vaccines (Basel) 2024; 12:875. [PMID: 39204001 PMCID: PMC11359255 DOI: 10.3390/vaccines12080875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/24/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024] Open
Abstract
In Italy, free vaccinations for Herpes Zoster (HZ), pneumococcal (PCV), and influenza (FLU) are recommended each year for individuals turning 65. Despite this, achieving optimal vaccination coverage remains challenging. This study assesses coverage rates for HZ, PCV, and FLU in Forlì, Northern Italy, and examines how altitude, urban planning, and health organization variables (such as the presence of a vaccination center) impact vaccine uptake. Vaccination coverages were calculated for birth cohorts between 1952 and 1958 for each municipality in the Forlì area as of 1 March 2024. The geographical factors influencing the vaccination uptake were extracted from the Italian National Institute of Statistics (ISTAT) records and evaluated through a multivariate analysis. The sample analyzed included 15,272 vaccine campaign targets from Forlì's province (185,525 citizens); the vaccine uptake rates for HZ, PCV, and FLU were 26.9%, 36.7%, and 43.5%, respectively. Gender did not appear to influence vaccine uptake. Living in a flat area appeared to increase vaccine uptake in a statistically significant way for all the vaccinations when compared to a mountainous area (HZ: OR: 1.50, PCV: OR: 1.33, FLU: OR: 1.67). The presence of a vaccine service in low-urbanized areas was shown to increase vaccine uptake for all vaccinations (HZ: OR: 1.65, PCV: OR: 1.93, FLU: OR: 1.53) compared with low-urbanized areas without a vaccination center or more urbanized areas with a vaccination center. This study emphasizes the significance of the territorial context, along with the ease of access to vaccinations and geographic barriers, as key determinants in achieving vaccination targets. Local health authorities should consider these factors when implementing vaccination campaigns.
Collapse
Affiliation(s)
- Andrea Ceccarelli
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Giorgia Soro
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Chiara Reali
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Emilia Biguzzi
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Roberta Farneti
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Valeria Frassineti
- Operative Unit of Hygiene and Public Health-Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Raffaella Angelini
- Operative Unit of Hygiene and Public Health-Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Gian Luigi Belloli
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
| | - Davide Gori
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Marco Montalti
- Operative Unit of Hygiene and Public Health—Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| |
Collapse
|
24
|
Willis DE, Purvis RS, Moore R, Li J, Selig JP, Imran T, Zimmerman S, McElfish PA. Social Processes and COVID-19 Vaccination of Children of Hesitant Mothers. J Community Health 2024; 49:700-707. [PMID: 38402520 DOI: 10.1007/s10900-024-01340-x] [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] [Accepted: 02/02/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Investigate relationships between pediatric COVID-19 vaccination and social processes of healthcare provider recommendations and school encouragement to provide insights into social processes that may support pediatric COVID-19 vaccination among hesitant mothers. METHODS We analyzed survey data from a subsample (n = 509) of vaccine-hesitant mothers to child patients (ages 2 to 17) in regional clinics across Arkansas. Data were collected between September 16th and December 6th, 2022. Full information maximum likelihood multivariable logistic regression was conducted to evaluate associations with pediatric COVID-19 vaccination. RESULTS Adjusted odds of pediatric COVID-19 vaccination were more than three times greater when a child's healthcare provider recommended vaccination compared to when they did not (aOR = 3.52; 95% CI[2.06, 6.01]). Adjusted odds of pediatric COVID-19 vaccination were 85% greater when a child's school encouraged parents to vaccinate compared to when the school did not (aOR = 1.85; 95% CI[1.13, 3.03]). CONCLUSIONS For pediatric COVID-19 vaccination, having a personal healthcare provider is not significantly different from having no personal healthcare provider if they do not recommend the child be vaccinated. PRACTICE IMPLICATIONS Clinical and public health interventions should consider social processes of healthcare provider recommendations and school encouragement.
Collapse
Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA.
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Tabasum Imran
- College of Medicine, University of Arkansas for Medical Sciences West, Fort Smith, AR, USA
| | - Stacy Zimmerman
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA
| |
Collapse
|
25
|
Sum Z, Sofija E, Sebar B. Exploring COVID-19 vaccine hesitancy among young adults in Australia. A qualitative study. Vaccine X 2024; 19:100515. [PMID: 39040885 PMCID: PMC11260859 DOI: 10.1016/j.jvacx.2024.100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
Background COVID-19 vaccine hesitancy among young adults in Australia is still poorly understood. Young adults aged 25-34 years have been identified as a population subgroup where COVID-19 vaccine-hesitant views are highly prevalent. Objective Exploring the attitudes, thoughts, feelings and social environments affecting the decision to have or not have the vaccine can provide vital transferrable lessons in future health campaigns. Methods A qualitative phenomenological study was conducted using semi-structured phone interviews between June 2021 and July 2021. Interview questions were adopted from the World Health Organization's guidance document 'Data for Action: Achieving High Uptake of COVID-19 Vaccines'. Participants aged 25-34 years (n = 26) were recruited via purposive and snowball sampling methods. Data were analysed thematically. Results Overall, participants presented themselves as highly vaccine literate, understanding their social contract with society. Many participants also did not display traditional vaccine-hesitant views. Six themes specifically regarding COVID-19 vaccine hesitancy were identified, namely (1) decision-making complexities, (2) perceived risk of COVID-19 infection, (3) media's misrepresentation of COVID-19, (4) vaccine-related issues, (5) inconsistent government messaging and program execution, and (6) social benefits assessment. In addition, motivators to COVID-19 vaccine uptake were classified into three categories: (1) tangible benefits, (2) protecting others, and (3) mandates and incentives. Findings suggest the motivators for COVID-19 vaccine uptake in young adults depend on individual benefits, highlighting the importance of recognising and addressing personal concerns. Conclusion There is a need to re-examine and redefine the meaning of vaccine hesitancy in young Australian adults. We offer an understanding of prospective challenges with vaccine hesitancy and potential solutions to address them. These include carefully tailored approaches regarding ongoing vaccine safety concerns and the expected personal benefits following vaccination. Combining these factors can aid in developing new methods of public engagement in the next public health crisis.
Collapse
Affiliation(s)
- Zachary Sum
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, 1 Parklands Dr, Southport, QLD 4222, Australia
| | - Ernesta Sofija
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, 1 Parklands Dr, Southport, QLD 4222, Australia
| | - Bernadette Sebar
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, 1 Parklands Dr, Southport, QLD 4222, Australia
| |
Collapse
|
26
|
Jia R, Coupland C, Vinogradova Y, Qureshi N, Turner E, Vedhara K. Mental health conditions and COVID-19 vaccine outcomes: A scoping review. J Psychosom Res 2024; 183:111826. [PMID: 38870550 DOI: 10.1016/j.jpsychores.2024.111826] [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: 11/21/2023] [Revised: 04/26/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Research shows that people with a history of mental health conditions were at increased risk of COVID-19 infection, hospitalisation, and mortality. However, the relationship between mental health conditions and COVID-19 vaccine outcomes such as vaccine intention, uptake and vaccine breakthrough is not yet well-understood. METHODS We conducted a systematic search on the topics of COVID-19 vaccine intentions, vaccine uptake, and vaccine breakthrough, in relation to mental health conditions (e.g., depression, schizophrenia), in four databases: PubMed, MEDLINE, SCOPUS, and PsychINFO, and the publication lists of Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), OpenSAFELY, and QResearch. Inclusion criteria focussed on studies reporting any of the aforementioned COVID-19 vaccine outcomes among people with mental health conditions. RESULTS Of 251 publications initially identified, 32 met our inclusion criteria. Overall, the evidence is inconclusive regarding the levels of intention to accept COVID-19 vaccines among people with mental health conditions. People with mental health conditions were more likely to have lower uptake of COVID-19 vaccines, compared to people without. Common barriers to COVID-19 vaccine uptake included concerns about the safety, effectiveness, and side effects of the vaccines. Limited evidence also suggests that vaccine breakthrough may be a particular risk for those with substance use disorder. CONCLUSIONS Evidence for the association between COVID-19 vaccine intentions and mental health conditions is mixed. Vaccine uptake might be lower in people with mental health conditions compared to people without, yielding interventions to encourage vaccine uptake in this population. Our understanding of COVID-19 vaccine breakthrough in this population also needs enhancing.
Collapse
Affiliation(s)
- Ru Jia
- Nuffield Department of Primary Care Health Sciences, Medical Science Division, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Carol Coupland
- Nuffield Department of Primary Care Health Sciences, Medical Science Division, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK; Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Yana Vinogradova
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Nadeem Qureshi
- Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Emma Turner
- Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK
| | - Kavita Vedhara
- School of Psychology, Cardiff University, Tower Building, Cardiff CF10 3AT, UK.
| |
Collapse
|
27
|
Bethke N, O'Sullivan JL, Keller J, von Bernuth H, Gellert P, Seybold J. Increasing vaccinations through an on-site school-based education and vaccination program: A city-wide cluster randomized controlled trial. Appl Psychol Health Well Being 2024; 16:1326-1348. [PMID: 38299711 DOI: 10.1111/aphw.12528] [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: 08/17/2023] [Accepted: 01/08/2024] [Indexed: 02/02/2024]
Abstract
Vaccination rates for mumps, measles, and rubella (MMR) and tetanus, diphtheria, pertussis, and polio (Tdap-IPV) fall short of global targets, highlighting the need for vaccination interventions. This study examines the effectiveness of a city-wide school-based educational vaccination intervention as part of an on-site vaccination program aimed at increasing MMR and Tdap-IPV vaccination rates versus on-site vaccination alone among sociodemographically diverse students from Berlin, Germany. The study was a 1:1 two-arm cluster randomized controlled trial, with schools randomly assigned to either the Educational Class Condition (ECC) or the Low-Intensity Information Condition (LIIC). Both received an on-site vaccination program, while students in the ECC received an additional educational unit. Primary outcomes were MMR and Tdap-IPV vaccination rates. In total, 6512 students from 25 randomly selected urban area secondary schools participated. For students providing their vaccination documents on the day of the intervention (2273, 34.9%), adjusted Poisson mixed models revealed significant between-group differences in favor of the ECC (MMR: logRR = 0.47, 95%CI [0.01,0.92], RR = 1.59; Tdap-IPV: logRR = 0.28, 95%CI [0.10,0.47], RR = 1.32). When adjusting for socioeconomic and migration background, between-group differences became non-significant for MMR but remained significant for Tdap-IPV. Findings suggest that educational, school-based on-site vaccination appears to be a promising strategy for increasing vaccination uptake in adolescents.
Collapse
Affiliation(s)
- Norma Bethke
- Medical Directorate, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Julie L O'Sullivan
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Mental Health (DZPG), Berlin/Potsdam, Germany
| | - Jan Keller
- Division of Health Psychology, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Immunology, Labor Berlin GmbH, Berlin, Germany
- Berlin Institute of Health, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Center for Mental Health (DZPG), Berlin/Potsdam, Germany
| | - Joachim Seybold
- Medical Directorate, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
28
|
Shiloh S, Peleg S, Nudelman G. Associations between vaccination and protective behaviors against COVID-19: transfer and redundancy effects as potential psychological mechanisms. PSYCHOL HEALTH MED 2024; 29:1296-1312. [PMID: 38240264 DOI: 10.1080/13548506.2024.2302331] [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: 11/29/2022] [Accepted: 01/02/2024] [Indexed: 07/06/2024]
Abstract
This study aimed to investigate mechanisms explaining associations between vaccination and protective health behaviors during the COVID-19 pandemic. The study used a secondary analysis of data from a longitudinal online study at four time points between April 2020 and March 2021. Two hundred and forty participants responded to questionnaires assessing adherence to multiple COVID-19 protection behaviors, COVID-19 vaccination, behavioral specific outcome expectancies and general healthy lifestyle. Statistical analyses included z statistic for differences between correlations and moderation analysis by the SPSS PROCESS macro. The correlation between initial adherence to protective behaviors prior to availability of vaccination and actual vaccination was positive, but when vaccination was available, the concurrent correlation between these behaviors was null. Healthy lifestyle and outcome expectancies moderated the association between vaccination and adherence to protection behaviors. These results were explained by a 'redundancy effect', conceptualized as beliefs that engagement in specific health behaviors justifies evading other health behaviors. The 'redundancy effect' cancelled the initial positive correlation between vaccination and protective health behaviors, produced by a 'transfer effect', based on similarities between the perceived purposes of those behaviors. Theoretical and practical implications of the findings were discussed.
Collapse
Affiliation(s)
- Shoshana Shiloh
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | - Gabriel Nudelman
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| |
Collapse
|
29
|
Girardini NA, Stopczynski A, Baranov O, Betsch C, Brockmann D, Lehmann S, Böhm R. Using smartphones to study vaccination decisions in the wild. PLOS DIGITAL HEALTH 2024; 3:e0000550. [PMID: 39116047 PMCID: PMC11309433 DOI: 10.1371/journal.pdig.0000550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/12/2024] [Indexed: 08/10/2024]
Abstract
One of the most important tools available to limit the spread and impact of infectious diseases is vaccination. It is therefore important to understand what factors determine people's vaccination decisions. To this end, previous behavioural research made use of, (i) controlled but often abstract or hypothetical studies (e.g., vignettes) or, (ii) realistic but typically less flexible studies that make it difficult to understand individual decision processes (e.g., clinical trials). Combining the best of these approaches, we propose integrating real-world Bluetooth contacts via smartphones in several rounds of a game scenario, as a novel methodology to study vaccination decisions and disease spread. In our 12-week proof-of-concept study conducted with N = 494 students, we found that participants strongly responded to some of the information provided to them during or after each decision round, particularly those related to their individual health outcomes. In contrast, information related to others' decisions and outcomes (e.g., the number of vaccinated or infected individuals) appeared to be less important. We discuss the potential of this novel method and point to fruitful areas for future research.
Collapse
Affiliation(s)
- Nicolò Alessandro Girardini
- Department of Information Engineering and Computer Science (DISI), University of Trento, Italy
- Mobile and Social Computing Lab (MobS), Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | - Olga Baranov
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- German Centre for Infection Research (DZIF), partner site Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Germany
| | - Cornelia Betsch
- Health Communication, Implementation Science, Bernhard Nocht Institute for Tropical Medicine, Germany
- Health Communication, Institute for Planetary Health Behaviour, University of Erfurt, Germany
| | - Dirk Brockmann
- Center Synergy of Systems AND Center for Interdisciplinary Digital Sciences AND Faculty of Biology AND Faculty of Physics, TUD Dresden University of Technology, Dresden, Germany
| | - Sune Lehmann
- Copenhagen Center for Social Data Science (SODAS), University of Copenhagen, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | - Robert Böhm
- Copenhagen Center for Social Data Science (SODAS), University of Copenhagen, Denmark
- Faculty of Psychology, University of Vienna, Austria
- Department of Psychology, University of Copenhagen, Denmark
| |
Collapse
|
30
|
Mäki KO, Karlsson LC, Kaakinen JK, Schmid P, Lewandowsky S, Antfolk J, Soveri A. COVID-19 and influenza vaccine-hesitancy subgroups. PLoS One 2024; 19:e0308159. [PMID: 39078836 PMCID: PMC11288446 DOI: 10.1371/journal.pone.0308159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/16/2024] [Indexed: 08/02/2024] Open
Abstract
Health communicators are faced with the challenge that people can hesitate vaccines for different reasons. Our aim was to identify and describe the qualities of distinct COVID-19 and influenza vaccine-hesitancy subgroups to facilitate the development of tailored vaccine-hesitancy communication. In two studies, we used agglomerative hierarchical cluster analysis to identify COVID-19 (N = 554) and influenza (N = 539) vaccine-hesitancy subgroups in the general population based on nine vaccine hesitancy-related variables (intent to get vaccinated, perceived vaccine safety, perceived vaccine efficacy, perceived disease threat, perceived vaccination responsibility, perceived vaccination convenience, distrust in authorities, conspiracy mentality, and reliance on anecdotal testimonies). We identified and described six distinct COVID-19 vaccine-hesitancy subgroups (the Vaccination Positive, the Ambivalent, the Fearing Skeptic, the Unconvinced, the Constrained Skeptic, and the Vaccination Opponent), and three influenza vaccine-hesitancy subgroups (the Vaccination Positive, the Complacent, and the Vaccination Opponent), with different levels of hesitancy. We discuss the implications of the results for health communicators. Our results shed light on the (dis)similarities between people who hesitate COVID-19 and influenza vaccines and suggest that there is greater variety in hesitancy concerning COVID-19 vaccinations than influenza vaccinations. These findings can be used to design and test tailored vaccination messages.
Collapse
Affiliation(s)
- Karl O. Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linda C. Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Johanna K. Kaakinen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- INVEST Research Flagship Centre, University of Turku, Turku, Finland
| | - Philipp Schmid
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Western Australia, Perth, Australia
- Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, Åbo Akademi University, Turku, Finland
| |
Collapse
|
31
|
Suragh TA, Adzrago D, Allicock MA, Yeh PG, Cuccaro P. Exploring the relationship between vaccine hesitancy and mothers' perspectives on COVID-19 vaccines for children ages 5-11 years during the omicron predominant period 2021-2022: a qualitative study. Front Public Health 2024; 12:1355452. [PMID: 39040866 PMCID: PMC11262113 DOI: 10.3389/fpubh.2024.1355452] [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: 12/14/2023] [Accepted: 06/11/2024] [Indexed: 07/24/2024] Open
Abstract
Background The United States Food and Drug Administration authorized COVID-19 vaccines for children ages 5-11 years in October 2021 during the Omicron predominant period. Parental vaccine hesitancy was prevalent during this time, resulting in low childhood COVID-19 vaccine uptake. Most studies exploring factors influencing parental vaccine hesitancy have focused on racial and ethnic minorities and lower socioeconomic populations; however, there is little knowledge of the drive drivers of vaccine hesitancy among White parents with higher education and socioeconomic statuses. Methods We conducted semi-structured interviews with a sample of 15 White mothers of children ages 5-11 years in Atlanta, GA, between October-December 2021. Thematic analysis was performed using NVivo 12. Results Mothers were college-educated, homeowners, and fully vaccinated against COVID-19. Key findings included decreased pediatrician's recommendations for COVID-19 vaccines, reliance on information from specialized doctors and scientists, distrust in public health authorities, high risk-perception of COVID-19 vaccines, and low risk-perception of COVID-19 disease. Factors related to vaccine acceptance were altruism and practicality. Conclusion This study adds to the sparse literature on reasons for vaccine hesitancy among White mothers of children ages 5-11 years with higher educational and socioeconomic status. Improving vaccine uptake among this group is critical for protecting the health of their children and other vulnerable populations. Tailored vaccine messaging and intervention are warranted to address their unique attitudes, beliefs, and behaviors. An enhanced understanding of the factors influencing subpopulations of parents can help vaccine policymakers and healthcare providers improve efforts to reduce vaccine hesitancy, particularly for new vaccines.
Collapse
Affiliation(s)
- Tiffany A. Suragh
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States
| | | | | | | | | |
Collapse
|
32
|
Shook LM, Rosen BL, Mara CA, Mosley C, Thompson AA, Smith-Whitley K, Schwartz L, Barriteau C, King A, Oke E, Jallow F, Murphy B, Crosby L. Attitudes, Beliefs, and Intention to Receive a COVID-19 Vaccine for Pediatric Patients With Sickle Cell Disease. J Pediatr Hematol Oncol 2024; 46:e305-e312. [PMID: 38775380 PMCID: PMC11188626 DOI: 10.1097/mph.0000000000002877] [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: 11/21/2023] [Accepted: 04/02/2024] [Indexed: 06/22/2024]
Abstract
Sickle cell disease (SCD), which occurs primarily in individuals of African descent, has been identified as a preexisting health condition for COVID-19 with higher rates of hospitalization, intensive care unit admissions, and death. National data indicate Black individuals have higher rates of vaccine hesitancy and lower COVID-19 vaccination rates. Understanding the key predictors of intention to receive a COVID-19 vaccine is essential as intention is strongly associated with vaccination behavior. This multisite study examined attitudes, beliefs, intentions to receive COVID-19 vaccines, and educational preferences among adolescents, young adults, and caregivers of children living with SCD. Participants completed an online survey between July 2021 and March 2022. Multivariate logistic regression was used to examine the association between participant age and COVID-19 vaccine attitudes, beliefs, and vaccine intentions. Of the 200 participants, 65.1% of adolescents, 62.5% of young adults, and 48.4% of caregivers intended to receive a COVID-19 vaccine for themselves or their child. Perception that the vaccine was safe was statistically significant and associated with patient and caregiver intention to receive the COVID-19 vaccine for themselves or their child. Participant age was also statistically significant and associated with the intent to get a booster for patients. Study findings highlight key concerns and influencers identified by patients with SCD and their caregivers that are essential for framing COVID-19 vaccine education during clinical encounters. Study results can also inform the design of messaging campaigns for the broader pediatric SCD population and targeted interventions for SCD subpopulations (eg, adolescents, caregivers).
Collapse
Affiliation(s)
- Lisa M. Shook
- Division of Hematology, Cancer and Blood Diseases Institute
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Brittany L. Rosen
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Constance A. Mara
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Cami Mosley
- Division of Hematology, Cancer and Blood Diseases Institute
| | - Alexis A. Thompson
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
- Division of Hematology
| | - Kim Smith-Whitley
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
- Division of Hematology
| | - Lisa Schwartz
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Christina Barriteau
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert Lurie Children's Hospital
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Allison King
- Department of Pediatric Hematology/Oncology, St. Louis Children’s Hospital
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO
| | - Eniola Oke
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert Lurie Children's Hospital
| | | | - Bridget Murphy
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Lori Crosby
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| |
Collapse
|
33
|
Shen Y, Wang J, Wang J, Nicholas S, Maitland E, Lv M, Yin T, Zhu D. Effectiveness of financial incentives on influenza vaccination among older adults in China: a randomized clinical trial. Clin Microbiol Infect 2024; 30:911-916. [PMID: 38341143 DOI: 10.1016/j.cmi.2024.02.004] [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: 11/28/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To investigate the short-term and long-term effectiveness of different levels of financial incentives on increasing the willingness to vaccinate and vaccine uptake. METHODS A randomized controlled trial was conducted to investigate the effectiveness of financial incentives of three groups with monetary incentives (CNY 20, CNY 40, and CNY 60; 1 CNY = 0.13 EUR) vs. a control group-CNY 0-on influenza vaccine uptake among 720 older adults (≥60 years) in Beijing, China. The primary outcome was vaccine uptake, and the secondary outcomes were intention to vaccinate and length of time to immunization. RESULTS Financial incentive significantly promoted higher intention to influenza vaccination (120/178 [67.42%] vs. 442/542 [81.55%]; Relative Risk [RR], 1.21; 95% CI, 1.02-1.42) and higher vaccination participation (74/178 [41.57%] vs. 316/542 [58.30%]; RR, 1.39; 95% CI, 1.10-1.75). CNY 60 had the largest impact on the intention to vaccinate (15.00% vs. 13.48% and 13.90%) and vaccination uptake (19.42% vs. 14.05% and 16.67%) compared with CNY 20 and CNY 40. Time to vaccination was significantly lower among participants receiving incentives than those without ([37.21 days; 95% CI, 34.33-39.99] vs. [48.27 days; 95% CI, 43.47-53.07]; Hazard Ratio [HR] 1.57, 95% CI 1.22-2.03). We found no long-term influence of financial incentives on vaccination decisions in the following year (217/542, 40.04% vs. 65/178, 36.52%; RR 1.08, 95% CI 0.82-1.42). DISCUSSION Our study suggests that modest financial incentives will boost short-term influenza vaccination rates and shorten the length of time to immunization in China. No one single-time financial incentive had a long-term effect on future vaccination behaviours or helped establish regular vaccination behaviours.
Collapse
Affiliation(s)
- Yang Shen
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingyu Wang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China; Center for Health Economics and Management at School of Economics and Management, Wuhan University, Wuhan, China
| | - Stephen Nicholas
- Health Services Research and Workforce Innovation Centre, Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia; Australian National Institite of Management and Commerce, Eveleigh, NSW, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China.
| | - Tao Yin
- Department of Technology, Capital Institute of Pediatrics, Beijing, China.
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China; International Research Center for Medicinal Administration (IRCMA), Peking University, Beijing, China.
| |
Collapse
|
34
|
Bates BR, Finkelshteyn S, Odunsi IA. 'We were having a rather long conversation about the uproar': memorable messages about COVID-19 vaccinations in a mostly young, white sample. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024; 17:143-153. [PMID: 37326437 DOI: 10.1080/17538068.2023.2223437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Interpersonal communication motivates many decisions related to COVID-19 prevention practices. Previous research shows that the frequency of interpersonal communication is significant. Less is known, however, about who messages interpersonal communication about COVID-19 and what information those messages convey. We sought to understand better these interpersonal communication messages for individuals who are asked to become vaccinated against COVID-19. METHODS Using a memorable messages approach, we interviewed 149 adults, mostly young, white, college students, about their vaccination choices as they were influenced by messages about vaccination they had received from respected members of their interpersonal networks. Date was analyzed using thematic analysis. RESULTS Three themes emerged from these interviews of primarily young, white, college students: a dialectic of feeling forced to become vaccinated vs. choice to become vaccinated; a tension between protecting oneself vs. protecting others through vaccination; and, finally, perceptions that family members who were also medical experts were particularly influential. CONCLUSIONS The dialectic between feelings of choice versus force may require further study into the longer-term impacts of messages that may prompt feelings of reactance and produce undesired outcomes. The dialectic between messages being remembered for their altruism as compared to their selfishness opens opportunities to consider the relative influence of these two impulses. These findings also provide insight into broader topics about countering vaccine hesitancy for other diseases. These findings may not be generalizable to older, more diverse populations.
Collapse
Affiliation(s)
- Benjamin R Bates
- School of Communication Studies, Scripps College of Communication, Ohio University, Athens, OH, USA
- Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Sheyla Finkelshteyn
- School of Communication Studies, Scripps College of Communication, Ohio University, Athens, OH, USA
| | | |
Collapse
|
35
|
Willis DE, Moore R, Selig JP, CarlLee S, Gurel-Headley MP, Cornett LE, McElfish PA. COVID-19 Booster Uptake: Are Hesitant Adopters Less Likely to Get a Booster Shot Than Nonhesitant Adopters? Behav Med 2024; 50:260-268. [PMID: 37722699 PMCID: PMC11229423 DOI: 10.1080/08964289.2023.2249168] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/10/2023] [Accepted: 08/09/2023] [Indexed: 09/20/2023]
Abstract
The main objective of this study was to assess whether hesitancy toward receiving the initial COVID-19 vaccine was associated with uptake of the COVID-19 booster several months after it became available to all US adults. We ask whether hesitancy toward the initial COVID-19 vaccine was significantly associated with lower odds of COVID-19 booster uptake among adults. We test this association within the context of the highly rural state of Arkansas. By January 2022, the US had set a global record of nearly 1 million daily cases. The purpose of this study was to advance our understanding of vaccine hesitancy among those who have already received a dose of the COVID-19 vaccine and how that hesitancy may shape COVID-19 booster uptake. We analyzed data from a random sample survey of Arkansan adults (N = 2,201) between March 1 and March 28, 2022 and constrained our analytical sample to those who had received a vaccine (N = 1,649). Nearly two-thirds of vaccinated Arkansas residents had received a COVID-19 booster. Hesitancy was common even among vaccinated individuals and was significantly associated with reduced odds of COVID-19 booster uptake, even after controlling for other factors. Findings provide further support for conceptualizing vaccine hesitancy as an attitude related to-but separate from-the behavior of vaccination, as opposed to conflating vaccination with being nonhesitant. Public health interventions aimed at increasing COVID-19 booster uptake should pay attention to vaccine hesitancy indicated at the initiation of the series and should not ignore the vaccinated as an important population to target for intervention.
Collapse
Affiliation(s)
- Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72762, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72762, USA
| | - James P. Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72762, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72762, USA
| | - Morgan P. Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Lawrence E. Cornett
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72762, USA
| |
Collapse
|
36
|
Purvis RS, Moore R, Willis DE, Li J, Selig JP, Kraleti S, Imran T, McElfish PA. Exploring Hesitancy, Motivations, and Practical Issues for COVID-19 Vaccination Among Vaccine-Hesitant Adopter Parents Using the Increasing Vaccination Model. J Pediatr Health Care 2024; 38:456-467. [PMID: 38430095 PMCID: PMC11222047 DOI: 10.1016/j.pedhc.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/12/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION COVID-19 vaccination coverage among children remains low, and many parents report being hesitant to get their children vaccinated. This study explores factors influencing hesitancy and the facilitators that helped hesitant adopter parents choose to vaccinate their children against COVID-19 despite their hesitancy. METHOD We use a qualitative descriptive design with individual interviews (n = 20) to explore COVID-19 vaccine hesitancy and facilitators of vaccination among hesitant adopter parents. The Increasing Vaccination Model domains (thoughts and feelings, social processes, and practical issues) provided the framework for initial coding, and the research team identified nine emergent themes. RESULTS Findings document the factors influencing hesitancy and the facilitators motivating COVID-19 vaccination among hesitant adopter parents. DISCUSSION Findings fill the gap in the literature by providing hesitant adopters' lived experience, perspectives on vaccine hesitancy, and the influential factors that helped participants overcome their hesitancy and choose to vaccinate their children against COVID-19.
Collapse
Affiliation(s)
- Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of
Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - James P. Selig
- Fay W. Boozman College of Public Health, University of
Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Shashank Kraleti
- College of Medicine, University of Arkansas for Medical
Sciences, Little Rock, AR, USA
| | - Tabasum Imran
- College of Medicine, University of Arkansas for Medical
Sciences West, Fort Smith, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical
Sciences Northwest, Springdale, AR, USA
| |
Collapse
|
37
|
Campos-Mercade P, Schneider FH. Monetary incentives for vaccination: effectiveness and unintended consequences. Clin Microbiol Infect 2024; 30:845-847. [PMID: 38556210 DOI: 10.1016/j.cmi.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Pol Campos-Mercade
- Department of Economics, Lund University and Institute for Future Studies, Lund, Sweden
| | - Florian H Schneider
- Department of Economics and Center for Economic Behavior and Inequality (CEBI), University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
38
|
Randell M, Wahyono TYM, Dynes M, Tinessia A, Li M, Danchin M, Oktarinda, Fitriyani F, Saraswati LD, Jenkins K, Aung KD, Noorzad AK, Shetye M, Dewi L, Yosephine P, Leask J, Sheel M. Service disruptions, trauma and burnout during the COVID-19 pandemic among healthcare providers delivering immunisation and maternal and child health services in Indonesia. BMJ Glob Health 2024; 9:e014318. [PMID: 38950913 PMCID: PMC11216070 DOI: 10.1136/bmjgh-2023-014318] [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: 10/23/2023] [Accepted: 06/07/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in extreme strain on health systems including the health workforce, essential health services and vaccination coverage. We examined disruptions to immunisation and maternal and child health (MCH) services, concerns of personal well-being and delivery of healthcare during the pandemic as well as factors associated with self-reported trauma or burnout among healthcare providers (HCPs). METHODS In March-April 2022, we conducted a cross-sectional survey among HCPs in two provinces of Indonesia. HCPs involved in COVID-19 or routine immunisation and MCH services were randomly selected from district/city health office registration lists. We descriptively analysed service disruptions experienced by HCPs as well as trauma, burnout and concerns of personal well-being and delivery of healthcare during the pandemic. Multivariate logistic regression analyses were undertaken to identify factors associated with trauma or burnout. RESULTS We recruited 604 HCPs. Mobilisation of staff from routine health services to COVID-19 response duties was a key reason for service disruptions (87.9%). Strategies such as community outreach and task shifting were implemented to overcome disruptions. Trauma or burnout during the pandemic was reported by 64.1% HCPs, with 23.5% reporting worse mental or emotional health.Factors associated with trauma or burnout included delivery of COVID-19 immunisation (adjusted OR (aOR) 2.54, 95% CI 1.08 to 5.94); and delivery of both COVID-19 immunisation and routine immunisation compared with no involvement in vaccination programmes (aOR 2.42, 95% CI 1.06 to 5.52); poor treatment in the workplace (aOR 2.26, 95% CI 1.51 to 3.38) and lower confidence to respond to patient queries on COVID-19 immunisation (aOR 1.51, 95% CI 1.03 to 2.22). CONCLUSION HCPs experienced service disruptions, trauma and burnout and implemented strategies to minimise disruptions to service delivery and improve patient experiences. Our study highlights the need to ensure that workforce resilience and strategies to protect and support HCPs are considered for pandemic planning, preparedness and management.
Collapse
Affiliation(s)
- Madeleine Randell
- The University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Tri Yunis Miko Wahyono
- Universitas Indonesia, Department of Epidemiology, Faculty of Public Health, Jakarta, Indonesia
| | - Michelle Dynes
- UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand
| | - Adeline Tinessia
- The University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Mu Li
- The University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Margie Danchin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Oktarinda
- Universitas Indonesia, Department of Epidemiology, Faculty of Public Health, Jakarta, Indonesia
| | - Fitriyani Fitriyani
- Universitas Indonesia, Department of Epidemiology, Faculty of Public Health, Jakarta, Indonesia
| | - Lintang Dian Saraswati
- Universitas Diponegoro, Department of Epidemiology, Faculty of Public Health, Semarang, Indonesia
| | - Kylie Jenkins
- The University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | | | | | | | - Lulu Dewi
- Ministry of Health of the Republic of Indonesia, Jakarta, Indonesia
| | - Prima Yosephine
- Ministry of Health of the Republic of Indonesia, Jakarta, Indonesia
| | - Julie Leask
- The University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Meru Sheel
- The University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| |
Collapse
|
39
|
Fisher CL, Mullis MD, McFarlane A, Hansen MD, Vilaro MJ, Bylund CL, Wiggins L, Corbitt H, Staras SAS. Promoting Rural-Residing Parents' Receptivity to HPV Vaccination: Targeting Messages and Mobile Clinic Implementation. Vaccines (Basel) 2024; 12:712. [PMID: 39066350 PMCID: PMC11281438 DOI: 10.3390/vaccines12070712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Interventions are needed to increase low HPV vaccination rates within rural areas in the United States, particularly in the state of Florida, which has the seventh highest number of HPV-related cancers. Florida also ranks low compared to other states in terms of HPV vaccination. Rural-residing parents may benefit from two evidence-based strategies to increase vaccination rates: reminder messages informing and prompting vaccination appointments and mobile clinics to reduce transportation barriers. We sought to identify parental attitudes towards (1) message features that promote rural-residing parents' receptivity to HPV vaccination; (2) parents' acceptability of three reminder message modalities (text, postcard, phone); and (3) implementation factors that promote parents' acceptability of using a mobile clinic for vaccination. We recruited 28 rural-residing parents of 9- to 12-year-old children (unvaccinated for HPV) for focus group and individual interviews and thematically analyzed transcripts. Three features promoted parents' receptivity to HPV vaccination messages: source credibility, specific information coverage, and personalization (name and birthday wishes). Parents most preferred text messages and identified three factors promoting parents' mobile clinic use: convenience and feasibility, trustworthiness, and detailed information. The findings indicate rural-residing parents' acceptability of reminder messages and mobile clinics as well as the importance of trust and feasibility when implementing these evidence-based strategies for rural-residing parents.
Collapse
Affiliation(s)
- Carla L. Fisher
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - M. Devyn Mullis
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - Antionette McFarlane
- Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL 32611, USA;
| | - Marta D. Hansen
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - Melissa J. Vilaro
- Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA;
| | - Carma L. Bylund
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - Lori Wiggins
- Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA; (L.W.); (H.C.)
| | - Halie Corbitt
- Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA; (L.W.); (H.C.)
| | - Stephanie A. S. Staras
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| |
Collapse
|
40
|
Werdin S, Neufeind J. The implementation of a new measles vaccine mandate in Germany: A qualitative study in local health departments. PLoS One 2024; 19:e0306003. [PMID: 38917137 PMCID: PMC11198778 DOI: 10.1371/journal.pone.0306003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Measles is a highly contagious disease with the potential for severe complications. Despite the availability of effective vaccines, there have been recurrent measles outbreaks in Germany over the past decades. In response, a new measles vaccine mandate was introduced on March 1, 2020, aimed at closing vaccination gaps in high-risk populations. This study evaluates the mandate's implementation, identifies operational challenges, assesses the impact of the Coronavirus disease 2019 pandemic, and investigates expert attitudes towards the new policy. METHODS Semi-structured expert interviews were conducted with staff members of 16 different local health departments in Germany. The interviews, carried out in April and May 2021, were electronically recorded, transcribed verbatim, and analyzed using the Framework method. RESULTS The implementation of the measles vaccine mandate in local health departments varied substantially. Challenges in implementing the mandate primarily arose from uncertainties regarding procedural specifics, such as handling fraudulent medical certificates and imposing sanctions, leading to a call from many interviewees for uniform guidelines to ensure coherent implementation. At the time the measles vaccine mandate came into force, managing the Coronavirus disease 2019 pandemic was a priority in most local health departments, often delaying the implementation of the mandate. Despite the difficulties encountered, most experts considered the mandate to be an effective step towards measles elimination. CONCLUSIONS The measles vaccine mandate has imposed a new responsibility on staff in German local health departments, which is associated with implementation challenges such as procedural uncertainties and vaccine hesitancy, but also the Coronavirus disease 2019 pandemic as a contextual impediment. Significant differences in the implementation approach underscore the need for harmonization to enhance implementation efficiency and public acceptance of the mandate. Despite the mandate's potential to increase vaccination rates, our findings advocate for a comprehensive approach, incorporating public education, accessible vaccination, and measures to address social disparities.
Collapse
Affiliation(s)
- Sophia Werdin
- Swiss Tropical and Public Health Institute, Swiss Centre for International Health, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Julia Neufeind
- Immunisation Unit, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
41
|
Yu H, Bonett S, Oyiborhoro U, Aryal S, Kim A, Kornides ML, Jemmott JB, Glanz K, Villarruel AM, Bauermeister JA. Psychosocial correlates of parents' willingness to vaccinate their children against COVID-19. PLoS One 2024; 19:e0305877. [PMID: 38913679 PMCID: PMC11195945 DOI: 10.1371/journal.pone.0305877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 06/05/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Public health guidance recommended that children who are 6 months or older be vaccinated against COVID-19 in June of 2022. In the U.S., 56% of children under 17 had not received the COVID-19 vaccination in 2023. We examine parents' willingness to vaccinate their children against COVID-19 using the theory of planned behavior in order to design effective strategies to promote vaccine uptake. METHODS The Philadelphia Community Engagement Alliance is part of an NIH community-engaged consortium focused on addressing COVID-19 disparities across the U.S. We surveyed 1,008 Philadelphia parents (mean age 36.86, SD 6.55; 42.3% racial/ethnic minorities) between September 2021 and February 2022, a period when guidance for child vaccination was anticipated. Structural Equation Modeling analysis examined associations between parental willingness and vaccine-related attitudes, norms, and perceived control. Covariates included parents' COVID-19 vaccination status, race/ethnicity, gender, and survey completion post-CDC pediatric COVID-19 vaccination guidelines. Subgroup analyses by race/ethnicity and gender were conducted. RESULTS Our model demonstrated good fit (χ2 = 907.37, df = 419, p<0.001; comparative fit index [CFI] = 0.951; non-normed fit index [NNFI] = 0.946; root mean square error of approximation [RMSEA] = 0.034 with 95% CI = 0.030-0.038). Attitudes ([Formula: see text] = 0.447, p<0.001) and subjective norms ([Formula: see text] = 0.309, p = 0.002) were predictors of intention. Racial/ethnic minority parents exhibited weaker vaccination intentions ([Formula: see text] = -0.053, p = 0.028) than non-Hispanic White parents. CONCLUSIONS Parents' attitudes and norms influence their vaccination intentions. Despite the survey predating widespread child vaccine availability, findings are pertinent given the need to increase and sustain pediatric vaccinations against COVID-19. Interventions promoting positive vaccine attitudes and prosocial norms are warranted. Tailored interventions and diverse communication strategies for parental subgroups may be useful to ensure comprehensive and effective vaccination initiatives.
Collapse
Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ufuoma Oyiborhoro
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Subhash Aryal
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Andrew Kim
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Melanie L. Kornides
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - John B. Jemmott
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Karen Glanz
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Antonia M. Villarruel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - José A. Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| |
Collapse
|
42
|
Adinugroho I, Stafford T, Bentall RP. The correlation between conspiracy mentality and vaccine intentions is moderated by social events: Evidence from longitudinal data during COVID-19 pandemic in the UK. Vaccine 2024; 42:3607-3614. [PMID: 38704262 DOI: 10.1016/j.vaccine.2024.04.071] [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: 11/01/2023] [Revised: 04/13/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
Social events may provide important cues that influence the sense of reality, including the perception that conspiracy theories are plausible. Using longitudinal panel data collected in the UK from March 2020 to December 2021, this study aims to identify whether social events influenced the strength of the association between conspiracy mentality and vaccine intentions during the COVID-19 pandemic. Consistent with previous research, the conspiracy mentality was a significant predictor of vaccine intentions across three-time points, but also that conspiracy mentality measured in March 2020 predicted that participants were more hesitant to the vaccines in December 2020. The primary finding was that different social events moderated the strength of the correlation between conspiracy mentality and vaccine intentions within similar participants. Conspiracy mentality became more vital to evaluate COVID-19 vaccines in December 2020, when the vaccination program was about to commence.
Collapse
Affiliation(s)
- Indro Adinugroho
- Department of Psychology, University of Sheffield, Sheffield, UK; Faculty of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
| | - Tom Stafford
- Department of Psychology, University of Sheffield, Sheffield, UK.
| | | |
Collapse
|
43
|
Abad N, Bonner KE, Huang Q, Baack B, Petrin R, Das D, Hendrich MA, Gosz MS, Lewis Z, Lintern DJ, Fisun H, Brewer NT. Behavioral and social drivers of COVID-19 vaccination initiation in the US: a longitudinal study March─ October 2021. J Behav Med 2024; 47:422-433. [PMID: 38587765 PMCID: PMC11026250 DOI: 10.1007/s10865-024-00487-1] [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: 09/28/2023] [Accepted: 03/15/2024] [Indexed: 04/09/2024]
Abstract
Many studies have examined behavioral and social drivers of COVID-19 vaccination initiation, but few have examined these drivers longitudinally. We sought to identify the drivers of COVID-19 vaccination initiation using the Behavioral and Social Drivers of Vaccination (BeSD) Framework. Participants were a nationally-representative sample of 1,563 US adults who had not received a COVID-19 vaccine by baseline. Participants took surveys online at baseline (spring 2021) and follow-up (fall 2021). The surveys assessed variables from BeSD Framework domains (i.e., thinking and feeling, social processes, and practical issues), COVID-19 vaccination initiation, and demographics at baseline and follow-up. Between baseline and follow-up, 65% of respondents reported initiating COVID-19 vaccination. Vaccination intent increased from baseline to follow-up (p < .01). Higher vaccine confidence, more positive social norms towards vaccination, and receiving vaccine recommendations at baseline predicted subsequent COVID-19 vaccine initiation (all p < .01). Among factors assessed at follow-up, social responsibility and vaccine requirements had the greatest associations with vaccine initiation (all p < .01). Baseline vaccine confidence, social norms, and vaccination recommendations were associated with subsequent vaccine initiation, all of which could be useful targets for behavioral interventions. Furthermore, interventions that highlight social responsibility to vaccinate or promote vaccination requirements could also be beneficial.
Collapse
Affiliation(s)
- Neetu Abad
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Brittney Baack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Dhiman Das
- Ipsos US Public Affairs, Washington, DC, USA
| | | | | | | | | | - Helen Fisun
- Ipsos US Public Affairs, Washington, DC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
44
|
Dodoo CC, Hanson-Yamoah E, Adedia D, Erzuah I, Yamoah P, Brobbey F, Cobbold C, Mensah J. Using machine learning algorithms to predict COVID-19 vaccine uptake: A year after the introduction of COVID-19 vaccines in Ghana. Vaccine X 2024; 18:100466. [PMID: 38444651 PMCID: PMC10911946 DOI: 10.1016/j.jvacx.2024.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
The impact of vaccine hesitancy on global health is one that carries dire consequences. This was evident during the outbreak of the COVID-19 pandemic, where numerous theories and rumours emerged. To facilitate targeted actions aimed at increasing vaccine acceptance, it is essential to identify and understand the barriers that hinder vaccine uptake, particularly regarding the COVID-19 vaccine in Ghana, one year after its introduction in the country. We conducted a cross-sectional study utilizing self-administered questionnaires to determine factors, including barriers, that predict COVID-19 vaccine uptake among clients visiting a tertiary and quaternary hospital using some machine learning algorithms. Among the findings, machine learning models were developed and compared, with the best model employed to predict and guide interventions tailored to specific populations and contexts. A random forest model was utilized for prediction, revealing that the type of facility respondents visited and the presence of underlying medical conditions were significant factors in determining an individual's likelihood of receiving the COVID-19 vaccine. The results showed that machine learning algorithms can be of great use in determining COVID-19 vaccine uptake.
Collapse
Affiliation(s)
| | - Ebo Hanson-Yamoah
- School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - David Adedia
- School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Irene Erzuah
- School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Peter Yamoah
- School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | | | | | | |
Collapse
|
45
|
Rosen BL, Meisman A, Sun Q, Real FJ, Steller A, Chandler E, Crosby L, Frenck R, Klein M, Kahn JA. Factors Associated With Racially and Ethnically Diverse Sample of Adolescents, Young Adults, and Parents' Intention to Receive a COVID-19 Vaccine. Am J Health Promot 2024; 38:672-682. [PMID: 38343081 DOI: 10.1177/08901171241233397] [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] [Indexed: 05/08/2024]
Abstract
PURPOSE Identify variables, including moderating variables, associated with adolescents, young adults, and parents' intention to receive a COVID-19 vaccine in January 2021. DESIGN Cross-sectional survey. SETTING United States Midwestern academic medical center. SAMPLE Adolescents (n = 242); young adults (n = 333); parents (n = 563). MEASURES Associations between predictors-participant characteristics, general vaccine hesitancy, COVID-19 and vaccine knowledge, perceptions, and normative beliefs-and intention to receive a COVID-19 vaccine (outcome) were assessed. To determine variables impacting the strength of the relationship between predictors and outcome, moderators included 2020/2021 influenza vaccine receipt, having experienced discrimination, and primary sources of information for COVID-19. ANALYSIS Multivariable logistic regression examined associations, including moderating effects, for adolescents, young adults, parents, and parents for child. RESULTS With 20,231 email addresses receiving the survey, 1138 participants were included in the analysis. Intention to receive a COVID-19 vaccine was reported by 60.7% adolescents (n = 147), 65.2% young adults (n = 217), and 38.5% parents (n = 217) and 38.2% parents (n = 215) intended to vaccinate their child. Intention was associated with lower general vaccine hesitancy for adolescents (AOR = 1.50), young adults (AOR = 1.39), parents (AOR = 1.18), and parents' intention for their child (AOR = 1.17). Parents citing reputable medical experts as primary source of COVID-19 information positively moderated vaccine perceptions and intention for self (AOR = 8.25) and child (AOR = 6.37). CONCLUSION Clinician training to address vaccine hesitancy may be effective at promoting positive COVID-19 vaccine perceptions.
Collapse
Affiliation(s)
- Brittany L Rosen
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrea Meisman
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Quin Sun
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Alyssa Steller
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emmanuel Chandler
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lori Crosby
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Robert Frenck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melissa Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica A Kahn
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
46
|
MacDonald SE, Reifferscheid L, Paudel YR, Robinson J. Patterns in COVID-19 vaccination among children aged 5-11 years in Alberta, Canada: Lessons for future vaccination campaigns. PUBLIC HEALTH IN PRACTICE 2024; 7:100467. [PMID: 38318226 PMCID: PMC10838944 DOI: 10.1016/j.puhip.2024.100467] [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: 09/26/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
Objectives In Alberta, Canada, the COVID-19 vaccination program for children aged 5-11 years was launched on November 26, 2021. Our objectives were to determine the cumulative vaccine coverage, stratified by age, during the first thirteen months of vaccine availability, and investigate factors associated with vaccine uptake. Study design This retrospective cohort study used population-based administrative health data. Methods We determined cumulative vaccine coverage among 5-11 year olds, stratified by year of age, during the first thirteen months of vaccine availability and used a modified Poisson regression to evaluate factors associated with vaccine uptake. Results Of 377,103 eligible children, 44.8 % (n = 168,761) received one or more doses of COVID-19 vaccine during the study period (9.7 % received only one dose, while 35.1 % received 2 doses). Almost 90 % of initial doses were received within the first two months of vaccine availability. We found a step-wise relationship between increasing child age and higher vaccine coverage. Conclusions Plateaued vaccine uptake indicates a need to adapt programmatic efforts to encourage parents to act on positive vaccination intentions, and reach the large contingent of parents who have reported that they remain undecided. In order to promote vaccine uptake, messaging around vaccine safety and need should be tailored to child age, rather than uniformly applied across the 5-11 year age range.
Collapse
Affiliation(s)
- Shannon E. MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Yuba Raj Paudel
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Joan Robinson
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
47
|
Shen Y, Wang J, Zhao Q, Lv M, Wu J, Nicholas S, Maitland E, He P, Zhu D. Predicting future vaccination habits: The link between influenza vaccination patterns and future vaccination decisions among old aged adults in China. J Infect Public Health 2024; 17:1079-1085. [PMID: 38705060 DOI: 10.1016/j.jiph.2024.04.017] [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: 01/26/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Annual influenza vaccination is crucially recommended for the elderly to maintain humoral immunity. Insufficient coverage requires us to understand the determinants of their influenza behaviors and how these patterns impact vaccination choices. METHODS Data from 540 Beijing residents aged over 65 were collected through interviews, capturing vaccination history and sociodemographic details. Individual influenza vaccination records from 2016 to 2020 were obtained from China's Immunization Information Systems. A latent class model identified three vaccination patterns. Multinomial logistic regression assessed relative risk ratios (RRRs) for vaccination based on sociodemographic factors. Vaccination patterns were used to predict future vaccination likelihood. RESULTS The analysis revealed three groups: sporadically vaccinated (63.33%), occasionally vaccinated (18.71%), and frequently vaccinated (17.96%). Factors associated with frequent vaccination included age over 70 (RRR = 2.81), lower income (RRR = 0.39), higher vaccine hesitancy (RRR = 3.10), multiple chronic conditions (RRR = 2.72), and rural residence (RRR = 2.48). The frequently vaccinated group was more likely to sustain regular vaccination habits in subsequent years compared to the occasionally vaccinated group. CONCLUSIONS Only 17.96% of Beijing's older population exhibited a consistent influenza vaccination pattern. Older age, rural residency, and chronic diseases correlated with repeated influenza vaccination. Segmenting the population based on past vaccination behavior can aid in designing targeted interventions to improve vaccination rates.
Collapse
Affiliation(s)
- Yang Shen
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingyu Wang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Quiping Zhao
- Xiaotao Municipal Center for Disease Control and Prevention, 9 Xiantao Avenue, Xiantao, Hubei 433000, China
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jiang Wu
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Stephen Nicholas
- Health Services Research and Workforce Innovation centre, Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia; Australian National Institute of Management and Commerce, 1 Central Avenue Australian Technology Park, Sydney, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China.
| | - Dawei Zhu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, No. 38 Yueyuan Road, Haidian District, Beijing 100191, China; International Research Center for Medicinal Administration (IRCMA), Peking University, No. 38 Yueyuan Road, Haidian District, Beijing 100191, China.
| |
Collapse
|
48
|
Moore R, Purvis RS, Willis DE, Li J, Selig JP, Ross J, McElfish PA. Influences on COVID-19 booster uptake among adults intending to receive a booster: a qualitative study. Health Promot Int 2024; 39:daae067. [PMID: 38902983 PMCID: PMC11190055 DOI: 10.1093/heapro/daae067] [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] [Indexed: 06/22/2024] Open
Abstract
Bivalent COVID-19 vaccine boosters have been recommended for all Americans 12 years of age and older. However, uptake remains suboptimal with only 17% of the United States (US) population boosted as of May 2023. This is a critical public health challenge for mitigating the ongoing effects of COVID-19 infection. COVID-19 booster uptake is not currently well understood, and few studies in the US have explored the vaccination process for booster uptake in a 'post-pandemic' context. This study fills gaps in the literature through qualitative analysis of interviews with a racially/ethnically diverse sample of Arkansans who received the COVID-19 vaccine main series and expressed intent to receive a booster (n = 14), but had not yet received the COVID-19 booster at the time we recruited them. All but one did not receive the booster by the time of the interview. Participants described influences on their vaccination behavior and uptake of boosters including reduced feelings of urgency; continued concerns about the side effects; social contagion as a driver of urgency; increasing practical barriers to access and missing provider recommendations. Our findings highlight the importance of considering vaccination as an ongoing, dynamic process drawing on past/current attitudes, prior experience, perceptions of risk and urgency and practical barriers. Based on these findings, healthcare providers should continue to provide strong, consistent recommendations for COVID-19 boosters to patients, even among those with histories of vaccine uptake.
Collapse
Affiliation(s)
- Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Jeanne Ross
- College of Medicine, University of Arkansas for Medical Sciences Northeast, 311 E. Matthews St., Jonesboro, AR 72401, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| |
Collapse
|
49
|
Nowak GJ, Bradshaw AS, Head KJ. Contributions and Impact of Health Communication Research to Vaccination Efforts and Acceptance. HEALTH COMMUNICATION 2024:1-7. [PMID: 38818795 DOI: 10.1080/10410236.2024.2361584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Vaccines (a medical product) and vaccination recommendations (expert advice on who should receive, when, and how often) have grown in importance and prominence in the past 15 years, including because of a recent COVID-19 pandemic. This essay highlights contributions from vaccine and vaccination-related health communication research since 2010. This research has had significant impacts - that is, visible and discernible positive effects - on the ways health communication is undertaken broadly (e.g. at the campaign level) and at the health care provider-patient level (e.g. conversations with parents and patients regarding vaccine benefits, risks, and safety). As this essay illustrates, health communication research has resulted in greater use of formative research to guide vaccination campaign and education efforts, better identification and understanding of the factors behind vaccination delay and declination, and greater recognition that communication efforts can fail to achieve desired outcomes or generate unintended consequences. Health communication research has also documented the powerful influence of healthcare provider communication on parent and patient understanding and compliance with immunization recommendations. Importantly, this research has also shown the characteristics of provider-patient communication matter much. Healthcare providers must have or establish a high degree of trust, be well-versed in vaccine efficacy and safety, and be adept at using their personal experiences, information tailoring/personalization, and evidence-based communication strategies to increase the likelihood of success.
Collapse
Affiliation(s)
- Glen J Nowak
- Center for Health & Risk Communication, Grady College of Journalism & Mass Communication, University of Georgia
| | - Amanda S Bradshaw
- Integrated Marketing Communications, School of Journalism and New Media, The University of Mississippi
| | - Katharine J Head
- Department of Communication Studies and Health Communication, School of Liberal Arts, Indiana University Indianapolis
| |
Collapse
|
50
|
Zhang N, Ma Q, Zhang X, Huang Q. Implicit theories of health predict HPV vaccination intention among young adult Chinese women: The mediating effect of consideration of future consequences and future self-continuity. J Health Psychol 2024:13591053241253065. [PMID: 38767276 DOI: 10.1177/13591053241253065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
This study investigated the predicting effect of implicit theories of health on HPV vaccination intention among young adult Chinese women and its underlying mechanisms. Four-hundred and eighty-three young Chinese women adults (18-26 years old) participated this study by completing measures on implicit theories of health, consideration of future consequences, future self-continuity, and reported their HPV vaccination intention. The results demonstrated that age, whether they knew someone being diagnosed with cancer, implicit (incremental) theories of health, consideration of future consequences (CFC-Future), and future self-continuity significantly predicted young adult Chinese women's HPV vaccination intention. The predicting effect of implicit theories of health was mediated by consideration of future consequences and future self-continuity. Implications of the current research for promoting HPV vaccination among young adult women and directions for future research are discussed.
Collapse
Affiliation(s)
- Ning Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Qinghua Ma
- The Third Hospital of Xiangcheng District, China
| | - Xiaoying Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Qing Huang
- College of Media and International Culture, Zhejiang University, China
| |
Collapse
|