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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.
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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
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McCollum G, Allgood A, Agne A, Cleveland D, Gray C, Ford E, Baral S, Mugavero M, Hall AG. Associations Between Social Networks and COVID-19 Vaccine Uptake in 4 Rural Alabama Counties: Survey Findings. Public Health Rep 2024:333549241250223. [PMID: 38780015 DOI: 10.1177/00333549241250223] [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: 05/25/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic demonstrated how vaccination decisions are influenced by misinformation, disinformation, and social pressures, leading to varied and inequitable uptake rates. In this study, we examined how COVID-19 vaccine messages received via social networks were associated with vaccine uptake in rural Alabama. METHODS From November 2021 through March 2022, we collected 700 responses to a telephone survey administered in 4 rural Alabama counties. We asked respondents to indicate whether certain social relationships (eg, family, businesses) tried to influence them to (1) obtain or (2) avoid a COVID-19 vaccine. We used χ2 tests, Kruskal-Wallis tests, Mantel-Haenszel χ2 tests, and Fisher exact tests to examine the associations between vaccination status and survey responses. RESULTS Respondents in majority-African American counties were significantly more likely than those in majority-White counties to have received ≥1 dose of COVID-19 vaccine (89.8% vs 72.3%; P < .001). Respondents who received ≥1 dose had a significantly higher mean age than those who had not (58.0 vs 39.0 years; P < .001). Respondents who were encouraged to get vaccinated by religious leaders were more likely to have received ≥1 dose (P = .001), and those who were encouraged to avoid vaccination by family (P = .007), friends (P = .02), coworkers (P = .003), and health care providers (P < .001) were less likely to have received ≥1 dose. Respondents with more interpersonal relationships that encouraged them to avoid vaccination were more likely to be unvaccinated (P < .001). CONCLUSIONS Interpersonal relationships and demographic characteristics appeared to be important in COVID-19 vaccine decision-making in rural Alabama. Further research needs to identify how to facilitate vaccine-positive interpersonal relationships, such as peer mentoring and trusted messenger interventions.
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Affiliation(s)
- Greer McCollum
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ashleigh Allgood
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April Agne
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dave Cleveland
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cicily Gray
- Community Health Program, Department of Health and Human Services, School of Education, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric Ford
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stefan Baral
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Michael Mugavero
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allyson G Hall
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Are EB, Card KG, Colijn C. The role of vaccine status homophily in the COVID-19 pandemic: a cross-sectional survey with modelling. BMC Public Health 2024; 24:472. [PMID: 38355444 PMCID: PMC10868109 DOI: 10.1186/s12889-024-17957-5] [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: 06/05/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Vaccine homophily describes non-heterogeneous vaccine uptake within contact networks. This study was performed to determine observable patterns of vaccine homophily, as well as the impact of vaccine homophily on disease transmission within and between vaccination groups under conditions of high and low vaccine efficacy. METHODS Residents of British Columbia, Canada, aged ≥ 16 years, were recruited via online advertisements between February and March 2022, and provided information about vaccination status, perceived vaccination status of household and non-household contacts, compliance with COVID-19 prevention guidelines, and history of COVID-19. A deterministic mathematical model was used to assess transmission dynamics between vaccine status groups under conditions of high and low vaccine efficacy. RESULTS Vaccine homophily was observed among those with 0, 2, or 3 doses of the vaccine. Greater homophily was observed among those who had more doses of the vaccine (p < 0.0001). Those with fewer vaccine doses had larger contact networks (p < 0.0001), were more likely to report prior COVID-19 (p < 0.0001), and reported lower compliance with COVID-19 prevention guidelines (p < 0.0001). Mathematical modelling showed that vaccine homophily plays a considerable role in epidemic growth under conditions of high and low vaccine efficacy. Furthermore, vaccine homophily contributes to a high force of infection among unvaccinated individuals under conditions of high vaccine efficacy, as well as to an elevated force of infection from unvaccinated to suboptimally vaccinated individuals under conditions of low vaccine efficacy. INTERPRETATION The uneven uptake of COVID-19 vaccines and the nature of the contact network in the population play important roles in shaping COVID-19 transmission dynamics.
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Affiliation(s)
- Elisha B Are
- Mathematics, Simon Fraser University, Burnaby, BC, Canada.
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada.
| | - Kiffer G Card
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Institute for Social Connection, Victoria, BC, Canada
| | - Caroline Colijn
- Mathematics, Simon Fraser University, Burnaby, BC, Canada
- Pacific Institute On Pathogens, Pandemics and Society (PIPPS), Simon Fraser University, Burnaby, BC, Canada
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Huang X, Lin Z, Qin J, Yu D, Zhang F, Fang G, Chen X, He J, Cen P, Li M, Zhang R, Luo T, Jiang J, An S, Liang H, Ye L, Liang B. Willingness to accept monkeypox vaccine and its correlates among men who have sex with men in Southern China: a web-based online cross-sectional study. Front Public Health 2024; 12:1289918. [PMID: 38384873 PMCID: PMC10879393 DOI: 10.3389/fpubh.2024.1289918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Background The May 2022 global outbreak of monkeypox (MPX) poses a threat to the health of men who have sex with men. However, there is limited data on the willingness of MSM to receive monkeypox vaccination in Southern China. This study aimed to assess the knowledge of MPX, concerns regarding MPX, and willingness to receive monkeypox vaccination, as well as their correlates, among MSM in China. Methods We conducted a Web-based online survey of MSM in Southern China from August to September 2022. Data were collected on the socio-demographic characteristics, knowledge, worries, concerns regarding MPX and willingness to receive monkeypox vaccination. Multivariate logistic regression was employed to explore the factors associated with willingness to receive monkeypox vaccination. Results A total of 1903 participants completed the survey. Among them, approximately 69.9% reported being aware of MPX awareness, 94.1% of the participants supported the promotion of monkeypox vaccination. The majority of participants (91.4%) expressed their willingness to receive monkeypox vaccination. Participants who considered monkeypox vaccination safe [adjusted odds ratio (aOR) = 4.82, 95% CI: 1.35-17.18], agreed on the necessity of government promotion of monkeypox vaccination in China (aOR = 6.03, 95% CI: 1.07-33.93), believed in prioritizing monkeypox vaccination for MSM (aOR = 5.01, 95% CI: 1.10-22.71), and had friends or sexual partners who had already received the monkeypox or smallpox vaccination (aOR = 10.37, 95% CI: 2.11-50.99) are more likely to be vaccinated. Conversely, married individuals (aOR = 0.13, 95% CI: 0.03-0.47), those engaging in anal sex 4-6 times per week in the past 3 months (aOR = 0.26, 95% CI: 0.09-0.77) expressed hesitancy toward monkeypox vaccination. Conclusion There was a high willingness to receive monkeypox vaccination among MSM in China. The hesitancy toward the monkeypox vaccine can be effectively mitigated by addressing concerns about its safety and potential adverse reactions. Moreover, increasing acceptance of the monkeypox vaccination among MSM and their peers is crucial, as social influence significantly impacts vaccine attitudes and behaviors.
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Affiliation(s)
- Xinju Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhifeng Lin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiao Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Dee Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Fei Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ganggang Fang
- Kaiyuan Center for Disease Control and Prevention, Kaiyuan, Yunnan, China
| | - Xi Chen
- Sanya Center for Disease Control and Prevention, Sanya, Hainan, China
| | - Jinfeng He
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Mu Li
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Rongjing Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Tong Luo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Sanqi An
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
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Kreuter MW, Butler T, Kinzer H, Carter T, Laker PA, Caburnay C, Olagoke A, Skinner K, Broadus D, Davis MH. Addressing COVID-19 Vaccine Hesitancy With Community Distribution of Conversation Cards. Am J Public Health 2024; 114:S87-S91. [PMID: 38207273 PMCID: PMC10785187 DOI: 10.2105/ajph.2023.307481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 01/13/2024]
Abstract
To increase community conversations about COVID-19 vaccine hesitancy, we distributed vaccine cardholders and conversation cards to 6000 newly vaccinated adults at vaccination sites and encouraged them to talk with unvaccinated friends and family members. In 257 onsite exit interviews, we found that cardholders and conversation cards were well liked, and most recipients expected to use them. Follow-up surveys two weeks later showed that 51% of respondents used a card to start a conversation and 41% gave a card to an unvaccinated friend or family member. (Am J Public Health. 2024;114(S1):S87-S91. https://doi.org/10.2105/AJPH.2023.307481).
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Affiliation(s)
- Matthew W Kreuter
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Taylor Butler
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Hannah Kinzer
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Tyla Carter
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Penina Acayo Laker
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Charlene Caburnay
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Ayokunle Olagoke
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Karen Skinner
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Damon Broadus
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
| | - Matifadza Hlatshwayo Davis
- Matthew W. Kreuter, Taylor Butler, Hannah Kinzer, Tyla Carter, Charlene Caburnay, Ayokunle Olagoke, and Karen Skinner are with the Health Communication Research Laboratory, the Brown School, Washington University in St. Louis, St. Louis, MO. Penina Acayo Laker is with the Health Communication Design Studio, Sam Fox School of Design, Washington University in St. Louis. Damon Broadus is with the St. Louis County Department of Public Health, St. Louis, MO. Matifadza Hlatshwayo Davis is with the City of St. Louis Department of Health, St. Louis, MO
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Moffroid H, Doglioni DO, Chyderiotis S, Sicsic J, Barret AS, Raude J, Bruel S, Gauchet A, Michel M, Gagneux-Brunon A, Thilly N, Mueller JE. Can physicians and schools mitigate social inequalities in human papillomavirus vaccine awareness, uptake and vaccination intention among adolescents? A cross-sectional study, France, 2021 to 2022. Euro Surveill 2023; 28:2300166. [PMID: 37971661 PMCID: PMC10655205 DOI: 10.2807/1560-7917.es.2023.28.46.2300166] [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: 03/15/2023] [Accepted: 08/27/2023] [Indexed: 11/19/2023] Open
Abstract
BackgroundIn France, human papillomavirus (HPV) vaccination coverage varies across socioeconomic levels.AimWe aimed at assessing HPV vaccine awareness, uptake and vaccination intention among adolescents in France.MethodsIn a cluster-randomised study, 13-15-year-old students in 61 French middle schools completed a web-based questionnaire. We used multivariable logistic regression to evaluate determinants of HPV vaccine awareness, self-reported uptake and vaccination intention among unvaccinated students and interaction terms to explore effects of visits to family physician and remembering school lessons on vaccination. The French deprivation index of school municipalities served as proxy for socioeconomic levels.ResultsAmong 6,992 participants, awareness was significantly associated with parental education (odds ratio (OR) = 0.82; 95% confidence interval (CI): 0.71-0.95), language spoken at home (OR = 0.59; 95% CI: 0.52-0.66) and deprivation level (OR = 0.57; 95% CI: 0.44-0.71), regardless of physician visit or school lessons. Vaccine uptake was associated with parental education without a recent physician visit (OR = 0.31; 95% CI: 0.16-0.59, vs OR = 0.64; 95% CI: 0.52-0.78 with a visit, interaction p = 0.045). Vaccination intention among unvaccinated was associated with deprivation level (moderate-low vs low) among students not remembering school lessons on vaccination (OR = 0.17; 95% CI: 0.05-0.62, vs OR = 0.93; 95% CI: 0.51-1.67 remembering school lessons, interaction p = 0.022). Parental education was associated with vaccination intention among students reporting a physician visit (OR = 0.41; 95% CI: 0.26-0.64 vs OR = 1.05; 95% CI: 0.50-2.20 without a visit, interaction p = 0.034).ConclusionOur results suggest that healthcare and school could promote vaccination and mitigate social inequalities in HPV vaccination coverage.
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Affiliation(s)
- Hadrien Moffroid
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, 75015 Paris, France
- University of Melbourne, Melbourne, Australia
| | - Damien Oudin Doglioni
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, 75015 Paris, France
| | - Sandra Chyderiotis
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, 75015 Paris, France
| | | | | | - Jocelyn Raude
- Université Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U1309 - 35000 Rennes, France
| | - Sebastien Bruel
- Department of General Practice, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Aurelie Gauchet
- Université Savoie Mont Blanc, Université Grenoble Alpes LIP/PC2S, Grenoble, France
| | - Morgane Michel
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, Paris, France
- Université Paris Cité, ECEVE, UMR1123, Inserm, Paris, France
| | - Amandine Gagneux-Brunon
- CHU de Saint-Etienne - Service d'infectiologie
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530
| | - Nathalie Thilly
- Université de Lorraine, APEMAC, Nancy, France
- Université de Lorraine, CHRU-Nancy, Département Méthodologie, Promotion, Investigation, Nancy, France
| | - Judith E Mueller
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, 75015 Paris, France
- Université Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U1309 - 35000 Rennes, France
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7
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Karashiali C, Konstantinou P, Christodoulou A, Kyprianidou M, Nicolaou C, Karekla M, Middleton N, Kassianos AP. A qualitative study exploring the social contagion of attitudes and uptake of COVID-19 vaccinations. Hum Vaccin Immunother 2023; 19:2260038. [PMID: 37758300 PMCID: PMC10538449 DOI: 10.1080/21645515.2023.2260038] [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: 07/12/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
Vaccination attitudes and uptake can spread within social networks. This study aims to understand the perceived social contagion mechanisms of vaccination uptake in the context of COVID-19 pandemic. Eleven semi-structured interviews were conducted following a purposive sampling of three hesitant, three anti- COVID-19 vaccine and five pro- COVID-19 vaccine (27% females). Thematic Analysis suggested two general themes reflecting the type of contagion: 1) information contagion and 2) behavior contagion. Transcending these themes was the notion of ownership of choice/decision. Almost all participants used the media and experts as the main source of information regarding vaccination. They influenced - and they were being influenced by - friends and family members with whom they share similar traits and attitudes and have a close relationship of trust and intimacy. Also, being exposed to positive attitudes and beliefs toward vaccination and COVID-19 vaccines, enhanced vaccination behaviors. However, the vaccination decision-making process was not perceived as a passive process - there was ownership over the decisions made. This study highlights the perceived mechanisms of social contagion. It also suggests that the meaning individuals pose on their social world is crucial on their decision-making. Policymakers are advised to consider including social networks of individuals and trusted sources (i.e. healthcare providers) when delivering interventions or educational campaigns on vaccinations.
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Affiliation(s)
| | | | - Andria Christodoulou
- Department of Social and Behavioral Sciences, European University Cyprus, Nicosia, Cyprus
| | - Maria Kyprianidou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | | | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Nicos Middleton
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Aparecido Magrini L, Monteiro Aguiar Baroni MP, Goulart A, Cilene Gadotti M. Correlations between COVID-19 cases and temperature, air humidity, and social isolating rate with cross wavelet transform and wavelet coherence: Case study of New York and São Paulo cities. CHAOS (WOODBURY, N.Y.) 2023; 33:083104. [PMID: 38060787 DOI: 10.1063/5.0160009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/14/2023] [Indexed: 12/18/2023]
Abstract
The COVID-19 pandemic originated in 2019 and has become an endemic disease that we must learn to live with, similar to other strains of influenza. The Organization (WHO) declared on May 5, 2023, in Geneva, Switzerland, the end of the Public Health Emergency of International Concern regarding COVID-19. As vaccines become more widely available and the pandemic appears to be improved, our focus shifts to the challenges we still face. Understanding how external factors like temperature, air humidity, and social isolation impact the spread of the SARS-CoV-2 virus remains a crucial challenge beyond our control. In this study, potential links between the number of COVID-19 cases in São Paulo City (SPC) and New York City (NWC) were explored. Our analysis was carried out utilizing the continuous wavelet transform, alongside other tools such as cross-wavelet transform and wavelet coherence. Based on our findings, there appears to be a correlation between the variables related to low frequencies, which aligns with previous research on the topic. Particularly, our research has revealed a connection between COVID-19 cases and factors such as temperature, air humidity, and social isolation rates. Regarding the latter, our findings indicate that implementing social distancing measures was a wise public policy decision, although the correlation with daily COVID-19 cases requires careful analysis. For this study, we analyzed data from February of 2020, when the first cases were reported in the cities under investigation, SPC and NWC, up until December 31, 2022, by which time the vaccination campaign was well under way.
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Affiliation(s)
- Luciano Aparecido Magrini
- Federal Institute of Education, Science and Technology of São Paulo (IFSP), São Paulo 01109-010, Brazil
| | | | - Amari Goulart
- Federal Institute of Education, Science and Technology of São Paulo (IFSP), São Paulo 01109-010, Brazil
| | - Marta Cilene Gadotti
- Mathematics Department, São Paulo State University (UNESP), Rio Claro 12227-010, Brazil
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9
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Zaildo T, Santino TA, Chaves G, da Silva BAK, Alchieri JC, Patino CM, Leite S, Luz KG, Guerra RO, da Penha THS, da Silva GR, Jácome AC, Monteiro KS, de Mendonça KMPP. Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis. Eur Respir Rev 2023; 32:220238. [PMID: 37343960 DOI: 10.1183/16000617.0238-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/03/2023] [Indexed: 06/23/2023] Open
Abstract
AIMS To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases. METHODS A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023. RESULTS We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators. CONCLUSIONS This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.
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Affiliation(s)
- Tácito Zaildo
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Thayla Amorim Santino
- Department of Physical Therapy, State University of Paraiba, Campina Grande, PB, Brazil
| | | | | | - João Carlos Alchieri
- Department of Psychology, Graduate Program in Science, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Cecilia M Patino
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Sarah Leite
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kleber Giovanni Luz
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Tito Hugo Soares da Penha
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Gabriel Rodrigues da Silva
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ada Cristina Jácome
- Public Health Department of the State of Rio Grande do Norte, Natal, RN, Brazil
| | - Karolinne Souza Monteiro
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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10
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Xu MA, Choi J, Capasso A, DiClemente R. Patient-Provider Health Communication Strategies: Enhancing HPV Vaccine Uptake among Adolescents of Color. Healthcare (Basel) 2023; 11:1702. [PMID: 37372820 DOI: 10.3390/healthcare11121702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Cervical cancer remains a public health issue in the United States, particularly among stigmatized racial and ethnic populations. The human papillomavirus (HPV) vaccine has been clinically proven to prevent cervical cancers, and other HPV-associated cancers, among men and women. However, HPV vaccine uptake is suboptimal; only 55% of adolescents complete the two-dose series by age 15. Past research has shown that provider HPV vaccine communication for people of marginalized races/ethnicities is subpar. This article focuses on provider communication strategies to promote HPV vaccine uptake effectively and equitably. The authors reviewed the literature on evidence-based patient-provider HPV vaccine communication techniques to create a set of communication language providers could use and avoid using to enhance HPV vaccine acceptance and uptake among adolescents of marginalized racial and ethnic groups. Evidence has shown that information and the manner of dissemination are critical for influencing HPV vaccine uptake. These communication strategies must be suited to the context of the targeted population, and the message content can be broadly categorized into source, content, and modality. Strategies to improve patient-provider communication among adolescents of color using source, modality, and content include the following: (1) Source: increase provider self-efficacy to provide the recommendation, building rapport between providers and parents; (2) Content: persistent, forceful language with minimal acquiescence should be employed, reframing the conversation focus from sex to cancer; and (3) Modality: use multiple vaccine reminder modalities, and work with the community to culturally adapt the vaccination language. Utilizing effective behavior-change communication adapted for adolescents of color can reduce missed opportunities for HPV prevention, potentially decreasing racial and ethnic disparities in HPV-related morbidity and mortality.
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Affiliation(s)
- Mia Ann Xu
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
| | - Jasmin Choi
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
| | | | - Ralph DiClemente
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA
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11
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Facciani M, Lazić A, Viggiano G, McKay T. Political network composition predicts vaccination attitudes. Soc Sci Med 2023; 328:116004. [PMID: 37295206 DOI: 10.1016/j.socscimed.2023.116004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/28/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
Political polarization is growing rapidly in the United States and has been linked to politicized public health issues including vaccination. Political homogeneity among one's interpersonal relationships may predict polarization levels and partisan bias. In this study, we analyzed if political network structure predicted partisan beliefs about the COVID-19 vaccine, beliefs about vaccines in general, and COVID-19 vaccine uptake. Personal networks were measured by whom the respondent discussed "important matters" with to obtain a list of individuals who are close to the respondent. The number of associates listed who share the political identity or vaccine status with the respondent was calculated as a measure of homogeneity. We find that having more Republicans and unvaccinated individuals in one's network predicted lower vaccine confidence whereas having more Democrats and vaccinated individuals in one's network predicted higher vaccine confidence. Exploratory network analyses revealed that non-kin others are especially impactful on vaccine attitudes when those network connections are also Republican and unvaccinated.
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12
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Amlani S, Kiesel S, Butters R. Polarization in COVID-19 Vaccine Discussion Networks. AMERICAN POLITICS RESEARCH 2023; 51:260-273. [PMID: 38603344 PMCID: PMC9813645 DOI: 10.1177/1532673x221148670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The emergence of COVID-19 spurred the fastest development of a vaccine in history. Yet, a large proportion of Americans remain hesitant to receive it. Our paper investigates how the social networks we inhabit might explain persistent vaccine hesitancy. We argue that the COVID-19 vaccination status of respondents' closest associates inhibits or motivates their decision to receive a COVID-19 vaccine. To test our argument, we conduct an original survey asking respondents a battery of questions about the people with whom individuals most frequently discuss vaccines and COVID-19. Our survey reports that individuals' discussion networks are polarized by vaccination status. Concurrently, there is a strong association between the social network's vaccination status and the respondent's vaccination status. This association is so robust that partisanship does not moderate the association between discussants' vaccination status and respondents' vaccination status. Together, our results imply that unvaccinated individuals remain hesitant because they face reinforcing social pressure from their closest associates. The unique timing of our survey, during an unprecedented vaccination campaign against a novel disease, offers a snapshot of how relationships may affect attitudes.
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Affiliation(s)
| | | | - Ross Butters
- Department of Political Science, UC Davis, CA, USA
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13
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Lohiniva AL, Hussein I, Lehtinen JM, Sivelä J, Hyökki S, Nohynek H, Nuorti P, Lyytikäinen O. Qualitative Insights into Vaccine Uptake of Nursing Staff in Long-Term Care Facilities in Finland. Vaccines (Basel) 2023; 11:530. [PMID: 36992113 PMCID: PMC10056830 DOI: 10.3390/vaccines11030530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in Finland. Methodology: The study was based on the Theoretical Domains Framework. Data were collected through qualitative in-depth interviews among nursing staff and managers of LTCFs. The analysis was based on thematic analysis. We identified seven behavioral domains, with several themes, that reduced the staff's intention to get vaccinated: knowledge (information overload, inability to identify trustworthy information sources, lack of vaccine-specific and understandable scientific information), beliefs about consequences (incorrect perceptions about the vaccine effectiveness, and lack of trust in the safety of the vaccine), social influences (influence of family and friends), reinforcement (limited abilities of the management to encourage vaccination), beliefs about capabilities (pregnancy or desire to get pregnant), psychological factors (coping with changing opinion), and emotions (confusion, suspicion, disappointment, and fatigue). We also identified three behavioral domains that encouraged vaccine uptake: social influences (trust in health authorities), environmental context and resources (vaccination logistics), and work and professional role (professional pride). The study findings can help authorities to develop tailored vaccine promotion strategies for healthcare workers in LTCFs.
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Affiliation(s)
- Anna-Leena Lohiniva
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Idil Hussein
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Jaana-Marija Lehtinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Suvi Hyökki
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Kalevankatu 4, 33520 Tampere, Finland
| | - Outi Lyytikäinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
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14
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A Protocol of a Pilot Experimental Study Using Social Network Interventions to Examine the Social Contagion of Attitudes Towards Childhood Vaccination in Parental Social Networks. HEALTH PSYCHOLOGY BULLETIN 2022. [DOI: 10.5334/hpb.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Coman IA, Xu S, Yamamoto M. COVID-19 Vaccine Hesitancy: Disadvantaged Groups’ Experience with Perceived Barriers, Cues to Action, and Attitudes. Am J Health Promot 2022; 37:488-498. [PMID: 36306535 PMCID: PMC9618917 DOI: 10.1177/08901171221136113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Drawing from the Health Belief Model, we explored how disadvantaged groups in the U.S., including Black, Hispanic, less educated and wealthy individuals, experienced perceived barriers and cues to action in the context of the COVID-19 vaccination. Design A cross-sectional survey administered in March 2021. Setting USA Subjects A national sample of U.S. residents (n = 795) recruited from Prolific. Measures Perceived barriers (clinical, access, trust, religion/spiritual), cues to action (authorities, social circles), attitudes toward COVID-19 vaccination. Analysis Factor analysis and Structural Equation Model (SEM) were performed in STATA 16. Results Black and less educated individuals experienced higher clinical barriers (CI [.012, .33]; CI [.027, .10]), trust barriers (CI [.49, .92]; CI [.057, .16]), and religious/spiritual barriers (CI [.28, .66]; CI [.026, .11]). Hispanics experienced lower levels of clinical barriers (CI [-.42, .0001]). Clinical, trust, and religious/spiritual barriers were negatively related to attitudes toward vaccination (CI [-.45, −.15]; CI [-.79, −.51]; CI [-.43, −.13]). Black and less educated individuals experienced fewer cues to action by authority (CI [-.47, −.083]; CI [-.093, −.002]) and social ties (CI [-.75, −.33]; CI [-.18, −.080]). Lower-income individuals experienced fewer cues to action by social ties (CI [-.097, −.032]). Cues from social ties were positively associated with vaccination attitudes (CI [.065, .26]). Conclusion Communication should be personalized to address perceived barriers disadvantaged groups differentially experience and use sources who exert influences on these groups.
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Affiliation(s)
- Ioana A Coman
- College of Media and Communication, Texas Tech University, Lubbock, TX, USA
| | - Shan Xu
- College of Media and Communication, Texas Tech University, Lubbock, TX, USA
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16
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Alvarez-Zuzek LG, Zipfel CM, Bansal S. Spatial clustering in vaccination hesitancy: The role of social influence and social selection. PLoS Comput Biol 2022; 18:e1010437. [PMID: 36227809 PMCID: PMC9562150 DOI: 10.1371/journal.pcbi.1010437] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
The phenomenon of vaccine hesitancy behavior has gained ground over the last three decades, jeopardizing the maintenance of herd immunity. This behavior tends to cluster spatially, creating pockets of unprotected sub-populations that can be hotspots for outbreak emergence. What remains less understood are the social mechanisms that can give rise to spatial clustering in vaccination behavior, particularly at the landscape scale. We focus on the presence of spatial clustering, and aim to mechanistically understand how different social processes can give rise to this phenomenon. In particular, we propose two hypotheses to explain the presence of spatial clustering: (i) social selection, in which vaccine-hesitant individuals share socio-demographic traits, and clustering of these traits generates spatial clustering in vaccine hesitancy; and (ii) social influence, in which hesitant behavior is contagious and spreads through neighboring societies, leading to hesitant clusters. Adopting a theoretical spatial network approach, we explore the role of these two processes in generating patterns of spatial clustering in vaccination behaviors under a range of spatial structures. We find that both processes are independently capable of generating spatial clustering, and the more spatially structured the social dynamics in a society are, the higher spatial clustering in vaccine-hesitant behavior it realizes. Together, we demonstrate that these processes result in unique spatial configurations of hesitant clusters, and we validate our models of both processes with fine-grain empirical data on vaccine hesitancy, social determinants, and social connectivity in the US. Finally, we propose, and evaluate the effectiveness of two novel intervention strategies to diminish hesitant behavior. Our generative modeling approach informed by unique empirical data provides insights on the role of complex social processes in driving spatial heterogeneity in vaccine hesitancy.
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Affiliation(s)
- Lucila G. Alvarez-Zuzek
- Department of Biology, Georgetown University, Washington, District of Columbia, United States of America
| | - Casey M. Zipfel
- Department of Biology, Georgetown University, Washington, District of Columbia, United States of America
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, District of Columbia, United States of America
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17
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Bubar KM, Middleton CE, Bjorkman KK, Parker R, Larremore DB. SARS-CoV-2 transmission and impacts of unvaccinated-only screening in populations of mixed vaccination status. Nat Commun 2022; 13:2777. [PMID: 35589681 PMCID: PMC9120147 DOI: 10.1038/s41467-022-30144-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Screening programs that test only the unvaccinated population have been proposed and implemented to mitigate SARS-CoV-2 spread, implicitly assuming that the unvaccinated population drives transmission. To evaluate this premise and quantify the impact of unvaccinated-only screening programs, we introduce a model for SARS-CoV-2 transmission through which we explore a range of transmission rates, vaccine effectiveness scenarios, rates of prior infection, and screening programs. We find that, as vaccination rates increase, the proportion of transmission driven by the unvaccinated population decreases, such that most community spread is driven by vaccine-breakthrough infections once vaccine coverage exceeds 55% (omicron) or 80% (delta), points which shift lower as vaccine effectiveness wanes. Thus, we show that as vaccination rates increase, the transmission reductions associated with unvaccinated-only screening decline, identifying three distinct categories of impact on infections and hospitalizations. More broadly, these results demonstrate that effective unvaccinated-only screening depends on population immunity, vaccination rates, and variant.
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Affiliation(s)
- Kate M Bubar
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, CO, USA
| | - Casey E Middleton
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
| | - Kristen K Bjorkman
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
| | - Roy Parker
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
- Department of Biochemistry, University of Colorado Boulder, Boulder, CO, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Daniel B Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA.
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA.
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18
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Hiraoka T, Rizi AK, Kivelä M, Saramäki J. Herd immunity and epidemic size in networks with vaccination homophily. Phys Rev E 2022; 105:L052301. [PMID: 35706197 DOI: 10.1103/physreve.105.l052301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
We study how the herd immunity threshold and the expected epidemic size depend on homophily with respect to vaccine adoption. We find that the presence of homophily considerably increases the critical vaccine coverage needed for herd immunity and that strong homophily can push the threshold entirely out of reach. The epidemic size monotonically increases as a function of homophily strength for a perfect vaccine, while it is maximized at a nontrivial level of homophily when the vaccine efficacy is limited. Our results highlight the importance of vaccination homophily in epidemic modeling.
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Affiliation(s)
- Takayuki Hiraoka
- Department of Computer Science, Aalto University, 00076 Espoo, Finland
| | - Abbas K Rizi
- Department of Computer Science, Aalto University, 00076 Espoo, Finland
| | - Mikko Kivelä
- Department of Computer Science, Aalto University, 00076 Espoo, Finland
| | - Jari Saramäki
- Department of Computer Science, Aalto University, 00076 Espoo, Finland
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19
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Prince L, Long E, Studdert DM, Leidner D, Chin ET, Andrews JR, Salomon JA, Goldhaber-Fiebert JD. Uptake of COVID-19 Vaccination Among Frontline Workers in California State Prisons. JAMA HEALTH FORUM 2022; 3:e220099. [PMID: 35977288 PMCID: PMC8917424 DOI: 10.1001/jamahealthforum.2022.0099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/19/2022] [Indexed: 01/25/2023] Open
Abstract
Question In California prisons, what proportion of prison staff who have direct contact with residents are unvaccinated, and what are their characteristics? Findings In this cohort study of 23 472 custody staff and 7617 health care staff in California state prisons, 14 317 custody staff (61%) and 2819 (36%) health care staff remained unvaccinated through June 30, 2021, despite widespread vaccine availability. Unvaccinated staff were younger and more likely to have had COVID-19; they were also more likely to work alongside other unvaccinated staff and live in communities with relatively low rates of vaccination. Meaning The study results suggest that low vaccination rates among prison staff pose continuing risks. Importance Prisons and jails are high-risk environments for COVID-19. Vaccination levels among workers in many such settings remain markedly lower than those of residents and members of surrounding communities. The situation is troubling because prison staff are a key vector for COVID-19 transmission. Objective To assess patterns and timing of staff vaccination in California state prisons and identify individual-level and community-level factors associated with remaining unvaccinated. Design, Setting, and Participants This cohort study used data from December 22, 2020, through June 30, 2021, to quantify the fractions of staff and incarcerated residents who remained unvaccinated among 23 472 custody and 7617 health care staff who worked in roles requiring direct contact with residents at 33 of the 35 prisons operated by the California Department of Corrections and Rehabilitation. Multivariable probit regressions assessed demographic, community, and peer factors associated with staff vaccination uptake. Main Outcomes and Measures Remaining unvaccinated throughout the study period. Results Of 23 472 custody staff, 3751 (16%) were women, and 1454 (6%) were Asian/Pacific Islander individuals, 1571 (7%) Black individuals, 9008 (38%) Hispanic individuals, and 6666 (28%) White individuals. Of 7617 health care staff, 5434 (71%) were women, and 2148 (28%) were Asian/Pacific Islander individuals, 1201 (16%) Black individuals, 1409 (18%) Hispanic individuals, and 1771 (23%) White individuals. A total of 6103 custody staff (26%) and 3961 health care staff (52%) received 1 or more doses of a COVID-19 vaccine during the first 2 months vaccines were offered, but vaccination rates stagnated thereafter. By June 30, 2021, 14 317 custody staff (61%) and 2819 health care staff (37%) remained unvaccinated. In adjusted analyses, remaining unvaccinated was positively associated with younger age (custody staff: age, 18-29 years vs ≥60 years, 75% [95% CI, 73%-76%] vs 45% [95% CI, 42%-48%]; health care staff: 52% [95% CI, 48%-56%] vs 29% [95% CI, 27%-32%]), prior COVID-19 infection (custody staff: 67% [95% CI, 66%-68%] vs 59% [95% CI, 59%-60%]; health care staff: 44% [95% CI, 42%-47%] vs 36% [95% CI, 36%-36%]), residing in a community with relatively low rates of vaccination (custody staff: 75th vs 25th percentile:, 63% [95% CI, 62%-63%] vs 60% [95% CI, 59%-60%]; health care staff: 40% [95% CI, 39%-41%] vs 34% [95% CI, 33%-35%]), and sharing shifts with coworkers who had relatively low rates of vaccination (custody staff: 75th vs 25th percentile, 64% [95% CI, 62%-66%] vs 59% [95% CI, 57%-61%]; health care staff: 38% [95% CI, 36%-41%] vs 35% [95% CI, 31%-39%]). Conclusions and Relevance This cohort study of California state prison custody and health care staff found that vaccination uptake plateaued at levels that posed ongoing risks of further outbreaks in the prisons and continuing transmission from prisons to surrounding communities. Prison staff decisions to forgo vaccination appear to be multifactorial, and vaccine mandates may be necessary to achieve adequate levels of immunity in this high-risk setting.
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Affiliation(s)
- Lea Prince
- Freeman Spogli Institute, Department of Health Policy, Stanford University School of Medicine, Stanford University, Stanford, California
| | - Elizabeth Long
- Freeman Spogli Institute, Department of Health Policy, Stanford University School of Medicine, Stanford University, Stanford, California
| | - David M. Studdert
- Freeman Spogli Institute, Department of Health Policy, Stanford University School of Medicine, Stanford University, Stanford, California
- Stanford Law School, Stanford, California
| | - David Leidner
- California Department of Corrections and Rehabilitation, Sacramento
| | - Elizabeth T. Chin
- Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Jason R. Andrews
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Joshua A. Salomon
- Freeman Spogli Institute, Department of Health Policy, Stanford University School of Medicine, Stanford University, Stanford, California
| | - Jeremy D. Goldhaber-Fiebert
- Freeman Spogli Institute, Department of Health Policy, Stanford University School of Medicine, Stanford University, Stanford, California
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20
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Contessa G. It Takes a Village to Trust Science: Towards a (Thoroughly) Social Approach to Public Trust in Science. ERKENNTNIS 2022; 88:1-26. [PMID: 35194273 PMCID: PMC8852979 DOI: 10.1007/s10670-021-00485-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/17/2021] [Indexed: 05/05/2023]
Abstract
In this paper, I distinguish three general approaches to public trust in science, which I call the individual approach, the semi-social approach, and the social approach, and critically examine their proposed solutions to what I call the problem of harmful distrust. I argue that, despite their differences, the individual and the semi-social approaches see the solution to the problem of harmful distrust as consisting primarily in trying to persuade individual citizens to trust science and that both approaches face two general problems, which I call the problem of overidealizing science and the problem of overburdening citizens. I then argue that in order to avoid these problems we need to embrace a (thoroughly) social approach to public trust in science, which emphasizes the social dimensions of the reception, transmission, and uptake of scientific knowledge in society and the ways in which social forces influence both positively and negatively the trustworthiness of science.
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Affiliation(s)
- Gabriele Contessa
- Philosophy Department, Carleton University, Patterson 3A46, 1125 Colonel By Drive, Ottawa, ON Canada
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21
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Risk-Perception Change Associated with COVID-19 Vaccine's Side Effects: The Role of Individual Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031189. [PMID: 35162211 PMCID: PMC8834391 DOI: 10.3390/ijerph19031189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 vaccine appears to be a crucial requirement to fight the pandemic. However, a part of the population possesses negative attitudes towards the vaccine. The spread of conspiracy theories and contradictory information about the pandemic have altered the population’s perception of risk. The risk-perception of the vaccine’s side effects may be affected by individual differences. The complex relationship between risk-perception and individual differences is relevant when people have to make decisions based on ambiguous and constantly changing information, as in the early phases of the Italian vaccination campaign. The present study aimed at measuring the effect of individual differences in risk-perception associated with the COVID-19 vaccine’s side effects in a context characterized by information ambiguity. An online survey was conducted to classify a sample of Italian pro-vaccine people into cognitive/behavioral style groups. Furthermore, changes in vaccine risk-perception after inconsistent communications regarding the vaccine’s side effects were compared between groups. The results showed that “analytical” individuals did not change their perception regarding the probability of vaccine side effects but changed their perception regarding the severity of side effects; “open” and “polarized” individuals neither changed their perception regarding the probability nor of the severity of side effects, showing a different kind of information processing, which could interfere with an informed decision-making process.
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22
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Higginson JD, Tumin D, Kuehhas TC, DeLozier-Hooks SE, Powell CA, Ramirez DD, Dabelić A, Basso MR. COVID-19 Vaccine Hesitancy Among Deployed Personnel in a Joint Environment. Mil Med 2021; 188:e32-e36. [PMID: 34897473 PMCID: PMC9383089 DOI: 10.1093/milmed/usab518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/12/2021] [Accepted: 12/01/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION In the United States, vaccine hesitancy has been identified as a major barrier to vaccination against COVID-19, but attitudes toward COVID-19 vaccination among military personnel are not well understood. We evaluated the prevalence and correlates of COVID-19 vaccine consent or refusal among deployed personnel in a joint environment. MATERIALS AND METHODS Deidentified data were retrospectively extracted from the electronic medical record of the Military Health System in May 2021. All personnel currently assigned to the deployment area of operations were included in the analysis if their choice to receive the vaccine was known. Personnel characteristics were compared by vaccine acceptance status using chi-square tests, Fisher's exact tests, or correlation coefficients. This analysis was exempted from Institutional Review Board review. RESULTS The sample included 1,809 individuals, primarily members of the Army (72%) and members of Reserve (53%) or National Guard (27%) units. In the overall sample, 61% accepted the vaccine, with vaccine acceptance rates being lowest among Black or African American personnel (54%; P = .03 for comparison across racial groups) and members of Reserve or National Guard units (59%; P < .001 for comparison by component). No differences in vaccine acceptance were found according to sex or health status (including prior COVID-19 infection). CONCLUSIONS Overall vaccine acceptance was greater among deployed military personnel than that reported in the U.S. population as a whole. However, lower vaccine acceptance among personnel from marginalized populations suggests a need to ensure that all service members have sufficient opportunities to have a frank and ongoing discussion with health care providers to address concerns related to vaccination. Additionally, lower vaccine acceptance among Reserve and National Guard personnel indicates a need for innovative educational approaches to counter vaccine hesitancy in the premobilization phase of deployment.
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Affiliation(s)
- Jason D Higginson
- Office of the Dean Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA
| | - Dmitry Tumin
- Office of the Dean Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA
| | | | | | | | | | | | - Michael R Basso
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55902, USA
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23
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Cristea D, Ilie DG, Constantinescu C, Fîrțală V. Vaccinating against COVID-19: The Correlation between Pro-Vaccination Attitudes and the Belief That Our Peers Want to Get Vaccinated. Vaccines (Basel) 2021; 9:1366. [PMID: 34835297 PMCID: PMC8621188 DOI: 10.3390/vaccines9111366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
This study verifies whether there is a strong correlation between the pro-vaccination, against COVID-19 attitude of the respondents and their belief that most of those around them want to be vaccinated against COVID-19. For this purpose, we analyzed data from a sociological survey conducted in April 2021 in Romania. The sample size was of 1001 respondents, the selection process was randomized and the population included in the sample is representative of the socio-demographic structure of Romania. The tool used to collect the data was CATI (telephonic interview). In order to test the existence of these correlations we performed the following tests: Chi-Square test, Kendall τ, Spearman ρ tests and Freeman's z-test. The pro-vaccination attitude strongly correlates with the perception of subjects that their primary group accepts vaccination and even correlates with the perception that the general public is rather pro-vaccination. The vaccination decision is closely linked to the social relations system and the rules of the community in which the subject lives. In this paper we discuss the correlation between attitude and belief, not the existence of a causal relation between the two of them.
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Affiliation(s)
- Darie Cristea
- Faculty of Sociology and Social Work, University of Bucharest, 010181 Bucharest, Romania; (D.-G.I.); (C.C.); (V.F.)
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24
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Bubar KM, Middleton CE, Bjorkman KK, Parker R, Larremore DB. SARS-CoV-2 Transmission and Impacts of Unvaccinated-Only Screening in Populations of Mixed Vaccination Status.. [PMID: 34909778 PMCID: PMC8669845 DOI: 10.1101/2021.10.19.21265231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AbstractCommunity testing programs focused on the unvaccinated population are being enacted in populations with mixed vaccination status to mitigate SARS-CoV-2 spread. Presumably, these policies assume that the unvaccinated are driving transmission, though it is not well understood how viral spread occurs in mixed-status populations. Here, we analyze a model of transmission in which a variable fraction of the population is vaccinated, with unvaccinated individuals proactively screened for infection. By exploring a range of transmission rates, vaccine effectiveness (VE) scenarios, and rates of prior infection, this analysis reveals principles of viral spread in communities of mixed vaccination status, with implications for screening policies. As vaccination rates increase, the proportion of transmission driven by the unvaccinated population decreases, such that most community spread is driven by breakthrough infections once vaccine coverage exceeds 55% (omicron) or 80% (delta), with additional variation dependent on waning or boosted VE. More broadly, the potential impacts of unvaccinated-only screening fall into three distinct parameter regions: (I) “flattening the curve” with little impact on cumulative infections, (II) effectively suppressing transmission, and (III) negligible impact because herd immunity is reached without screening. By evaluating a wide range of scenarios, this work finds broadly that effective mitigation of SARS-CoV-2 transmission by unvaccinated-only screening is highly dependent on vaccination rate, population-level immunity, screening compliance, and vaccine effectiveness against the current variant.
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25
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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