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Condie J, Northstone K, Major-Smith D, Halstead I. Exploring associations between the Big Five personality traits and cognitive ability with COVID-19 vaccination hesitancy and uptake among mothers and offspring in a UK prospective cohort study. Vaccine 2024; 42:2817-2826. [PMID: 38521675 DOI: 10.1016/j.vaccine.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/17/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Vaccines reduce the severity of symptoms, and risk of hospitalisation and death from infectious diseases. Yet, vaccination hesitancy persists. Research identifying psychological risk factors for vaccination hesitancy is limited and reports conflicting results. This study sought to address these inconsistencies and explore the role of personality and cognitive ability in COVID-19 vaccination hesitancy and uptake in a prospective cohort study. METHODS Data came from young adults (Generation-1; G1) and their mothers (Generation-0; G0) in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multinomial logistic regressions, adjusting for several sociodemographic confounders, were used to explore whether personality and cognitive ability were associated with COVID-19 vaccination hesitancy and uptake. 4,960 G1 and 4,853 G0 mothers were included in the study population. FINDINGS Among G1, 38.4% exhibited vaccination hesitancy, yet 91.9% of the cohort received the vaccine. In adjusted models, higher levels of openness, agreeableness, conscientiousness, and cognitive ability were associated with an increased probability of wanting the vaccine. Similarly, higher levels of agreeableness, openness and cognitive ability were associated with an increased probability of vaccination uptake. However, the evidence of associations with vaccine uptake were generally weaker than with vaccination hesitancy. 56.7% of the offspring who did not want the vaccine either received the vaccine or intended to, whilst 43.3% still had no intention.Among G0 mothers, 25.6% were vaccination hesitant, yet 99.0% of the cohort received the vaccine. 3.1% said they did not want the vaccine; approximately 80% of these either received the vaccine or intended to. We found inconclusive evidence for an association between cognitive ability and vaccination hesitancy among G0 mothers. INTERPRETATION This study identified psychological factors associated with vaccination hesitancy and uptake. If these associations are causal, these findings may help design more effective vaccination hesitancy interventions.
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Affiliation(s)
- Jennifer Condie
- Centre for Trials Research, Cardiff University, Cardiff, Neuadd Meirionnydd CF14 4YS, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Daniel Major-Smith
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Isaac Halstead
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
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Huf SW, Grailey K, Crespo RF, Woldmann L, Chisambi M, Skirrow H, Black K, Hassanpourfard B, Nguyen J, Klaber B, Darzi A. Testing the impact of differing behavioural science informed text message content in COVID-19 vaccination invitations on vaccine uptake: A randomised clinical trial. Vaccine 2024; 42:2919-2926. [PMID: 38553291 DOI: 10.1016/j.vaccine.2024.03.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
Behavioural science constructs can be incorporated into messaging strategies to enhance the effectiveness of public health campaigns by increasing the occurrence of desired behaviours. This study investigated the impact of behavioural science-informed text message strategies on COVID-19 vaccination rates in 18-39-year-olds in an area of low uptake in London during the first vaccination offer round in the United Kingdom. This three-armed randomised trial recruited unvaccinated residents of an urban Central London suburb being offered their first vaccination between May and June 2021. Participants were randomised to receive the control (current practice) text message or one of two different behavioural science-informed COVID-19 vaccine invitation strategies. Both intervention strategies contained the phrase "your vaccine is ready and waiting for you", aiming to evoke a sense of ownership, with one strategy also including a pre-alert message. The main outcome measures were vaccination rates at 3 and 8 weeks after message delivery. A total of 88,820 residents were randomly assigned to one of the three trial arms. Each arm had a vaccine uptake rate of 27.2 %, 27.4 % and 27.3 % respectively. The mean age of participants was 28.2 years (SD ± 5.7), the mean index of multiple deprivation was 4.3 (SD ± 2.0) and 50.4 % were women. Vaccine uptake varied by demographics, however there was no significant difference between trial arms (p = 0.872). Delivery was successful for 53.6 % of text messages. Our choice of behavioural science informed messaging strategies did not improve vaccination rates above the rate seen for the current practice message. This likely reflects the wide exposure to public health campaigns during the pandemic, as such text messages nudges were unlikely to alter existing informed decision-making processes. Text message delivery was relatively low, indicating a need for accurate mobile phone number records and multi-modal approaches to reach eligible patients for vaccination. The protocol was registered at clinicaltrials.gov (NCT04895683) on 20/05/2021.
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Affiliation(s)
- Sarah W Huf
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Kate Grailey
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
| | - Roberto Fernandez Crespo
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Lena Woldmann
- Imperial College Health Partners, London, United Kingdom
| | | | - Helen Skirrow
- School of Public Health, Imperial College London, London, United Kingdom
| | - Kirstie Black
- Central London Healthcare CIC, London, United Kingdom
| | | | - Joe Nguyen
- NHS North West London Integrated Care Board (ICB), London, United Kingdom
| | - Bob Klaber
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
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Haeder SF. U.S. public support and opposition to vaccination mandates in K-12 education in light of the COVID-19 pandemic. Vaccine 2023; 41:7103-7115. [PMID: 37858447 DOI: 10.1016/j.vaccine.2023.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Vaccination mandates have long been an effective tool in increasing vaccination rates and reducing the potential for disease outbreaks. In the wake of COVID-19, opposition to mandates in the K-12 setting has garnered more attention, and policymakers opposed to them have become more active. This study sought to assess whether these efforts are supported by the U.S. public. METHODS We fielded a large, national survey (N = 16,461) from January to April of 2022 to assess U.S. public opinion about seven specific vaccination mandates (diphtheria, tetanus, & pertussis (DTaP); polio; chickenpox; measles, mumps, and rubella (MMR); hepatitis; human papillomavirus (HPV); and COVID-19) in K-12 educational settings. RESULTS We found that Americans are overwhelmingly supportive of all vaccination mandates with support ranging from a high 90 percent of respondents for DTaP, polio, chickenpox, and MMR to a low of 68 percent for COVID-19. Individuals who deemed vaccines safe and important, those with trust in the National Institutes of Health and the Food and Drug Administration, urban residents, and ethnic and racial minorities tended to be consistently more supportive. Perceptions about vaccine effectiveness were positively associated with mandate support in most cases, as was trust in medical doctors. Respondents who believed that vaccines cause autism, those with better health and more trust in religious leaders tended to be consistently more opposed. Women were generally more supportive of mandates except for HPV and COVID-19. Ideology and partisanship affected opinion for COVID-19 as did trust in the Centers for Disease Control and Prevention. We found no effects for income or education. CONCLUSION Vaccination mandates in K-12 have broad support among the American public, even in more controversial cases such as HPV and COVID-19. Vocal opposition and growing interest by policymakers to limit or undo vaccination mandates are not supported by the broader public.
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Affiliation(s)
- Simon F Haeder
- Department of Health Policy & Management, School of Public Health, Texas A&M University, TAMU 1266, 212 Adriance Lab Rd, College Station, TX 77843, United States.
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Di Giuseppe G, Pelullo CP, Napoli A, Napolitano F. Willingness to receive Herpes Zoster vaccination among adults and older people: A cross sectional study in Italy. Vaccine 2023; 41:7244-7249. [PMID: 37880069 DOI: 10.1016/j.vaccine.2023.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/26/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
The objective of this study was to explore the Herpes Zoster (HZ) knowledge and the willingness to receive the HZ vaccination in adults and older people in Italy. The study was conducted on a sample of patients aged ≥65 years and over 50 years with chronic conditions who went to the clinics of general practitioners (GPs) in Campania region, Italy. Data was collected with a questionnaire administered through an interview. Multivariate logistic regression analysis was performed. 427 participants (83.2 %) had heard about HZ infection and correctly knew the main symptoms of the HZ disease, and 196 of them (45.9 %) were aware of the main complications of the infection, such as post-Herpetic Neuralgia (NPE) and Herpes Zoster ophthalmicus (HZO). Only 61 participants (11.8 %) had heard of the availability of a vaccination against HZ in Italy and 39 of them (63.9 %) knew that the vaccination is recommended in at-risk patients aged at least 50 years and for adults aged ≥65 years. 137 participants (26.6 %) had a positive attitude toward the willingness to receive the HZ vaccination. Participants aged 50-64 years, those who have more than one chronic disease, those who have received at least one recommended vaccination, those who had a positive attitude on the usefulness of HZ vaccination, and those who feel the need to receive additional information about HZ vaccination were more likely to have a positive attitude toward the willingness to receive the HZ vaccination. It is needed to implement effective strategies to improve HZ vaccination coverage in order to protect especially frail patients from the most serious complications of the disease.
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Affiliation(s)
- Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy
| | - Concetta Paola Pelullo
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina, 40, 80133 Naples, Italy
| | - Annalisa Napoli
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy
| | - Francesco Napolitano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy.
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Petrovici N, Belbe SȘ, Mare CC, Cotoi CC. Hybrid health regimes: Access to primary care physicians and COVID-19 vaccine uptake across municipalities in Romania. Soc Sci Med 2023; 337:116305. [PMID: 37857237 DOI: 10.1016/j.socscimed.2023.116305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/01/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
This study analyses COVID-19 vaccine uptake at the municipal level in Romania using the global health regimes and vaccine hesitancy perspectives. Our spatial regression (SARAR-het Durbin) shows that the number of primary care physicians is a significant predictor of vaccine uptake, and municipalities with higher access to the labour market have higher vaccination rates. We provide a historical perspective to demonstrate that the current health regime in Romania is a hybrid of internationalist and global health regimes, with socialist investments affecting labour participation, education, poverty, and vaccination rates. Our findings highlight the impact of regional disparities and partial privatization of the health system.
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Affiliation(s)
- Norbert Petrovici
- Dep. of Sociology, Faculty of Sociology and Social Work, Babes-Bolyai University, 1, Anghel Saligny, 400394, Cluj-Napoca, Romania; Interdisciplinary Centre for Data Science, Babes-Bolyai University, 68, Avram Iancu Str., 400083, 4th Floor, Cluj-Napoca, Romania.
| | - Stefana Ștefana Belbe
- Dep. of Statistics, Forecasts, Mathematics, Faculty of Economics and Business Administration, Babes-Bolyai University, 58-60, Teodor Mihali Str., 400591, Cluj-Napoca, Romania; Interdisciplinary Centre for Data Science, Babes-Bolyai University, 68, Avram Iancu Str., 400083, 4th Floor, Cluj-Napoca, Romania.
| | - Codruta Codruța Mare
- Dep. of Statistics, Forecasts, Mathematics, Faculty of Economics and Business Administration, Babes-Bolyai University, 58-60, Teodor Mihali Str., 400591, Cluj-Napoca, Romania; Interdisciplinary Centre for Data Science, Babes-Bolyai University, 68, Avram Iancu Str., 400083, 4th Floor, Cluj-Napoca, Romania.
| | - Calin Călin Cotoi
- Dep. of Sociology, Faculty of Sociology and Social Work, University of Bucharest, 9, Schitu Magureanu Blv., Sector 1, Bucharest, Romania.
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Junghans C, Antonacci G, Williams A, Harris M. Learning from the universal, proactive outreach of the Brazilian Community Health Worker model: impact of a Community Health and Wellbeing Worker initiative on vaccination, cancer screening and NHS health check uptake in a deprived community in the UK. BMC Health Serv Res 2023; 23:1092. [PMID: 37821938 PMCID: PMC10568890 DOI: 10.1186/s12913-023-10084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Delays in preventative service uptake are increasing in the UK. Universal, comprehensive monthly outreach by Community Health and Wellbeing Workers (CHW), who are integrated at the GP practice and local authority, offer a promising alternative to general public health campaigns as it personalises health promotion and prevention of disease holistically at the household level. We sought to test the ability of this model, which is based on the Brazilian Family Health Strategy, to increase prevention uptake in the UK. METHODS Analysis of primary care patient records for 662 households that were allocated to five CHWWs from July 2021. Primary outcome was the Composite Referral Completion Indicator (CRCI), a measure of how many health promotion activities were received by members of a household relative to the ones that they were eligible for during the period July 2021-April 2022. The CRCI was compared between the intervention group (those who had received at least one visit) and the control group (allocated households that were yet to receive a visit). A secondary outcome was the number of GP visits in the intervention and control groups during the study period and compared to a year prior. RESULTS Intervention and control groups were largely comparable in terms of household occupancy and service eligibilities. A total of 2251 patients in 662 corresponding households were allocated to 5 CHWs and 160 households had received at least one visit during the intervention period. The remaining households were included in the control group. Overall service uptake was 40% higher in the intervention group compared to control group (CRCI: 0.21 ± 0.15 and 0.15 ± 0.19 respectively). Likelihood of immunisation uptake specifically was 47% higher and cancer screening and NHS Health Checks was 82% higher. The average number of GP consultations per household decreased by 7.4% in the intervention group over the first 10 months of the pilot compared to the 10 months preceding its start, compared with a 0.6% decrease in the control group. CONCLUSIONS Despite the short study period these are promising findings in this deprived, traditionally hard to reach community and demonstrates potential for the Brazilian community health worker model to be impactful in the UK. Further analysis is needed to examine if this approach can reduce health inequalities and increase cost effectiveness of health promotion approaches.
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Affiliation(s)
- Cornelia Junghans
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Grazia Antonacci
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
- Centre for Health Economics and Policy Innovation (CHEPI), Business School, Imperial College London, London, UK
| | - Alison Williams
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Matthew Harris
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
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Derbie A, Mekonnen D, Misgan E, Maier M, Woldeamanuel Y, Abebe T. Acceptance of human papillomavirus vaccination and parents' willingness to vaccinate their adolescents in Ethiopia: a systematic review and meta-analysis. Infect Agent Cancer 2023; 18:59. [PMID: 37821992 PMCID: PMC10566039 DOI: 10.1186/s13027-023-00535-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION Despite the global vaccination campaign to prevent HPV-related morbidity, HPV vaccination uptake remains unacceptably low in the developing world, like Ethiopia. For strong interventional measures, compiled data in the field is required which is otherwise missed in the Ethiopian context. Therefore, this systematic review aimed to provide an estimate of the HPV vaccination uptake, mothers' willingness to vaccinate their adolescent girls, and associated factors in Ethiopia. METHODS Articles were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Two reviewers assessed study eligibility, extracted data, and assessed the risk of bias independently. Meta-analysis was performed using STATA v 14 to pool the vaccination uptake and mothers' willingness toward HPV vaccination in Ethiopia. RESULTS We included 10 articles published between 2019 and 2022 covering reports of 3,388 adolescent girls and 2,741 parents. All the included articles had good methodological quality. The pooled estimate of the proportion of good knowledge about HPV vaccination and the agreement of girls to get the vaccine was 60% (95%CI: 59-62) and 65% (95%CI: 64-67), respectively. The pooled estimate of vaccination uptake of at least one dose of HPV vaccine among girls was 55% (95%CI: 53-57). Positive attitudes to the vaccine, higher maternal education, and having knowledge about HPV and its vaccine were reported as statistically significant predictors. On the contrary, not having adequate information about the vaccine and concerns about possible side effects were reported as reasons to reject the vaccine. Likewise, the pooled estimate of mothers who were knowledgeable about HPV vaccination, who had a positive attitude, and willing to vaccinate their children were 38% (95%CI: 36-40) 58% (95%CI: 56-60), and 74% (95%CI: 72-75), respectively. CONCLUSIONS Knowledge about the HPV vaccine among girls and their vaccination uptake is suboptimal that falls short of the 2030 WHO targets. Therefore, stakeholders need major efforts in rolling out vaccination programs and monitoring their uptake. Social mobilization towards primary prevention of HPV infection should focus on adolescents. The existing strategies need to address the predictors of uptake by educating girls and parents.
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Affiliation(s)
- Awoke Derbie
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia.
- Department of Medical Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Daniel Mekonnen
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melanie Maier
- Department of Virology, Institute of Medical Microbiology and Virology, Leipzig University Hospital, Leipzig, Germany
| | - Yimtubezinash Woldeamanuel
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Department of Medical Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Medical Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Poghosyan H, Dinan MA, Tamamyan G, Nelson L, Jeon S. Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History. J Racial Ethn Health Disparities 2023; 10:2354-2362. [PMID: 36149576 PMCID: PMC9510246 DOI: 10.1007/s40615-022-01415-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was to estimate COVID-19 vaccination rate among Medicare beneficiaries with cancer history and determine whether COVID-19 vaccine uptake is higher among non-Hispanic White beneficiaries compared with racially and ethnically minoritized beneficiaries. METHODS We used US representative, cross-sectional data from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 Rapid Response Community Supplement Survey. A total of 1,863 respondents with self-reported cancer history (other than skin cancer) were included. The outcome was self-reported receipt of at least one coronavirus vaccine dose since vaccines became available. The key independent variable of interest was self-reported race and ethnicity. We applied sample weights to account for the survey design and provide population estimates to 9.6 million beneficiaries with cancer history. Weighted descriptive statistics and multivariable logistic regression analyses were conducted. RESULTS During the first 4 months of vaccine availability, 69.6% of beneficiaries received at least one vaccine dose of which 65.4% had two vaccine doses. A larger proportion of non-Hispanic White beneficiaries (71.9%) had at least one vaccine dose compared with non-Hispanic Black (60.4%) and Hispanic (57.4%) beneficiaries. An estimated 30.4% of beneficiaries were still unvaccinated, that represents approximately 2.9 million unvaccinated beneficiaries with cancer history. Hispanic beneficiaries were 42% (OR: 0.58; 95% CI: 0.33-0.99; p = .048) less likely to be vaccinated compared with non-Hispanic White beneficiaries. CONCLUSIONS Results indicate racial and ethnic differences in vaccine uptake among Medicare beneficiaries with cancer history. Effective strategies are needed to help increase vaccine confidence and uptake among adults with cancer history.
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Affiliation(s)
- Hermine Poghosyan
- Yale School of Nursing, Yale University, New Haven, CT USA
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT USA
| | - Michaela A. Dinan
- Yale School of Public Health, Co-Leader of the Cancer Prevention and Control Research Program, Yale Comprehensive Cancer Center, Yale School of Medicine, New Haven, CT USA
| | - Gevorg Tamamyan
- Institute of Cancer and Crisis, Yerevan, Armenia
- Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center After Prof. R.H. Yeolyan, Yerevan, Armenia
- Department of Pediatric Oncology and Hematology, Yerevan State Medical University, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
| | - LaRon Nelson
- Yale School of Nursing, Yale University, New Haven, CT USA
- Global Affairs & Planetary Health Independence Foundation, Yale School of Nursing, Yale University, New Haven, CT USA
| | - Sangchoon Jeon
- Yale School of Nursing, Yale University, New Haven, CT USA
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Phiriyasart F, Aimyong N, Jirapongsuwan A, Roseh N. COVID-19 vaccine hesitancy among older adult Thai Muslim people: A case-control study. Vaccine 2023; 41:6048-6054. [PMID: 37643925 DOI: 10.1016/j.vaccine.2023.08.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023]
Abstract
The highest death toll during the COVID-19 pandemic in Thailand was among unvaccinated older adults. Deaths among older adults in Narathiwat Province were related to a lower COVID-19 vaccination rate. This study explored the factors influencing COVID-19 vaccination hesitancy in a Muslim community with low vaccination rates. A case-control study was conducted with participants assigned to the unvaccinated "case" group and the vaccinated "control" group. The sample was Thai older adults who practiced Islam and lived in Narathiwat Province. Purposive sampling was conducted by selecting a case house and finding the control around the case house in a 1:2 ratio. This study included 141 participants with a median age of 67 years (interquartile range [IQR], 8). More than 80% of both groups were retired and lived with their extended relatives. More participants in the vaccinated group believed that vaccines could prevent death from COVID-19 than in the unvaccinated group. In the multivariable analysis, factors related to the low perceived importance of the COVID-19 vaccination (odds ratio [OR] = 2.63) and a lack of vaccine recommendation from religious leaders (OR = 4.67) significantly influenced COVID-19 vaccination refusal. The COVID-19 guidance from religious leaders and the perceived importance of COVID-19 vaccination influence vaccination uptake among Muslim older adults in Thailand.
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Affiliation(s)
- Farooq Phiriyasart
- MPH Program, Faculty of Public Health, Mahidol University and Su-ngai Kolok Hospital, Narathiwat Provincial Public Health Office, 96120, Thailand.
| | - Natnaree Aimyong
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 10400, Thailand.
| | - Ann Jirapongsuwan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, 10400, Thailand.
| | - Norisan Roseh
- Kampong Baru Community Public Healthcare Center, Social Medicine Department, Naradhiwas Rajanagarindra Hospital, Narathiwat Province 96000, Thailand.
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Uthoff SAK, Zinkevich A, Franiel D, Below M, Splieth H, Iwen J, Biedermann M, Heinemeier D, Ansmann L. A complex intervention on vaccination uptake among older adults (≥ 60 years) in Germany - a study protocol with a mixed methods design. BMC Prim Care 2023; 24:148. [PMID: 37452283 PMCID: PMC10349490 DOI: 10.1186/s12875-023-02101-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The current uptake of many vaccinations recommended for persons aged 60 and older is unsatisfactory in Germany. Lack of confidence in the safety and efficacy of vaccinations, lack of knowledge and insecurities about possible side effects, and numerous pragmatic barriers are just some of the reasons to be mentioned. General practitioners (GPs) play a central role in the vaccination process. Therefore, effective interventions in this context are needed to address the various barriers and improve the vaccination uptake rates. METHODS A complex intervention will be implemented and evaluated in 1057 GPs' practices in two German federal states. The components include trainings for GPs and medical assistants on communication psychology, medical aspects, and organisational vaccination processes. The primary outcome influenza vaccination rate and the secondary outcomes vaccination uptake rate of other vaccinations as well as vaccine literacy of patients will be examined. The intervention will be evaluated in a mixed methods study with a controlled design. Survey data will be analysed descriptively and by using mean comparisons as well as multivariable multilevel analyses. The qualitative data will be analysed with qualitative content analysis. The secondary data will be analysed by using descriptive statistics, a pre-post comparison by performing mean comparisons, cluster analysis, and subgroup analyses. DISCUSSION In this study, a complex intervention to improve vaccination rates in GP practices for the vaccinations recommended for people aged 60 years and older will be implemented and evaluated. Additionally, improvements in patients' vaccine-related health literacy and knowledge, and patients' intention to get vaccinated are expected. The mixed methods design can deliver results that can be used to improve preventive health care for elderly people and to gain more knowledge on vaccination uptake and the intervention's effectiveness. TRIAL REGISTRATION Trial registration number: DRKS00027252 (retrospectively registered).
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Affiliation(s)
- Sarah A K Uthoff
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany.
| | - Anna Zinkevich
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Chair of Medical Sociology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Dominika Franiel
- Central Research Institute of Ambulatory Health Care in Germany, Salzufer 8, 10587, Berlin, Germany
| | - Maike Below
- Central Research Institute of Ambulatory Health Care in Germany, Salzufer 8, 10587, Berlin, Germany
| | - Helene Splieth
- Association of Substitute Health Funds (Vdek) e.V, Askanischer Platz 1, 10963, Berlin, Germany
| | - Julia Iwen
- Association of Substitute Health Funds (Vdek) e.V, Askanischer Platz 1, 10963, Berlin, Germany
| | - Marc Biedermann
- The National Association of Statutory Health Insurance Physicians, Herbert-Lewin-Platz 2, 10623, Berlin, Germany
| | - Dorothee Heinemeier
- Communication Lab Erfurt, Bahnhofstraße. 16/Büßleber Gasse, 99084, Erfurt, Germany
| | - Lena Ansmann
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Chair of Medical Sociology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
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11
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Voss SS, Nørgaard SK, Valentiner-Branth P. Identification of subgroups in the Danish population for targeted human papillomavirus vaccination efforts. Vaccine 2023; 41:3525-3533. [PMID: 37142460 DOI: 10.1016/j.vaccine.2023.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/04/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND In the Danish childhood vaccination program, the human papillomavirus (HPV) vaccination coverage is lower than for other vaccines. To tailor a targeted HPV vaccination effort, we aimed to identify girls in Denmark with lower first dose HPV vaccination coverage than girls in general. METHODS A population-based retrospective cohort study was performed of girls born in 2001-2004, residing in Denmark in September 2019 (N = 128,351). Data from the Danish Vaccination Register was linked to sociodemographic data from the Danish Civil Registration System and Statistics Denmark. Cox's proportional hazard regression models were used to compare vaccination uptake rates between subgroups of girls. RESULTS HPV vaccination coverage at 14 years of age varied widely by municipality (53.4-80.6%). Girls living with neither of their parents had a lower chance of being vaccinated compared to girls living with both their parents (HR 0.43; 95% CI 0.41-0.46), likewise for girls attending special need education compared with girls attending public schools (HR 0.50; 95% CI 0.42-0.59). The vaccination uptake among immigrants was lower compared to Danish-born girls (HR 0.51; 95% CI 0.49-0.54), especially among immigrant girls whose parents had not passed any Danish exams. Finally, girls who were DTaP-IPV revaccinated had a 50% greater chance of being HPV vaccinated compared to girls who were not (HR 1.61; 95% CI 1.58-1.64). CONCLUSION To increase the HPV vaccination uptake, we recommend vaccination efforts targeting girls living without any of their parents, girls attending special need education, immigrants, and girls who are not DTaP-IPV revaccinated. When targeting immigrants, the effort should focus on disseminating sufficient and understandable information about the Danish childhood vaccination program to the parents.
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Affiliation(s)
- Sidsel Skou Voss
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - Sarah Kristine Nørgaard
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - Palle Valentiner-Branth
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
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12
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Hirst J, Mi E, Copland E, Patone M, Coupland C, Hippisley-Cox J. Uptake of COVID-19 vaccination in people with blood cancer: Population-level cohort study of 12 million patients in England. Eur J Cancer 2023; 183:162-170. [PMID: 36870190 PMCID: PMC9916184 DOI: 10.1016/j.ejca.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND People with blood cancers have increased risk of severe outcomes from COVID-19 and were prioritised for vaccination. METHODS Individuals in the QResearch database aged 12 years and above on 1st December 2020 were included in the analysis. Kaplan-Meier analysis described time to COVID-19 vaccine uptake in people with blood cancer and other high-risk disorders. Cox regression was used to identify factors associated with vaccine uptake in people with blood cancer. RESULTS The analysis included 12,274,948 individuals, of whom 97,707 had a blood cancer diagnosis. 92% of people with blood cancer received at least one dose of vaccine, compared to 80% of the general population, but there was lower uptake of each subsequent vaccine dose (31% for fourth dose). Vaccine uptake decreased with social deprivation (HR 0.72, 95% CI 0.70, 0.74 for most deprived versus most affluent quintile for first vaccine). Compared with White groups, uptake of all vaccine doses was significantly lower in people of Pakistani and Black ethnicity, and more people in these groups remain unvaccinated. CONCLUSIONS COVID-19 vaccine uptake declines following second dose and there are ethnic and social disparities in uptake in blood cancer populations. Enhanced communication of benefits of vaccination to these groups is needed.
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Affiliation(s)
- Jennifer Hirst
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Emma Mi
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Emma Copland
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Martina Patone
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Carol Coupland
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK; Lifespan and Population Health Unit, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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13
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Iwuagwu AO, Rayner D, Ngwu CN, Kalu ME. Why I Have Not Taken the COVID-19 Vaccine" a Descriptive Qualitative Study of Older Adults' Perceived Views of COVID-19 Vaccine Uptake in Nigeria. J Popul Ageing 2023:1-21. [PMID: 36747959 PMCID: PMC9892676 DOI: 10.1007/s12062-023-09410-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023]
Abstract
Globally, the COVID-19 vaccine uptake is increasing, but slowly among older adults residing in lower and middle-income countries, including Nigeria. Following this, we explored the perceived views of older adults on the uptake of the COVID-19 vaccine in Nigeria. We adopted a qualitative descriptive study design and purposively selected and interviewed 16 retirees of older adults. Data were analyzed using conventional content analysis. Findings show that older adults' willingness to receive the COVID-19 vaccine was dissuaded by their past experiences with the government, religion, and Western media, including affordability and accessibility problems related to vaccination campaigns. Findings also show that the uncertainty about the COVID-19 virus existence and perceptions about COVID-19 vaccine risks influence older adults' decisions regarding vaccine uptake. Finally, older adults' views on getting vaccinated for COVID-19 were positively influenced by the trust they placed in their physicians and other members of their healthcare system. The government should incentivize healthcare workers to serve as a nudge to increase COVID-19 vaccine uptake among older adults in Nigeria.
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Affiliation(s)
| | - Daniel Rayner
- Department of Health Research methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
| | | | - Micheal Ebe Kalu
- School of rehabilitation Science, McMaster University, Hamilton, Ontario Canada
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14
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Zarzeczna N, Bertlich T, Većkalov B, Rutjens BT. Spirituality is associated with Covid-19 vaccination scepticism. Vaccine 2023; 41:226-235. [PMID: 36446652 PMCID: PMC9691453 DOI: 10.1016/j.vaccine.2022.11.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
Vaccine scepticism poses a significant global health risk, which has again become clear during the ongoing Covid-19 pandemic. Previous research has identified spirituality as an important contributor to general vaccine scepticism. In the present manuscript, we assessed whether self-identified spirituality similarly contributes to scepticism towards Covid-19 vaccines, vaccine uptake, and indecisiveness in intention to be vaccinated. We conducted three studies online in the UK in late 2020, early 2021, and the summer 2021. In Studies 1 and 2 (N = 585), as expected, individuals who strongly identified as spiritual were more sceptical about Covid-19 vaccines. This association was explained by low faith in science, but not by conspiracy beliefs. Importantly, among the vaccinated participants, those who were more spiritual were more indecisive to get a Covid-19 vaccine. Using structural equation modelling (SEM), we further found that spirituality directly predicted lower likelihood of being vaccinated against Covid-19 (Study 3, N = 456). We also identified low science literacy as an additional predictor of Covid-19 scepticism, but not self-reported vaccine uptake. To conclude, spiritual beliefs are an important factor to consider when aiming to increase understanding of vaccine-related science scepticism and vaccination rejection.
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Affiliation(s)
- Natalia Zarzeczna
- Corresponding author at: Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, Postbus 15900, 1001 NK Amsterdam, the Netherlands
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15
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Beale S, Burns R, Braithwaite I, Byrne T, Lam Erica Fong W, Fragaszy E, Geismar C, Hoskins S, Kovar J, Navaratnam AMD, Nguyen V, Patel P, Yavlinsky A, Van Tongeren M, Aldridge RW, Hayward A. Occupation, Worker Vulnerability, and COVID-19 Vaccination Uptake: Analysis of the Virus Watch prospective cohort study. Vaccine 2022; 40:7646-7652. [PMID: 36372668 PMCID: PMC9637514 DOI: 10.1016/j.vaccine.2022.10.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Occupational disparities in COVID-19 vaccine uptake can impact the effectiveness of vaccination programmes and introduce particular risk for vulnerable workers and those with high workplace exposure. This study aimed to investigate COVID-19 vaccine uptake by occupation, including for vulnerable groups and by occupational exposure status. METHODS We used data from employed or self-employed adults who provided occupational information as part of the Virus Watch prospective cohort study (n = 19,595) and linked this to study-obtained information about vulnerability-relevant characteristics (age, medical conditions, obesity status) and work-related COVID-19 exposure based on the Job Exposure Matrix. Participant vaccination status for the first, second, and third dose of any COVID-19 vaccine was obtained based on linkage to national records and study records. We calculated proportions and Sison-Glaz multinomial 95% confidence intervals for vaccine uptake by occupation overall, by vulnerability-relevant characteristics, and by job exposure. FINDINGS Vaccination uptake across occupations ranged from 89-96% for the first dose, 87-94% for the second dose, and 75-86% for the third dose, with transport, trade, service and sales workers persistently demonstrating the lowest uptake. Vulnerable workers tended to demonstrate fewer between-occupational differences in uptake than non-vulnerable workers, although clinically vulnerable transport workers (76%-89% across doses) had lower uptake than several other occupational groups (maximum across doses 86%-96%). Workers with low SARS-CoV-2 exposure risk had higher vaccine uptake (86%-96% across doses) than those with elevated or high risk (81-94% across doses). INTERPRETATION Differential vaccination uptake by occupation, particularly amongst vulnerable and highly-exposed workers, is likely to worsen occupational and related socioeconomic inequalities in infection outcomes. Further investigation into occupational and non-occupational factors influencing differential uptake is required to inform relevant interventions for future COVID-19 booster rollouts and similar vaccination programmes.
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Affiliation(s)
- Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK.
| | - Rachel Burns
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Isobel Braithwaite
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Cyril Geismar
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Susan Hoskins
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Annalan M D Navaratnam
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Vincent Nguyen
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK; Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Parth Patel
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Alexei Yavlinsky
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Martie Van Tongeren
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College London NW1 2DA, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
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16
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Avirappattu G, Pach Iii A, Locklear CE, Briggs AQ. An optimized machine learning model for identifying socio-economic, demographic and health-related variables associated with low vaccination levels that vary across ZIP codes in California. Prev Med Rep 2022; 28:101858. [PMID: 35706686 PMCID: PMC9186792 DOI: 10.1016/j.pmedr.2022.101858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/06/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Machine learning was used to assess extensive and specific COVID-19 vaccination risk variables. Machine learning explained higher vaccination level variation than standard statistical tests. Twenty socioeconomic risk variables explained 72.90% variance in unvaccinated counts. Age groups, housing types, household income and education were among the most high-risk variables. ZIP Code assessments provided more specific, localized public health targets than counties.
There is an urgent need for an in-depth and systematic assessment of a wide range of predictive factors related to populations most at risk for delaying and refusing COVID-19 vaccination as cases of the disease surge across the United States. Many studies have assessed a limited number of general sociodemographic and health-related factors related to low vaccination rates. Machine learning methods were used to assess the association of 151 social and health-related risk factors derived from the American Community Survey 2019 and the Centers for Disease Control and Prevention (CDC) BRFSS with the response variables of vaccination rates and unvaccinated counts in 1,555 ZIP Codes in California. The performance of various analytical models was evaluated according to their ability to regress between predictive variables and vaccination levels. Machine learning modeling identified the Gradient Boosting Regressor (GBR) as the predictive model with a higher percentage of the explained variance than the variance identified through linear and generalized regression models. A set of 20 variables explained 72.90% of the variability of unvaccinated counts among ZIP Codes in California. ZIP Codes were shown to be a more meaningful geo-local unit of analysis than county-level assessments. Modeling vaccination rates was not as effective as modeling unvaccinated counts. The public health utility of this model provides for the analysis of state and local conditions related to COVID-19 vaccination use and future public health problems and pandemics.
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Affiliation(s)
- George Avirappattu
- Center for Data Analytics, School of Mathematical Sciences, Kean University, NJ, USA
| | - Alfred Pach Iii
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | | | - Anthony Q Briggs
- NYU Langone Health, Grossman School of Medicine, New York University, New York, USA
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17
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Alya WA, Maraqa B, Nazzal Z, Odeh M, Makhalfa R, Nassif A, Aabed M. COVID-19 vaccine uptake and its associated factors among Palestinian healthcare workers: Expectations beaten by reality. Vaccine 2022; 40:3713-3719. [PMID: 35595663 PMCID: PMC9098917 DOI: 10.1016/j.vaccine.2022.05.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/17/2022] [Accepted: 05/07/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND In response to this extraordinary outbreak, many countries and companies rush to develop an effective vaccine, authorize, and deliver it to all people across the world. Despite these extensive efforts, curbing this pandemic relies highly upon vaccination coverage. This study aimed to determine SARS-COV-2 vaccine uptake among Palestinian healthcare workers, the factors that influence vaccination uptake, and the motivators and barriers to vaccination. METHODS A cross-sectional study was conducted using an online anonymous self-administered questionnaire during April and May 2021, after the Palestinian Ministry of Health launched the COVID-19 vaccination campaign. The questionnaire collected socio-demographic characteristics, vaccination attitude and vaccination uptake status, and motivators and barriers towards vaccination. In addition, multivariate logistic regression was performed to identify the influencing factors of vaccination uptake. RESULTS The study included 1018 participants from different professions, including 560 (55.0%) females. Of the participants, 677 (66.5%; 95% CI: 63.5-69.4%) received the vaccine. Higher uptake was observed among males (aOR = 1.5; 95 %CI: 1.1-2.1), single HCWs (aOR = 1.3; 95 %CI: 1.1-1.8), HCWs working in the non-governmental sector (aOR = 1.6; 95 %CI: 1.2-2.4), higher monthly income (aOR = 1.9; 95 %CI: 1.4-2.8) and smoking (aOR = 1.5; 95 %CI: 1.1-3.5). The lower level of negative vaccination attitudes predicted higher intake; mistrust of vaccine belief (aOR = 1.6; 95 %CI: 1.4-1.7) and worries over unforeseen future effects (aOR = 1.2; 95 %CI: 1.1-1.3). CONCLUSION In conclusion, the COVID-19 vaccination uptake was comparable to other studies worldwide but still needs to be improved, especially in the context of this ongoing global pandemic. It is imperative to invest resources to promote vaccination uptake and target all the vaccine misconceptions and fears.
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Affiliation(s)
- Walaa Abu Alya
- Primary Health Directorate, Ministry of Health, Palestine
| | - Beesan Maraqa
- Consultant Family Medicine, Ministry of Health, Palestine
| | - Zaher Nazzal
- Consultant Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine,Corresponding author
| | - Mahmoud Odeh
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rabee Makhalfa
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ali Nassif
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mousa Aabed
- Consultant Family Medicine, Ministry of Health, Palestine
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Alagarsamy S, Mehrolia S, Pushparaj U, Jeevananda S. Explaining the intention to uptake COVID-19 vaccination using the behavioral and social drivers of vaccination (BeSD) model. Vaccine X 2022; 10:100140. [PMID: 35013727 PMCID: PMC8730788 DOI: 10.1016/j.jvacx.2021.100140] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/02/2021] [Accepted: 12/30/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) has proposed a tool to measure behavioral and social drivers (BeSD) of vaccination uptake intentions of people across all countries. This study tests BeSD model to predict people's intentions to uptake COVID-19 vaccination in rural India. METHODS An online cross-sectional survey was developed for the purpose based on the components of the BeSD model, i.e., confidence, motivation, and behavioral intention. A convenient sampling technique was used to collect samples, amounting to a total of 625, from rural Bengaluru, in the Karnataka state of India. Structural equation modelling (SEM) was applied to examine the proposed model. All respondents for the survey were in the age category of 18-68 years with a mean age of 35 years. FINDINGS The results showed that 85% of COVID-19 vaccine uptake intentions can directly or indirectly be attributed to the government's vaccine communication strategy, perceived threats about the vaccine, and their trust in the healthcare sector. The dimensions of the vaccine acceptance scale (motivation factors) act as a mediator between these factors and COVID-19 vaccination uptake (the behavioral factor). CONCLUSION The study demonstrates that the BeSD framework is an efficient model for predicting the COVID-19 vaccination uptake in India.
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Affiliation(s)
| | - Sangeeta Mehrolia
- School of Business and Management, Christ University, Bangalore, India
| | - Ushanandini Pushparaj
- Department of Anaesthesiology, St. John's Medical College Hospital, Bangalore, India
| | - S Jeevananda
- School of Business and Management, Christ University, Bangalore, India
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McPhedran R, Gold N, Bemand C, Weston D, Rosen R, Scott R, Chadborn T, Amlôt R, Mawby M, Toombs B. Location, location, location: a discrete choice experiment to inform COVID-19 vaccination programme delivery in the UK. BMC Public Health 2022; 22:431. [PMID: 35246082 PMCID: PMC8894545 DOI: 10.1186/s12889-022-12823-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large-scale vaccination is fundamental to combatting COVID-19. In March 2021, the UK's vaccination programme had delivered vaccines to large proportions of older and more vulnerable population groups; however, there was concern that uptake would be lower among young people. This research was designed to elicit the preferences of 18-29-year-olds regarding key delivery characteristics and assess the influence of these on intentions to get vaccinated, to inform planning for this cohort. METHODS From 25 March to 2 April 2021, an online sample of 2012 UK adults aged 18-29 years participated in a Discrete Choice Experiment. Participants made six choices, each involving two SMS invitations to book a vaccination appointment and an opt-out. Invitations had four attributes (1 × 5 levels, 3 × 3 levels): delivery mode, appointment timing, proximity, and sender. These were systematically varied according to a d-optimal design. Responses were analysed using a mixed logit model. RESULTS The main effects logit model revealed a large alternative-specific constant (β = 1.385, SE = 0.067, p < 0.001), indicating a strong preference for 'opting in' to appointment invitations. Pharmacies were dispreferred to the local vaccination centre (β = - 0.256, SE = 0.072, p < 0.001), appointments in locations that were 30-45 min travel time from one's premises were dispreferred to locations that were less than 15 min away (β = - 0.408, SE = 0.054, p < 0.001), and, compared to invitations from the NHS, SMSs forwarded by 'a friend' were dispreferred (β = - 0.615, SE = 0.056, p < 0.001) but invitations from the General Practitioner were preferred (β = 0.105, SE = 0.048, p = 0.028). CONCLUSIONS The results indicated that the existing configuration of the UK's vaccination programme was well-placed to deliver vaccines to 18-29-year-olds; however, some adjustments might enhance acceptance. Local pharmacies were not preferred; long travel times were a disincentive but close proximity (0-15 min from one's premises) was not necessary; and either the 'NHS' or 'Your GP' would serve as adequate invitation sources. This research informed COVID-19 policy in the UK, and contributes to a wider body of Discrete Choice Experiment evidence on citizens' preferences, requirements and predicted behaviours regarding COVID-19.
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Affiliation(s)
- Robert McPhedran
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK.
| | - Natalie Gold
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK.,Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.,Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Charlotte Bemand
- Solent NHS Trust, NHS England, Highpoint Venue, Bursledon Rd, Southampton, Hampshire, SO19 8BR, UK
| | - Dale Weston
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Rachel Rosen
- Economics and Strategic Analysis Team, NHS England and NHS Improvement, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Robert Scott
- Economics and Strategic Analysis Team, NHS England and NHS Improvement, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Tim Chadborn
- Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Max Mawby
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK
| | - Ben Toombs
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK
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20
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Touray E, Barrow A, Kinteh B, Badjie M, Nget M, Touray J, Kinteh SLS, Jatta SPS, Ceesay L. Childhood vaccination uptake and associated factors among children 12-23 months in rural settings of the Gambia: a community-based cross-sectional study. BMC Public Health 2021; 21:1740. [PMID: 34560877 PMCID: PMC8464143 DOI: 10.1186/s12889-021-11810-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, immunization prevents 2–3 million deaths annually from vaccine-preventable diseases such as diphtheria, tetanus, pertussis, influenza, and measles. In developing countries, several immunization programs have made progress, but the coverage remains a standstill in some areas. In order to inform policies and practices, the present study aimed at assessing vaccination uptake and contextual-associated factors among children aged 12–23 months in rural Gambia. Methods A community-based triangulated cross-sectional design was conducted in January 2020, with 200 caregivers with children aged 12–23 months in selected households in rural communities across Upper River Region of the Gambia using multistage sampling technique were recruited. A structured interview questionnaire was developed and Infant Welfare Cards were assessed to elicit information regarding contextual household characteristics towards childhood immunization uptake. Percentages, chi-square/fisher exact test for variables with p-value ≤0.15 were considered for inclusion into logistic regression model. The significance level was set at p < 0.05. The adjusted Odds Ratio (aOR) with 95% Confidence Interval (CI) were reported to declare significance. Results The proportion of children who received all the required vaccines was 66%. At the level of antigen-specific coverage, about 88.5% received BCG, 71% received OPV 3, 82.5% received Penta 3, while 72 and 71% received Measles-Rubella and yellow fever, respectively. Caregivers who had primary education level 88.8% (aOR = 0.112; 95% CI = 0.029–0.434), secondary & above 87.2% (aOR = 0.128; 95% CI = 0.029, 0. 561) and arabic/madrassa 95.7% (aOR = 0.043; 95% CI = 0.008–1.227) were less likely to be fully vaccinated when compared to those who have never been to school. Farmers are less likely by 88.9% (aOR = 0.111; 95% CI 0.020, 0.635) while children from family size of more than 20 members had reduced odds (aOR = 0.420; 95% CI = 0.197, 0.894) for their children to complete their vaccination schedule as compared to those with at most 20 household members. Conclusion There is moderately a burden of incomplete vaccination in rural Gambia. Vaccination programs should be constantly monitored and evaluated by the Ministry of Health, especially in rural areas. To increase societal awareness and vaccine acceptance, a robust community-based health education efforts are desperately needed as part of initiatives to increase vaccine service utilization for these high-risk classes.
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Affiliation(s)
- Ebrima Touray
- School of Public Health, Gambia College, Brikama, The Gambia
| | - Amadou Barrow
- School of Public Health, Gambia College, Brikama, The Gambia. .,Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia.
| | - Bakary Kinteh
- School of Public Health, Gambia College, Brikama, The Gambia
| | - Mansour Badjie
- School of Public Health, Gambia College, Brikama, The Gambia
| | - Musa Nget
- School of Public Health, Gambia College, Brikama, The Gambia
| | - Jainaba Touray
- School of Public Health, Gambia College, Brikama, The Gambia
| | | | | | - Lamin Ceesay
- Regional Health Directorate, Upper River Region, Ministry of Health, Basse Santa Su, The Gambia
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Prabhu VS, Bansal N, Liu Z, Finalle R, Sénécal M, Kothari S, Trowers K, Myers E. HPV vaccination uptake and administration from 2006 to 2016 in a commercially insured population of the United States. BMC Public Health 2021; 21:1629. [PMID: 34488705 PMCID: PMC8422649 DOI: 10.1186/s12889-021-11664-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 08/25/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection can cause various cancers and can be prevented through vaccination. The American Cancer Society (ACS) has set an HPV vaccination completion target in 13-year-old children to 80% by 2026. While HPV vaccine coverage (proportion ever vaccinated) estimates are available, annual uptakes (proportion initiating vaccine in a year) in the United States (U.S.) are not well-known. METHODS We analyzed MarketScan® claims database to assess HPV vaccination uptakes in the U.S. among the 9- to 26-year-olds in 2006-2016. The annual uptake was the ratio of the number of enrollees who had a first record of an HPV vaccine during the year, and the number of enrollees of similar age and sex that year. RESULTS Uptake was below 1% among children turning 9 and 10 years old during the year. Since 2009 among female and since 2013 among males, the annual uptake has been the highest in those turning 13 years old (19.7% among females and 17.6% among males in 2016). Catch-up vaccination among older adolescents and young adults increased after Advisory Committee for Immunization Practices (ACIP) recommendations, but eventually slowed down as more younger persons were vaccinated. Most young adolescents were vaccinated by pediatricians, whereas young adult women were predominantly vaccinated by obstetricians/gynecologists and young adult males by family physicians. While only about half of the adolescents had well-check visits, the majority of those who initiated HPV vaccination had one the same year. CONCLUSION Continued increase in uptake is needed to reach the ACS 2026 goals.
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Affiliation(s)
- Vimalanand S Prabhu
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA.
| | - Neha Bansal
- Complete HEOR Solutions (CHEORS), North Wales, PA, USA
| | - Zhiwen Liu
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA
| | - Rodney Finalle
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA
| | | | - Smita Kothari
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA
| | - Kemar Trowers
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, 07033, USA
| | - Evan Myers
- Division of Women's Community and Population Health, Department of Obstetrics & Gynaecology, Duke University Medical Center, Durham, NC, USA
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Roller-Wirnsberger R, Lindner S, Kolosovski L, Platzer E, Dovjak P, Flick H, Tziraki C, Illario M. The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review. Aging Clin Exp Res 2021; 33:2123-2132. [PMID: 33587270 PMCID: PMC7882864 DOI: 10.1007/s40520-021-01793-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
Background Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others. Aims Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults to strengthen prevention approaches in the context of an overall burden of infectious diseases. Methods We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not. Results Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions. Discussion and conclusions This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01793-3.
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Abstract
Maternal immunisation is a public health strategy that aims to provide protection against certain infections to both mother and her foetus or newborn child. Vaccination of pregnant women induces vaccine-specific antibodies that lead to the subsequent transfer of these antibodies across the placenta or through breastfeeding to the offspring. At present, vaccinations in pregnancy are limited to pertussis, tetanus, diphtheria, polio, and the seasonal Influenza vaccine. Recently, some countries have incorporated routine antenatal vaccinations in their national immunisation programmes. Future vaccines targeted at pregnant women such as respiratory syncytial virus (RSV) and Group B streptococcus (GBS) are under development. The recently approved Covid-19 vaccines have no safety data for use in pregnancy at present, but have been considered in the UK in extremely vulnerable pregnant women or pregnant frontline health and social care workers. In this article, we review the evidence supporting maternal immunisation and discuss the uptake of vaccines in pregnant women, challenges of recording the data on vaccine coverage, and consider reasons behind the present levels of uptake and strategies for future improvements.
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Affiliation(s)
- Mercede Sebghati
- Fetal Medicine Unit, St George's University Hospitals, Blackshaw Road, London, UK
| | - Asma Khalil
- Fetal Medicine Unit, St George's University Hospitals, Blackshaw Road, London, UK; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, UK.
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24
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Constantinou CA, Ziogas DC, Venetsanopoulou A, Gamaletsou MN, Koutsogeorgopoulou L, Barbouni A, Tzioufas AG, Sipsas NV. A clinical audit of pneumococcal vaccination among patients with autoimmune rheumatic diseases living in Greece: The power of awareness. Vaccine 2021; 39:1593-1597. [PMID: 33610375 DOI: 10.1016/j.vaccine.2021.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Patients with autoimmune rheumatic diseases (ARDs) are at increased risk for pneumococcal infections and should be vaccinated against Streptococcus pneumoniae. Data on the rates of pneumococcal vaccination among patients with ARDs in Southern Europe are scarce. Here, we estimate the pneumococcal vaccination rate in patients living in Greece with ARDs, explore the patients' awareness regarding vaccination, and try to recognize factors that influence the vaccine uptake. METHODS Between October 2015 and September 2016, a structured questionnaire was provided to all consecutive patients with ARDs attending one outpatient clinic of our department. The survey included parameters concerning patients' demographics, underlying ARD and immunosuppressive medications, other comorbidities, vaccine type, knowledge about infection risk and necessity of vaccination. Univariate and multivariate analyses were performed to study any association of these factors with the vaccination uptake. RESULTS Overall, 395 patients with ARDs (30.13% aged >65 years and 78.99% female) participated in our survey. The most frequent ARD was rheumatoid arthritis (43.04%); 40.51% of patients were receiving biologic agents and 44.56% steroids. Pneumococcal vaccination rate was 49.37%, while 45.06% of patients have been vaccinated during the last five years and only 8.21% of them had a second pneumococcal vaccine, as per national guidelines. The decision of vaccination was significantly influenced by the patient's age (>65 years) (p < 0.001) and the complete awareness of reasons for being vaccinated (p < 0.001), but not by presence of comorbidities, the type of ARD or administration of a biologic agent. The main reason for no vaccination was that it was not suggested by the caring physician (82.50%). CONCLUSIONS In our cohort of patients with ARDs the pneumococcal vaccination was suboptimal. Better understanding of the significance of vaccination by the patient and suggestion for vaccination by the caring physician will improve vaccination uptake and optimize the clinical benefits among patients with ARDs.
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Affiliation(s)
- Costas A Constantinou
- Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece
| | - Dimitrios C Ziogas
- First Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece.
| | - Aliki Venetsanopoulou
- Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece
| | - Maria N Gamaletsou
- Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece
| | - Loukia Koutsogeorgopoulou
- Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece
| | - Anastasia Barbouni
- National School of Public Health, University of West Attica, Athens, Greece
| | - Athanasios G Tzioufas
- Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece
| | - Nikolaos V Sipsas
- Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Laikon General Hospital, Athens, Greece
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Akmatov MK, Holstiege J, Steffen A, Bätzing J. Utilization of influenza vaccination among chronically ill individuals in Germany: A nationwide claims-based analysis. Vaccine 2021; 39:952-960. [PMID: 33451775 DOI: 10.1016/j.vaccine.2020.12.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Individuals with chronic diseases have a higher risk of serious complications or even death in case of influenza infection. The European Union (EU) set a goal to reach a vaccination coverage of 75% in seniors and chronically ill individuals. The aim of this study was to assess influenza vaccination uptake among individuals with a wide spectrum of chronic diseases and examine its regional variations and temporal trends over a period of the last ten years. METHODS We used nationwide SHI-physician outpatient claims data from the years 2009 to 2018 covering 87% of the total German population to assess influenza vaccination uptake among individuals over 1 year of age with at least one of the following chronic diseases: pulmonary, cardiovascular, liver, kidney, metabolic, neurological and musculoskeletal diseases, as well as immune deficiency disorders, including HIV infection. RESULTS Influenza vaccination coverage varied across patient populations between 19% (multiple sclerosis) and 44% (chronic kidney disease) in the influenza season 2017/18. Vaccination coverage was slightly higher among females than males, except for HIV/AIDS patients. Among HIV-patients vaccination coverage was higher by 7 percent points among males (43%) than females (37%). The coverage was higher nearly for all patient groups in the eastern than western federal states. Over the observation period vaccination uptake showed decreasing trends in most of the target groups. Among patients with HIV/AIDS and immune deficiency disorders a stagnating trend was observed. CONCLUSIONS Vaccination uptake among chronically ill individuals is suboptimal and far from the EU-defined target of 75%. There were substantial variations in coverage by disease groups, individual factors and regions. The disease-specific evaluation of the current study allows identification of populations at higher risk with considerable vaccination gaps. Further efforts are needed to improve vaccination uptake in these vulnerable population groups.
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Affiliation(s)
- Manas K Akmatov
- Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany, Berlin, Germany.
| | - Jakob Holstiege
- Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany, Berlin, Germany
| | - Annika Steffen
- Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany, Berlin, Germany
| | - Jörg Bätzing
- Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany, Berlin, Germany
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Abstract
Vaccination saves millions of lives, and the World Health Organization (WHO) European Region celebrated record high coverage in 2018. Still, national or sub-national coverage is insufficient to stop the spread of vaccine-preventable diseases. Health authorities are increasingly aware of the need to prioritize the “demand” side of vaccination. Achieving high and equitable vaccination uptake in all population groups is not a quick-fix; it requires long-term investment in multifaceted interventions, informed by research with the target groups. The WHO focuses on both individual and context determinants of vaccination behaviours. Individual determinants include risk perceptions, (dis)trust and perceived constraints; insights from psychology help us understand these. Context determinants include social norms, socioeconomic status and education level, and the way health systems are designed, operate and are financed. The WHO recommends using a proven theoretical model to understand vaccination behaviours and has adapted the “COM‑B model” for their Tailoring Immunization Programmes (TIP) approach. This adapted model is described in the article. Informed by insights into the factors affecting vaccination behaviours, interventions and policies can be planned to increase vaccination uptake. Some evidence exists on proven methods to do this. At the individual level, some interventions have been seen to increase vaccination uptake, and experimental studies have assessed how certain messages or actions affect vaccination perceptions. At the context level, there is more documentation for effective strategies, including those that focus on making vaccination the easy, convenient and default behaviour and that focus on the interaction between caregivers and health workers.
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Affiliation(s)
- Katrine Bach Habersaat
- World Health Organization Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark.
| | - Cath Jackson
- World Health Organization Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark.,Valid Research Limited, Wetherby, UK
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27
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Arat A, Burström B, Östberg V, Hjern A. Social inequities in vaccination coverage among infants and pre-school children in Europe and Australia - a systematic review. BMC Public Health 2019; 19:290. [PMID: 30866881 PMCID: PMC6417277 DOI: 10.1186/s12889-019-6597-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Herd immunity levels of vaccine uptake are still not reached in some high-income countries, usually in countries with persisting social inequities in uptake. Previous studies have focused on factors within one health care system. This study takes a broader health care systems approach by reviewing the socioeconomic distribution of vaccination coverage on the national level in light of structural and organizational differences of primary care for children. METHODS A systematic literature review of socio-economic patterns of uptake of Measles-Mumps-Rubella (MMR) and/or Diphteria-Tetanus-Pertusis (DTP) in population based studies of children 0-5 years of age living in the 30 European Economic Area (EEA) or European Free Trade Association (EFTA) countries and Australia, was carried out using the PRISMA guidelines. The health care system in the countries in the study were categorized by degree of freedom of the primary care provider (hierarchical or non-hierarchical) and whether preventive services were provided in a separate organization (well-baby clinics). RESULTS The review identified 15 studies from 10 European countries and Australia that fulfilled the criteria. Although the heterogeneity of the socio-economic indicators did not allow for a conclusive meta-analysis, the study pointed towards lower levels of inequities in primary care models with well-baby clinics. In non-hierarchical primary care organizations that also lacked well-baby clinics, socioeconomic gaps in uptake were often found to be large. CONCLUSION This review indicates that structural and organizational aspects of health care systems for young children are important for equity in vaccine uptake.
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Affiliation(s)
- Arzu Arat
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden. .,Centre for Health Equity Studies, Karolinska Institutet/Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Bo Burström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Anders Hjern
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Health Equity Studies, Karolinska Institutet/Stockholm University, SE-106 91, Stockholm, Sweden
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de Bekker-Grob EW, Veldwijk J, Jonker M, Donkers B, Huisman J, Buis S, Swait J, Lancsar E, Witteman CLM, Bonsel G, Bindels P. The impact of vaccination and patient characteristics on influenza vaccination uptake of elderly people: A discrete choice experiment. Vaccine 2018; 36:1467-76. [PMID: 29426662 DOI: 10.1016/j.vaccine.2018.01.054] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/17/2018] [Accepted: 01/19/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To improve information for patients and to facilitate a vaccination coverage that is in line with the EU and World Health Organization goals, we aimed to quantify how vaccination and patient characteristics impact on influenza vaccination uptake of elderly people. METHODS An online discrete choice experiment (DCE) was conducted among 1261 representatives of the Dutch general population aged 60 years or older. In the DCE, we used influenza vaccination scenarios based on five vaccination characteristics: effectiveness, risk of severe side effects, risk of mild side effects, protection duration, and absorption time. A heteroscedastic multinomial logit model was used, taking scale and preference heterogeneity (based on 19 patient characteristics) into account. RESULTS Vaccination and patient characteristics both contributed to explain influenza vaccination uptake. Assuming a base case respondent and a realistic vaccination scenario, the predicted uptake was 58%. One-way changes in vaccination characteristics and patient characteristics changed this uptake from 46% up to 61% and from 37% up to 95%, respectively. The strongest impact on vaccination uptake was whether the patient had been vaccinated last year, whether s/he had experienced vaccination side effects, and the patient's general attitude towards vaccination. CONCLUSIONS Although vaccination characteristics proved to influence influenza vaccination uptake, certain patient characteristics had an even higher impact on influenza vaccination uptake. Policy makers and general practitioners can use these insights to improve their communication plans and information regarding influenza vaccination for individuals aged 60 years or older. For instance, physicians should focus more on patients who had experienced side effects due to vaccination in the past, and policy makers should tailor the standard information folder to patients who had been vaccinated last year and to patient who had not.
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Liao Q, Lam WWT, Cowling BJ, Fielding R. Psychosocial Influences on Parental Decision-Making Regarding Vaccination Against Seasonal Influenza for Young Children in Hong Kong: a Longitudinal Study, 2012-2013. Int J Behav Med 2017; 23:621-34. [PMID: 26987657 DOI: 10.1007/s12529-016-9551-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Vaccination uptake remained low, although annual subsidies are provided to encourage 6-72-month-old Hong Kong children to be vaccinated against seasonal influenza. This study was aimed to investigate the psychosocial influences on parental decision-making regarding young children's seasonal influenza vaccination. METHODS One-thousand two-hundred twenty-six parents of eligible children were recruited using random digit dialing in August-October 2012 to assess baseline perceptions and re-contacted in March 2013 to record children's vaccination uptake. Structural equation modeling (SEM) was performed to examine factors associated with parental decision about children's vaccination based on the complete data of 1222 respondents. RESULTS Of the 1226 respondents who completed the follow-up survey, 34.3 % reported that their child was vaccinated during the follow-up period. Child's past influenza vaccination history (β = 0.48), belief in vaccination safety (β = 0.35), and social norms (β = 0.25) were strongly associated with parental intention to vaccinate their child which directly predicted child vaccination uptake (β = 0.57). Belief in vaccination safety (β = 0.42) and social norms (β = 0.36) were strongly associated with vaccination intention of parents whose children never received influenza vaccine. CONCLUSION Interventions that address concerns on vaccination safety and utilize social norms may be effective to initiate Chinese parents to vaccinate their children.
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Affiliation(s)
- Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China.
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China
| | - Benjamin J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China
| | - Richard Fielding
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China
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30
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Makarovs K, Achterberg P. Contextualizing educational differences in " vaccination uptake": A thirty nation survey. Soc Sci Med 2017; 188:1-10. [PMID: 28692824 DOI: 10.1016/j.socscimed.2017.06.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/26/2017] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
This paper addresses the issue of public acceptance of vaccination with specific attention being paid to the role of education in vaccine uptake. Using Flash Eurobarometer 287 (2009) survey data and exploring it through the lens of Beck's reflexive modernization and Roger's protection motivation theories we examined how individual-level factors affect intention to get vaccinated, particularly aimed at examining whether higher education predicts more or less vaccination intention in different societies. The empirical results support an idea that at least for seasonal flu educational differences in vaccination uptake are contextual upon the reflexivity of the society in which respondent happens to live. Educated people living in more reflexive modernized countries tend to oppose vaccination against seasonal flu more that those highly educated living in less advanced societies, indicating that skeptical attitude towards science that is intrinsic to the modern post-industrial nations induces the immunization opposition among most informed and distrustful social group.
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Affiliation(s)
- Kirils Makarovs
- National Research University Higher School of Economics, Myasnitskaya St., 9/11, Office 443, 101000, Moscow, Russia.
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Alberts CJ, van der Loeff MFS, Hazeveld Y, de Melker HE, van der Wal MF, Nielen A, El Fakiri F, Prins M, Paulussen TGWM. A longitudinal study on determinants of HPV vaccination uptake in parents/guardians from different ethnic backgrounds in Amsterdam, the Netherlands. BMC Public Health 2017; 17:220. [PMID: 28222722 PMCID: PMC5320738 DOI: 10.1186/s12889-017-4091-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/30/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination coverage in the Netherlands is low (~60%) compared to other childhood vaccinations (>90%), and even lower among ethnic minorities. The aim of this study was to explore the possible impact of ethnicity on the determinants of both HPV vaccination intention and HPV vaccination uptake among parents/guardians having a daughter that is invited for the HPV vaccination. METHODS In February 2014, parents/guardians living in Amsterdam were invited to complete a questionnaire about social-psychological determinants of their decision making process regarding the HPV vaccination of their daughter and socio-demographic characteristics. This questionnaire was sent approximately one month before the daughter was scheduled to receive her first HPV vaccine dose. Their daughters' HPV vaccination status was retrieved from the national vaccination database. We distinguished four ethnic groups: Dutch (NL), Surinamese, Netherlands Antillean, and Aruban (SNA), Middle-Eastern and North-African (MENA), and Other. To assess the impact of determinants on both intention and uptake, linear and logistic regression analyses were used respectively. Missing data were imputed using multiple imputation by chained equation. RESULTS In total 1,309 parents/guardians participated (33% participation rate). In all groups we found the mothers' intention to be the strongest predictor of their daughters' HPV vaccination uptake. Explained variance of uptake was highest in the NL-group (pseudo-R2:0.56) and lower in the other ethnic groups (pseudo-R2 varied between 0.23 and 0.29). The lower explained variance can be attributed to the relative large proportion of participants with a positive intention that finally did not go for vaccination in the SNA-group (11%) and MENA-group (30%). Explained variance (R2) of intention varied between 0.66 and 0.77 across ethnic groups, and was best explained by the proximal social-psychological determinants. The strength of association of these determinants with both intention and uptake were largely similar across ethnic groups. CONCLUSION We conclude that the same determinants should be targeted in the different ethnic groups, although the mode of delivery of the intervention needs to be tailored to the different cultural backgrounds. Further research is needed to explain the observed discrepancy between intention and uptake, especially among parents/guardians in the non-Dutch groups.
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Affiliation(s)
- Catharina J Alberts
- Department of Infectious Diseases, Research and Prevention, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, 1018, WT, Amsterdam, The Netherlands. .,Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands.
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Research and Prevention, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, 1018, WT, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Yvonne Hazeveld
- Department of Youth Health Service, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Hester E de Melker
- Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marcel F van der Wal
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Astrid Nielen
- Department of Youth Health Service, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Fatima El Fakiri
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Research and Prevention, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, 1018, WT, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Theo G W M Paulussen
- TNO (Netherlands Organization for Applied Scientific Research), Expertise Centre Child Health, Leiden, The Netherlands
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Godinho CA, Yardley L, Marcu A, Mowbray F, Beard E, Michie S. Increasing the intent to receive a pandemic influenza vaccination: Testing the impact of theory-based messages. Prev Med 2016; 89:104-111. [PMID: 27235605 DOI: 10.1016/j.ypmed.2016.05.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/22/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Vaccination is an effective preventive measure to reduce influenza transmission, especially important in a pandemic. Despite the messages encouraging vaccination during the last pandemic, uptake remained low (37.6% in clinical risk groups). This study investigated the effect of different types of messages regarding length, content type, and framing on vaccination intention. METHOD An online experiment was conducted in February 2015. A representative sample of 1424 people living in England read a mock newspaper article about a novel influenza pandemic before being randomised to one of four conditions: standard Department of Health (DoH) (long message) and three brief theory-based messages - an abridged version of the standard DoH and two messages additionally targeting pandemic influenza severity and vaccination benefits (framed as risk-reducing or health-enhancing, respectively). Intention to be vaccinated and potential mediators were measured. RESULTS The shortened DoH message increased vaccination intention more than the longer one, by increasing perceived susceptibility, anticipated regret and perceived message personal relevance while lowering perceived costs, despite the longer one being rated as slightly more credible. Intention to be vaccinated was not improved by adding information on severity and benefits, and the health-enhancing message was not more effective than the risk-reducing. CONCLUSION A briefer message resulted in greater intention to be vaccinated, whereas emphasising the severity of pandemic influenza and the benefits of vaccination did not. Future campaigns should consider using brief theoretically-based messages, targeting knowledge about influenza and precautionary measures, perceived susceptibility to pandemic influenza, and the perceived efficacy and reduced costs of vaccination.
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Affiliation(s)
- Cristina A Godinho
- Research Department of Clinical, Educational and Health Psychology, University College London, WC1E 7HB, UK
| | - Lucy Yardley
- Department of Psychology, Faculty of Social and Human Sciences, University of Southampton, UK
| | - Afrodita Marcu
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, UK
| | - Fiona Mowbray
- Department of Psychology, Faculty of Social and Human Sciences, University of Southampton, UK
| | - Emma Beard
- Research Department of Clinical, Educational and Health Psychology, University College London, WC1E 7HB, UK
| | - Susan Michie
- Research Department of Clinical, Educational and Health Psychology, University College London, WC1E 7HB, UK.
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Chambongo PE, Nguku P, Wasswa P, Semali I. Community vaccine perceptions and its role on vaccination uptake among children aged 12-23 months in the Ileje District, Tanzania: a cross section study. Pan Afr Med J 2016; 23:162. [PMID: 27303578 PMCID: PMC4894730 DOI: 10.11604/pamj.2016.23.162.8925] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/28/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Underutilization of vaccines still remains a challenge in many regions across the world. Ileje district is one of the districts in Tanzania with consistently low pentavalent vaccine uptake (69%) and with drop out of 15%. We determined the vaccination completion with regard to Oral Polio virus, Measles, Bacillus Calmette-Guérin, and pentavalent vaccines and its association with community perceptions on vaccines. METHODS We conducted a cross sectional study in Ileje district from October to December 2013. We sampled 380 mothers using a multistage random sampling technique. We analysed data using EPI INFO. We summarized descriptive variables using mean and standard deviation and categorical variables using proportions. We conducted bivariate and multivariate logistic regression to identify factors influencing vaccination uptake, statistical significance was assessed at 95% confidence interval. RESULTS Mean age of the mothers was 27 years (SD 6.5 years) while that of their children was 16 months (SD 3.6 months). Fully vaccinated children were 71.1% and partially vaccinated were 28.9%, 99.2% were vaccinated with BCG vaccine and 73.4% were vaccinated with all OPV vaccine. Predictors of vaccination completion included negative perception on the vaccine provider-client relationship (AOR 1.86, 95%CI1.03-3.35), Perceived satisfaction with vaccination services (AOR 2.63, 95%CI 1.1 - 6.3). Others include child being born in the health facility (AOR 13.8 95% CI 8.04-25.8) and younger age of a child (AOR 0.51, 95%CI 0.29-0.9). CONCLUSION Improving quality of vaccination services, promoting health education and sensitizing community on health facility delivery will improve child vaccination completion in the district.
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Affiliation(s)
- Pai Elia Chambongo
- Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania
| | | | - Peter Wasswa
- African Field Epidemiology Network,Kampala, Uganda
| | - Innocent Semali
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences,Dar es Salaam, Tanzania
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Eilers R, Krabbe PF, de Melker HE. Factors affecting the uptake of vaccination by the elderly in Western society. Prev Med 2014; 69:224-34. [PMID: 25456809 DOI: 10.1016/j.ypmed.2014.10.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/09/2014] [Accepted: 10/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To present the results of a literature review on factors related to vaccine uptake by elderly persons. METHODS A systematic literature search was performed using Medline, Embase, and SciSearch to collect all publications available on factors related to vaccine uptake from 1966 until October 2012 for West European and North American societies. In total, 1001 articles were identified and 60 were included in the review. RESULTS We identified six main themes that influence the willingness to be vaccinated: 1) attitudes and beliefs regarding vaccination in general including positive and negative attitudes and beliefs; 2) perceived risk and severity including knowledge, perceived susceptibility and severity and personal experience; 3) vaccine characteristics including side-effects, effectiveness, content of the vaccine and knowledge; 4) advice and information including influence of the healthcare worker and relatives and the information source and format; 5) general health-related behavior including previous vaccinations, visiting GP or senior center and other preventive behaviors; and 6) accessibility and affordability including logistics, combinations of vaccines and costs. CONCLUSION The most important factors related to vaccine uptake are people's attitudes and beliefs regarding vaccination (especially their negative attitudes), recommendations of healthcare workers, side effects and effectiveness of the vaccine, and perceived susceptibility.
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Lehmann BA, Ruiter RAC, Chapman G, Kok G. The intention to get vaccinated against influenza and actual vaccination uptake of Dutch healthcare personnel. Vaccine 2014; 32:6986-6991. [PMID: 25454867 DOI: 10.1016/j.vaccine.2014.10.034] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/07/2014] [Accepted: 10/14/2014] [Indexed: 11/19/2022]
Abstract
Health Authorities recommend annual vaccination of healthcare personnel (HCP) against influenza to protect vulnerable patients. Nevertheless, vaccination rates have been low among European HCP. Here we report on a longitudinal survey study to identify social cognitive predictors of the motivation to obtain influenza vaccination, and to test whether intention is a good predictor of actual vaccination behaviour. Dutch HCP (N=1370) were invited to participate in a survey (baseline). To link intention to behaviour, participants who completed the first survey (N=556) were sent a second survey after vaccinations were offered (follow-up). Multinominal regression analysis showed that HCP with a positive attitude and a higher frequency of past vaccinations were more likely to have a high intention to get vaccinated. A negative attitude, high feelings of autonomy in the decision whether to get vaccinated, a preference of inaction over vaccination, a lesser sense of personal responsibility, and high self-protection motives increased the probability of no intention to get vaccinated. Social cognitive predictors were identified that explain the intention to get vaccinated against influenza of HCP, which in turn proved to be a good predictor of behaviour. Future interventions should focus on these variables to increase vaccination coverage rates.
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Affiliation(s)
- Birthe A Lehmann
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | - Robert A C Ruiter
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | - Gretchen Chapman
- Department of Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, United States.
| | - Gerjo Kok
- Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
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Liao Q, Wong WS, Fielding R. How do anticipated worry and regret predict seasonal influenza vaccination uptake among Chinese adults? Vaccine 2013; 31:4084-90. [PMID: 23867015 DOI: 10.1016/j.vaccine.2013.07.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/27/2013] [Accepted: 07/03/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test two hypothesized models of how anticipated affect, cognitive risk estimate and vaccination intention might influence vaccination uptake against seasonal influenza. METHODS The study collected baseline and follow-up data during the main influenza seasons (January-March) of 2009 and 2010, respectively, among 507 university students and staff of a university in Hong Kong. Following logistic regression to determine eligible variables, two mediation models of cognitive risk estimate, anticipated affect, vaccination intention and vaccination uptake against seasonal influenza were tested using structural equation modeling. RESULTS Mediation analyses found that anticipated worry if not vaccinated influenced seasonal influenza vaccination uptake through its effects on either perceived probability of influenza infection (β=0.45) or intention (β=0.45) while anticipated regret if not vaccinated influenced vaccination uptake through its effect on intention (β=0.45) only; anticipated regret if vaccinated impeded vaccination uptake indirectly through its effect on vaccination intention (β=-0.26) or directly (β=-0.20); perceived probability of influenza infection influenced vaccination uptake through its effect on intention (β=0.20) or directly (β=0.22); and finally, intention influenced vaccination uptake directly (β=0.58). CONCLUSION The results suggest that anticipated affect seems to drive risk estimates related to seasonal influenza vaccination rather than vice versa and intention remains an important mediator of the associations of anticipated affect and cognitive risk estimate with vaccination uptake against seasonal influenza.
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Affiliation(s)
- Q Liao
- Health Behaviors Research Group, School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China.
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