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Miao Y, Bai J, Shen Z, Li Y, Zhang W, Zhu D, Ren R, Zhang J, Guo D, Tarimo CS, Dong W, Liu R, Zhao Q, Hu J, Li M, Wei W. How urban versus rural population relates to COVID-19 booster vaccine hesitancy: A propensity score matching design study. Hum Vaccin Immunother 2024; 20:2297490. [PMID: 38214317 DOI: 10.1080/21645515.2023.2297490] [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: 08/29/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
During the COVID-19 pandemic, the vaccine hesitancy has significantly affected the vaccination. To evaluate the booster vaccine hesitancy and its influencing factors among urban and rural residents, as well as to estimate the net difference of booster vaccine hesitancy between urban and rural residents. We conducted a nationwide, cross-sectional Internet survey on 1-8 February 2023, and employed stratified random sampling technique to select participants (≥18 years old) from urban and rural areas. Multivariate logistic regression was used to determine the factors impacting booster vaccine hesitancy. Propensity Score Matching was used to estimate the net difference of COVID-19 booster vaccine hesitancy between urban and rural residents. The overall COVID-19 booster vaccine hesitancy rate of residents was 28.43%. The COVID-19 booster vaccine hesitancy rate among urban residents was found to be 34.70%, among rural residents was 20.25%. Chronic diseases, infection status, vaccination benefits, and trust in vaccine developers were associated with booster vaccine hesitancy among urban residents. Barriers of vaccination were associated with booster vaccine hesitancy among rural residents. PSM analysis showed that the urban residents have a higher booster vaccine hesitancy rate than rural residents, with a net difference of 6.20%. The vaccine hesitancy rate increased significantly, and the urban residents have a higher COVID-19 booster vaccine hesitancy than rural residents. It becomes crucial to enhance the dissemination of information regarding the advantages of vaccination and foster greater trust among urban residents toward the healthcare system.
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Affiliation(s)
- Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Institute for Hospital Management of Henan Province, Henan, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dan Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Rongmei Liu
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiuping Zhao
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianping Hu
- Henan Engineering technology Research Center for Health Big Data Governance, Henan Medical Communication and Project Forward Center, Zhengzhou, Henan, China
| | - Miaojun Li
- Henan Engineering technology Research Center for Health Big Data Governance, Henan Medical Communication and Project Forward Center, Zhengzhou, Henan, China
| | - Wei Wei
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Brohman I, Blank G, Mitchell H, Dubé E, Bettinger JA. Opportunities for HPV vaccine education in school-based immunization programs in British Columbia, Canada: A qualitative study. Hum Vaccin Immunother 2024; 20:2326779. [PMID: 38517252 PMCID: PMC10962613 DOI: 10.1080/21645515.2024.2326779] [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: 10/10/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Despite the availability of school-based immunization programs (SBIPs) in Canada, human papillomavirus (HPV) vaccine uptake remains suboptimal. Vaccine education may improve vaccine uptake among adolescents. The objective of this qualitative study was to identify opportunities for HPV vaccine education in British Columbia, Canada, by exploring the perspectives of students, parents, school staff, and public health nurses on the current SBIP. Individual semi-structured interviews were conducted with adult participants and focus groups were conducted with grade 6 students between November 2019 and May 2020. The interviews and focus groups were transcribed and then analyzed using reflexive thematic analysis. Opportunities for HPV vaccine education were identified in three themes: 1) making SBIPs student-centered; 2) adopting a collaborative and interdisciplinary approach to vaccine education; and 3) actualizing parent education opportunities. Broad support existed for a formal, collaborative HPV grade 6 vaccine curriculum delivered by teachers and public health nurses to provide evidence-based health information. Participants voiced that the curriculum should integrate students' perspectives on topics of interest and address needle associated pain and anxiety. Parents were identified as the primary vaccine decisionmakers, therefore, participants stated it was crucial to also provide parent-directed vaccine education as part of SBIP. Our findings support the development of a collaborative HPV vaccine curriculum directed to and informed by students and parents to buttress current SBIPs in British Columbia.
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Affiliation(s)
- Isabella Brohman
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Gabriel Blank
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Hana Mitchell
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Laval, QC, Canada
| | - Julie A. Bettinger
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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de Souza Amorim Matos CC, Couto MT, Oduwole EO, Shey Wiysonge C. Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital. Hum Vaccin Immunother 2024; 20:2298562. [PMID: 38196242 PMCID: PMC10793707 DOI: 10.1080/21645515.2023.2298562] [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: 07/03/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024] Open
Abstract
Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.
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Affiliation(s)
- Camila Carvalho de Souza Amorim Matos
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina, Araranguá, Brazil
| | - Marcia Thereza Couto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Elizabeth O. Oduwole
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, Universal Health Coverage/Communicable and Non-Communicable Diseases Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Biasio LR, Lorini C, Zanobini P, Bonaccorsi G. The still unexplored mediating role of vaccine literacy. Hum Vaccin Immunother 2024; 20:2310360. [PMID: 38314760 PMCID: PMC10863508 DOI: 10.1080/21645515.2024.2310360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Affiliation(s)
| | - Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy
| | - Patrizio Zanobini
- Department of Health Science, University of Florence, Florence, Italy
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Chen G, Yao Y, Zhang Y, Zhao F. The impact of risk perception and institutional trust on COVID-19 vaccine hesitancy in China. Hum Vaccin Immunother 2024; 20:2301793. [PMID: 38282324 PMCID: PMC10826627 DOI: 10.1080/21645515.2024.2301793] [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: 10/26/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024] Open
Abstract
Vaccination has become the primary means for citizens to prevent severe morbidity and mortality during the pandemic. However, vaccine hesitancy poses a major threat to global public health security. Based on the data from Chinese General Social Survey in 2021, this study aims to explore the socio-political aspects of COVID-19 vaccine hesitancy, focusing on the relationship between COVID-19 risk perceptions, institutional trust and vaccine hesitancy. Among the samples, 39.8% of the respondents exhibited COVID-19 vaccine hesitancy, 48.9% had a high awareness of the risk of COVID-19, and 74.6% presented a high level of trust in institutions. The results showed that higher risk perception and institutional trust are negatively correlated with vaccine hesitancy (p < .001). Institutional trust had no statistically significant moderating effect on the association between risk perception and vaccine hesitancy, but the role of institutional trust in influencing vaccine hesitancy is more significant at a lower level of perceptions of COVID-19 risk. Furthermore, regional variations in the factors contributing to vaccine hesitancy were demonstrated in China. These findings have important implications for developing strategies to address vaccine hesitancy.
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Affiliation(s)
- Guiwu Chen
- Department of Public Administration, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
| | - Yiyun Yao
- Department of Public Administration, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
| | - Yaowen Zhang
- The Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Master of Public Administration Education Center, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
| | - Fei Zhao
- The Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Master of Public Administration Education Center, School of Public Administration and Emergency Mangement, Jinan University, Guangzhou, Guangdong, China
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Newman PA, Dinh DA, Massaquoi N, Williams CC, Lacombe-Duncan A, Tepjan S, Nyoni T. "Going vaccine hunting": Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults-a qualitative study. Hum Vaccin Immunother 2024; 20:2301189. [PMID: 38346919 PMCID: PMC10863362 DOI: 10.1080/21645515.2023.2301189] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
High levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and vaccine hesitancy among predominantly racialized sexual and gender minority individuals. Semi-structured online interviews explored perspectives and experiences around COVID-19 vaccination. Interviews were recorded, transcribed, uploaded into ATLAS.ti, and reviewed using thematic analysis. Among 40 participants (mean age, 29.0 years [SD, 9.6]), all identified as sexual and/or gender minority, 82.5% of whom were racialized. COVID-19 vaccination experiences were dominated by structural barriers: systemic racism, transphobia and homophobia in healthcare and government/public health institutions; limited availability of vaccination/appointments in vulnerable neighborhoods; absence of culturally-tailored and multi-language information; lack of digital/internet access; and prohibitive indirect costs of vaccination. Vaccine hesitancy reflected in uncertainties about a novel vaccine amid conflicting information and institutional mistrust was integrally linked to structural factors. Findings suggest that the uncritical application of "vaccine hesitancy" to unilaterally explain undervaccination among marginalized populations risks conflating structural and institutional barriers with individual-level psychological factors, in effect placing the onus on those most disenfranchised to overcome societal and institutional processes of marginalization. Rather, disaggregating structural determinants of vaccination availability, access, and institutional stigma and mistrust from individual attitudes and decision-making that reflect vaccine hesitancy, may support 1) evidence-informed interventions to mitigate structural barriers in access to vaccination, and 2) culturally-informed approaches to address decisional ambivalence in the context of structural homophobia, transphobia, and racism.
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Affiliation(s)
- Peter A. Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Duy Anh Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Notisha Massaquoi
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto, Scarborough, Ontario, Canada
| | - Charmaine C. Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Social Work, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Yang X, Yang X, Jiang W, Luo N, Hu Y, Yang Y, Yang X, Hou L, Zhang J, Hu C, Lin J. A cross-sectional investigation of factors influencing mpox vaccine hesitancy for students in Southwest China. Hum Vaccin Immunother 2024; 20:2309704. [PMID: 38300140 PMCID: PMC10841021 DOI: 10.1080/21645515.2024.2309704] [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: 11/20/2023] [Accepted: 01/21/2024] [Indexed: 02/02/2024] Open
Abstract
From July to September 2023, China reported over 1, 400 confirmed cases of mpox transmitted mainly through sexual contact between males. Meanwhile, the percentage of men who have sex with men at universities in southwestern China is increasing every year, which is likely to lead to a potential spread of mpox on campuses. Vaccination is an effective preventive measure against infectious diseases, this study examined the willingness of university students in Southwest China to receive the mpox vaccine and analyzed the factors influencing their decision. A cross-sectional survey was conducted among 7311 university students from 10 universities in Southwest China between August 13 and September 1, 2023. The survey revealed a hesitancy rate of 56.13% toward the mpox vaccine, with the most common reason being concerns about vaccine safety (1407/4104, 34.29%). Univariate analysis identified 13 variables that significantly differed between the vaccine acceptance and vaccine hesitancy groups. Multivariate logistic regression analyses indicated protective factors for vaccine hesitancy, such as sexually transmitted diseases, previous knowledge about mpox, frequent information about mpox, people can get reinfection of mpox, and worries about mpox endemic in China. Additionally, the confidence and convenience dimensions in the 3Cs model were identified as risk factors for mpox vaccine hesitancy. This study found a high rate of vaccine hesitancy among university students in Southwest China regarding the mpox vaccine. Collaboration between university and healthcare departments is recommended to address mpox vaccine hesitancy among college students, thereby promoting their willingness to receive the mpox vaccine.
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Affiliation(s)
- Xiu Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Xuetao Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Wenyi Jiang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Na Luo
- Department of Operation Room, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yibo Hu
- Department of Stomatology, School of Medicine, Nankai University, Tianjin, China
| | - Ya Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Xidan Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Lingli Hou
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jingjing Zhang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Congxia Hu
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jihui Lin
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
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Hewage IM, Church KEM, Schwartz EJ. Investigating the impact of vaccine hesitancy on an emerging infectious disease: a mathematical and numerical analysis. J Biol Dyn 2024; 18:2298988. [PMID: 38174737 DOI: 10.1080/17513758.2023.2298988] [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] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
Throughout the last two centuries, vaccines have been helpful in mitigating numerous epidemic diseases. However, vaccine hesitancy has been identified as a substantial obstacle in healthcare management. We examined the epidemiological dynamics of an emerging infection under vaccination using an SVEIR model with differential morbidity. We mathematically analyzed the model, derived R 0 , and provided a complete analysis of the bifurcation at R 0 = 1 . Sensitivity analysis and numerical simulations were used to quantify the tradeoffs between vaccine efficacy and vaccine hesitancy on reducing the disease burden. Our results indicated that if the percentage of the population hesitant about taking the vaccine is 10%, then a vaccine with 94% efficacy is required to reduce the peak of infections by 40%. If 60% of the population is reluctant about being vaccinated, then even a perfect vaccine will not be able to reduce the peak of infections by 40%.
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Affiliation(s)
- Indunil M Hewage
- Department of Mathematics & Statistics, Washington State University, Pullman, Washington, USA
| | - Kevin E M Church
- Centre de Recherches Mathématiques, Université de Montréal, Montreal, Quebec, Canada
| | - Elissa J Schwartz
- Department of Mathematics & Statistics and School of Biological Sciences, Washington State University, Pullman, Washington, USA
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Nguyen KH, Chen S, Bao Y, Lu Y, Bednarczyk RA, Vasudevan L. COVID-19 Diagnosis, Severity, and Long COVID Among U.S. Adolescents, National Health Interview Survey, 2022. Am J Health Promot 2024; 38:534-539. [PMID: 38311899 DOI: 10.1177/08901171241231642] [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] [Indexed: 02/06/2024]
Abstract
PURPOSE Understanding disparities in COVID-19 outcomes, overall and stratified by vaccination status, is important for developing targeted strategies to increase vaccination coverage and protect adolescents from COVID-19. DESIGN The 2022 National Health Interview Survey (NHIS) is a cross-sectional nationally representative household survey of U.S. adults. SETTING A probability sample of households in the U.S. SAMPLE One child aged 12-17 years is randomly selected from each family in the household. A knowledgeable adult (eg, parent or guardian), responds on behalf of the child through an in-person interview (response rate = 49.9%). MEASURES Input measures-sociodemographic characteristics and COVID-19 vaccination status; output measures-ever had COVID-19, moderate/severe COVID-19, long COVID. ANALYSIS Prevalence of COVID-19 outcomes was assessed for adolescents aged 12-17 years. Factors associated with each COVID-19 outcome were assessed with multivariable logistic regression analyses. RESULTS Among 2758 adolescents aged 12-17 years in 2022, 60.5% had received ≥1 dose of COVID-19 vaccine, 30.2% had ever been diagnosed by a doctor that they had COVID-19, 29.5% had moderate/severe COVID-19, and 6.2% had long COVID. Adolescents who were vaccinated with ≥1 dose were less likely to be diagnosed with COVID-19 (aOR = .79) and less likely to have long COVID (aOR = .30). CONCLUSION Targeted messaging to highlight the importance of early treatment, the harms of long COVID-19, and the benefits of vaccination in protecting against long-term effects may be necessary to ensure that all adolescents and their families are adequately protected.
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Affiliation(s)
- Kimberly H Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, George Washington University School of Public Health and Health Sciences, Washington, DC, USA
| | - Siyu Chen
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Yingjun Bao
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Yang Lu
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Efendi F, Dewi YS, Arifin H, Hargono A, Apriyanto Y, Adnani QES, Gouda ADK, Susanti IA. Policies and cultural beliefs: Community perceptions about COVID-19 vaccine hesitancy in Indonesia. Public Health Nurs 2024. [PMID: 38613243 DOI: 10.1111/phn.13318] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Vaccine hesitancy is a global concern and a significant threat to COVID-19 vaccination programs. This study aimed to explore vaccine hesitancy from the perspective of the Indonesian community related to policies and cultural beliefs. DESIGN A descriptive qualitative approach was utilized in this study. SAMPLE Twenty participants were recruited from various settings to ensure the representation of experiences in different contexts in Indonesia. MEASUREMENT Audio-recorded, semi-structured, individual, in-depth interviews were carried out. Content analysis was performed to identify the main key themes. RESULTS Twenty participants were recruited from various regions of Java Island, Indonesia. The participants revealed hesitancy about the COVID-19 vaccine, including the themes of mistrust, controversy, and the culture and beliefs of the community. CONCLUSIONS This study highlights COVID-19 vaccine hesitancy in Indonesia, which may have implications for the community's perceptions and beliefs regarding the uptake of the COVID-19 vaccine. The trust issue remains a major challenge to convincing the community to accept the vaccine at the grassroots level. Targeted education and communication strategies are essential in addressing trust issues surrounding COVID-19 vaccines among critical stakeholders and religious leaders in Indonesia. Public health nursing plays a crucial role in fostering community acceptance and ensuring the success of vaccination programs.
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Affiliation(s)
- Ferry Efendi
- Department of Advanced Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Yulis Setiya Dewi
- Department of Advanced Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Hidayat Arifin
- Department of Basic Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Arief Hargono
- Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | | | | | - Amel Dawod Kamel Gouda
- Maternal and Newborn Health Nursing, Faculty of Nursing, Cairo University, Giza, Egypt
- Maternity Nursing, College of Nursing-Riyadh, King Saud bin Abdul-Aziz University for Health Sciences, KSA. King Abdulaziz Medical City. King Abdullah International Research Center., Riyadh, Saudi Arabia
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Hirschtick JL, DiFranceisco W, Hunt B, Jacobs J, Valencia J, Walsh JL, Quinn K. Coronavirus Disease 2019 Vaccination by Gender and Age in a Sample of Black Adults in Chicago. Health Educ Behav 2024:10901981241245060. [PMID: 38606988 DOI: 10.1177/10901981241245060] [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] [Indexed: 04/13/2024]
Abstract
Although vaccine behaviors differ greatly by gender and age, few studies have examined vaccination at the intersection of gender and age within the Black community. We examined COVID-19 vaccination by gender and age using a survey of over 500 Black adults in Chicago, Illinois, fielded from September 2021 to March 2022. Although 54% had received at least one COVID-19 vaccine, the proportion vaccinated was considerably lower for Black men (28%) and women (37%) under 40 years old than Black men (92%) and women (86%) over 40 years (p < .001). Concern about vaccine side effects was the most reported barrier for unvaccinated women (56%) and men (38%) under 40 years. Our results suggest that targeted efforts to improve COVID-19 vaccine uptake in the Black community in Chicago after the initial rollout should have focused on young adults, particularly young Black men, with emphasis on addressing concern about vaccine side effects.
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Rybacki M, Szkiela M, Rybacka M, Marcinkiewicz A. Attitudes regarding vaccination on the example of COVID-19 prevention. Med Pr 2024:185593. [PMID: 38567412 DOI: 10.13075/mp.5893.01522] [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] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND COVID-19 vaccines for public use were approved at the turn of 2020 and 2021. The level of vaccination coverage against COVID-19 in Poland is one of the lowest in Europe. Despite scientific studies there are people who are afraid of vaccinations and spread false information about them. Vaccinations against COVID-19 allowed us to learn about the attitudes of people who decided to be vaccinated, which can be used to improve the effectiveness of the infectious diseases prevention in the work and public environment. The aim of the study was to analyze the main reasons determining a decision to get vaccinated against COVID-19. MATERIAL AND METHODS The study was carried on among all the people who decided to be vaccinated against COVID-19 in Nofer Institute of Occupational Medicine in Łódź. All vaccinated people completed an anonymous survey containing questions related to the most important factors, which encouraged them to undergo this vaccination. RESULTS The study involved 945 people vaccinated against COVID-19. Statistical significance was revealed between 3 different reasons (one's own health, stress-free work, safe travelling and easier access to entertainment) for getting vaccinated and age, gender and a form of employment. The authors also found statistical significance of the correlation between the age, gender, education and form of employment of the respondents and the reason for choosing the specific vaccine product. CONCLUSIONS Despite evidence presented by scientists about the effectiveness and safety of vaccinations, many people refused and still refuse to receive the vaccine. In order to increase the readiness of the population for vaccinations against COVID-19 and subsequent ones, if there is a need to limit new epidemics, the following should be done: introduce activities to raise health awareness, intensify strategies and campaigns aimed at increasing public trust in available vaccines against COVID-19, devolop individualized messages that contribute to vaccine hesitancy.
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Affiliation(s)
- Marcin Rybacki
- Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Occupational Diseases and Environmental Health)
| | - Marta Szkiela
- Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Occupational Diseases and Environmental Health)
| | | | - Andrzej Marcinkiewicz
- Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Occupational Diseases and Environmental Health)
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13
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Mishra V, Dexter JP. Response of Unvaccinated US Adults to Official Information About the Pause in Use of the Johnson & Johnson-Janssen COVID-19 Vaccine: Cross-Sectional Survey Study. J Med Internet Res 2024; 26:e41559. [PMID: 38557597 DOI: 10.2196/41559] [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: 08/25/2022] [Revised: 05/26/2023] [Accepted: 12/29/2023] [Indexed: 04/04/2024] Open
Abstract
Using a rapid response web-based survey, we identified gaps in public understanding of the Centers for Disease Control and Prevention's messaging about the pause in use of the Johnson & Johnson-Janssen COVID-19 vaccine and estimated changes in vaccine hesitancy using counterfactual questions.
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Affiliation(s)
- Vishala Mishra
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
| | - Joseph P Dexter
- Data Science Initiative, Harvard University, Allston, MA, United States
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, United States
- Institute of Collaborative Innovation, University of Macau, Taipa, Macao
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14
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Pavey L, Rotella A, Vallée-Tourangeau G. Moral obligation, autonomous motivation and vaccine hesitancy: Highlighting moral obligation increases reactance in hesitant individuals. Appl Psychol Health Well Being 2024. [PMID: 38561930 DOI: 10.1111/aphw.12540] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
Vaccine hesitancy is widespread, and developing effective communication strategies that encourage hesitant individuals to choose vaccination is essential. This pre-registered research aimed to examine associations among moral obligation, autonomous motivation, vaccination intentions and reactance, and to test messages highlighting moral obligation and autonomy support. In Study 1, participants who had not received a Covid-19 vaccine (N = 1036) completed measures of autonomous motivation, moral obligation, reactance, intentions to vaccinate and vaccine hesitancy. Autonomous motivation and moral obligation emerged as strong independent predictors of lower reactance, lower hesitancy and greater vaccination intentions. In Study 2 (N = 429), the participants received a vaccination-promoting message that highlighted moral obligation versus personal protection and used autonomy supportive versus controlling language. Messages with autonomy-supportive language and highlighting personal protection elicited lower reactance and greater perceived legitimacy compared to messages with controlling language and highlighting moral obligation. All messages elicited greater reactance and lower perceived legitimacy compared to an information-only message, and there were no effects of message type on vaccination intentions or vaccine hesitancy. The research has implications for the design of communications encouraging vaccination in hesitant individuals and suggests caution should be taken when developing messages to encourage vaccination in hesitant individuals.
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Affiliation(s)
- Louisa Pavey
- Department of Psychology, Kingston University, Kingston-upon-Thames, UK
| | - Amanda Rotella
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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15
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Dele-Ojo BF, Adesokan A, Fadare JO, Ajayi PO, Raimi TH, Dada SA, Ojo OD, Ogunmodede JA, Ipinnimo TM, Ariyo OE, Godman B. Short-term COVID-19 vaccine adverse effects among adults in Ekiti State, Nigeria. Curr Med Res Opin 2024; 40:621-627. [PMID: 38323854 DOI: 10.1080/03007995.2024.2316217] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The safety of the COVID-19 vaccines has been a topic of concern globally. This issue of safety is associated with vaccine hesitancy due to concerns about the adverse effects of the vaccines. Consequently, this study determined the short-term safety profile of the Oxford/AstraZeneca COVID-19 vaccine in Ekiti State, Nigeria. METHODS Descriptive cross-sectional study conducted between May and July 2021 among individuals who had received the first dose of the first batch of the Oxford/AstraZeneca COVID-19 vaccine at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria. A Google form was used to collect data on the adverse effects of the vaccine. RESULTS Out of over 1,000 individuals who were approached, 758 respondents completed the study. A large percentage (57.4%) of those who received the vaccines were healthcare workers. Adverse effects were reported in 70.8% of the participants with most manifesting on the first day of the vaccination. The predominant adverse effects were injection site soreness (28.5%), followed by fatigue (18.7%) and muscle pain (8.6%). There was no report of severe adverse effects such as anaphylactic reactions, thrombosis, myocarditis, transient myelitis, or Guillen-Barre syndrome. CONCLUSION This study found that self-reported adverse effects of the Oxford/AstraZeneca COVID-19 vaccine were mild and short in duration. This outcome has promising implications for improving COVID-19 vaccine uptake in the immediate environment and Nigeria.
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Affiliation(s)
- Bolade Folasade Dele-Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Adedapo Adesokan
- Emergency Medicine Department, Kingsmill Hospital, Sutton-in-Ashfield, Scotland
| | | | - Paul Oladapo Ajayi
- Department of Community Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Owolabi Dele Ojo
- Department of Surgery, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Olumuyiwa Elijah Ariyo
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, United Kingdom
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Kwok G, Reese S, Dugad S, Donovan KA, Tsui J, Sahler OJZ, Levonyan-Radloff K, Barnett ME, Manne S, Ohman-Strickland P, Devine KA. Factors Associated with COVID‑19 Vaccine Uptake Among Adolescents and Young Adults Recently Diagnosed with Cancer. J Adolesc Young Adult Oncol 2024; 13:352-357. [PMID: 36367717 PMCID: PMC10998015 DOI: 10.1089/jayao.2022.0113] [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] [Indexed: 11/13/2022] Open
Abstract
Adolescents and young adults (AYAs) recently diagnosed with cancer are medically vulnerable but little is known about vaccine uptake/intent in this group. AYAs reported on their COVID-19 vaccine uptake/intent. Logistic regression models examined factors associated with vaccine uptake. Higher education (adjusted odds ratio [aOR] = 1.9, 95% confidence interval [CI]: 1.0-3.5) and knowing someone diagnosed with COVID-19 (aOR = 7.2, 95% CI: 1.6-33.5) were associated with increased vaccine uptake. Prior personal diagnosis of COVID-19 (aOR = 0.1, 95% CI: 0.1-0.7) was associated with lower odds of uptake. Targeted interventions may be needed to improve uptake among this group. (ClinicalTrials.gov Identifier: NCT04585269).
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Affiliation(s)
- Gary Kwok
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Samantha Reese
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Sanjana Dugad
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Olle Jane Z. Sahler
- Department of Pediatrics, Hematology and Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Marie E. Barnett
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sharon Manne
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Pamela Ohman-Strickland
- Department of Biostatistics and Epidemiology, Rutgers University School of Public Health, Piscataway, New Jersey, USA
| | - Katie A. Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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17
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Martinelli M, Veltri GA. COVID-19 vaccine acceptance: A comparative longitudinal analysis of the association between risk perception, confidence, and the acceptance of a COVID-19 vaccine. Risk Anal 2024; 44:802-816. [PMID: 37496470 DOI: 10.1111/risa.14200] [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] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/28/2023]
Abstract
Following the outbreak of COVID-19, scientists rushed to develop vaccines to protect individuals and ferry the world out of the pandemic. Unfortunately, vaccine hesitancy is a major threat to the success of vaccination campaigns. Research on previous pandemics highlighted the centrality of perceived risk and confidence as core determinants of vaccine acceptance. Research on COVID-19 is less conclusive, and frequently it relies on one-country, cross-sectional data, thus making it hard to generalize results across contexts and observe these relationships over time. To bridge these gaps, in this article, we analyzed the association between perceived risk, confidence, and vaccine acceptance cross-sectionally at individual and country levels. Then, we longitudinally explored whether a within-country variation in perceived risk and confidence was correlated with a variation in vaccine acceptance. We used data from a large-scale survey of individuals in 23 countries and 19 time-points between June 2020 and March 2021 and comparative longitudinal multilevel models to estimate the associations at different levels of analysis simultaneously. Results show the existence of cross-sectional relationships at the individual and country levels but no significant associations within countries over time. This article contributes to our understanding of the roles of risk perception and confidence in COVID-19 vaccines' acceptance by underlining that these relationships might differ at diverse levels of analysis. To foster vaccine uptake, it might be important to address individual concerns and persisting contextual characteristics, but increasing levels of perceived risk and confidence might not be a sufficient strategy to increase vaccine acceptance rates.
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Affiliation(s)
- Mauro Martinelli
- Department of Sociology, University of Copenhagen, København, Denmark
| | - Giuseppe A Veltri
- Department of Sociology and Social Research, University of Trento, Trento, Italy
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18
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Charles CM, Noles M, Munezero A, Gallardo N, Bahamondes L, Bento SF, de Pádua KS, Nhauche M, Metelus S, Cecatti JG, Souza RT, Pacagnella RC. Risk factors related to the SARS-CoV-2 vaccine additional doses hesitancy among pregnant and non-pregnant people of reproductive age and partners: A Brazilian cross-sectional study. Int J Gynaecol Obstet 2024. [PMID: 38532554 DOI: 10.1002/ijgo.15512] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The aim of this study was to assess the predictors of acceptance and hesitancy of additional doses of any SARS-CoV-2 (COVID-19) vaccine among pregnant or recently pregnant and non-pregnant people of reproductive age and partners in Brazil. METHODS We conducted an online cross-sectional study from June 2022 to April 2023 and invited women and partners between 18 and 49 years old to participate. We employed a snowball strategy to reach all potential eligible participants. Our primary outcome was the acceptance rate of the COVID-19 booster vaccine. We estimated the frequency and percentage for the three groups and compared categorical variables using the Chi-square test. Moreover, bivariate, backward stepwise regression, and subgroup analyses were performed to evaluate risk factors and predictors of COVID-19 vaccine booster hesitancy. We reported the effect size as OR with a 95% CI. RESULTS We included 1487 participants, and among them, 334 (22.5%) were pregnant or recently pregnant people, 905 (60.8%) were non-pregnant people, and 247 (16.6%) were male partners. Pregnant and recently pregnant people showed greater hesitancy for the COVID-19 vaccine booster than non-pregnant people (28% vs 15%, P < 0.001) and male partners (28% vs 16%, P < 0.001). Non-pregnant women accepted the COVID-19 vaccine more often than pregnant or recently pregnant people (OR 1.75; 95% CI: 1.13-2.70). The associated factors to the reduced COVID-19 vaccine booster acceptance were family income between US$ 566-945.00 (54%), evangelic religion (65%), concern about vaccine safety (80%) and perceived common vaccine importance (93%). CONCLUSION Pregnant people were more hesitant than non-pregnant people to accept the COVID-19 booster vaccine. Family income, religious beliefs, vaccine safety concerns, and perceived common vaccine importance were significant barriers to accepting COVID-19 booster vaccines. The impact of these factors was more evident among pregnant or recently pregnant people, emphasizing the harmful effect of misinformation among this vulnerable population.
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Affiliation(s)
- Charles M Charles
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Provincial Health Administration, DPS Manica, Chimoio, Mozambique
| | - Marcelo Noles
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Aline Munezero
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Negli Gallardo
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Silvana F Bento
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
- Women's Hospital "Prof. Dr. José A Pinotti" - Center for Integral Attention to Women (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Karla S de Pádua
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
- Women's Hospital "Prof. Dr. José A Pinotti" - Center for Integral Attention to Women (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Marta Nhauche
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - Sherly Metelus
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
| | - José G Cecatti
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brazil
| | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas - (UNICAMP), Campinas, SP, Brazil
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Samel-Kowalik P, Jankowski M, Tomaszewska A, Sobeczek K, Rakocy K, Samoliński BK, Gujski M, Pinkas J, Vatsenko A, Raciborski F. A national registry-based study on uptake of the first dose of MMR vaccine in 380 administrative regions in Poland, 2013-2016-2020. Ann Agric Environ Med 2024; 31:65-71. [PMID: 38549478 DOI: 10.26444/aaem/172887] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION AND OBJECTIVE Regular monitoring of the measles, mumps, and rubella (MMR) vaccine uptake quickly exposes immunity gaps in the population. In Poland, the first dose of the MMR vaccine is mandatory for children between 13 and 15 months of life. This study aimed to assess the uptake of the first dose of MMR vaccine in 380 administrative counties in Poland in 2020, as well as to analyze the MMR vaccine uptake trends in 2013-2016-2020. MATERIAL AND METHODS This study is an epidemiological retrospective national registry-based analysis. Data on mandatory childhood vaccinations in all 380 counties in Poland were collected from the epidemiological reports of the State Sanitary Inspectorate territorial representatives. MMR vaccine uptake was calculated as the percentage of children who received the first dose of MRR vaccine to all children subject to mandatory vaccination in the county. RESULTS The uptake of the first dose of MMR vaccine decreased from 99.4% in 2013, to 95.5% in 2016 and 91.9% in 2020. In 2013, 93.2% of countys MMR vaccine uptake level reached the herd immunity level, followed by 77.1% of counties in 2016 and only 38.3% of countys in 2020. In 2020, two counties reached complete (100%) MMR vaccine uptake, and the lowest MMR vaccine uptake was 63.88%. Of the 380 counties in Poland, in 226 (61.1%) the MMR vaccine uptake level was lower than the herd immunity level, and a downward trend was observed. MMR vaccine uptake decreased with an increased number of residents in a county (r= -0.35; p<0.001). CONCLUSIONS This study revealed that in 61% of administrative regions in Poland, the MMR vaccine uptake was below the herd immunity level. Regional differences in the MMR vaccine uptake were observed. A significant decrease in MMR vaccine uptake between 2013 - 2020 poses a risk of measles outbreaks.
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Affiliation(s)
- Piotr Samel-Kowalik
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Aneta Tomaszewska
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | - Karolina Sobeczek
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | | | | | - Mariusz Gujski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
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20
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Abebe D, Mengistu T, Demssie EA, Mesfin S. Corona virus vaccine hesitancy among higher education students in Adama City, Oromia, Ethiopia. Front Public Health 2024; 12:1364225. [PMID: 38590806 PMCID: PMC10999607 DOI: 10.3389/fpubh.2024.1364225] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
Background Vaccination stands as the most efficient approach for managing the continued transmission of infections and preventing the emergence of novel variants. Coronavirus disease 2019 (COVID-19) vaccine hesitancy poses a significant burden in the fight to achieve herd immunity. Methods A cross-sectional study, based on institutional parameters, was conducted among a cohort of 530 higher education students, selected via a simple random sampling method. Study participants were selected using a systematic random sampling technique from February to March 2022. Structured questionnaire data were gathered and subsequently analyzed using SPSS version 21. The strength of the association between various factors and COVID-19 vaccine hesitancy was assessed using the odds ratio along with its 95% confidence interval. Statistical significance was deemed to be present at a p-value of < 0.05. Result The prevalence of coronavirus vaccine hesitancy was 47.5%. The factors that were found to be significantly associated with COVID-19 vaccine hesitancy were residential address (AOR = 2.398, 95% CI: 1.476-3.896); agreeing with leaders and groups that do not support COVID-19 vaccination (AOR = 2.292, 95% CI: 1.418-3.704); coming from a community whose leaders support COVID-19 vaccination for young adults (AOR = 0.598, 95% CI: 0.381-0.940), and believing that COVID-19 vaccines are safe (AOR = 0.343,95% CI: 0.168-0.701). Conclusion Approximately five out of 10 students who participated in this study were hesitant to get vaccinated against coronavirus. Incorporating messages and initiatives into local plans to specifically target the factors identified in this study is imperative for substantially increasing the COVID-19 vaccine uptake among students in higher education institutions.
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Affiliation(s)
- Dawit Abebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Tewodros Mengistu
- Department of Public Health, Adama General Hospital and Medical College, Adama, Ethiopia
| | - Enku Afework Demssie
- Department of Public Health, Adama General Hospital and Medical College, Adama, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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21
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Kanan M, Abdulrahman S, Alshehri A, AlSuhaibani R, Alotaibi NM, Alsaleh A, Nasser B, Baowaydhan R, Alredaini I, Khalid T, Almukhtar F, Altoaimi N, Alhneshel A, Alanazi S, Algmaizi S. Factors Underlying Vaccine Hesitancy and Their Mitigations in Saudi Arabia: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e54680. [PMID: 38517463 PMCID: PMC10998176 DOI: 10.2196/54680] [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: 11/18/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing concern in Saudi Arabia, impacting even well-educated parents. The decision-making process involves various factors such as accessibility, trustworthy information, and the influence of social networks, reflecting a complex interplay of emotional, cultural, social, spiritual, and political dimensions. OBJECTIVE This review seeks to evaluate the prevalence and trends of vaccine hesitancy, identify contributing factors, and explore potential solutions to enhance immunization rates. This review aligns with global concerns, as the World Health Organization has identified vaccine hesitancy as a top global health threat. METHODS Our systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive assessment. We will conduct a thorough search across various databases, encompassing a wide range of vaccines, and pay special attention to vaccination campaigns and refusals. Inclusion criteria involve descriptive, observational, and analytical studies focusing on factors influencing vaccine acceptance or hesitancy. The study will use the Crowe Critical Appraisal Tool for quality assessment and perform a narrative synthesis to summarize findings thematically. RESULTS This systematic review is expected to unveil the prevalence and trends of vaccine hesitancy in diverse populations in Saudi Arabia, shedding light on cultural, religious, and social factors contributing to hesitancy. It aims to assess the effectiveness of implemented strategies, enable regional and global comparisons, and provide implications for tailored vaccination policies. Additionally, the review may pinpoint research gaps, guiding future investigations to address and mitigate vaccine hesitancy effectively. CONCLUSIONS The findings are expected to have direct policy implications and guide interventions to strengthen vaccination programs and improve public health outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54680.
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Affiliation(s)
- Mohammed Kanan
- Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Renad AlSuhaibani
- Department of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Northern Border University, Rafha, Saudi Arabia
| | - Azhar Alsaleh
- Department of Nursing, Prince Saud Bin Jalawi Hospital, Alhasa, Saudi Arabia
| | - Bushra Nasser
- Department of Clinical Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rana Baowaydhan
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Taif Khalid
- Department of Clinical Laboratory, Al-Jawf University, Al-Jawf, Saudi Arabia
| | - Fatima Almukhtar
- Department of Medicine, Ministry of Health, Dammam, Saudi Arabia
| | - Nourah Altoaimi
- Department of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Almaha Alhneshel
- Department of Medicine, Suliman Alrajhi University, Qassim, Saudi Arabia
| | - Shouq Alanazi
- Department of Medicine, Northern Border University, Northern Borders, Arar, Saudi Arabia
| | - Shahad Algmaizi
- Department of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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22
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Lan Y, Jin L. Heritage and hesitancy: how preference for traditional Chinese medicine influences vaccine attitudes. Front Public Health 2024; 12:1355720. [PMID: 38566787 PMCID: PMC10985209 DOI: 10.3389/fpubh.2024.1355720] [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: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Vaccine hesitancy, amplified by the COVID-19 pandemic, is a pressing public health challenge. This study investigates the association between Traditional Chinese Medicine (TCM) preference and COVID-19 vaccine hesitancy within China. Methods The study uses data from the 2021 Chinese General Social Survey (CGSS) (N = 2,690). Logistic regressions and Karlson-Holm-Breen (KHB) method are employed to analyzed the relationship between TCM preference and vaccine hesitancy. Results The study reaffirms prior findings by revealing a robust and stable association between TCM preference and vaccine hesitancy, which remains unaffected by socioeconomic and demographic confounders, as well as institutional trust dynamics of healthcare system. Contrary to expectations, TCM enthusiasts do not exhibit vaccine hesitancy based on divergent epistemological views concerning vaccine risks and immunity acquisition compared to biomedicine. Discussion This research enriches understandings of the intricate relations between healthcare paradigms and vaccine attitudes, inviting further inquiry into the role of CAM in shaping vaccination behaviors across different cultures and contexts. The insights bear significant public health implications for enhancing vaccine acceptance and coverage, particularly among populations where CAM practices wield substantial influence.
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Affiliation(s)
- Yaxin Lan
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Shanghai, China
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lei Jin
- Faculty of Social Science, The Chinese University of Hong Kong, Shatin, Hong Kong Region, Hong Kong SAR, China
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Lasander M, Elo K, Joronen K, Dub T. Barriers to vaccine acceptance in the adult population of mainland Finland, 2021. Epidemiol Infect 2024; 152:e54. [PMID: 38487840 DOI: 10.1017/s0950268824000463] [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] [Indexed: 04/06/2024] Open
Abstract
There has been a lack of information on vaccine acceptance for Finnish adults. We conducted a secondary analysis of cross-sectional data collected through the Finnish Medicines Agency Medicine Barometer 2021 survey (response rate: 20.6%). We described and explained vaccine acceptance by investigating the associations between socio-demographic factors and statements using logistic regression and conducted a factor analysis. The majority of respondents (n = 2081) considered vaccines to be safe (93%), effective (97%), and important (95%). However, 20% and 14% felt they did not have enough information about vaccines and vaccine-preventable diseases (VPDs), respectively. Respondents aged 18-39 were 2.8 times more likely to disagree that they had enough information about VPDs compared to respondents aged 60-79 (p < 0.001), while respondents with poorer self-perceived health were 1.8 times more likely to declare not having enough information about vaccines (p < 0.001). We generated three-factor dimensions from the eight statements. They were related to 'Confidence and attitudes towards vaccines', 'Access to information on vaccines and VPDs', and 'Debate on vaccine issues', which may reflect the underlying thinking patterns. Access to and understanding of information about vaccines and VPDs need to be improved for Finnish adults to increase vaccine acceptance and uptake, thus preventing the spread of VPDs.
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Affiliation(s)
- Mervi Lasander
- Infection Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland
| | - Kimmo Elo
- Faculty of Social Sciences, Centre for Parliamentary Studies, University of Turku, Turku, Finland
| | - Katja Joronen
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland
| | - Timothée Dub
- Infection Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
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Çelik H, Özer M, Zincir H. Modification and Validation of the Vaccine Hesitancy Scale for Turkish Adult Vaccination. J Nurs Meas 2024; 32:82-94. [PMID: 37827583 DOI: 10.1891/jnm-2022-0020] [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] [Indexed: 10/14/2023]
Abstract
Background and Purpose: For public health, it is important to investigate vaccine hesitancy, determine populations reluctant for vaccines, and investigate barriers and facilitators for vaccination in these groups. This study aims to modify and validate the Vaccine Hesitancy Scale specific to adults in Turkish society. Methods: The study, which was designed as a methodological and survey type, was conducted using a Google questionnaire with 720 participants who met the inclusion criteria with a convenient sampling method. Results: After factor and reliability analysis, a 2-factor, 10-item scale with an acceptable and perfect range of fit index values emerged. It has been observed that individuals who are young, single, do not have children, have vaccine allergy, and do not believe that the vaccine will protect the society are adversely affected by the environment, and those who do not have COVID-19 and flu have a high level of hesitancy to vaccine. Conclusions: The Vaccine Hesitancy Scale is a valid and reliable tool to detect vaccine hesitation in adults in Turkish society.
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Affiliation(s)
- Hakan Çelik
- Department of Nursing, Public Health Nursing, Cukurova University, Adana, Turkey
| | - Mustafa Özer
- Department of Medical Services and Techniques, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Handan Zincir
- Department of Nursing, Public Health Nursing, Erciyes University, Kayseri, Turkey
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Skaathun B, Salgin L, Muñoz FA, Talavera GA, Smith DM, Stockman JK, O’Bryan SE, Ramirez D, James-Price C, Servin AE. Study protocol: Project 2VIDA! SARS-CoV-2 vaccine intervention delivery for adults in Southern California. Front Public Health 2024; 12:1291332. [PMID: 38550328 PMCID: PMC10977100 DOI: 10.3389/fpubh.2024.1291332] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/28/2024] [Indexed: 04/02/2024] Open
Abstract
Background To date, the United States (US) leads the world in the number of infections and deaths due to the Coronavirus Disease 2019 (COVID-19). Racial and ethnic disparities in COVID-19 morbidity and mortality are staggering. Age-adjusted data show that AA and Latino individuals have had higher rates of death over most of the pandemic and during surges. Project 2VIDA! is community-based participatory research (CBPR) that was developed to address individual, social, and contextual factors related to access and acceptance of the COVID-19 vaccine among African American and Latino communities in Southern California. This paper describes the study protocol and overarching objectives. Methods and design Project 2VIDA! is a multilevel intervention that builds on the principals of CBPR and is designed to increase uptake of the COVID-19 vaccine among African American and Latino individuals (≥16 years and older) in San Diego County. The intervention was developed with a working group comprised of representatives from community and academia and centers on targeted COVID-19 individual awareness and education, linkage to medical and supportive services, COVID-19 community outreach and health promotion and offering the COVID-19 vaccine through community pop-up clinics. Discussion Findings from 2VIDA! will provide data on the impact, feasibility, and acceptability of the intervention which are all crucial for the adaptation, refinement, and improvement of vaccine outreach interventions for COVID-19 and other vaccine preventable infectious diseases that severely impact African American and Latino communities. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT05022472?term=Project+2VIDA&draw=2&rank=1, NCT05022472.
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Affiliation(s)
- Britt Skaathun
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Linda Salgin
- San Ysidro Health Center, San Diego, CA, United States
| | | | | | - Davey M. Smith
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Jamila K. Stockman
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Sophie E. O’Bryan
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | | | | | - Argentina E. Servin
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
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26
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Parums DV. A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination. Med Sci Monit 2024; 30:e944436. [PMID: 38525549 PMCID: PMC10946219 DOI: 10.12659/msm.944436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
On 22 February 2024, the World Health Organization (WHO) stated that, following the recent resurgence of measles cases in Europe, more than half the world's countries could expect significant measles outbreaks this year. Measles is a highly infectious virus with a primary case reproduction number (R0) of 12-18. Measles infection can be severe, resulting in pneumonia, and also more rarely in subacute sclerosing panencephalitis (SSPE), which occurs in 1 child out of every 1,000 and can be fatal. Until the 1990s, the hope of eliminating measles seemed possible following the successful development of effective vaccines, given individually or in the combined measles, mumps, and rubella (MMR) vaccine. Vaccine hesitancy due to misinformation about possible vaccine side effects, reduced vaccine uptake during and after the COVID-19 pandemic, and lack of awareness of the severe consequences of measles infection have contributed to low vaccine uptake, resulting in vulnerable communities. This article aims to review the recent resurgence of measles cases in the US, Europe, and the UK, to provide a reminder of the potential severity of measles, and to consider the causes of the failure to eliminate this vaccine-preventable viral infection.
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Jafar A, Dollah R, Sakke N, Mapa MT, Atang C, Joko EP, Sarjono F, Zakaria NS, George F, Vun Hung C. Public Perception Toward the Malaysian National COVID-19 Immunisation Programme (PICK) in the State of Sabah, Malaysia: A Cross-Sectional Survey. Disaster Med Public Health Prep 2024; 18:e43. [PMID: 38450457 DOI: 10.1017/dmp.2024.31] [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] [Indexed: 03/08/2024]
Abstract
The Malaysian Government has initiated the National COVID-19 Immunisation Programme, known as PICK, to be a national strategy for addressing the spread of the coronavirus disease (COVID-19) pandemic across the country. Although the government intensified public awareness to increase program registration, the total number that registered in the state of Sabah, located in East Malaysia, was relatively low during August 2021, accounting for only 42.9% as compared to that of Peninsular Malaysia. Therefore, this paper examines the public perception toward the PICK program in Sabah based on 4 main components: safety, communication, psychology, and milieu. This study is based on the empirical findings drawn from 1024 respondents across Sabah using online Google Form surveys. This study adopts 5 methodologies for data analysis by using K-means clustering, mean score, Mann-Whitney U test, spatial analysis, and frequency analysis. It has been revealed that the percentage of respondents (categorized as Cluster 1) who have a negative perception toward the vaccination program is higher (55.9%) than those who have a positive perception (44.1%). This study further discovered that Cluster 1 has shown high skepticism regarding the vaccination program, which can be explained through the communication component (M = 3.33, SD = 0.588), especially Co2, Co3, Co1, and Co4. Following the communication factor, a chain of negative perceptions also affects other components such as safety, psychology, and milieu among Cluster 1, all of which contribute to poor participation in the PICK program. The study outcomes are extremely useful for informing local authorities to establish policies related to public interests, primarily in the areas of public health. Understanding the community's perspectives and their obstacles in participating in such programs may assist local authorities in developing or implementing public policies and campaigns that ensure such related public programs can be conducted more effectively in the future.
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Affiliation(s)
- Adi Jafar
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Ramli Dollah
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Nordin Sakke
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Mohammad Tahir Mapa
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Colonius Atang
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Eko Prayitno Joko
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Fauzie Sarjono
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Noor Syakirah Zakaria
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Fionna George
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
| | - Chong Vun Hung
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, 88400, Malaysia
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Olanlesi-Aliu A, Kemei J, Alaazi D, Tunde-Byass M, Renzaho A, Sekyi-Out A, Mullings DV, Osei-Tutu K, Salami B. COVID-19 among Black people in Canada: a scoping review. Health Promot Chronic Dis Prev Can 2024; 44:112-125. [PMID: 38501682 DOI: 10.24095/hpcdp.44.3.05] [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] [Indexed: 03/20/2024]
Abstract
INTRODUCTION The COVID-19 pandemic exacerbated health inequities worldwide. Research conducted in Canada shows that Black populations were disproportionately exposed to COVID-19 and more likely than other ethnoracial groups to be infected and hospitalized. This scoping review sought to map out the nature and extent of current research on COVID-19 among Black people in Canada. METHODS Following a five-stage methodological framework for conducting scoping reviews, studies exploring the effects of the COVID-19 pandemic on Black people in Canada, published up to May 2023, were retrieved through a systematic search of seven databases. Of 457 identified records, 124 duplicates and 279 additional records were excluded after title and abstract screening. Of the remaining 54 articles, 39 were excluded after full-text screening; 2 articles were manually picked from the reference lists of the included articles. In total, 17 articles were included in this review. RESULTS Our review found higher rates of COVID-19 infections and lower rates of COVID-19 screening and vaccine uptake among Black Canadians due to pre-COVID-19 experiences of institutional and structural racism, health inequities and a mistrust of health care professionals that further impeded access to health care. Misinformation about COVID-19 exacerbated mental health issues among Black Canadians. CONCLUSIONS Our findings suggest the need to address social inequities experienced by Black Canadians, particularly those related to unequal access to employment and health care. Collecting race-based data on COVID-19 could inform policy formulation to address racial discrimination in access to health care, quality housing and employment, resolve inequities and improve the health and well-being of Black people in Canada.
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Affiliation(s)
| | - Janet Kemei
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Dominic Alaazi
- Health and Immigration Policies and Practices Research Program (HIPP), University of Alberta, Edmonton, Alberta, Canada
| | - Modupe Tunde-Byass
- Black Physicians of Ontario, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, University of Ontario, Toronto, Ontario, Canada
| | - Andre Renzaho
- Translational Health Research Institute, School of Medicine, Campbell Town Campus, Western Sydney University, Australia
| | | | - Delores V Mullings
- School of Social Work, Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Kannin Osei-Tutu
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Health and Immigration Policies and Practices Research Program (HIPP), University of Alberta, Edmonton, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Pan WKM. The application of behavioral change theories in addressing vaccine hesitancy: A Literature Review. Public Health Nurs 2024; 41:318-324. [PMID: 38246855 DOI: 10.1111/phn.13280] [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: 06/09/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
Vaccination is vital in combating infectious diseases, including COVID-19. Nevertheless, vaccine hesitancy poses a substantial obstacle to achieving high vaccination rates. This study investigated the determinants of vaccine hesitancy using behavioral change theories and proposes a comprehensive conceptual framework to address this challenge.The paper conducted a review of several behavior change theories relevant to understanding vaccine hesitancy. The health belief model (HBM) highlighted the importance of individuals' perceptions of the effectiveness of health behaviors and their perceived susceptibility to illness. The social cognitive model (SCT) underscored the role of personal experiences, environmental factors, and social support in shaping health behaviors. The theory of reasoned action and planned behavior (TRA) suggested that attitudes and subjective norms are crucial in determining behavioral intentions. The transtheoretical model (TTM) outlined stages of behavior change, while the socio-ecological model (SEM) considered factors at individual, relationship, community, and societal levels. Comprehending vaccine hesitancy is essential for developing effective strategies to promote vaccine acceptance. This study, which examined vaccine hesitancy through various behavior change theories, sought to shed light on the factors influencing vaccine hesitancy among Filipinos. The resulting conceptual framework offers guidance for future interventions aimed at addressing vaccine hesitancy and ultimately improving vaccination rates.
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Affiliation(s)
- Warren Kemuel M Pan
- Graduate Student, University of the Philippines Manila College of Public Health Department of Health Promotion and Education, Manila, Philippines
- Faculty Member, University of Santo Tomas College of Nursing, Manila, Philippines
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Steinmayr A, Rossi M. Vaccine-skeptic physicians and patient vaccination decisions. Health Econ 2024; 33:509-525. [PMID: 38015034 DOI: 10.1002/hec.4781] [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] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/12/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
What is the role of general practitioners (GPs) in supporting or hindering public health efforts? We investigate the influence of vaccine-skeptic GPs on their patients' decisions to get a COVID-19 vaccination. We identify vaccine-skeptic GPs from the signatories of an open letter in which 199 Austrian physicians expressed their skepticism about COVID-19 vaccines. We examine small rural municipalities where patients choose a GP primarily based on geographic proximity. These vaccine-skeptic GPs reduced the vaccination rate by 5.6 percentage points. This estimate implies that they discouraged 7.9% of the vaccinable population. The effect appears to stem from discouragement rather than rationing vaccine access.
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31
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Konstantopoulos A, Dayton L, Latkin C. The politics of vaccination: a closer look at the beliefs, social norms, and prevention behaviors related to COVID-19 vaccine uptake within two US political parties. PSYCHOL HEALTH MED 2024; 29:589-602. [PMID: 37992282 PMCID: PMC10922401 DOI: 10.1080/13548506.2023.2283401] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
COVID-19 vaccine hesitancy and suboptimal vaccine uptake rates are pressing public health challenges. Vaccine hesitancy has been observed for different vaccines. For COVID-19 vaccines, multiple factors influence vaccine uptake in the U.S. including political ideology. A more nuanced understanding of the factors influencing COVID-19 vaccine uptake within political parties is needed. This study assesses the relationship between known vaccine hesitancy factors and vaccine uptake within two major political parties. Data from 804 U.S. participants in an online survey from June 2021 was used to assess the association between COVID-19 vaccine uptake (no dose vs. any dose) and categories of factors thought to influence vaccine uptake (sociodemographic variables, COVID-19 disease and vaccine belief variables, belief in COVID-19 prevention behavior variables, and social network features variables) for Republicans and Democrats using bivariate and multivariate regression. 65.4% of the sample reported having received at least one dose of the COVID-19 vaccine (22.6% Republican and 52.1% Democrat). In the total sample bivariate model, Democrat participants had significantly greater odds of having received a dose of the vaccine as compared to Republican participants (OR = 2.51, 95%CI = 1.73-3.64). In adjusted models, the speed of vaccine development was negatively associated with vaccine uptake for both Republicans (aOR = 0.18, 95%CI = 0.06-0.57) and Democrats (aOR = 0.40, 95%CI = 0.19-0.86), as was concern about side effects from the vaccine (Republicans: aOR = 0.15; 95%CI = 0.05-0.47; Democrats: aOR = 0.14, 95%CI = 0.06-0.31). COVID-19 vaccine uptake among Republicans, but not Democrats, was associated with belief that the vaccine prevents COVID-19 (aOR = 3.29, 95%CI = 1.29-8.37) and belief about friends' vaccine intentions (aOR = 6.19, 95%CI = 2.39-16.05). There were no significant factors unique to Democrats. Concerns about aspects of COVID-19 vaccine safety for both political groups suggest that vaccine advocacy interventions should universally address these factors. However, Republican beliefs in vaccine efficacy and in friends' vaccine intentions suggest a need for Republican-specific messaging.
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Affiliation(s)
- Arianna Konstantopoulos
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Lauren Dayton
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Banerjee S, Sarvottam K, Gupta AK. Assessment of the Knowledge, Attitudes, and Practices of Indian Medical Students Towards Coronavirus Disease 2019 (COVID-19) After Two Doses of Vaccination and Their Approach Towards the Third (Booster) Dose. Cureus 2024; 16:e55588. [PMID: 38576675 PMCID: PMC10993081 DOI: 10.7759/cureus.55588] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Background and objectives Medical students not only directly impact coronavirus disease 2019 (COVID-19) transmission due to their behavior and perceptions but also play an important role in influencing the behavior and vaccine intentions of their families and the community at large. The study's objective was to assess the knowledge, attitudes, and practices of medical students who have completed two doses of the COVID-19 vaccine towards the disease and their approach towards the third (booster) dose. Methods A total of 705 individual responses were obtained from a cross-sectional web-based study deployed using Google Forms. After getting consent and basic information, data was obtained regarding knowledge of the disease, attitudes towards the disease, and practices regarding the same. The mean score was calculated for the above different categories and compared with their respective cut-offs using a one-sample t-test. Data was also collected regarding their approach towards the booster dose of the COVID-19 vaccine, and the proportion of each response for different categories of questions was calculated. Results Participants were found to have mean scores in the range of moderate knowledge in the first part (47.67±4.49) and the second part (6.96±1.10) of the questionnaire and moderate practices (30.6±4.27) regarding COVID-19 disease. However, they had a mean score in the range of low attitude (39.79±4.07). The majority of participants acknowledge the role of vaccines in preventing the severity and spread of the disease (71.95%) and its effect on workers and medical professionals (60.26%). Mixed opinions were obtained for concerns regarding its pre-market testing and adverse effects and the government's vaccination policy. Interpretation and conclusion Responses of the medical students obtained in this study were majorly positive and in accordance with pre-vaccination studies concerning knowledge and practices. However, the low mean score in attitude obtained can be possibly explained due to their lack of direct exposure to patient management during the pandemic. The majority of participants had a positive response towards the use of the vaccine and the effectiveness of the booster dose, but concerns regarding pre-market testing, adverse effects, and the government's vaccination policy suggested the role of awareness campaigns and government endeavors to curb the same.
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Affiliation(s)
- Saptarshi Banerjee
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
| | - Kumar Sarvottam
- Department of Physiology, All India Institute of Medical Sciences, Gorakhpur, IND
| | - Ashish Kumar Gupta
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
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Gadzekpo A, Tietaah GKM, Yeboah-Banin AA, Kwame Ampofo Adjei D. Media coverage of COVID-19 vaccines: sources of information, and verification practices of journalists in Ghana. J Commun Healthc 2024; 17:15-29. [PMID: 37161948 DOI: 10.1080/17538068.2023.2208893] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Research on vaccines confirms the crucial role media play in framing discourses and mobilizing public support for successful immunization campaigns. What journalists cover on vaccination issues and their diligence in producing stories can influence attitudes to and uptake of vaccines. This paper contributes to emerging discussions on the role of the media in pandemics and in vaccination programs by interrogating the information seeking and verification practices of journalists reporting on COVID-19 vaccines in Ghana. METHODS A cross-sectional online survey was conducted among journalists from June to July 2021 through self-administered questionnaires by means of Google forms. The opinions of 300 respondents, randomly drawn from members of the Ghana Journalists' Association, were solicited and a response rate of 73% obtained. RESULTS Majority of journalists surveyed relied on official health sources for their information on COVID-19 vaccines (61.5%) and were confident the benefits of vaccines outweigh the risks (70%). While journalists relied on a variety of expert sources, social media platforms served as important sources of information also, with respondents stating a preference for Facebook (48.3%), and WhatsApp (44%). Journalists stated they were guided by sound practices such as source credibility and relevance, but betrayed weaknesses in their verification practices with a third of them admitting to sharing unsolicited information from social media. CONCLUSIONS Journalists in Ghana generally display a positive attitude towards COVID-19 vaccines and regularly search for information from official sources to inform their work, thus making them vital allies in overcoming vaccine hesitancy. Laxity in verification practices, however, makes them inadvertent agents of misinformation.
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Affiliation(s)
- Audrey Gadzekpo
- Department of Communication Studies, University of Ghana, Accra, Ghana
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Taddio A, Coldham J, Logeman C, McMurtry CM, Bucci LM, Gudzak V, MacDonald NE, Little C, Samborn T, Moineddin R. CARD (Comfort Ask Relax Distract) for school-based immunizations in Calgary, Canada: a pragmatic cluster trial. Pain 2024; 165:644-656. [PMID: 37824173 PMCID: PMC10859848 DOI: 10.1097/j.pain.0000000000003050] [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: 03/27/2023] [Revised: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 10/13/2023]
Abstract
ABSTRACT School-based immunizations are fear-inducing events for many students and contribute to vaccine hesitancy. We developed an immunization delivery framework called the CARD (Comfort Ask Relax Distract) system that incorporates evidence-based interventions to improve the experience (eg, reduce fear, pain, dizziness). We evaluated CARD in grades 6 and 9 students in Calgary, Canada. In this pragmatic, hybrid, effectiveness-implementation, cluster trial, we randomized 8 Community Health Centres providing regional immunization services to CARD or control (usual care). In the CARD group, public health staff educated students about CARD and planned processes to reduce fear cues and support student coping choices during immunization. Students self-reported fear, pain, and dizziness during immunization using a 0-10 numerical rating scale; staff recorded procedure details, including vaccines administered, fainting episodes, and coping strategies used. Staff participated in focus groups afterward. Altogether, 8839 children from 105 schools in the 2019 to 2020 school calendar year were included. Fear was lower for CARD (mean = 3.6 [SD = 3.1] vs control 4.1 [3.2]; mean difference = -0.5; 95% confidence interval = -0.74 to -0.21; P < 0.001). Effectiveness persisted after stratification by student gender (male and female) and grade level (grade 6 and grade 9). Other symptoms did not differ. Compared with control, CARD students used peers, privacy, muscle tension, and topical anesthetics more; verbal distraction, deep breathing, and adult support were used less frequently ( P < 0.05, all analyses). Immunization rate did not differ. Staff reported positive to neutral attitudes about CARD. In summary, this pragmatic trial demonstrated that CARD improved the immunization experiences of students at school.
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Affiliation(s)
- Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Charlotte Logeman
- Child Health Evaluative Services, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Lucie M. Bucci
- Bucci-Hepworth Health Services Inc., Pincourt, QC, Canada
| | - Victoria Gudzak
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Noni E. MacDonald
- Faculty of Medicine, Dalhousie University, IWK Health Centre, Halifax, NS, Canada
| | | | - Tracy Samborn
- Cochrane Community Health Centre, Alberta Health Services, Cochrane, AL, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Dreyer NA, Knuth KB, Xie Y, Reynolds MW, Mack CD. COVID-19 Vaccination Reactions and Risk of Breakthrough Infections Among People With Diabetes: Cohort Study Derived From Community Reporters. JMIR Diabetes 2024; 9:e45536. [PMID: 38412008 PMCID: PMC10933718 DOI: 10.2196/45536] [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: 01/05/2023] [Revised: 09/16/2023] [Accepted: 12/28/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND This exploratory study compares self-reported COVID-19 vaccine side effects and breakthrough infections in people who described themselves as having diabetes with those who did not identify as having diabetes. OBJECTIVE The study uses person-reported data to evaluate differences in the perception of COVID-19 vaccine side effects between adults with diabetes and those who did not report having diabetes. METHODS This is a retrospective cohort study conducted using data provided online by adults aged 18 years and older residing in the United States. The participants who voluntarily self-enrolled between March 19, 2021, and July 16, 2022, in the IQVIA COVID-19 Active Research Experience project reported clinical and demographic information, COVID-19 vaccination, whether they had experienced any side effects, test-confirmed infections, and consented to linkage with prescription claims. No distinction was made for this study to differentiate prediabetes or type 1 and type 2 diabetes nor to verify reports of positive COVID-19 tests. Person-reported medication use was validated using pharmacy claims and a subset of the linked data was used for a sensitivity analysis of medication effects. Multivariate logistic regression was used to estimate the adjusted odds ratios of vaccine side effects or breakthrough infections by diabetic status, adjusting for age, gender, education, race, ethnicity (Hispanic or Latino), BMI, smoker, receipt of an influenza vaccine, vaccine manufacturer, and all medical conditions. Evaluations of diabetes medication-specific vaccine side effects are illustrated graphically to support the examination of the magnitude of side effect differences for various medications and combinations of medications used to manage diabetes. RESULTS People with diabetes (n=724) reported experiencing fewer side effects within 2 weeks of vaccination for COVID-19 than those without diabetes (n=6417; mean 2.7, SD 2.0 vs mean 3.1, SD 2.0). The adjusted risk of having a specific side effect or any side effect was lower among those with diabetes, with significant reductions in fatigue and headache but no differences in breakthrough infections over participants' maximum follow-up time. Diabetes medication use did not consistently affect the risk of specific side effects, either using self-reported medication use or using only diabetes medications that were confirmed by pharmacy health insurance claims for people who also reported having diabetes. CONCLUSIONS People with diabetes reported fewer vaccine side effects than participants not reporting having diabetes, with a similar risk of breakthrough infection. TRIAL REGISTRATION ClinicalTrials.gov NCT04368065; https://clinicaltrials.gov/study/NCT04368065.
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Affiliation(s)
| | | | - Yiqiong Xie
- Real World Solutions, IQVIA, Durham, NC, United States
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Karuppannan M, Ming LC, Abdul Wahab MS, Mohd Noordin Z, Yee S, Hermansyah A. Self-reported side effects of COVID-19 vaccines among the public. J Pharm Policy Pract 2024; 17:2308617. [PMID: 38420042 PMCID: PMC10901186 DOI: 10.1080/20523211.2024.2308617] [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] [Indexed: 03/02/2024] Open
Abstract
Background The safety, side effects and efficacy profile of COVID-19 vaccines remain subjects of ongoing concern among the public in Malaysia. The aim of this study was to determine the types of adverse effects following immunisation with COVID-19 vaccines and the differences based on various types of COVID-19 vaccines to raise public awareness and reduce vaccine hesitancy among the public. Methods A total of 901 Malaysian adults (≥18 years) who received various COVID-19 vaccines were selected to participate in our cross-sectional study through an online survey between December 2021 and January 2022. Results A total of 814 (90.3%) of the participants reported ≥1 side effect following COVID-19 immunisation. Of these, the predominant symptoms were swelling at the injection site (n = 752, 83.5%), headache (n = 638, 70.8%), pain or soreness at the injection site (n = 628, 69.7%), fatigue or tiredness (n = 544, 60.4%), muscle weakness (n = 529, 58.7%) and diarrhea (n = 451, 50.1%). Recipients of the Pfizer-BioNTech (Comirnaty ®) vaccine reported the highest number of adverse effects (n = 355, 43.6%), followed by mixed COVID-19 vaccines (n = 254, 31.2%), the Oxford-AstraZeneca (ChAdOx1-®[recombinant]) vaccine (n = 113, 13.9%) and the Sinovac (CoronaVac®) vaccine (n = 90, 11.1%). The study showed that individuals who reported significantly more side effects were of elderly age, female gender and high educational level [P value < 0.05]. Mixed COVID-19 vaccine recipients also reported significantly more local and systemic symptoms after the first dose and third dose when compared with other single vaccine recipients. Conclusion This study demonstrated the types of self-reported adverse effects following immunisation with single and mixed COVID-19 vaccines. These findings may provide the side effects of different COVID-19 vaccines with the hope of educating the public on the safety profiles of these vaccines and reducing vaccine hesitancy among the public.
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Affiliation(s)
- Mahmathi Karuppannan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Bandar Puncak Alam, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, Bandar Puncak Alam, Malaysia
| | - Long Chiau Ming
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
- School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
| | - Mohd Shahezwan Abdul Wahab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Bandar Puncak Alam, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, Bandar Puncak Alam, Malaysia
| | - Zakiah Mohd Noordin
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Bandar Puncak Alam, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, Bandar Puncak Alam, Malaysia
| | - Shermaine Yee
- Faculty of Medicine, Quest International University, Ipoh, Malaysia
| | - Andi Hermansyah
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
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Lounis M, Hamimes A, Dahmani A. Assessment of Monkeypox (MPOX) Knowledge and Vaccination Intention among Health and Life Sciences Students in Algeria: A Cross-Sectional Study. Infect Dis Rep 2024; 16:170-180. [PMID: 38525760 PMCID: PMC10961808 DOI: 10.3390/idr16020013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Monkeypox (MPOX) is a viral zoonotic disease affecting endemically the Central and Western regions of Africa. The ongoing outbreak in non-endemic countries has made this disease a global concern. While no cases have been reported in Algeria, it is important to raise awareness about the disease to prepare for a potential outbreak, especially in light of the cases reported in neighboring Middle East and North African (MENA) countries. This study aimed to evaluate the knowledge and attitude of Algerian Health and Life Sciences students toward MPOX and its vaccine through an anonymous online survey. A total of 196 students participated in this study. Students of medicine (64.3%), females (85.7%), and those under 20 years of age (55.1%) were the most represented. The results revealed a low level of knowledge represented by a score of only 42.8% for correct answers with multiple gaps in epidemiology, etiology, and clinical manifestations of MPOX. Students of veterinary sciences showed the highest levels of knowledge (OR: 6.71; CI95%: 1.23-36.77), while those aged between 20 and 30 years old (OR: 0.11; CI95%: 0.02-0.79) and those vaccinated against seasonal flu (OR: 0.42; CI95%: 0.21-0.85) were associated with low levels of knowledge. Regarding MPOX vaccination, the study found a moderate level of acceptance (48.5%) among the surveyed students with Natural and Life Sciences students and those having a high vaccine conspiracy belief score (VCBS) showing the lowest level of acceptance. These findings highlight the need for educational programs and intensified public awareness campaigns to improve knowledge about MPOX and emphasize the importance of vaccination in preventing outbreaks and overcoming vaccine reluctance.
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Affiliation(s)
- Mohamed Lounis
- Department of Agro-Veterinary Sciences, Faculty of Natural and Life Sciences, University of Ziane Achour, BP 3117, Road of Moudjbara, Djelfa 17000, Algeria
- Laboratoire d’Exploration e et Valorisation des Écosystèmes Steppiques, Faculty of Natural and Life Sciences, University of Ziane Achour, BP 3117, Road of Moudjbara, Djelfa 17000, Algeria
| | - Ahmed Hamimes
- Laboratory of Biostatistics, Bioinformatics and Mathematical Methodology Applied to Health Sciences (BIOSTIM), Faculty of Medicine, University of Constantine 3, Constantine 25000, Algeria;
| | - Ali Dahmani
- Institute of Veterinary Sciences, University of Blida 1, Blida 09000, Algeria;
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Kopilaš V, Nasadiuk K, Martinelli L, Lhotska L, Todorovic Z, Vidmar M, Machado H, Svalastog AL, Gajović S. Perspectives on the COVID-19 Vaccination Rollout in 17 Countries: Reflexive Thematic and Frequency Analysis Based on the Strengths, Weaknesses, Opportunities, and Threats (SWOT) Framework. JMIR Hum Factors 2024; 11:e44258. [PMID: 38373020 PMCID: PMC10896317 DOI: 10.2196/44258] [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: 11/12/2022] [Revised: 07/16/2023] [Accepted: 09/26/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND As the SARS-CoV-2 virus created a global pandemic and rapidly became an imminent threat to the health and lives of people worldwide, the need for a vaccine and its quick distribution among the population was evident. Due to the urgency, and on the back of international collaboration, vaccines were developed rapidly. However, vaccination rollouts showed different success rates in different countries and some also led to increased vaccine hesitancy. OBJECTIVE The aim of this study was to identify the role of information sharing and context sensitivity in various vaccination programs throughout the initial COVID-19 vaccination rollout in different countries. Moreover, we aimed to identify factors in national vaccination programs related to COVID-19 vaccine hesitancy, safety, and effectiveness. Toward this end, multidisciplinary and multinational opinions from members of the Navigating Knowledge Landscape (NKL) network were analyzed. METHODS From May to July 2021, 25 completed questionnaires from 27 NKL network members were collected. These contributors were from 17 different countries. The responses reflected the contributors' subjective viewpoints on the status and details of the COVID-19 vaccination rollout in their countries. Contributors were asked to identify strengths, weaknesses, opportunities, and threats (ie, SWOT) of the respective vaccination programs. The responses were analyzed using reflexive thematic analysis, followed by frequency analysis of identified themes according to the represented countries. RESULTS The perspectives of NKL network members showed a link between organizational elements of the vaccination rollout and the accompanying societal response, both of which were related to strengths and weaknesses of the process. External sociocultural variables, improved public communication around vaccination-related issues, ethical controversies, and the spread of disinformation were the dominant themes related to opportunities and challenges. In the SWOT 2×2 matrix, Availability and Barriers emerged as internal categories, whereas Transparent communication and promotion and Societal divide emerged as key external categories. CONCLUSIONS Inventory of themes and categories inspired by elements of the SWOT framework provides an informative multidisciplinary perspective for effective implementation of public health strategies in the battle against COVID-19 or any future pandemics of a similar nature.
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Affiliation(s)
- Vanja Kopilaš
- Department of Psychology, Faculty of Croatian Studies, University of Zagreb, Zagreb, Croatia
| | - Khrystyna Nasadiuk
- Department of Biochemistry, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | | | - Lenka Lhotska
- Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Prague, Czech Republic
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Zoran Todorovic
- University Hospital Medical Center "Bežanijska kosa", Belgrade,
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade,
| | - Matjaz Vidmar
- Institute for the Study of Science, Technology and Innovation, The University of Edinburgh, Edinburgh, United Kingdom
- School of Engineering, The University of Edinburgh, Edinburgh, United Kingdom
| | - Helena Machado
- Institute for Social Sciences, University of Minho, Braga, Portugal
| | - Anna Lydia Svalastog
- Østfold University College, Halden, Norway
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Srećko Gajović
- BIMIS-Biomedical Research Center Šalata, University of Zagreb School of Medicine, Zagreb, Croatia
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Mahmood B, Adu P, McKee G, Bharmal A, Wilton J, Janjua NZ. Ethnic Disparities in COVID-19 Vaccine Mistrust and Receipt in British Columbia, Canada: Population Survey. JMIR Public Health Surveill 2024; 10:e48466. [PMID: 38363596 PMCID: PMC10896316 DOI: 10.2196/48466] [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: 04/25/2023] [Revised: 09/16/2023] [Accepted: 12/15/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Racialized populations in the United States, Canada, and the United Kingdom have been disproportionately affected by COVID-19. Higher vaccine hesitancy has been reported among racial and ethnic minorities in some of these countries. In the United Kingdom, for example, higher vaccine hesitancy has been observed among the South Asian population and Black compared with the White population, and this has been attributed to lack of trust in government due to historical and ongoing racism and discrimination. OBJECTIVE This study aimed to assess vaccine receipt by ethnicity and its relationship with mistrust among ethnic groups in British Columbia (BC), Canada. METHODS We included adults ≥18 years of age who participated in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) from March 8, 2021, to August 8, 2022. The survey included questions about vaccine receipt and beliefs based on a behavioral framework. Multivariable logistic regression was used to assess the association between mistrust in vaccines and vaccine receipt among ethnic groups. RESULTS The analysis included 25,640 adults. Overall, 76.7% (22,010/28,696) of respondents reported having received at least 1 dose of COVID-19 vaccines (Chinese=86.1%, South Asian=79.6%, White=75.5%, and other ethnicity=73.2%). Overall, 13.7% (3513/25,640) of respondents reported mistrust of COVID-19 vaccines (Chinese=7.1%, South Asian=8.2%, White=15.4%, and other ethnicity=15.2%). In the multivariable model (adjusting for age, sex, ethnicity, educational attainment, and household size), mistrust was associated with a 93% reduced odds of vaccine receipt (adjusted odds ratio 0.07, 95% CI 0.06-0.08). In the models stratified by ethnicity, mistrust was associated with 81%, 92%, 94%, and 95% reduced odds of vaccine receipt among South Asian, Chinese, White, and other ethnicities, respectively. Indecision, whether to trust the vaccine or not, was significantly associated with a 70% and 78% reduced odds of vaccine receipt among those who identified as White and of other ethnic groups, respectively. CONCLUSIONS Vaccine receipt among those who identified as South Asian and Chinese in BC was higher than that among the White population. Vaccine mistrust was associated with a lower odds of vaccine receipt in all ethnicities, but it had a lower effect on vaccine receipt among the South Asian and Chinese populations. Future research needs to focus on sources of mistrust to better understand its potential influence on vaccine receipt among visible minorities in Canada.
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Affiliation(s)
- Bushra Mahmood
- Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Prince Adu
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, United States
| | - Geoffrey McKee
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Aamir Bharmal
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - James Wilton
- British Columbia Center for Disease Control, Vancouver, BC, Canada
| | - Naveed Zafar Janjua
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
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Rizzi M, Attwell K. Giving Bad Science the Stamp of Approval: Policy and Legal Consequences of a Vaccine Scare in Italy. Public Health Rev 2024; 45:1606756. [PMID: 38419733 PMCID: PMC10899427 DOI: 10.3389/phrs.2024.1606756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Marco Rizzi
- UWA Law School, University of Western Australia, Perth, WA, Australia
| | - Katie Attwell
- School of Social Sciences, University of Western Australia, Perth, WA, Australia
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Yoon S, Kim H, An J, Jin SW. Exploring human papillomavirus vaccine hesitancy among college students and the potential of virtual reality technology to increase vaccine acceptance: a mixed-methods study. Front Public Health 2024; 12:1331379. [PMID: 38414894 PMCID: PMC10896851 DOI: 10.3389/fpubh.2024.1331379] [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: 11/01/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
Background Human papillomavirus (HPV) can cause cancers in men and women. Despite the availability of an effective vaccine, HPV vaccination coverage remains suboptimal among college students. Literature showed that hesitancy for HPV vaccination is a leading barrier to the uptake in this group. However, prior interventions have shown limitations in reducing HPV vaccine hesitancy in college students. Thus, this study examined a conventional educational approach using a vaccine information statement (VIS), and subsequently explored college students' HPV vaccine hesitancy and the potential of virtual reality (VR) technology to overcoming the limitations of interventional efforts. Methods We employed a mixed-methods design along with convenience sampling, constituting a one-way pre- and post-intervention (HPV VIS) survey (Study A) and individual interviews (Study B). All data collections occurred with 44 college students at an urban public university at the mid-south region of the U.S. between October 2022 and April 2023. Study A assessed changes in HPV vaccination outcomes including knowledge, beliefs/attitudes, vaccine hesitancy, and intentions. Study B measured college students' primary reasons for HPV vaccine hesitancy and preferred strategies for the vaccination promotion including VR-based education. We conducted paired t-test and Wilcoxon signed ranks test for quantitative data and framework analysis for qualitative data. Results Participants reported significant improvements in knowledge [t(43) = 6.68, p < 0.001] regarding HPV vaccination between before and after reading the HPV VIS. No change was observed in beliefs/attitudes, vaccine hesitancy, and intentions. The framework analysis revealed college students' reasons for HPV vaccine hesitancy, needed information, and preferred strategies along with the potential of VR technology for future HPV vaccination education. Conclusion The findings provided essential information on designing HPV vaccination information focused on vaccine hesitancy among college students. Future research should consider these findings in developing interventions including VR to increasing HPV vaccine acceptance among college students.
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Affiliation(s)
- Sangchul Yoon
- Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, Republic of Korea
- Center for Global Development, Yonsei lnstituite for Global Health, Yonsei University Health System, Seoul, Republic of Korea
| | - Heeyeon Kim
- Center for Global Development, Yonsei lnstituite for Global Health, Yonsei University Health System, Seoul, Republic of Korea
| | - Juhyeong An
- Center for Global Development, Yonsei lnstituite for Global Health, Yonsei University Health System, Seoul, Republic of Korea
| | - Seok Won Jin
- School of Social Work, The University of Memphis, Memphis, TN, United States
- Institute of Media Arts, Yonsei University, Seoul, Republic of Korea
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Montalti M, Salussolia A, Capodici A, Scognamiglio F, Di Valerio Z, La Fauci G, Soldà G, Fantini MP, Odone A, Costantino C, Leask J, Larson HJ, Lenzi J, Gori D. Human Papillomavirus (HPV) Vaccine Coverage and Confidence in Italy: A Nationwide Cross-Sectional Study, the OBVIOUS Project. Vaccines (Basel) 2024; 12:187. [PMID: 38400170 PMCID: PMC10891781 DOI: 10.3390/vaccines12020187] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) vaccination rates are still below the target due to vaccine refusal or delay, lack of knowledge, and logistical challenges. Understanding these barriers is crucial for developing strategies to improve HPV vaccination rates. METHODS This cross-sectional study used a questionnaire to investigate social and behavioral factors influencing decision making about the HPV vaccine. The survey was conducted from 11 April to 29 May 2022 and involved 10,000 Italian citizens aged ≥ 18 years. The sample was stratified based on region of residence, gender, and age group. RESULTS 3160 participants were surveyed about themselves, while 1266 respondents were surveyed about their children's vaccine uptake. Among females aged ≥ 26 years, the national average HPV vaccine uptake was 21.7%, with variations across different regions. In the 18-25 age group, females had a vaccine uptake (80.8%) twice as much as males (38.1%), while vaccine uptake among male and female children aged 9-11 was similar. CONCLUSIONS The OBVIOUS study in Italy reveals factors influencing low HPV vaccine uptake, suggesting targeted approaches, tailored information campaigns, heightened awareness of eligibility, promoting early vaccination, addressing low-risk perception among males, addressing safety concerns, and enhancing perceived accessibility to improve vaccine uptake and mitigate health risks.
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Affiliation(s)
- Marco Montalti
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Aurelia Salussolia
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Angelo Capodici
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
- Interdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, 56127 Pisa, Italy
| | - Francesca Scognamiglio
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Zeno Di Valerio
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Giusy La Fauci
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Giorgia Soldà
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy
| | - Julie Leask
- School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Heidi J. Larson
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Institute of Health Metrics, London WC1E 7HT, UK
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
| | - Davide Gori
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy (D.G.)
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Akilimali PZ, Egbende L, Kayembe DM, Kabasubabo F, Kazenza B, Botomba S, Tran NT, Mashinda DK. COVID-19 Vaccine Coverage and Factors Associated with Vaccine Hesitancy: A Cross-Sectional Survey in the City of Kinshasa, Democratic Republic of Congo. Vaccines (Basel) 2024; 12:188. [PMID: 38400171 PMCID: PMC10892748 DOI: 10.3390/vaccines12020188] [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: 01/23/2024] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
Vaccination against COVID-19 has been the main strategy used by most countries to limit the spread of the virus. However, vaccine uptake has been low in Africa, leading to the implementation of several interventions in order to improve vaccine coverage. This study was conducted due to the lack of information about COVID-19 vaccine coverage and the factors associated with vaccine hesitancy. This cross-sectional study was carried out in Kinshasa city using multi-stage random sampling. A total of 2160 households were included in this study. The data were analyzed using Stata 17 software. The means and standard deviations were computed for continuous data that followed a normal distribution, whereas proportions together with their 95% confidence intervals (CIs) were computed for categorical variables. The connections between dependent variables and each independent variable were tested using either Pearson's chi-square test or Fisher's exact test. The logistic regression method was employed to determine the factors that are linked to hesitation in obtaining the COVID-19 immunization. The majority of respondents were aged between 25 and 34 and 35 and 49 (28.9%). During this study, 15% (95% CI [13.25-17.9]) of respondents had received at least one dose of the COVID-19 vaccine. The prevalence of vaccine hesitancy was 67% (CI95%:64.9-69.1). Among the reasons given for refusing to be vaccinated, most respondents cited concerns about the vaccine being unsafe or causing adverse reactions (45%). Among the reasons given for accepting the vaccine, 26% thought that the vaccine prevented superinfection. The factors associated with hesitancy toward the COVID-19 vaccine were female gender, an age of less than 35 years, and living in non-slum households. Despite the interventions implemented across the country, the reluctance to be vaccinated remains a problem; this could lead to poor health outcomes, especially among the elderly and those with pre-existing conditions. It is important to step up awareness-raising campaigns in the community in order to increase the uptake of vaccination.
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Affiliation(s)
- Pierre Z. Akilimali
- Patrick Kayembe Research Center, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (D.M.K.); (F.K.)
- Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (L.E.); (B.K.); (S.B.)
| | - Landry Egbende
- Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (L.E.); (B.K.); (S.B.)
| | - Dynah M. Kayembe
- Patrick Kayembe Research Center, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (D.M.K.); (F.K.)
| | - Francis Kabasubabo
- Patrick Kayembe Research Center, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (D.M.K.); (F.K.)
| | - Benito Kazenza
- Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (L.E.); (B.K.); (S.B.)
| | - Steve Botomba
- Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo; (L.E.); (B.K.); (S.B.)
| | - Nguyen Toan Tran
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, P.O. Box 123, Sydney, NSW 2007, Australia;
- Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Genève, Switzerland
| | - Désiré K. Mashinda
- Department of Biostatistics and Epidemiology, Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Congo;
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Aghajafari F, Wall L, Weightman A, Ness A, Lake D, Anupindi K, Moorthi G, Kuk B, Santana M, Coakley A. COVID-19 Vaccinations, Trust, and Vaccination Decisions within the Refugee Community of Calgary, Canada. Vaccines (Basel) 2024; 12:177. [PMID: 38400160 PMCID: PMC10891815 DOI: 10.3390/vaccines12020177] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders.
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Affiliation(s)
- Fariba Aghajafari
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Laurent Wall
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Amanda Weightman
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Alyssa Ness
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Deidre Lake
- Alberta International Medical Graduates Association, Calgary, AB T2E 3K8, Canada
| | - Krishna Anupindi
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Gayatri Moorthi
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Bryan Kuk
- Habitus Consulting Collective, Calgary, AB T2T 1P3, Canada; (L.W.); (A.W.)
| | - Maria Santana
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Annalee Coakley
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Mosaic Refugee Health Clinic, Calgary, AB T2A 5H5, Canada
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Haji Said A, Winskell K, Bednarczyk RA, Reardon EE, Vasudevan L. Interactive Narrative-Based Digital Health Interventions for Vaccine Communication: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e51137. [PMID: 38335024 PMCID: PMC10891492 DOI: 10.2196/51137] [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: 07/22/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Interactive narrative-based digital health interventions hold promise for effectively addressing the complex determinants of vaccine hesitancy and promoting effective communication across a wide range of settings and vaccine types. Synthesizing evidence related to the implementation and evaluation of these interventions could offer valuable perspectives for shaping future strategies in vaccine communication. Prior systematic and scoping reviews have examined narrative-based vaccine communication interventions but not the inclusion of interactivity in such interventions. OBJECTIVE The overall objective of the scoping review is to summarize the evidence on the use of interactive narrative-based digital health interventions for vaccine communication. Specific research questions focus on describing the use of interactive narrative-based digital health interventions (RQ1), describing evaluations of the impact of interactive narrative-based digital health interventions on promoting vaccine uptake (RQ2), and factors associated with their implementation (RQ3). METHODS A detailed search string will be used to search the following databases for records that are relevant to the review questions: PubMed, Embase, Scopus, Web of Science, CINAHL, and PsycINFO. Two reviewers will independently screen the titles and abstracts of identified records against the predefined eligibility criteria. Subsequently, eligible records will undergo comprehensive full-text screening by 2 independent reviewers to assess their relevance to review questions. A data charting tool will be developed and used to extract relevant information from the included articles. The extracted information will be analyzed following the review questions and presented as a narrative summary. Tabular or graphical representations will be used to display review findings, as relevant. RESULTS Public health informationists were consulted to develop the detailed search strategy. The final search string comprised terms related to narrative communication, digital health, and vaccines. The search string was customized to each proposed publication database and implemented on April 18, 2023. A total of 4474 unique records were identified using the search strategy and imported into the Covidence (Veritas Health Innovation Ltd) review management software for title and abstract screening. Title and abstract screening of identified records are ongoing as of December 29, 2023. CONCLUSIONS To our knowledge, this will be the first scoping review to investigate the features of interactive narrative-based digital health interventions and their role in vaccine communication. The goal of this study is to provide a comprehensive overview of the current research landscape and identify prevailing gaps in knowledge. The findings will provide insights for future research and development of novel applications of interactive narrative-based digital health vaccine communication interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51137.
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Affiliation(s)
- Ahmed Haji Said
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Kate Winskell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Erin E Reardon
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, United States
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Moore R, Purvis RS, Willis DE, Li J, Langner J, Gurel-Headley M, Kraleti S, Curran GM, Macechko MD, McElfish PA. "Every Time It Comes Time for Another Shot, It's a Re-Evaluation": A Qualitative Study of Intent to Receive COVID-19 Boosters among Parents Who Were Hesitant Adopters of the COVID-19 Vaccine. Vaccines (Basel) 2024; 12:171. [PMID: 38400154 PMCID: PMC10892107 DOI: 10.3390/vaccines12020171] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
COVID-19 vaccine coverage remains low for US children, especially among those living in rural areas and the Southern/Southeastern US. As of 12 September 2023, the CDC recommended bivalent booster doses for everyone 6 months and older. Emerging research has shown an individual may be vaccine hesitant and also choose to receive a vaccine for themselves or their child(ren); however, little is known regarding how hesitant adopters evaluate COVID-19 booster vaccinations. We used an exploratory qualitative descriptive study design and conducted individual interviews with COVID-19 vaccine-hesitant adopter parents (n = 20) to explore COVID-19 parental intentions to have children receive COVID-19 boosters. Three primary themes emerged during the analysis: risk, confidence, and intent, with risk assessments from COVID-19 and COVID-19 vaccine confidence often related to an individual parent's intent to vaccinate. We also found links among individuals with persistent concerns about the COVID-19 vaccine and low COVID-19 vaccine confidence with conditional and/or low/no intent and refusal to receive recommended boosters for children. Our findings suggest that healthcare providers and public health officials should continue making strong recommendations for vaccines, continue to address parental concerns, and provide strong evidence for vaccine safety and efficacy even among the vaccinated.
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Affiliation(s)
- Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
| | - Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Jonathan Langner
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA;
| | - Morgan Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; (M.G.-H.); (S.K.)
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Shashank Kraleti
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; (M.G.-H.); (S.K.)
| | - Geoffrey M. Curran
- College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA;
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 4300 W. 7th St., North Little Rock, AR 72114, USA
| | - Michael D. Macechko
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA;
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA; (R.M.); (R.S.P.); (D.E.W.)
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Krasner H, Harmon N, Martin J, Olaco CA, Netski DM, Batra K. Community Level Correlates of COVID-19 Booster Vaccine Hesitancy in the United States: A Cross-Sectional Analysis. Vaccines (Basel) 2024; 12:167. [PMID: 38400150 PMCID: PMC10892894 DOI: 10.3390/vaccines12020167] [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: 12/05/2023] [Revised: 01/27/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Introduction: Evidence exists that individual-level sociodemographic factors contribute to vaccine hesitancy, but it is unknown how community-level factors affect COVID-19 booster dose hesitancy. The current study aims to fill this knowledge gap by comparing data from a nationwide survey on COVID-19 vaccine hesitancy with a community-level indicator, i.e., the Distressed Communities Index (DCI). Methods: Attitudes toward vaccinations, vaccine literacy, COVID-19 vaccine confidence index, and trust were measured using a 48-item, psychometrically valid and reliable survey tool. In this study, 2138 survey participants residing in the United States were divided into quintiles of varying community distress levels based on their zip codes using the DCI. Data were analyzed through Chi-square, one-way ANOVA, and post hoc analysis with Tukey's test. Results: A significantly higher proportion of participants from the distressed communities had lower trust than their prosperous counterparts (26.6% vs. 37.6%, p < 0.001). On the contrary, participants from the prosperous communities had significantly higher vaccine confidence index scores than those in distressed communities (2.22 ± 1.13 vs. 1.70 ± 1.01, p < 0.001). Conclusions: These findings affirm the importance of developing community-level interventions to promote trust in COVID-19 vaccinations and increase booster dose uptake. From these results, future studies can examine the efficacy of various community-level interventions.
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Affiliation(s)
- Henry Krasner
- Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA; (J.M.); (C.-A.O.)
| | - Nicolette Harmon
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA;
| | - Jeffrey Martin
- Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA; (J.M.); (C.-A.O.)
| | - Crysty-Ann Olaco
- Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA; (J.M.); (C.-A.O.)
| | - Dale M. Netski
- Office of Faculty Affairs, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA;
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
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Liu Shiu Cheong D, Tran J, Chong W, May S, Carlson SJ, Salter SM, Attwell K. Attitudes, perceptions, and experiences of Western Australians towards vaccine safety surveillance systems following COVID-19 vaccines: A qualitative descriptive study. Aust N Z J Public Health 2024; 48:100108. [PMID: 38141591 DOI: 10.1016/j.anzjph.2023.100108] [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: 01/16/2023] [Revised: 07/27/2023] [Accepted: 11/07/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE Concerns regarding adverse events following immunisation are a barrier to vaccine uptake. Health professionals use vaccine safety surveillance systems (VSSSs) to monitor vaccines and inform the public of safety data. With little known about public attitudes, perceptions, and experiences with VSSS, we examined them in the context of COVID-19 vaccinations in Western Australia. METHODS Researchers conducted 158 qualitative interviews between March 2021 and May 2022 within the broader [name redacted] project. Data regarding VSSS were coded in NVivo using the deductive and inductive methods. RESULTS Despite some not knowing about VSSS, participants expected follow-up post COVID-19 vaccination. Vaccine hesitant or refusing participants knew about VSSS and regarded these systems positively. Additional considerations concerned the reliability of data collected by VSSS. CONCLUSION Perceptions of VSSS signal a lack of understanding about how these systems work. Future studies should further explore the public's understanding of VSSS, whether VSSS improves vaccine confidence, and how governments can better communicate to the public about VSSS. IMPLICATIONS FOR PUBLIC HEALTH Lack of understanding of how VSSS operate may be stymying attempts to build public vaccine confidence. Healthcare providers and governments could build public knowledge and understanding of VSSS to mitigate concerns of adverse events following immunisation.
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Affiliation(s)
- Denis Liu Shiu Cheong
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jayden Tran
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Wyitt Chong
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Scott May
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sandra M Salter
- School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia.
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Doğan E, Genç FZ, Kaya E, Bilgili N, Kitiş Y, Kan A. Attitudes towards vaccination among parents of children aged 0-5 years: A scale development study. Int J Nurs Pract 2024; 30:e13210. [PMID: 37778400 DOI: 10.1111/ijn.13210] [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: 04/19/2021] [Revised: 09/02/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. DESIGN This study was designed as an instrument development study. METHODS This study aimed to develop a scale to measure the attitudes of parents with children aged 0-5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item-level test-retest analyses for reliability. RESULTS The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28-item two factors = 62.47%). CONCLUSION This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health-care services based on the results of the measurement.
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Affiliation(s)
- Emel Doğan
- Health Care Services, Vocational School of Health Services, Selçuk University, Konya, Turkey
| | - Fatma Zehra Genç
- Department of Public Health Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey
| | - Emine Kaya
- Republic of Turkey Ministry of Health, General Directorate of Health Services, Ankara, Turkey
| | - Naile Bilgili
- Department of Public Health Nursing, Faculty of Nursing, Gazi University, Ankara, Turkey
| | - Yeter Kitiş
- Department of Public Health Nursing, Faculty of Nursing, Gazi University, Ankara, Turkey
| | - Adnan Kan
- Department of Guidance and Psychological Counseling, Faculty of Education, Gazi University, Ankara, Turkey
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50
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Zhang Z, Tang S, Huang Z, Tan J, Wu X, Hong Q, Yuan Y. Mapping trends and hotspots in research on global influenza vaccine hesitancy: A bibliometric analysis. Health Sci Rep 2024; 7:e1820. [PMID: 38323124 PMCID: PMC10845823 DOI: 10.1002/hsr2.1820] [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: 07/21/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
Background and Aims Influenza is one of the most widespread respiratory infections and poses a huge burden on health care worldwide. Vaccination is key to preventing and controlling influenza. Influenza vaccine hesitancy is an important reason for the low vaccination rate. In 2019, Vaccine hesitancy was identified as one of the top 10 threats to global health by the World Health Organization. However, there remains a glaring scarcity of bibliometric research in that regard. This study sought to identify research hotspots and future development trends on influenza vaccine hesitation and provide a new perspective and reference for future research. Methods We retrieved publications on global influenza vaccine hesitancy from the Web of Science Core Collection database, Scopus, and PubMed databases from inception to 2022. This study used VOSviewer and CiteSpace for visualization analysis. Results Influenza vaccine hesitancy-related publications increased rapidly from 2012 and peaked in 2022. One hundred and nine countries contributed to influenza vaccine hesitation research, and the United States ranked first with 541 articles and 7161 citations. Vaccines-Basel was the journal with the largest number of published studies on influenza vaccine hesitations. MacDonald was the most frequently cited author. The most popular research topics on influenza vaccine hesitancy were (1) determinants of influenza vaccination in specific populations, such as healthcare workers, children, pregnant women, and so on; (2) influenza and COVID-19 vaccine hesitancy during the COVID-19 pandemic. Conclusions The trend in the number of annual publications related to influenza vaccine hesitancy indicating the COVID-19 pandemic will prompt researchers to increase their attention to influenza vaccine hesitancy. With healthcare workers as the key, reducing vaccine hesitancy and improving vaccine acceptance in high-risk groups will be the research direction in the next few years.
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Affiliation(s)
- Zhengyu Zhang
- Department of Medical Records, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Songjia Tang
- Department of Plastic and Aesthetic Surgery, Affiliated Hangzhou First People's HospitalZhejiang University School of MedicineHangzhouZhejiangChina
| | - Zhihui Huang
- Department of RespiratoryPeople's Hospital of Anji, Anji CountyHuzhouZhejiangChina
| | - Juntao Tan
- Operation Management OfficeAffiliated Banan Hospital of Chongqing Medical UniversityChongqingChina
| | - Xiaoxin Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesZhejiang University School of MedicineHangzhouZhejiangChina
| | - Qian Hong
- Department of Medical RecordsThe First Hospital of Lanzhou UniversityLanzhouChina
| | - Yuan Yuan
- Department of Medical RecordsWomen and Children's Hospital of Chongqing Medical UniversityChongqingChina
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