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Vaccines Hesitancy and Public Health
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Vaccines Hesitancy and Public Health

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 28342

Special Issue Editors

Prof. Dr. Francisco Javier Pérez-Rivas

E-Mail Website
Guest Editor
Nursing Department, School of Nursing, Physiotherapy and Podiatry, Complutense University, 28040 Madrid, Spain
Interests: public health; community health care; primary health care; lifestyle; nursing care; vaccines; nursing process; nursing education research
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. María Julia Ajejas Bazán

E-Mail Website
Co-Guest Editor
Nursing Department, School of Nursing, Physiotherapy and Podiatry, Complutense University, 28040 Madrid, Spain
Interests: public health; community health care; vaccines; epidemiology; biostatistics; nursing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Vaccines are the most effective example of primary prevention for the control of communicable diseases. Despite this, the World Health Organization in 2019, in light of global measles outbreaks and preceding, considered vaccine reluctance as one of the ten threats to global health. Today, in the context of the COVID-19 pandemic, vaccination programs are suffering significant drops and delays. Hence the importance of maintaining high vaccination coverage to avoid the emergence and re-emergence of these diseases, some of which are potentially serious or fatal.

In recent years, the presence of anti-vaccine groups in the world has increased alarmingly and they constitute a growing threat to vaccination programs. Although relatively small, the anti-vaccine movement actively uses social media to amplify its messages by targeting people who are insecure about vaccines, particularly parents' groups.

Due to the development of information and communication technologies, the messages of these groups are more widely disseminated. The decision not to vaccinate not only entails risks at the individual level, but also at the collective level, which has been corroborated by the drop in vaccination coverage, with the consequent appearance of cases and outbreaks of diseases that have even led to deaths. To maintain the achievements of vaccination, it is also necessary to "immunize".

This Special Issue aims to maintain the achievements of vaccination, it is also necessary to "immunize" against everything that opposes it. In this new era of information and communications, all social actors involved must be able to work to maintain this great health achievement. The main objective of this special issue is to show to what extent vaccination causes doubts among health professionals and the rest of the population, whether after the pandemic, the rise of anti-vaccine groups has diminished and if the attitude towards vaccination has changed positively, increasing vaccination coverage. Original articles and systematic reviews dealing with the objective of this special issue are welcome.

We look forward to receiving your contributions.

Prof. Dr. Francisco Javier Pérez-Rivas
Prof. Dr. María Julia Ajejas Bazán
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Research

Jump to: Review, Other

12 pages, 274 KiB  
Article
Has the COVID-19 Pandemic Changed Parental Attitudes and Beliefs Regarding Vaccinating Their Children against the Flu?
by Liora Shmueli
Vaccines 2023, 11(10), 1519; https://doi.org/10.3390/vaccines11101519 - 24 Sep 2023
Viewed by 876
Abstract
Background: This study assessed whether the COVID-19 pandemic has altered parents’ attitudes toward vaccinating their children against the flu and barriers to school-based vaccination programs. Methods: A cross-sectional online survey was conducted with 975 parents of children aged 6 months to 11 years [...] Read more.
Background: This study assessed whether the COVID-19 pandemic has altered parents’ attitudes toward vaccinating their children against the flu and barriers to school-based vaccination programs. Methods: A cross-sectional online survey was conducted with 975 parents of children aged 6 months to 11 years between 21–31 December 2022. A multivariate regression was performed to determine predictors of parents’ willingness to vaccinate their children against the flu in the winter of 2023. Results: 45% of parents did not plan to vaccinate their children against the flu, citing concerns about side effects and vaccine effectiveness; 39% already vaccinated their children, and 41% of them reported an increased intention to vaccinate following the pandemic. Only 37% of parents chose school-based vaccination programs, mainly due to a preference for HMO clinics and a lack of available nurses at school. The Health Belief Model variables, namely, perceived susceptibility, severity, and benefits, displayed the largest effect sizes. Conclusions: Healthcare providers and public health officials should address parents’ concerns about flu vaccine safety and efficacy to improve vaccination rates among children. Notably, the pandemic has increased vaccine receptivity among some parents. Enhancing accessibility to nursing staff in student health facilities could help boost vaccine uptake. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
18 pages, 1113 KiB  
Article
Acceptance of a Text Messaging Vaccination Reminder and Recall System in Malaysia’s Healthcare Sector: Extending the Technology Acceptance Model
by Kamal Karkonasasi, Yu-N Cheah, Mogana Vadiveloo and Seyed Aliakbar Mousavi
Vaccines 2023, 11(8), 1331; https://doi.org/10.3390/vaccines11081331 - 06 Aug 2023
Viewed by 1428
Abstract
Malaysian healthcare institutions still use ineffective paper-based vaccination systems to manage childhood immunization schedules. This may lead to missed appointments, incomplete vaccinations, and outbreaks of preventable diseases among infants. To address this issue, a text messaging vaccination reminder and recall system named Virtual [...] Read more.
Malaysian healthcare institutions still use ineffective paper-based vaccination systems to manage childhood immunization schedules. This may lead to missed appointments, incomplete vaccinations, and outbreaks of preventable diseases among infants. To address this issue, a text messaging vaccination reminder and recall system named Virtual Health Connect (VHC) was studied. VHC simplifies and accelerates immunization administration for nurses, which may result in improving the completion and timeliness of immunizations among infants. Considering the limited research on the acceptance of these systems in the healthcare sector, we examined the factors influencing nurses’ attitudes and intentions to use VHC using the extended technology acceptance model (TAM). The novelty of the conceptual model is the incorporation of new predictors of attitude, namely, perceived compatibility and perceived privacy and security issues. We conducted a survey among 121 nurses in Malaysian government hospitals and clinics to test the model. We analyzed the collected data using partial least squares structural equation modeling (PLS-SEM) to examine the significant factors influencing nurses’ attitudes and intentions to use VHC. Moreover, we applied an artificial neural network (ANN) to determine the most significant factors of acceptance with higher accuracy. Therefore, we could offer more accurate insights to decision-makers in the healthcare sector for the advancement of health services. Our results highlighted that the compatibility of VHC with the current work setting of nurses developed their positive perspectives on the system. Moreover, the nurses felt optimistic about the system when they considered it useful and easy to use in the workplace. Finally, their attitude toward using VHC played a pivotal role in increasing their intention to use it. Based on the ANN models, we also found that perceived compatibility was the most significant factor influencing nurses’ attitudes towards using VHC, followed by perceived ease of use and perceived usefulness. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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12 pages, 270 KiB  
Article
Understanding Concerns about COVID-19 and Vaccination: Perspectives from Kidney Transplant Recipients
by Sarah R. MacEwan, Alice A. Gaughan, Graham N. Dixon, Ramona G. Olvera, Willi L. Tarver, Saurabh Rahurkar, Laura J. Rush, Austin D. Schenk, Jack Stevens and Ann Scheck McAlearney
Vaccines 2023, 11(7), 1134; https://doi.org/10.3390/vaccines11071134 - 22 Jun 2023
Cited by 1 | Viewed by 1216
Abstract
The COVID-19 pandemic poses a significant risk for immunosuppressed groups such as transplant patients. The purpose of this study was to improve our understanding of the impact of the COVID-19 pandemic on kidney transplant recipients, including their views on COVID-19 vaccination. Semi-structured interviews [...] Read more.
The COVID-19 pandemic poses a significant risk for immunosuppressed groups such as transplant patients. The purpose of this study was to improve our understanding of the impact of the COVID-19 pandemic on kidney transplant recipients, including their views on COVID-19 vaccination. Semi-structured interviews were conducted from December 2021 to August 2022 with 38 kidney transplant recipients who had an appointment with their transplant care team within the previous 6 months. We used qualitative thematic analysis to characterize the perspectives of interviewees. Regardless of COVID-19 vaccination status, most interviewees reported utilizing public health measures such as masking, hand washing, and avoiding crowds to protect themselves against COVID-19. Vaccinated interviewees (n = 31) noted that they chose to receive a COVID-19 vaccine because of their increased risk due to their immunocompromised state. For unvaccinated interviewees (n = 7), reasons for not receiving a COVID-19 vaccine included concerns about the safety and efficacy of the vaccine. Both vaccinated and unvaccinated interviewees expressed concerns about the lack of adequate testing of the vaccine in transplant patients and questioned if the vaccine might have unknown side effects for transplant recipients. Regardless of the vaccination status, most interviewees noted having trust in their healthcare team. Interviewees also described interpersonal tensions that arose during the pandemic, many of which surrounded vaccination and other preventive measures that were important to participants to protect their health. Together, these data demonstrate differing concerns and experiences related to the COVID-19 pandemic for vaccinated and unvaccinated transplant recipients. These findings highlight the unique needs of transplant recipients and reveal opportunities to support this vulnerable patient population in efforts to protect their health as the COVID-19 pandemic evolves. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
15 pages, 998 KiB  
Article
Impact of the COVID-19 Pandemic on Attitudes toward Vaccination: Representative Study of Polish Society
by Tomasz Sobierajski, Piotr Rzymski and Monika Wanke-Rytt
Vaccines 2023, 11(6), 1069; https://doi.org/10.3390/vaccines11061069 - 06 Jun 2023
Cited by 5 | Viewed by 1735
Abstract
The study explored the association between individuals’ attitudes toward vaccination and their actual vaccination behavior. We also examined the impact of the coronavirus disease 2019 (COVID-19) pandemic and the ongoing vaccination debate on changing attitudes towards vaccination, specifically within different demographic groups. The [...] Read more.
The study explored the association between individuals’ attitudes toward vaccination and their actual vaccination behavior. We also examined the impact of the coronavirus disease 2019 (COVID-19) pandemic and the ongoing vaccination debate on changing attitudes towards vaccination, specifically within different demographic groups. The survey was conducted among a representative sample of Poles (N = 805) using computer-assisted web interview (CAWI) technology. As demonstrated, those who identified themselves as strong vaccine supporters were statistically significantly more frequently to be vaccinated with COVID-19 booster doses, to follow a physician’s recommendation on any vaccine without hesitation, and to be strengthened in their confidence in vaccines during the COVID-19 pandemic (p < 0.001 for all). However, over half of the responders declared themselves as moderate vaccine supporters/opponents, the groups whose further attitudes are likely to be affected by (mis)communication. Importantly, more than half of moderate vaccine supporters declared that their vaccine confidence was weakened during the COVID-19 pandemic, while 43% were not vaccinated against COVID-19. In addition, the study demonstrated that older and better-educated individuals were more likely to be COVID-19-vaccinated (p < 0.001 and p = 0.013, respectively). The results of this study imply that, in order to improve vaccine acceptance, it is essential to strengthen public health communication and avoid communication errors conducted during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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17 pages, 2750 KiB  
Article
Are We Facing a Tsunami of Vaccine Hesitancy or Outdated Pandemic Policy in Times of Omicron? Analyzing Changes of COVID-19 Vaccination Trends in Poland
by Marcin Piotr Walkowiak, Jan Domaradzki and Dariusz Walkowiak
Vaccines 2023, 11(6), 1065; https://doi.org/10.3390/vaccines11061065 - 05 Jun 2023
Cited by 3 | Viewed by 2030
Abstract
In this study, we analyzed Polish COVID-19 vaccination data until January 2023 from the European Centre for Disease Prevention and Control to understand individual decision making during the milder Omicron wave. Our findings show a general decline in subsequent vaccine uptake. As the [...] Read more.
In this study, we analyzed Polish COVID-19 vaccination data until January 2023 from the European Centre for Disease Prevention and Control to understand individual decision making during the milder Omicron wave. Our findings show a general decline in subsequent vaccine uptake. As the number of government-provided doses increased, completion rates among certain low-risk groups dropped to less than 1%. Elderly individuals, especially those aged 70–79, showed greater adherence but also exhibited decreased interest in subsequent boosters. Healthcare workers exhibited a dramatic shift in their attitude, disregarding the recommended schedule. The overwhelming majority opted out of receiving the second boosters, while the remaining individuals adjusted their timing based on infection trends or the availability of updated boosters. Two factors positively influenced vaccination decisions: societal influence and the availability of updated boosters. Lower-risk individuals were more likely to postpone vaccination until updated boosters were available. Our findings highlight that while Polish policy aligns with international guidelines, it fails to garner significant adherence from the Polish population. Previous studies have shown that vaccinating low-risk groups resulted in more sick days due to adverse events following immunization than the days gained by preventing infection. Consequently, we advocate for the official abandonment of this policy, as its practical abandonment has already taken place, and persisting in pretending otherwise only serves to erode public trust. Therefore, we propose a shift toward treating COVID-19-like influenza with vaccination for vulnerable individuals and those who have close contact with them before the season. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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30 pages, 3892 KiB  
Article
Invasive Meningococcal Disease and Meningococcal Serogroup B Vaccination in Adults and Their Offspring: Knowledge, Attitudes, and Practices in Italy (2019)
by Matteo Riccò, Milena Pia Cerviere, Federico Marchesi and Marco Bottazzoli
Vaccines 2023, 11(3), 508; https://doi.org/10.3390/vaccines11030508 - 22 Feb 2023
Cited by 1 | Viewed by 1789
Abstract
Despite its effectiveness in preventing invasive meningococcal disease (IMD), pediatric uptake of recombinant meningococcal vaccination for serogroup B meningitis (MenB) is low in Italy. This study aimed to investigate knowledge, attitudes, and practice (KAP) about IMD and the vaccine uptake for MenB from [...] Read more.
Despite its effectiveness in preventing invasive meningococcal disease (IMD), pediatric uptake of recombinant meningococcal vaccination for serogroup B meningitis (MenB) is low in Italy. This study aimed to investigate knowledge, attitudes, and practice (KAP) about IMD and the vaccine uptake for MenB from July to December 2019, in a sample collected from a series of local Facebook discussion groups from the provinces of Parma and Reggio Emilia (North-Eastern Italy; 337,104 registered users). A self-administered anonymous web-based questionnaire was used to collect demographics, knowledge status, perceived risk for contracting meningitis, attitude towards the utility of meningococcal vaccine, and willingness to receive/perform MenB vaccine in their offspring. In total, 541 parents returned a fully completed questionnaire (response rate of 1.6% of potential recipients), with a mean age of 39.2 years ± 6.3 (78.1% females). Meningococcal infection was identified as severe or highly severe by most participants (88.9%), while it was recognized as being frequent/highly frequent in the general population by 18.6% of respondents. The overall knowledge status was unsatisfactory (57.6% ± 33.6 of correct answers to the knowledge test). Even though 63.4% of participants were somewhat favorable to MenB/MenC vaccines, offspring’s vaccination towards MenB was reported by only 38.7% of participants. In a binary logistic regression model, the male gender of respondents (adjusted odds ratio [aOR] 3.184, 95% confidence interval [95%CI] 1.772 to 5.721), living in a municipality >15,000 inhabitants (aOR 1.675, 95%CI 1.051 to 2.668), reporting a favorable attitude on meningococcus B vaccine (aOR 12.472, 95%CI 3.030 to 51.338), having been vaccinated against serogroup B (aOR 5.624, 95%CI 1.936 to 16.337) and/or serogroup C (aOR 2.652, 95%CI 1.442 to 4.872), and having previously vaccinated their offspring against serogroup C meningococcus (aOR 6.585, 95%CI 3.648 to 11.888) were characterized as positive effectors of offspring’s vaccination. On the contrary, having a higher risk perception on vaccines was identified as the only negative effector (aOR 0.429, 95%CI 0.241 to 0.765). Our results hint towards extensive knowledge gaps on IMD and preventive interventions in the general population, suggesting that a positive attitude towards vaccines and vaccinations could be identified as the main effector also for MenB acceptance. Interventions in the general population aimed at improving confidence, compliance, and acknowledgment of the collective responsibility, as well as preventing actual constraints and the sharing of false beliefs on infectious diseases and their preventive measures, could therefore increase vaccination acceptance in both targeted individuals and their offspring. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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8 pages, 249 KiB  
Article
Association between COVID-19 and Seasonal Influenza Vaccines to Vaccine Hesitancy, Intolerance of Uncertainty and Mental Health
by Maayan Shacham, Yaira Hamama-Raz, Menachem Ben-Ezra and Yafit Levin
Vaccines 2023, 11(2), 403; https://doi.org/10.3390/vaccines11020403 - 09 Feb 2023
Cited by 3 | Viewed by 1473
Abstract
Vaccine hesitancy is a universal problem that is becoming more prevalent, ranging from partial acceptance to the complete refusal of various vaccines. The current study seeks to assess the relationship between vaccine hesitancy, intolerance of uncertainty, and mental health factors and those who [...] Read more.
Vaccine hesitancy is a universal problem that is becoming more prevalent, ranging from partial acceptance to the complete refusal of various vaccines. The current study seeks to assess the relationship between vaccine hesitancy, intolerance of uncertainty, and mental health factors and those who were vaccinated against COVID-19 and seasonal influenza in comparison to those who did not vaccinate against both or decided to be vaccinated with only one of these vaccines. Employing a cross-sectional design, 1068 Israeli participants were recruited via social media (mainly Facebook) and Whatsapp and completed questionnaires assessing vaccine hesitancy, intolerance of uncertainty, and mental health factors. Our results revealed that previous history of neither COVID-19 nor seasonal influenza vaccination was associated with increased vaccine hesitancy. In addition, individuals who received either one vaccine or both claimed elevated levels of intolerance of uncertainty and reported elevated levels of mental health symptoms. Therefore, an association between vaccine hesitancy and intolerance of uncertainty and mental health symptoms is demonstrated. Future campaigns against vaccine hesitancy may focus on the intolerance of uncertainty in vaccine-hesitant individuals. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
12 pages, 286 KiB  
Article
Predictors of Seasonal Influenza Vaccination Willingness among High-Risk Populations Three Years after the Onset of the COVID-19 Pandemic
by Aglaia Katsiroumpa, Panayota Sourtzi, Daphne Kaitelidou, Olga Siskou, Olympia Konstantakopoulou and Petros Galanis
Vaccines 2023, 11(2), 331; https://doi.org/10.3390/vaccines11020331 - 01 Feb 2023
Cited by 7 | Viewed by 2035
Abstract
High-risk populations are at increased risk of severe influenza-related illness, hospitalization, and death due to influenza. The aim of our study was to assess the willingness of high-risk populations to take the influenza vaccine for the 2022–2023 season, and to investigate the factors [...] Read more.
High-risk populations are at increased risk of severe influenza-related illness, hospitalization, and death due to influenza. The aim of our study was to assess the willingness of high-risk populations to take the influenza vaccine for the 2022–2023 season, and to investigate the factors associated with such willingness. We conducted a cross-sectional study in Greece in September 2022 using a convenience sample. We considered demographic characteristics, COVID-19-related variables, resilience, social support, anxiety, depression, and COVID-19-related burnout as potential predictors. Among participants, 39.4% were willing to accept the seasonal influenza vaccine, 33.9% were unwilling, and 26.8% were hesitant. Multivariable analysis identified that increased age and increased family support were associated with increased influenza vaccination willingness. Moreover, participants that have received COVID-19 booster doses were more willing to accept the influenza vaccine. In contrast, adverse effects because of COVID-19 vaccination and exhaustion due to measures against COVID-19 reduced influenza vaccination willingness. We found that the intention of high-risk populations to receive the influenza vaccine was low. Our study contributes to an increased understanding of the factors that affect vaccination willingness. Public health authorities could use this information to update vaccination programs against influenza. Emphasis should be given on safety and effectiveness issues. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
16 pages, 1299 KiB  
Article
Perceived Barriers and Intentions to Receive COVID-19 Vaccines: Psychological Distress as a Moderator
by Ngo Thi Viet Nga, Vu Ngoc Xuan, Vu Anh Trong, Pham Huong Thao and Duong Cong Doanh
Vaccines 2023, 11(2), 289; https://doi.org/10.3390/vaccines11020289 - 28 Jan 2023
Cited by 4 | Viewed by 1217
Abstract
A high vaccination uptake degree is crucial to achieve herd immunity to COVID-19 and restrict the spread of the COVID-19 pandemic. However, little is known about the antecedents that reduce or contribute to shaping the intention to receive COVID-19 vaccines, as well as [...] Read more.
A high vaccination uptake degree is crucial to achieve herd immunity to COVID-19 and restrict the spread of the COVID-19 pandemic. However, little is known about the antecedents that reduce or contribute to shaping the intention to receive COVID-19 vaccines, as well as how psychological distress—a mental health problem—can reinforce or dampen the translation from antecedents into intention to receive COVID-19 vaccines. The objective of this study was to explore the effects of perceived clinical and access barriers, self-efficacy, and attitudes towards COVID-19 vaccines on the intention to receive COVID-19 vaccines. Simultaneously, the moderation effects of psychological distress on this relationship were also examined. Using a sample of 2722 Vietnamese adults and structural equation modeling (SEM), this study illustrated that self-efficacy and attitudes towards COVID-19 vaccines were significantly interrelated with intention to receive COVID-19 vaccines. Self-efficacy, attitudes towards COVID-19 vaccines, and intention to receive COVID-19 vaccines were negatively influenced by perceived access barriers but were positively associated with perceived clinical barriers. Importantly, our study reported that when psychological distress was higher, the link between self-efficacy and intention to receive COVID-19 vaccines will become weaker, but the effect of perceived clinical barriers on intention to receive COVID-19 vaccines will be reinforced. Moreover, self-efficacy and attitudes towards COVID-19 vaccines served as mediators in the linkages between perceived barriers and intention to receive COVID-19 vaccines. Besides providing contributions to the extant COVID-19 vaccine literature, this study provides useful recommendations for practitioners and policymakers to foster adults’ COVID-19 vaccine acceptance. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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11 pages, 280 KiB  
Article
Seasonal Influenza Vaccine Intention among Nurses Who Have Been Fully Vaccinated against COVID-19: Evidence from Greece
by Petros Galanis, Aglaia Katsiroumpa, Irene Vraka, Olga Siskou, Olympia Konstantakopoulou, Theodoros Katsoulas and Daphne Kaitelidou
Vaccines 2023, 11(1), 159; https://doi.org/10.3390/vaccines11010159 - 11 Jan 2023
Cited by 7 | Viewed by 1641
Abstract
Seasonal influenza continues to be a significant public health issue causing hundreds of thousands of deaths annually. Nurses are a priority risk group for influenza vaccination and a high vaccine uptake rate among them is crucial to protect public health. Thus, the aim [...] Read more.
Seasonal influenza continues to be a significant public health issue causing hundreds of thousands of deaths annually. Nurses are a priority risk group for influenza vaccination and a high vaccine uptake rate among them is crucial to protect public health. Thus, the aim of our study was to estimate the levels of influenza vaccine acceptance, as well as its determinants, among nurses for the 2022/2023 season. We conducted a cross-sectional study with a convenience sample in Greece. We collected data via an online survey in September 2022. Most of the nurses in the study possessed a MSc/PhD diploma (56.2%) and had previously been infected by SARS-CoV-2 (70.3%). Among nurses, 57.3% were willing to accept the influenza vaccine, 19% were hesitant, and 23.7% were unwilling. Older age, higher levels of perceived support from significant others, and higher COVID-19-related physical exhaustion were positively related to influenza vaccination intention. In contrast, more side effects because of COVID-19 vaccination and higher levels of exhaustion due to measures taken against COVID-19 were negatively associated with vaccination intention. Since the influenza vaccination acceptance rate among nurses was moderate, policymakers should develop and implement measures tailored specifically to nurses in the context of the COVID-19 pandemic to decrease vaccine hesitancy. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
32 pages, 5868 KiB  
Article
Vaccine or Garlic–Is It a Choice? Awareness of Medical Personnel on Prevention of Influenza Infections
by Tomasz Sobierajski, Dominika Rykowska, Monika Wanke-Rytt and Ernest Kuchar
Vaccines 2023, 11(1), 66; https://doi.org/10.3390/vaccines11010066 - 28 Dec 2022
Viewed by 1433
Abstract
Background: Preventing the spread of the influenza virus is one of the primary health policy challenges of many countries worldwide. One of the more effective ways to prevent infection is influenza vaccination, and the people who enjoy the most public confidence in preventive [...] Read more.
Background: Preventing the spread of the influenza virus is one of the primary health policy challenges of many countries worldwide. One of the more effective ways to prevent infection is influenza vaccination, and the people who enjoy the most public confidence in preventive health care are health workers (HWs). For this reason, it is crucial to study the attitudes of HWs toward influenza vaccination. Methods: The survey was conducted among 950 medical (physicians and nurses) and administrative staff in three academic hospitals. Respondents to the survey were selected on a random-target basis to represent hospital employees in the study best. The survey was conducted using the PAPI method between August and September 2020. Results: Respondents considered hand washing (52.8%) and avoiding contact with sick people (49.3%) the most effective ways to prevent influenza infection. Three in ten respondents considered wearing a protective mask (30.1%) and getting vaccinated against influenza (29.9%) is fully effective in preventing influenza. Influenza vaccination as effective in preventing influenza virus infection was chosen more often by those who worked in a pediatric hospital. Nurses were twice less likely than physicians to declare that influenza vaccination prevents infection (42.4% for nurses vs. 84.0% for physicians). At the same time, 20.4% of nurses believed that eating garlic effectively prevented influenza infection, and 28.1% declared daily vitamin C helpful. Conclusions: The study pointed to significant educational gaps regarding the role and effectiveness of influenza vaccination in the process of influenza virus infection and indicated a firm belief in medical myths, especially in the nursing community, related to protection against influenza virus infection. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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11 pages, 277 KiB  
Article
COVID-19 Vaccination among a Population Experiencing Homelessness: A Survey in Italy
by Giorgia Della Polla, Grazia Miraglia del Giudice, Annalisa Napoli, Lucio Folcarelli and Italo Francesco Angelillo
Vaccines 2022, 10(12), 2118; https://doi.org/10.3390/vaccines10122118 - 11 Dec 2022
Cited by 6 | Viewed by 1190
Abstract
The purposes of this cross-sectional study were to determine the knowledge, attitudes, and behaviors about COVID-19 and its vaccination among 313 individuals experiencing homelessness in Italy and to identify the associated factors. A total of 20.5% identified the virus as a causative agent [...] Read more.
The purposes of this cross-sectional study were to determine the knowledge, attitudes, and behaviors about COVID-19 and its vaccination among 313 individuals experiencing homelessness in Italy and to identify the associated factors. A total of 20.5% identified the virus as a causative agent for COVID-19 and 44.2% identified how the SARS-CoV-2 infection wastransmitted. Those living in homeless shelters were more likely to have this knowledge. Concerns about the safety of the COVID-19 vaccine werehigher in those who were younger, with secondary school as the highest level of education, who practiced Christianity, and who did not believe that COVID-19 was a severe disease. A total of 83.9% received the vaccination. Those who were older, who had correct knowledge, whoperceived to be at a higher risk of getting the disease, and who had a lower concern about the vaccine side effects were more likely to have received the vaccination. The primary reasons for accepting the COVID-19 vaccine were that it wasa preventive measure and that it wasmandatory; those unvaccinated indicated, as the main reasons, a fear of side effects and that it wasnot useful. A relationship and communication between healthcare professionals and this hard-to-reach population are needed, with the implementation of educational and information programs. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)

Review

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18 pages, 813 KiB  
Review
A Systematic Review of Population-Based Studies Assessing Knowledge, Attitudes, Acceptance, and Hesitancy of Pregnant and Breastfeeding Women towards the COVID-19 Vaccine
by Vincenza Gianfredi, Pasquale Stefanizzi, Alessandro Berti, Marilena D’Amico, Viola De Lorenzo, Antonio Di Lorenzo, Lorenza Moscara and Silvana Castaldi
Vaccines 2023, 11(8), 1289; https://doi.org/10.3390/vaccines11081289 - 27 Jul 2023
Cited by 4 | Viewed by 1356
Abstract
The anti-SARS-CoV-2 vaccination is recommended for pregnant women due to the high risk of complications. However, pregnancy has been associated with vaccine hesitancy. Our review aims at summarizing the existing literature about anti-SARS-CoV-2 vaccine hesitancy in pregnant and lactating women. The research was [...] Read more.
The anti-SARS-CoV-2 vaccination is recommended for pregnant women due to the high risk of complications. However, pregnancy has been associated with vaccine hesitancy. Our review aims at summarizing the existing literature about anti-SARS-CoV-2 vaccine hesitancy in pregnant and lactating women. The research was conducted on PubMed/MEDLINE, ExcerptaMedica Database (EMBASE), and Scopus, according to PRISMA guidelines. Articles regarding the COVID-19 vaccine’s acceptance and/or refusal by pregnant and lactating women were selected. Only observational, population-based studies were included. The Joanna Briggs Institute quality assessment tools were employed. A total of 496 articles were retrieved, and after the selection process, 21 papers were included in the current analysis. All the included studies were cross-sectional, mostly from Europe and North America. The sample sizes ranged between 72 and 25,111 subjects. All of them included pregnant subjects, except one that focused on breastfeeding women only. Vaccine hesitancy rates ranged from 26% to 57% among different studies. Fear of adverse events and lack of knowledge were shown to be the main drivers of hesitancy. Approximately half of the studies (11/21) were classified as low quality, the remaining (9/21) were classified as moderate, and only one study was classified as high quality. Primigravidae were also shown to be more likely to accept anti-SARS-CoV-2 vaccination. Our findings confirm significant anti-SARS-CoV-2 vaccine hesitancy among pregnant women. Information gaps should be addressed to contain concerns related to adverse events. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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33 pages, 1856 KiB  
Review
Worldwide Estimation of Parental Acceptance of COVID-19 Vaccine for Their Children: A Systematic Review and Meta-Analysis
by Zainab Alimoradi, Chung-Ying Lin and Amir H. Pakpour
Vaccines 2023, 11(3), 533; https://doi.org/10.3390/vaccines11030533 - 24 Feb 2023
Cited by 18 | Viewed by 2537
Abstract
Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, [...] Read more.
Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents’ and guardians’ willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents’ acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents’ or guardians’ willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18–70) years and that of their children was 8.45 (range: 0–18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52–62%, I2: 99.92%, τ2: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents’ COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents’ knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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9 pages, 468 KiB  
Review
Causes of Vaccine Hesitancy in Adults for the Influenza and COVID-19 Vaccines: A Systematic Literature Review
by Simran Kumar, Zayna Shah and Sara Garfield
Vaccines 2022, 10(9), 1518; https://doi.org/10.3390/vaccines10091518 - 13 Sep 2022
Cited by 23 | Viewed by 3306
Abstract
Background: Vaccine hesitancy was labelled as one of the top ten threats to global health by the World Health Organization in 2019 and is associated with negative health outcomes. Previous reviews on cause of vaccines have not included vaccine hesitancy related to the [...] Read more.
Background: Vaccine hesitancy was labelled as one of the top ten threats to global health by the World Health Organization in 2019 and is associated with negative health outcomes. Previous reviews on cause of vaccines have not included vaccine hesitancy related to the COVID-19 vaccine. This review aimed to fill this gap by synthesising the findings of studies identifying causes of vaccine hesitancy to the COVID-19 and influenza vaccines. Methods: A systematic literature review was conducted. Searches were carried out in the PubMed, EMBASE and Cochrane databases. Following data extraction, a thematic analysis was conducted of the causes of vaccine hesitancy in adults for the influenza and COVID-19 vaccines. Results: Fourteen papers were included. Four themes were identified as causes of vaccine hesitancy comprising: concerns over safety, lack of trust, lack of need for vaccination and cultural reasons. While concerns over safety were found in all countries, some of these were specific to particular countries and cultures. Our findings suggest that scientific knowledge of vaccines and size of clinical trials during their development reduce vaccine hesitancy. However, pharmaceutical companies were not a trusted source of information. Conclusion: Our findings build on those of previous research to suggest specific information that may be helpful in addressing vaccine hesitancy. Targeted approaches from trusted sources are needed to address specific safety concerns. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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10 pages, 457 KiB  
Commentary
Megastudies: A New Approach to Reducing Vaccine Hesitation Worldwide
by Lian Yu, Jiaqi Qiao, Wai-Kit Ming and Yibo Wu
Vaccines 2023, 11(1), 133; https://doi.org/10.3390/vaccines11010133 - 06 Jan 2023
Cited by 2 | Viewed by 1731
Abstract
Vaccine hesitancy is a considerable obstacle to achieving vaccine protection worldwide. There needs to be more evidence-based research for interventions for vaccine hesitancy. Existing effectiveness evaluations are limited to one particular hypothesis, and no studies have compared the effectiveness of different interventions. A [...] Read more.
Vaccine hesitancy is a considerable obstacle to achieving vaccine protection worldwide. There needs to be more evidence-based research for interventions for vaccine hesitancy. Existing effectiveness evaluations are limited to one particular hypothesis, and no studies have compared the effectiveness of different interventions. A megastudy takes a large-scale, multi-intervention, uniform participant and the same evaluation criteria approach to evaluate many interventions simultaneously and find the most effective ones. Therefore, megastudies can help us find the most effective interventions for vaccine hesitancy. Additionally, considering the complex causes of vaccine hesitancy, we design interventions that involve social factors in megastudies. Lastly, quality control and justice are critical issues for megastudies in the future. Full article
(This article belongs to the Special Issue Vaccines Hesitancy and Public Health)
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