2023

Jump to: 2022, 2021

14 pages, 1276 KiB

Open AccessArticle

Understanding Factors Contributing to Vaccine Hesitancy in a Large Metropolitan Area

by Paolo Montuori, Immanuela Gentile, Claudio Fiorilla, Michele Sorrentino, Benedetto Schiavone, Valerio Fattore, Fabio Coscetta, Alessandra Riccardi, Antonio Villani, Ugo Trama, Francesca Pennino, Maria Triassi and Antonio Nardone

Vaccines 2023, 11(10), 1558; https://doi.org/10.3390/vaccines11101558 - 02 Oct 2023

Cited by 3 | Viewed by 1284

Abstract

Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be [...] Read more.

Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be 27 billion dollars per year in the US alone. To investigate the association between demographic variables and knowledge, attitudes, and behaviours related to vaccination, a survey-based cross-sectional study was conducted with 1163 individuals. Three models were used to perform a multiple linear regression analysis. In Model I, knowledge about vaccinations was found to be associated with smoking habits, education, and marital status. In Model II, attitudes towards vaccinations were significantly associated with sex, smoking habits, education, marital status, and knowledge. In Model III, behaviours related to vaccination were associated with sex, smoking habits, having children, knowledge, and attitudes. One potential solution to improve behaviours related to vaccinations in the general population is to implement specific public health programs, which can be a cost-effective intervention. This study provides valuable insights into the determinants of knowledge, attitudes, and behaviours related to vaccinations in the general population. Full article

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21 pages, 279 KiB

Open AccessArticle

Vaccine Hesitancy in College Students

by Emily Gilbert-Esparza, Amelia Brady, Sierrah Haas, Heather Wittstruck, Jennifer Miller, Qing Kang and Ellyn R. Mulcahy

Vaccines 2023, 11(7), 1243; https://doi.org/10.3390/vaccines11071243 - 15 Jul 2023

Cited by 3 | Viewed by 1588

Abstract

(1) Background: Following the COVID-19 pandemic, vaccine hesitancy has become an increasingly important topic and has created significant concerns in public health. It is important to explore vaccine hesitancy among college students as they have been identified to be a high-risk group for [...] Read more.

(1) Background: Following the COVID-19 pandemic, vaccine hesitancy has become an increasingly important topic and has created significant concerns in public health. It is important to explore vaccine hesitancy among college students as they have been identified to be a high-risk group for COVID-19 transmission. This study aims to investigate COVID-19 vaccine hesitancy in college students on a midsized midwestern university campus. (2) Methods: Data were collected from 311 undergraduate and graduate college students during June and July 2021. Participants completed a survey on COVID-19 vaccine behaviors, perceptions, and opinions. Quantitative and qualitative analysis was performed to identify vaccine hesitancy and influencing factors in the student population. (3) Results: The results of this study demonstrated significant relationships between older and younger undergraduate students (OR > 1, p < 0.05), students who received a yearly influenza vaccine and those that did not (p < 0.05), and students who had a previous COVID-19 infection and those that did not (OR > 1, p < 0.05). We also determined a significant difference between some racial/ethnic groups and vaccine hesitancy status. (4) Conclusions: COVID-19 vaccine hesitancy exists on college campuses, and is influenced by age and student status, influenza vaccination status, previous COVID-19 infection, and race/ethnicity. Full article

2022

Jump to: 2023, 2021

12 pages, 547 KiB

Open AccessArticle

Vaccine Hesitancy and Perceptions of the Community about Polio in High-Risk Areas of Karachi, Sindh, Pakistan

by Fayaz Hussain Abbasi, Ahmed Ali Shaikh, Jaishri Mehraj, Syed Musa Raza, Shumaila Rasool, Umar Farooq Bullo, Sandeep Mehraj, Zamir Ali Phul, Sundeep Sahitia, Asif Ali Zardari and Shoukat Ali Chandio

Vaccines 2023, 11(1), 70; https://doi.org/10.3390/vaccines11010070 - 28 Dec 2022

Cited by 7 | Viewed by 4905

Abstract

The study aimed to determine the reasons for polio vaccine hesitancy among parents of persistently missed children (PMCs) in the high-risk areas of Karachi, Pakistan. A cross-sectional survey of parents of PMCs was conducted in April 2019 in 34 high-risk union councils of [...] Read more.

The study aimed to determine the reasons for polio vaccine hesitancy among parents of persistently missed children (PMCs) in the high-risk areas of Karachi, Pakistan. A cross-sectional survey of parents of PMCs was conducted in April 2019 in 34 high-risk union councils of Karachi. PMCs were randomly selected from the polio program database, and further information was collected on a questionnaire by trained staff using face-to-face interviews with parents of PMCs. A total of 325 participants were included in the study. Among refusals, 112 (37.3%) had no trust in vaccine quality, followed by 45 (15.0%) who were afraid of side effects, 42 (14.0%) whose elders did not allow polio vaccination, 39 (13.0%) who refused due to the influence of negative social media videos, and 20 (6.7%) who had no trust in polio teams. We concluded that misconception is still a big challenge, and the program needs to strive for community acceptance. Low levels of trust in vaccines and teams as well as fear of OPV side effects were among the main reason for vaccine hesitancy. The participant communities recommended involving famous medical doctors, religious influencers, and TV or sports stars to enhance knowledge and acceptance of polio vaccination. Full article

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9 pages, 457 KiB

Open AccessCommunication

False Contraindications for Vaccinations Result in Sub-Optimal Vaccination Coverage in Quito, Ecuador: A Cross-Sectional Study

by Felipe Andrade-Guerrero, Adriana Tapia, Vinicio Andrade, Jorge Vásconez-González, José Andrade-Guerrero, Carlos Noroña-Calvachi, Juan S. Izquierdo-Condoy, Justin Yeager and Esteban Ortiz-Prado

Vaccines 2023, 11(1), 60; https://doi.org/10.3390/vaccines11010060 - 27 Dec 2022

Viewed by 2195

Abstract

Vaccination coverage in Ecuador has decreased since 2013, falling short of the World Health Organization’s vaccination goal. There are several causes for this deficiency in coverage, one of these are lost vaccination opportunities, which are caused when a patient without contraindications postpones, or [...] Read more.

Vaccination coverage in Ecuador has decreased since 2013, falling short of the World Health Organization’s vaccination goal. There are several causes for this deficiency in coverage, one of these are lost vaccination opportunities, which are caused when a patient without contraindications postpones, or for other reasons fails to receive a recommended immunization. The objective of this study was to determine the state of knowledge regarding vaccination contraindications among the Metropolitan District of Quito health personnel to assess missed vaccination opportunities. Through this cross-sectional descriptive study, health personnel were surveyed online and asked 18 clinical scenarios which were created to evaluate their knowledge of the true contraindications of vaccination, and measure missed opportunities. A total of 273 surveys were collected; 74% belonged to the public health system, and the rest represented by private practitioners. Of those surveyed, 98.2% of health personnel had improperly denied vaccination at least once. We specifically found vaccinations were incorrectly denied more frequently in cases where the hypothetical patient presented mild or moderate fever cases. The use of corticosteroids, autoimmune diseases, and egg allergy were also incorrectly denied (89%, 71.4%, 72.9%, and 58.6%, respectively). Among the health personnel surveyed, there is an apparent lack of knowledge of the true contraindications of vaccination and differences in knowledge about contraindications according to personnel in charge of administering immunization to children. Our preliminary results suggest that lack of education related to side effects could be biasing medical professionals’ decisions, causing them to unnecessarily delay or deny vaccinations, which likely contributes to explaining low overall vaccination coverage in Quito, the capital city of Ecuador. Full article

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17 pages, 309 KiB

Open AccessArticle

Anti-Vaccine Discourse on Social Media: An Exploratory Audit of Negative Tweets about Vaccines and Their Posters

by An Nguyen and Daniel Catalan-Matamoros

Vaccines 2022, 10(12), 2067; https://doi.org/10.3390/vaccines10122067 - 01 Dec 2022

Cited by 9 | Viewed by 4920

Abstract

As the anti-vaccination movement is spreading around the world, this paper addresses the ever more urgent need for health professionals, communicators and policy-makers to grasp the nature of vaccine mis/disinformation on social media. A one-by-one coding of 4511 vaccine-related tweets posted from the [...] Read more.

As the anti-vaccination movement is spreading around the world, this paper addresses the ever more urgent need for health professionals, communicators and policy-makers to grasp the nature of vaccine mis/disinformation on social media. A one-by-one coding of 4511 vaccine-related tweets posted from the UK in 2019 resulted in 334 anti-vaccine tweets. Our analysis shows that (a) anti-vaccine tweeters are quite active and widely networked users on their own; (b) anti-vaccine messages tend to focus on the “harmful” nature of vaccination, based mostly on personal experience, values and beliefs rather than hard facts; (c) anonymity does not make a difference to the types of posted anti-vaccine content, but does so in terms of the volume of such content. Communication initiatives against anti-vaccination should (a) work closely with technological platforms to tackle anonymous anti-vaccine tweets; (b) focus efforts on mis/disinformation in three major arears (in order of importance): the medical nature of vaccines, the belief that vaccination is a tool of manipulation and control for money and power, and the “freedom of health choice” discourse against mandatory vaccination; and (c) go beyond common factual measures—such as detecting, labelling or removing fake news—to address emotions induced by personal memories, values and beliefs. Full article

13 pages, 977 KiB

Open AccessArticle

The Multidimensional Vaccine Hesitancy Scale: A Validation Study

by Beatrice Adriana Balgiu, Ruxandra Sfeatcu, Ana Maria Cristina Țâncu, Marina Imre, Ana Petre and Laura Tribus

Vaccines 2022, 10(10), 1755; https://doi.org/10.3390/vaccines10101755 - 20 Oct 2022

Cited by 6 | Viewed by 2063

Abstract

Vaccination hesitancy (VH) is a phenomenon which increases the occurrence of vaccine-preventable diseases. The study tests the validity of the Multidimensional Vaccine Hesitancy Scale (MVHS) in the case of a sample of Romanian adults (n = 528; Mean_age = 30.57). The [...] Read more.

Vaccination hesitancy (VH) is a phenomenon which increases the occurrence of vaccine-preventable diseases. The study tests the validity of the Multidimensional Vaccine Hesitancy Scale (MVHS) in the case of a sample of Romanian adults (n = 528; Mean_age = 30.57). The latter filled in an online cross-sectional survey. The construct validity of MVHS was assessed by using confirmatory factor analysis (CFA), the reliability was calculated by using the internal consistency, and the convergent and discriminant validity was assessed by using the composite reliability (CR), and average variance extracted (AVE). The obtained model was invariant across gender. The structural equation model was designed for predictive validity by using the partial least square method (PLS-SEM) which analyses the relation between the MVHS dimensions and the vaccination willingness. The results show support for the 8-factor structure of the scale (χ²/df = 2.48; CFI = 0.95; RMSEA = 0.053). The Cronbach’s coefficients α > 0.70; McDonald’s ω > 0.70 and CR > 0.80 have very good values. The structural equation model shows that there are more dimensions of the scale which predict vaccination hesitancy in various types of vaccines—the main predictors remain the dimensions of health risk and healthy condition. The study’s conclusion led to the idea that the MVHS is suitable for medical practice and for research on the analysis of vaccination behaviours and intentions. Full article

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17 pages, 1462 KiB

Open AccessArticle

Drivers of the Intention to Receive a COVID-19 Booster Vaccine: Insights from the UK and Australia

by Kirsten Barnes and Ben Colagiuri

Vaccines 2022, 10(10), 1730; https://doi.org/10.3390/vaccines10101730 - 17 Oct 2022

Cited by 3 | Viewed by 1669

Abstract

As the global pandemic perpetuates, keeping the population vaccinated will be imperative to maintain societal protection from the SARS-CoV-2 (COVID-19) virus. However, while empirical evidence regarding predictors of the intention to receive a first COVID-19 vaccine has amassed, our understanding regarding the psychological [...] Read more.

As the global pandemic perpetuates, keeping the population vaccinated will be imperative to maintain societal protection from the SARS-CoV-2 (COVID-19) virus. However, while empirical evidence regarding predictors of the intention to receive a first COVID-19 vaccine has amassed, our understanding regarding the psychological and behavioral drivers of continued COVID-19 vaccination remains limited. In this pre-registered study (UK: AsPredicted#78370|Australia: AsPredicted#81667), factors predicting the intention to receive a COVID-19 booster vaccine were investigated in two adult samples from the UK (N = 1222) and Australia (N = 1197) that were nationally representative on factors of age, gender, and geographic location. High levels of booster intent were found (73% and 67%, respectively). Exploratory Structural Equation Modelling (ESEM) revealed three key predictors of the intention to receive a booster vaccine that emerged across both UK and Australian samples: concern regarding the COVID-19 virus, positive perceptions of the COVID-19 vaccines, and the perceived severity of side effects experienced to the last COVID-19 vaccine dose. Several additional factors (age, months since the last COVID-19 vaccine, familiarity with side effects, and regularly receiving the influenza vaccine) were present in the Australian dataset. These findings provide important evidence that targeting psychological perceptions of the COVID-19 vaccine and virus may serve to maintain participation in the COVID-19 vaccination programme, paving the way for future behavioural research in this area. Full article

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14 pages, 267 KiB

Open AccessArticle

Trends in Vaccine Refusal and Acceptance Using Electronic Health Records from a Large Pediatric Hospital Network, 2013–2020: Strategies for Change

by Angela K. Shen, Robert W. Grundmeier and Jeremey J. Michel

Vaccines 2022, 10(10), 1688; https://doi.org/10.3390/vaccines10101688 - 10 Oct 2022

Viewed by 1384

Abstract

Understanding trends in vaccine refusal is critical to monitor as small declines in vaccination coverage can lead to outbreaks of vaccine-preventable diseases. Using electronic heath record (EHR) data from the Children’s Hospital of Philadelphia’s 31 outpatient primary care sites, we created a cohort [...] Read more.

Understanding trends in vaccine refusal is critical to monitor as small declines in vaccination coverage can lead to outbreaks of vaccine-preventable diseases. Using electronic heath record (EHR) data from the Children’s Hospital of Philadelphia’s 31 outpatient primary care sites, we created a cohort of 403,448 children less than age 20 years who received at least one visit from 1 January 2013 through 31 December 2020. The sample represented 1,449,061 annualized patient and 181,131 annualized preventive vaccination visits per year. We characterized trends in vaccine refusal and acceptance using a repeated cross-sectional observational analysis of electronic health records (EHR) data using a single annual merged observation measure for patients seen multiple times for preventive healthcare within a calendar year. Refusals were identified for 212,900 annualized patient-visit year observations, which represented 14.6% of annualized patient-visit year observations and 25.1% of annualized vaccine patient-year observations. The odds of having a refusal marker were significantly increased in patients seen in suburban practices (aOR [CI]: 2.35 [2.30–2.40, p < 0.001]), in patients with increased age 11–17 years (aOR [CI]: 3.85 [3.79–3.91], p < 0.001), and those eligible for the VFC program (aOR [CI]: 1.10 [1.08–1.11]. Parental refusal (61.0%) and provider decisions (32.0%) were the most common documented in progress notes for not administering vaccines, whereas contraindications (2.5%) and supply issues (1.8%) were the least common. When offered, vaccine acceptance increased for human papillomavirus, hepatitis B, measles-mumps-rubella-containing and varicella-containing vaccines and decreased for hepatitis A and meningococcal vaccines. Repeated offering of vaccines was central to increasing acceptance, in part due to increased opportunities to address specific concerns. Full article

11 pages, 515 KiB

Open AccessArticle

Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations

by Katherine Nicolich, Jacob Gerken, Blaire Mallahan, David W. Ross and Isain Zapata

Vaccines 2022, 10(10), 1579; https://doi.org/10.3390/vaccines10101579 - 21 Sep 2022

Cited by 2 | Viewed by 1260

Abstract

The objective of this study was to evaluate the impact of selected sociodemographic factors on childhood vaccination hesitancy and to define their role according to specific exemptions. This population-based cohort study utilized vaccination rate and sociodemographic data from 1st to 12th grade from [...] Read more.

The objective of this study was to evaluate the impact of selected sociodemographic factors on childhood vaccination hesitancy and to define their role according to specific exemptions. This population-based cohort study utilized vaccination rate and sociodemographic data from 1st to 12th grade from 2017 to 2021 for all school districts in Colorado. Data included immunization status and exemptions for each vaccine, race, ethnicity, and free and reduced meal status. Data were evaluated through dimensional analysis and Generalized Linear Mixed Models. School districts with a higher representation of White students had lower immunization rates and use more personal exemptions while school districts with larger Hispanic populations and higher proportions of free and reduced lunches had higher vaccination rates and used more religious exemptions. Black and Pacific Islander populations had higher rates of incomplete vaccination records while Asian American population displayed increased vaccination compliance. Colorado is a robust example of how socioeconomic and cultural differences are important factors with a direct influence on vaccination rates. Future childhood vaccination campaigns and legislation should consider complex socioeconomic and cultural factors. Full article

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14 pages, 3403 KiB

Open AccessArticle

Attitudes and Beliefs around the Value of Vaccination in the United States

by Sarah Childers-Strawbridge, Amanda L. Eiden, Mawuli K. Nyaku and Alexandra A. Bhatti

Vaccines 2022, 10(9), 1470; https://doi.org/10.3390/vaccines10091470 - 05 Sep 2022

Cited by 1 | Viewed by 1789

Abstract

Despite the benefits of immunization, differences in attitudes persist toward vaccines. We captured individuals’ perceptions of vaccines and vaccination across the United States (US) to inform vaccine-related policy development. A survey was completed by 5000 respondents from 10 states. Respondents were screened for [...] Read more.

Despite the benefits of immunization, differences in attitudes persist toward vaccines. We captured individuals’ perceptions of vaccines and vaccination across the United States (US) to inform vaccine-related policy development. A survey was completed by 5000 respondents from 10 states. Respondents were screened for inclusion, which included individuals ≥ 18 years of age that had received a vaccine or were unvaccinated but indicated a favorable or neutral attitude towards vaccinations. Participants were excluded if they indicated they did not support the idea of vaccinations. Questions explored perceptions of vaccines for all age groups. Among unvaccinated individuals, the most common concerns were about safety (38%). Most respondents (95%) highlighted the importance of state immunization programs for disease prevention. Access to health and immunization records and immunization information systems were important to 96% and 88% of respondents, respectively, for future health planning. Doctors and healthcare professionals (HCPs) were considered trusted sources for vaccine information (95%). Overall, respondents recognized the importance of vaccination, but documented concerns among the unvaccinated indicated a need for greater promotion regarding vaccine safety. Doctors and HCPs, as trusted information sources, should continue to and increasingly advocate for the importance of immunization to increase vaccine uptake. Full article

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14 pages, 1103 KiB

Open AccessArticle

Factors Driving COVID-19 Vaccine Hesitancy in Cameroon and Their Implications for Africa: A Comparison of Two Cross-Sectional Studies Conducted 19 Months Apart in 2020 and 2022

by Jerome Nyhalah Dinga, Andreas Ateke Njoh, Stanley Dobgima Gamua, Synthia Eni Muki and Vincent P. K. Titanji

Vaccines 2022, 10(9), 1401; https://doi.org/10.3390/vaccines10091401 - 26 Aug 2022

Cited by 8 | Viewed by 2155

Abstract

Many efficacious COVID-19 vaccines have been approved for general use but their ability to control the disease is being undermined by slow uptake. Resources are needed to persuade people to obtain a COVID-19 vaccine. Here we compare this present study and a previous [...] Read more.

Many efficacious COVID-19 vaccines have been approved for general use but their ability to control the disease is being undermined by slow uptake. Resources are needed to persuade people to obtain a COVID-19 vaccine. Here we compare this present study and a previous one to assess the impact of the Cameroon government’s policy and efforts to reduce COVID-19 vaccine hesitancy after one year of implementation. After obtaining ethical clearance and informed consent, 6732 participants completed a questionnaire about COVID-19 vaccine hesitancy and acceptance. It was observed that the government’s policies and efforts reduced COVID-19 vaccine hesitancy significantly, but this was not enough to ensure the herd immunity necessary to control the disease. The risk factors associated with vaccine hesitancy were the consumption of traditional herbal remedies; living in an urban setting; being female, jobless or a student; working in the education sector; being a politician/policy maker/administrator, engineer or technician; medium income; no education/primary school/secondary/high school/professional training; and working in the informal sector. In contrast, people who were male, healthcare personnel, high-income earners, participants who do not consume traditional herbal remedies, infected or knowing someone who has been infected by COVID-19, and having a chronic illness or comorbidity, were associated with COVID-19 vaccine acceptance. Participants also gave several reasons they were either hesitant or willing to take the vaccine. A more rigorous surveillance system is needed to systematically monitor drivers of vaccine hesitancy, establish tailored interventions promoting vaccine acceptance, and evaluate the impact of these interventions. Full article

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10 pages, 259 KiB

Open AccessArticle

Pilot Study of Evaluating Attitudes toward Childhood Immunization among Healthcare Workers in Japan

by Aya Saitoh, Yugo Shobugawa, Isamu Sato, Yuki Yonekura, Ai Kawabata, Akihiko Saitoh and Reiko Saito

Vaccines 2022, 10(7), 1055; https://doi.org/10.3390/vaccines10071055 - 30 Jun 2022

Cited by 3 | Viewed by 1285

Abstract

Providing appropriate immunization information during the perinatal period is important for improving immunization rates among infants and children; however, the distribution of immunization information by healthcare workers (HCWs) is not standardized in Japan. We investigated HCWs’ attitudes toward childhood immunization and factors related [...] Read more.

Providing appropriate immunization information during the perinatal period is important for improving immunization rates among infants and children; however, the distribution of immunization information by healthcare workers (HCWs) is not standardized in Japan. We investigated HCWs’ attitudes toward childhood immunization and factors related to vaccine hesitancy. We conducted a cross-sectional descriptive survey of HCWs involved in childhood immunization in Niigata City, Japan, from November 2017 to January 2018. We assessed contextual, individual and group, and vaccine/vaccination-specific influences. Of 290 HCWs, 139 (47.9%) returned completed questionnaires. Most HCWs (87/139, 64.9%) reported providing immunization information verbally to parents; 51/87 (58.6%) spent fewer than five minutes doing so. Pediatricians provided vaccines based on the parents’ best interest, whereas public health nurses and midwives emphasized government policy. Nurses had greater hesitancy related to personal perceptions and social/peer factors than pediatricians (p < 0.001). Nurses were significantly more likely than pediatricians to suggest that children receive more shots than necessary (p < 0.01). Nurses tended to have more negative attitudes toward vaccination and little awareness of immunization promotion compared to pediatricians. Thus, all HCWs involved in childhood immunization should receive sufficient information to provide timely and appropriate immunization to infants and children. Full article

12 pages, 514 KiB

Open AccessArticle

Knowledge and Attitude on Childhood Vaccination among Healthcare Workers in Hospital Universiti Sains Malaysia

by Ahmad Faiq Mukhtar, Azidah Abdul Kadir, Norhayati Mohd Noor and Ahmad Hazim Mohammad

Vaccines 2022, 10(7), 1017; https://doi.org/10.3390/vaccines10071017 - 24 Jun 2022

Cited by 6 | Viewed by 2581

Abstract

(1) Background: Vaccine hesitancy is recognized as an important issue globally and healthcare workers (HCWs) have a powerful influence on the public. Recent studies have reported that there are increasing numbers of vaccine hesitancies among HCWs. This study was conducted to assess the [...] Read more.

(1) Background: Vaccine hesitancy is recognized as an important issue globally and healthcare workers (HCWs) have a powerful influence on the public. Recent studies have reported that there are increasing numbers of vaccine hesitancies among HCWs. This study was conducted to assess the knowledge and attitudes on childhood vaccinations among HCWs in Hospital Universiti Sains Malaysia (HUSM). (2) Methods: This is a cross-sectional study conducted among one hundred and ninety-eight HCWs in HUSM, Kubang Kerian, Kelantan who were selected via convenient sampling. Data on their socio-demographic details, working experience, and main source of information regarding childhood vaccination were collected. A validated, Malay version of the knowledge and attitude on childhood vaccination (KACV) questionnaire was used during the study. (3) Results: Female (OR (95% CI):3.15, (1.39, 7.12), p < 0.05) and a higher education level (degree and above) (OR (95% CI): 2.36 (1.14, 4.89), p < 0.05) are significantly associated with good knowledge. Respondents with a history of side effects of the vaccines among their relatives were about 66% less likely to have good knowledge (OR (95% CI): 0.342 (0.16, 0.73), p < 0.05). A positive attitude towards childhood vaccination was significantly associated with a higher level of education participants, who had significantly better knowledge than participants with a lower education level (OR (95% CI): 3.81, (1.92, 7.57), p < 0.001). On the contrary, participants having direct contact with patients were less likely to have a good attitude towards childhood vaccination (OR (95% CI): 0.207 (0.043, 0.10), p < 0.05), and those with a history of severe side effects of the vaccines among their relatives were also significantly associated with a poor attitude towards childhood vaccination (OR (95% CI: 0.342 (0.16, 0.76), p < 0.05).; (4) Conclusions: The survey findings showed a good level of knowledge and a good attitude of participants towards childhood vaccination. Good knowledge is important for the HCWs to have a favourable attitude to educate the general population on childhood vaccination. Full article

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12 pages, 1562 KiB

Open AccessArticle

Appraisal of COVID-19 Vaccination Acceptance in the Romanian Pregnant Population

by Cosmin Citu, Veronica Daniela Chiriac, Ioana Mihaela Citu, Oana Maria Gorun, Bogdan Burlea, Felix Bratosin, Daniela-Eugenia Popescu, Adrian Ratiu, Oana Buca and Florin Gorun

Vaccines 2022, 10(6), 952; https://doi.org/10.3390/vaccines10060952 - 15 Jun 2022

Cited by 10 | Viewed by 1832

Abstract

Widespread COVID-19 vaccination is crucial for limiting the spread of SARS-CoV-2 and minimizing the risk of novel variants arising in the general population, especially in pregnant women. According to the publicly available research data, vaccination intentions vary significantly by country, with Romania among [...] Read more.

Widespread COVID-19 vaccination is crucial for limiting the spread of SARS-CoV-2 and minimizing the risk of novel variants arising in the general population, especially in pregnant women. According to the publicly available research data, vaccination intentions vary significantly by country, with Romania among the European countries with the lowest vaccination rates. Thus, we sought to determine the scale of acceptance of the COVID-19 vaccination campaign among pregnant women in Romania, as well as the variables affecting their choices. A cross-sectional study was conducted on pregnant women referred to the Obstetrics and Gynecology Clinic of the Timisoara Municipal Emergency Hospital in Romania, where participants were asked to complete an online survey including standardized and unstandardized questionnaires indicating their willingness to receive a COVID-19 vaccine and the reasons for their willingness. Out of the 500 women who were requested to participate, there was a total of 345 validated questionnaires, with 184 vaccinated and 161 unvaccinated pregnant women. The statistically significant determinant factors for COVID-19 vaccination acceptance were the urban area of residence (OR = 0.86), having a higher level of education (OR = 0.81), the third trimester of pregnancy (OR = 0.54), trusting the government (OR = 0.83), being a frequent traveler (OR = 0.76), fearing the severity of COVID-19 (OR = 0.68), the higher availability of COVID-19 vaccines nearby (OR = 0.87), and seeing more people getting vaccinated (OR = 0.75). As there are no increased risks associated with SARS-CoV-2 immunization in pregnant women, the variables identified in this research are crucial in determining the acceptability of COVID-19 vaccines that should be addressed in this vulnerable group to increase vaccination rates. Full article

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12 pages, 850 KiB

Open AccessArticle

Parental Hesitancy towards the Established Childhood Vaccination Programmes in the COVID-19 Era: Assessing the Drivers of a Challenging Public Health Concern

by Christos Derdemezis, Georgios Markozannes, Marina O. Rontogianni, Marianthi Trigki, Afroditi Kanellopoulou, Dimitris Papamichail, Eleni Aretouli, Evangelia Ntzani and Konstantinos K. Tsilidis

Vaccines 2022, 10(5), 814; https://doi.org/10.3390/vaccines10050814 - 20 May 2022

Cited by 11 | Viewed by 2383

Abstract

(1) Background: Vaccine hesitancy remains a major public health concern. The reasons behind this attitude are complex and warrant careful consideration, especially in the context of the COVID-19 era. The purpose of this study was to estimate vaccine hesitancy towards the established childhood [...] Read more.

(1) Background: Vaccine hesitancy remains a major public health concern. The reasons behind this attitude are complex and warrant careful consideration, especially in the context of the COVID-19 era. The purpose of this study was to estimate vaccine hesitancy towards the established childhood immunization programmes in a non-random sample of Greek parents and explore possible links with important drivers of this phenomenon. (2) Methods: An online self-administered questionnaire was used from October 2020 to April 2021 to collect socio-demographic, lifestyle, and health status data and evaluate knowledge, views, and attitudes of the Greek population on COVID-19 pandemic-related issues. Parents were further asked to complete the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. (3) Results: A total of 1095 parents participated in the study with a mean age of 50 years (SD 9.5 years). The hesitancy against the established childhood vaccinations was estimated at 8.9% (95% CI, 7.3–10.8%). Married status and higher education and income were negatively correlated with hesitancy, whereas positive correlations were found for stress and depressive symptoms and current smoking. Variables related to proper awareness, sound knowledge, and trust toward authorities regarding the COVID-19 pandemic were strongly associated with being less hesitant against the established childhood vaccination programmes. (4) Conclusion: The estimated parental hesitancy against the established childhood vaccination programmes is worrisome. Variables related to good awareness and knowledge of the COVID-19 pandemic were strongly associated with being less hesitant against childhood vaccinations. Since controversy surrounding COVID-19 vaccinations may decrease parents’ confidence in routine childhood vaccinations, appreciating the complex reasons behind vaccine hesitancy may inform public health policies to overcome barriers and increase vaccine acceptance. Full article

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13 pages, 799 KiB

Open AccessArticle

Influences on Attitudes Regarding COVID-19 Vaccination in Germany

by John Paul Fobiwe, Peter Martus, Brian D. Poole, Jamie L. Jensen and Stefanie Joos

Vaccines 2022, 10(5), 658; https://doi.org/10.3390/vaccines10050658 - 22 Apr 2022

Cited by 8 | Viewed by 2047

Abstract

Trust in institutions and democracy may be a major contributor to the willingness to be vaccinated. We investigated these factors and others with regard to COVID-19 vaccine uptake in Germany. Even though effective vaccination is a major contributor to slowing down the current [...] Read more.

Trust in institutions and democracy may be a major contributor to the willingness to be vaccinated. We investigated these factors and others with regard to COVID-19 vaccine uptake in Germany. Even though effective vaccination is a major contributor to slowing down the current pandemic, vaccine hesitancy remains a major challenge. To analyze attitudes toward vaccine hesitancy, a web-based cross-sectional survey was used to understand and describe the influences of attitudes about vaccination against COVID-19 in the German population. A descriptive analysis for the entire dataset was carried out, and multiple proportional odds regression, path model, and structural equation modeling (SEM) were subsequently used to analyze any relationship between latent variables and COVID-19 vaccine acceptance. In total, 1092 responses from across Germany were analyzed. SEM modeling revealed that trust in institutions, trust in non-pharmaceutical interventions, and various demographic factors were associated with intent to vaccinate. Descriptive analysis and multiple proportional odds regression confirmed that a history of influenza vaccination and level of satisfaction with democratic institutions were highly predictive (p < 0.05) for COVID-19 vaccine acceptance. Additionally, social determinants of health such as gender, age, number of children in the family, and the degree of satisfaction with life were also predictors (p < 0.05) for COVID-19 vaccine acceptance. Results also demonstrated a significant relationship between receiving the flu vaccine and acceptance of the COVID-19 vaccination. Governments that provide COVID-19 vaccines and control messaging should strive for trust and transparency to maximize vaccine uptake. Government-based vaccine measures should also involve measures to communicate trust in democratic and scientific institutions. Full article

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15 pages, 464 KiB

Open AccessArticle

Attitude of Health Care Workers and Medical Students towards Vaccination against COVID-19

by Beata Jankowska-Polańska, Kathie Sarzyńska, Eddie Czwojdziński, Natalia Świątoniowska-Lonc, Krzysztof Dudek and Agnieszka Piwowar

Vaccines 2022, 10(4), 535; https://doi.org/10.3390/vaccines10040535 - 29 Mar 2022

Cited by 12 | Viewed by 2526

Abstract

The role of medical personnel in promoting vaccination and pro-health attitudes seems to be of key importance for protection against COVID-19. The aim of the study was to assess the attitudes of health care workers and students of medical faculties towards preventive vaccinations [...] Read more.

The role of medical personnel in promoting vaccination and pro-health attitudes seems to be of key importance for protection against COVID-19. The aim of the study was to assess the attitudes of health care workers and students of medical faculties towards preventive vaccinations against COVID-19. A cross-sectional online self-administered survey was conducted among 497 people. The questions concerned attitudes towards vaccination as well as concerns about the side effects of the vaccine and contracting COVID-19. A positive attitude to vaccination was observed in 82% of the respondents. More than 54% respondents were concerned about side effects after COVID-19 vaccination. Medical students under 26 years had a more positive attitude towards COVID-19 vaccination, twice as high as among health care workers OR (95%Cl): 2.20 (1.03–4.66) vs. 4.06 (2.54–6.48), respectively. Students were more concerned than nurses about adverse effects of COVID-19 vaccine 3.8 (3.2–4.1) vs. 3.0 (2.7–3.5) and contracting the virus (1.7 (1.2–2.5) vs. 1.2 (1.0–2.0). Medical students had a more positive attitude toward vaccination than nursing students 4.2 (3.9–4.3) vs. 3.7 (3.3–4.3). In conclusion, predictors of positive attitudes toward vaccination were medical student status and young age. Full article

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10 pages, 522 KiB

Open AccessArticle

COVID-19 Vaccination Willingness and Vaccine Uptake among Healthcare Workers: A Single-Center Experience

by Marija Zdravkovic, Viseslav Popadic, Vladimir Nikolic, Slobodan Klasnja, Milica Brajkovic, Andrea Manojlovic, Novica Nikolic and Ljiljana Markovic-Denic

Vaccines 2022, 10(4), 500; https://doi.org/10.3390/vaccines10040500 - 24 Mar 2022

Cited by 4 | Viewed by 1907

Abstract

Healthcare workers (HCWs) are at higher risk of developing COVID-19 due to their professional exposition to the SARS-CoV-2 virus. This study assesses the intention of vaccination against COVID-19 before the vaccines were approved, and the rate of vaccine uptake during the first nine [...] Read more.

Healthcare workers (HCWs) are at higher risk of developing COVID-19 due to their professional exposition to the SARS-CoV-2 virus. This study assesses the intention of vaccination against COVID-19 before the vaccines were approved, and the rate of vaccine uptake during the first nine months of immunization among HCWs. A cross-sectional seroprevalence study was carried out during July 2020 in University Clinical Hospital Center Bezanijska Kosa in Belgrade, Serbia that included 62.8% of all HCWs. Besides serological testing for IgG antibodies, data about HCWs’ intention to accept COVID-19 vaccination if a vaccine became available were collected. This cohort of HCWs was followed up until the end of October 2021 to assess the number of vaccinated and PCR-positive staff. In the cross-sectional study, 18.3% HCWs had positive SARS-CoV-2 IgG antibodies without difference with IgG-negative HCWs regarding age, gender, profession type, and years of service. Before vaccines became available, a significantly higher percentage of IgG-positive HCWs compared to IgG-negative HCWs was unsure whether to be vaccinated (62.5% vs. 49.0%), and significantly fewer stated that they would not be vaccinated (16.7% vs. 25.1%). When the vaccines became available in Serbia, among IgG-negative HCWs, those who stated clear positive (yes) and clear negative (no) attitude toward vaccination before the immunization period had begun were vaccinated at 28% and 20%, respectively, while 51% of unsure HCWs received a vaccine (p = 0.006). Among IgG-positive HCWs, there was no statistical difference in vaccine uptake regarding those with previous negative, positive, and unsure opinions about vaccination (p = 0.498). In multivariate analysis, independent factors associated with uptake were being female (OR = 1.92; 95%CI: 1.04–3.55), age of 30–59 years, previously vaccine-unsure (OR = 1.84; 95%CI: 1.04–3.25), and those with previous positive vaccine attitudes (OR = 2.48; 95%CI:1.23–5.01), while nurses were less likely to become vaccinated (OR = 0.39 95% CI: 0.20–0.75) These findings indicate a positive change in attitudes of HCWs towards COVID-19 vaccination. Full article

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13 pages, 1446 KiB

Open AccessArticle

Effects of Religious Practice and Teachings about Sexual Behavior on Intent to Vaccinate against Human Papillomavirus

by David S. Redd, Jamie L. Jensen, Savannah J. Hughes, Kendall Pogue, Chantel D. Sloan-Aagard, Dashiell S. Miner, Jessica D. Altman, Triston B. Crook, Lydia Zentz, Ruth J. Bodily and Brian D. Poole

Vaccines 2022, 10(3), 397; https://doi.org/10.3390/vaccines10030397 - 04 Mar 2022

Cited by 6 | Viewed by 2927

Abstract

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Most infections are mild and clear without treatment in 1 to 2 years. Some HPV strains result in persistent infection, which can cause various cancers, including cervical, penile, anal, [...] Read more.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Most infections are mild and clear without treatment in 1 to 2 years. Some HPV strains result in persistent infection, which can cause various cancers, including cervical, penile, anal, mouth, and throat cancers. Vaccines have been developed that provide protection against the highest risk HPV strains. Despite HPV vaccines having been proven to be safe and effective, uptake has been low. Religiosity has been negatively correlated with HPV vaccine uptake in some studies. It is hypothesized that religiosity and Christian religious affiliation could impact parents’ decision to vaccinate their children against HPV via teachings and beliefs about sexual behaviors. A survey was distributed to participants to determine what factors, including religiosity and views about sex, impacted HPV vaccination. The survey results (n = 442) were analyzed using confirmatory factor analysis, structural equation modeling, and univariate factor analysis. The association between religious practice and vaccine attitudes were complex, with religious practice slightly positively correlated with pro-vaccine attitudes and vaccine knowledge, but also with the belief that religious adherence to expectations surrounding sexual behavior will protect children from HPV infection, as well as more negative views towards vaccines, in general. Full article

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9 pages, 549 KiB

Open AccessArticle

Determinants of COVID-19 Vaccination Hesitancy among Romanian Pregnant Women

by Ioana Mihaela Citu, Cosmin Citu, Florin Gorun, Andrei Motoc, Oana Maria Gorun, Bogdan Burlea, Felix Bratosin, Emanuela Tudorache, Madalin-Marius Margan, Samer Hosin and Daniel Malita

Vaccines 2022, 10(2), 275; https://doi.org/10.3390/vaccines10020275 - 10 Feb 2022

Cited by 29 | Viewed by 3612

Abstract

Universal COVID-19 immunization is seen as a critical approach for limiting the spread of SARS-CoV-2 and reducing the danger of new variations emerging in the general population, especially in pregnant women. The literature and accessible research data indicate that vaccination intentions vary greatly [...] Read more.

Universal COVID-19 immunization is seen as a critical approach for limiting the spread of SARS-CoV-2 and reducing the danger of new variations emerging in the general population, especially in pregnant women. The literature and accessible research data indicate that vaccination intentions vary greatly by country, with Romania ranking among the European nations with the lowest vaccination rates. Thus, we aimed to investigate the prevalence and extent of COVID-19 vaccine hesitancy among pregnant women in Romania and the factors influencing their decision. A cross-sectional study was conducted on pregnant women referred to the Obstetrics and Gynecology Clinic of the Timisoara Municipal Emergency Hospital in Romania. Participants were asked to complete the validated VAX scale about vaccine hesitancy and to report their willingness to receive a COVID-19 vaccine and their reasons for hesitancy. The group of 184 pregnant women who completed the survey recorded significantly more hesitant respondents than the non-pregnant group with 161 respondents (52.2% vs. 40.3%). They had significantly higher average scores in all VAX scale subsections, while 78.1% of them gave credits to social media for their COVID-19 vaccination decision, compared with 63.0% of non-pregnant women. The independent risk factors for hesitancy were determined as not being afraid of COVID-19 OR = 1.89, below-average income OR = 2.06, trusting social media rumors OR = 2.38, not believing in SARS-CoV-2 existence OR = 2.67, and being a vaccination non-believer OR = 3.15. We advocate for pregnant women to get vaccinated against COVID-19 and for the development of targeted campaigns to address the factors of hesitation. This research emphasizes the critical need for delivering the COVID-19 immunization to the whole community, including pregnant women who may have vaccine-related concerns. Full article

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16 pages, 945 KiB

Open AccessArticle

Impact of Local and Demographic Factors on Early COVID-19 Vaccine Hesitancy among Health Care Workers in New York City Public Hospitals

by Afsheen Afzal, Masood A. Shariff, Victor Perez-Gutierrez, Amnah Khalid, Christina Pili, Anjana Pillai, Usha Venugopal, Moiz Kasubhai, Balavenkatesh Kanna, Brian D. Poole, Brett E. Pickett, David S. Redd and Vidya Menon

Vaccines 2022, 10(2), 273; https://doi.org/10.3390/vaccines10020273 - 10 Feb 2022

Cited by 8 | Viewed by 2293

Abstract

Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. [...] Read more.

Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. We conducted a survey-based study to understand the factors affecting COVID-19 vaccine attitudes among health care professionals in NYC Health and Hospitals, at a time when the vaccine was new, and received 3759 responses. Machine learning and chi-square analyses were applied to determine the factors most predictive of vaccine hesitancy. Demographic factors, education, role at the hospital, perceptions of the pandemic itself, and location of work and residence were all found to significantly contribute to vaccine attitudes. Location of residence was examined for both borough and neighborhood, and was found to have a significant impact on vaccine receptivity. Interestingly, this borough-level data did not correspond to the number or severity of cases in the respective boroughs, indicating that local social or other influences likely have a substantial impact. Local and demographic factors should be strongly considered when preparing pro-vaccine messages or campaigns. Full article

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17 pages, 1797 KiB

Open AccessArticle

Vaccine Hesitancy and Anti-Vaccination Attitudes during the Start of COVID-19 Vaccination Program: A Content Analysis on Twitter Data

by Hüseyin Küçükali, Ömer Ataç, Ayşe Seval Palteki, Ayşe Zülal Tokaç and Osman Hayran

Vaccines 2022, 10(2), 161; https://doi.org/10.3390/vaccines10020161 - 21 Jan 2022

Cited by 37 | Viewed by 8143

Abstract

Twitter is a useful source for detecting anti-vaccine content due to the increasing prevalence of these arguments on social media. We aimed to identify the prominent themes about vaccine hesitancy and refusal on social media posts in Turkish during the COVID-19 pandemic. In [...] Read more.

Twitter is a useful source for detecting anti-vaccine content due to the increasing prevalence of these arguments on social media. We aimed to identify the prominent themes about vaccine hesitancy and refusal on social media posts in Turkish during the COVID-19 pandemic. In this qualitative study, we collected public tweets (n = 551,245) that contained a vaccine-related keyword and had been published between 9 December 2020 and 8 January 2021 through the Twitter API. A random sample of tweets (n = 1041) was selected and analyzed by four researchers with the content analysis method. We found that 90.5% of the tweets were about vaccines, 22.6% (n = 213) of the tweets mentioned at least one COVID-19 vaccine by name, and the most frequently mentioned COVID-19 vaccine was CoronaVac (51.2%). We found that 22.0% (n = 207) of the tweets included at least one anti-vaccination theme. Poor scientific processes (21.7%), conspiracy theories (16.4%), and suspicions towards manufacturers (15.5%) were the most frequently mentioned themes. The most co-occurring themes were “poor scientific process” with “suspicion towards manufacturers” (n = 9), and “suspicion towards health authorities” (n = 5). This study may be helpful for health managers, assisting them to identify the major concerns of the population and organize preventive measures through the significant role of social media in early spread of information about vaccine hesitancy and anti-vaccination attitudes. Full article

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12 pages, 1998 KiB

Open AccessArticle

Training Physicians in Motivational Communication to Address Influenza Vaccine Hesitation: A Proof-of-Concept Study

by Sara Labbé, Inés Colmegna, Valeria Valerio, Vincent Gosselin Boucher, Sandra Peláez, Anda I. Dragomir, Catherine Laurin, Elizabeth M. Hazel, Simon L. Bacon and Kim L. Lavoie

Vaccines 2022, 10(2), 143; https://doi.org/10.3390/vaccines10020143 - 19 Jan 2022

Cited by 3 | Viewed by 2055

Abstract

Background: Strategies to support health care professionals on how to address vaccine hesitancy are needed. Methods: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC [...] Read more.

Background: Strategies to support health care professionals on how to address vaccine hesitancy are needed. Methods: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. Adherence to MC during clinical consultations and changes in vaccine intentions was measured as secondary outcomes. Results: Seven rheumatology physicians participated in the training. MITI scores increased in all participants, and 71% (n = 5) achieved thresholds of clinical competency (i.e., ≥3.5/5 at MITI global score and ≥3/5 on at least 3 individual competency score) post-training. Autonomy/support and empathy competencies reached competency thresholds (+2.4 ± 1.3 to +4.1 ± 0.7 and +2.1 ± 0.7 to +4.1 ± 0.7, respectively). Evocation and collaboration competencies improved but without reaching competency thresholds (+1.4 ± 0.8 to +3.1 ± 1.1; +1.4 ± 0.8 to +2.9 ± 1.1, respectively). Direction did not improve. Among 21 patient consultations post-training, 15 (71%) were MC-consistent. Of the 15 patients, 67% (10/15) intended to receive the influenza vaccine and 33% (5/15) received it. Conclusion: A brief MC training program targeting vaccine hesitancy increased MC competency among rheumatology physicians and promoted behavioral change among patients. Full article

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13 pages, 4376 KiB

Open AccessArticle

Acceptance of a Third Dose of COVID-19 Vaccine and Associated Factors in China Based on Health Belief Model: A National Cross-Sectional Study

by Chenyuan Qin, Ruitong Wang, Liyuan Tao, Min Liu and Jue Liu

Vaccines 2022, 10(1), 89; https://doi.org/10.3390/vaccines10010089 - 07 Jan 2022

Cited by 45 | Viewed by 4676

Abstract

COVID-19 infections are returning to many countries because of the emergence of variants or declining antibody levels provided by vaccines. An additional dose of vaccination is recommended to be a considerable supplementary intervention. We aim to explore public acceptance of the third dose [...] Read more.

COVID-19 infections are returning to many countries because of the emergence of variants or declining antibody levels provided by vaccines. An additional dose of vaccination is recommended to be a considerable supplementary intervention. We aim to explore public acceptance of the third dose of the COVID-19 vaccine and related influencing factors in China. This nationwide cross-sectional study was conducted in the general population among 31 provinces in November, 2021. We collected information on basic characteristics, vaccination knowledge and attitudes, and vaccine-related health beliefs of the participants. Univariable and multivariable logistic regression models were used to assess factors associated with the acceptance of a third COVID-19 vaccine. A total of 93.7% (95% CI: 92.9–94.6%) of 3119 Chinese residents were willing to receive a third dose of the COVID-19 vaccine. Individuals with low level of perceived susceptibility, perceived benefit, cues to action cues, and high level of perceived barriers, old age, low educational level, low monthly household income, and low knowledge score on COVID-19 were less likely to have the acceptance of a third dose of COVID-19 (all p < 0.05). In the multivariable logistic regression model, acceptance of the third dose of COVID-19 vaccine was mainly related to previous vaccination history [Sinopharm BBIP (aOR = 6.55, 95% CI 3.30–12.98), Sinovac (aOR = 5.22, 95% CI:2.72–10.02), Convidecia (aOR = 5.80, 95% CI: 2.04–16.48)], high level of perceived susceptibility (aOR = 2.48, 95% CI: 1.48–4.31) and high level of action cues (aOR = 23.66, 95% CI: 9.97–56.23). Overall, residents in China showed a high willingness to accept the third dose of COVID-19 vaccines, which can help vaccine manufacturers in China to manage the vaccine production and distribution for the huge domestic and international vaccine demand. Relevant institutions could increase people’s willingness to booster shots by increasing initial COVID-19 vaccination rates, public’s perception of COVID-19 susceptibility and cues to action through various strategies and channels. Meanwhile, it also has certain reference significance for other countries to formulate vaccine promotion strategies. Full article

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2021

Jump to: 2023, 2022

12 pages, 892 KiB

Open AccessArticle

Factors Influencing Decision Making Regarding the Acceptance of the COVID-19 Vaccination in Egypt: A Cross-Sectional Study in an Urban, Well-Educated Sample

by Mohamed Elsayed, Radwa Abdullah El-Abasiri, Khaled T. Dardeer, Manar Ahmed Kamal, Mila Nu Nu Htay, Birgit Abler and Roy Rillera Marzo

Vaccines 2022, 10(1), 20; https://doi.org/10.3390/vaccines10010020 - 24 Dec 2021

Cited by 16 | Viewed by 5072

Abstract

Background: The COVID-19 pandemic has raised the necessity to rapidly develop safe and effective vaccines to limit the spread of infections. Meanwhile, vaccine hesitancy is a significant barrier to community vaccination strategies. Methods: An internet-based cross-sectional survey was conducted from March to April [...] Read more.

Background: The COVID-19 pandemic has raised the necessity to rapidly develop safe and effective vaccines to limit the spread of infections. Meanwhile, vaccine hesitancy is a significant barrier to community vaccination strategies. Methods: An internet-based cross-sectional survey was conducted from March to April 2021 during the start of the vaccination campaigns. Results: A total of 1009 subjects participated, and the mean age (±SD) was 29.11 ± 8.2 years. Among them, 68.8% believed that vaccination is an effective method to control the spread of the disease, 81.2% indicated acceptance of the vaccine, and 87.09% reported that their doctor’s recommendation was essential for decision making. After adjusting for socioeconomic characteristics, rural residency (AOR 1.783, 95%CI: 1.256–2.531), working a part-time job (AOR 2.535, 95%CI: 1.202–5.343) or a full-time job (AOR 1.951, 95%CI: 1.056–3.604), being a student (AOR 3.516, 95%CI: 1.805–6.852) and having a partner (AOR 1.457, 95%CI: 1.062–2.00) were significant predictors for higher vaccine acceptance among the study participants. Believing in the vaccine’s efficacy showed the strongest correlation with vaccine acceptance (Spearman’s r = 0.309, p < 0.001). Conclusions: Although general vaccine acceptance is high (32.85%) in participants in our study, gender and geographic disparities were observed in the investigated urban population of young, well-educated Egyptians. Full article

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13 pages, 525 KiB

Open AccessArticle

Intention of Parents to Immunize Children against SARS-CoV-2 in Italy

by Luisa Russo, Ileana Croci, Ilaria Campagna, Elisabetta Pandolfi, Alberto Villani, Antonino Reale, Maria Antonietta Barbieri, Massimiliano Raponi, Francesco Gesualdo and Alberto Eugenio Tozzi

Vaccines 2021, 9(12), 1469; https://doi.org/10.3390/vaccines9121469 - 11 Dec 2021

Cited by 20 | Viewed by 2414

Abstract

Several countries have targeted adolescents for immunization against SARS-CoV-2 to mitigate COVID-19 spread. In Italy, immunization for children ≥ 12 years has been available starting from June 2021. We conducted a cross-sectional study to investigate the knowledge, attitude and intention to vaccinate children [...] Read more.

Several countries have targeted adolescents for immunization against SARS-CoV-2 to mitigate COVID-19 spread. In Italy, immunization for children ≥ 12 years has been available starting from June 2021. We conducted a cross-sectional study to investigate the knowledge, attitude and intention to vaccinate children < 18 years in Italian families. We used a multinomial logistic regression model to investigate factors associated with intention to vaccinate. We collected a total of 1696 responses. Among the 491 families of children ≥ 12 years, 41.2% would not vaccinate their children and 21.2% were uncertain, while among the 1205 families of children < 12 years, 36.1% would not vaccinate and 33.8% were uncertain. Determinants of intention to vaccinate both age groups were perceived safety and efficacy of vaccines and perceived risk of transmitting infection to adults. For children < 12 years, additional determinants were perceived risk of being infected and being hospitalized because of COVID-19. In view of the expanding strategy to vaccinate adolescents and the availability of immunization for children < 12 years, our results call for a communication strategy targeted at families of children focused on the safety and efficacy of COVID-19 vaccine in children and on the dynamics of infection spread across different age groups. As perceptions in families are volatile and may change rapidly over time, repeated surveys for measuring attitudes to vaccinate would be advisable. Full article

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15 pages, 1517 KiB

Open AccessReview

Factors Associated with COVID-19 Vaccine Hesitancy among Visible Minority Groups from a Global Context: A Scoping Review

by Candy Ochieng, Sabrita Anand, George Mutwiri, Michael Szafron and Khrisha Alphonsus

Vaccines 2021, 9(12), 1445; https://doi.org/10.3390/vaccines9121445 - 07 Dec 2021

Cited by 32 | Viewed by 5808

Abstract

Vaccine hesitancy is one of the top ten greatest threats to global health. During the COVID-19 era, vaccine hesitancy poses substantial risks, especially in visible minorities, who are disproportionately affected by the pandemic. Although evidence of vaccine hesitancy exists, there is minimal focus [...] Read more.

Vaccine hesitancy is one of the top ten greatest threats to global health. During the COVID-19 era, vaccine hesitancy poses substantial risks, especially in visible minorities, who are disproportionately affected by the pandemic. Although evidence of vaccine hesitancy exists, there is minimal focus on visible minorities and the reasons for hesitancy in this group are unclear. Identifying these populations and their reasons for vaccine hesitancy is crucial in improving vaccine uptake and curbing the spread of COVID-19. This scoping review follows a modified version of the Arksey and O’Malley strategy. Using comprehensive search strategies, advanced searches were conducted on Medline, CINAHL, and PubMed databases to acquire relevant articles. Full-text reviews using inclusion and exclusion criteria were performed to extract themes of vaccine hesitancy. Themes were grouped into factors using thematic qualitative analysis and were objectively confirmed by principal component analysis (PCA). To complement both analyses, a word cloud of titles and abstracts for the final articles was generated. This study included 71 articles. Themes were grouped into 8 factors and the top 3 recurring factors were safety and effectiveness of the vaccine, mistrust, and socioeconomic characteristics. Shedding light on these factors could help mitigate health inequities and increase overall vaccine uptake worldwide through interventions and policies targeted at these factors. Ultimately, this would help achieve global herd immunity. Full article

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12 pages, 273 KiB

Open AccessArticle

Vaccine Knowledge, Awareness and Hesitancy: A Cross Sectional Survey among Parents Residing at Sandakan District, Sabah

by James Yau Hon Voo, Qi Ying Lean, Long Chiau Ming, Nur Hafzan Md. Hanafiah, Yaser Mohammed Al-Worafi and Baharudin Ibrahim

Vaccines 2021, 9(11), 1348; https://doi.org/10.3390/vaccines9111348 - 17 Nov 2021

Cited by 18 | Viewed by 5809

Abstract

Background: Incomplete childhood immunization against communicable diseases is a major concern and vaccine hesitancy remains a hurdle to overcome in primary vaccination programs. This study was to examine the parents’ vaccine knowledge, awareness and hesitancy in relation to their children’s immunization status. Methods: [...] Read more.

Background: Incomplete childhood immunization against communicable diseases is a major concern and vaccine hesitancy remains a hurdle to overcome in primary vaccination programs. This study was to examine the parents’ vaccine knowledge, awareness and hesitancy in relation to their children’s immunization status. Methods: A cross-sectional questionnaire study design was used. The parents who brought their children for immunization visit or follow-up at four public health clinics located in Sandakan district were invited to participate in this survey. Informed consent was obtained before each participant completed a hard copy of self-administered questionnaire in either English or Malay versions. Results: Of 405 parents responded, they generally had good knowledge and awareness of vaccines, only a small percentage (6.8%) of parents were found vaccine hesitant. There were significant differences in vaccine knowledge and awareness in those from different education levels and employment status; similarly, these two factors also significantly affected the vaccine hesitancy among the parents. The parents’ knowledge score was found to be moderately associated with their awareness (r = 0.551, p < 0.01) and inversely correlated to vaccine hesitancy (r = −0.397, p < 0.01). Most of the children (n = 376, 92.8%) in the study were immunized. The children’s immunization status was significantly associated with the parents’ education level (p = 0.025). There was also a significant difference in the total vaccine knowledge scores between the groups of parents with different child immunization status (p = 0.05). Conclusion: This study revealed that parents with higher education had a better knowledge of vaccinations, were less vaccine hesitant and were more likely to ensure that their children complete the recommended course of immunization. It is crucial to ensure parents are well-informed about the safety and efficacy of vaccines so that the children are protected from communicable diseases by the child vaccination program. Full article

5 pages, 217 KiB

Open AccessBrief Report

Investigating Adherence to COVID-19 Vaccination and Serum Antibody Concentration among Hospital Workers—The Experience of an Italian Private Hospital

by Guglielmo Forgeschi, Giuseppe Cavallo, Chiara Lorini, Fiamma Balboni, Francesca Sequi and Guglielmo Bonaccorsi

Vaccines 2021, 9(11), 1332; https://doi.org/10.3390/vaccines9111332 - 16 Nov 2021

Cited by 3 | Viewed by 2014

Abstract

SARS-CoV-2 transmission has been high, especially among healthcare workers worldwide during the first wave. Vaccination is recognized as the most effective approach to combat the pandemic, but hesitation to get vaccinated represents an obstacle. Another important issue is the duration of protection after [...] Read more.

SARS-CoV-2 transmission has been high, especially among healthcare workers worldwide during the first wave. Vaccination is recognized as the most effective approach to combat the pandemic, but hesitation to get vaccinated represents an obstacle. Another important issue is the duration of protection after administration of the full vaccination cycle. Based on these premises, we conducted a study to evaluate vaccination adherence and the anti-S antibodies levels among hospital workers, from January to March, 2021. To assess adherence, an anonymous questionnaire was used. Anti-S antibody levels were obtained from the monitoring serological sample database. In total, 56.2% of the unvaccinated people did not report a previous infection from COVID-19. Among those who have not been vaccinated, 12.5% showed distrust against the vaccine, 8.3% stated to have received contraindications to the vaccination, and 6.3% did not report any choice. Analyzing anti-S antibody levels, only one person was found to have a value below the lower cut-off, two weeks, and three months after receiving their second dose. One was below the cut-off after two weeks, and then above the same cut-off after three months. The results of our survey should be seen as a stimulus to further sensitize hospital staff to the importance of vaccination and pay attention to anti-S antibody levels monitoring. Full article

12 pages, 4921 KiB

Open AccessArticle

Factors Influencing Vaccine Hesitancy in China: A Qualitative Study

by Jianli Wang, Qianqian Ji, Shuheng Dong, Shuangyu Zhao, Xinchen Li, Qiuqi Zhu, Sigui Long, Jingjing Zhang and Hui Jin

Vaccines 2021, 9(11), 1291; https://doi.org/10.3390/vaccines9111291 - 07 Nov 2021

Cited by 21 | Viewed by 4512

Abstract

Vaccine hesitancy has become a significant issue. We aimed to elucidate the factors influencing vaccine hesitation in Chinese residents and to analyze and recommend promotional strategies and measures. In total, 92 Chinese residents from 10 provinces were interviewed using semi-structured face-to-face interviews following [...] Read more.

Vaccine hesitancy has become a significant issue. We aimed to elucidate the factors influencing vaccine hesitation in Chinese residents and to analyze and recommend promotional strategies and measures. In total, 92 Chinese residents from 10 provinces were interviewed using semi-structured face-to-face interviews following a predetermined survey framework in this qualitative study. We found trust in vaccine safety, access to professional advice, and vaccine price and effectiveness to be the main factors influencing vaccine hesitation. Additionally, residents in areas with a higher per capita GDP tend to receive more social support, believe that vaccination is beneficial and can prevent diseases, pay more attention to whether the vaccine is safe and has undergone various clinical trials, and are more likely to seek advice from individuals with vaccination experience as opposed to their counterparts in areas with a lower per capita GDP. Notably, as per capita GDP rises, individuals become more concerned about the price of vaccines. Measures such as clarifying vaccine safety and effectiveness, reducing self-funded vaccine prices, offering free vaccination for special groups, strengthening the publicity role of medical staff, and taking advantage of network platforms are essential to reduce vaccine hesitancy among Chinese residents. Full article

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12 pages, 8859 KiB

Open AccessFeature PaperArticle

Vaccine Hesitancy and Trust in the Scientific Community in Italy: Comparative Analysis from Two Recent Surveys

by Chiara Cadeddu, Martina Sapienza, Carolina Castagna, Luca Regazzi, Andrea Paladini, Walter Ricciardi and Aldo Rosano

Vaccines 2021, 9(10), 1206; https://doi.org/10.3390/vaccines9101206 - 19 Oct 2021

Cited by 20 | Viewed by 3365

Abstract

Vaccination rates in Italy fell until 2015 because of unfounded safety concerns. Public education and a 2017 law on mandatory vaccination have boosted rates since then. The aim of our study is to explore how trust in the scientific community and attitudes towards [...] Read more.

Vaccination rates in Italy fell until 2015 because of unfounded safety concerns. Public education and a 2017 law on mandatory vaccination have boosted rates since then. The aim of our study is to explore how trust in the scientific community and attitudes towards vaccines have changed in the period of 2017–2019 in Italy. Data were extracted from the Italian section of the 2017 and 2019 editions of the European Social Survey (ESS). We compared the two surveys highlighting changes in public opinion on vaccines. A descriptive analysis of the socio-cultural variables according to the answers provided to key questions on the harmfulness of vaccines was conducted. Differences between percentages were tested by using the χ² test. The association between the opinion about the harmfulness of vaccines and trust in the scientific community was analyzed through a logistic regression model. Compared to ESS8, ESS9 showed an increase in the percentage of respondents disagreeing with the harmfulness of vaccines. Trust in the scientific community raised in the period from 2017 to 2019 (59% vs. 69.6%). Higher education was significantly associated with disagreement regarding the harmfulness of vaccines (odds ratio (OR) = 2.41; 95% confidence interval (95%CI) 1.75–3.31), the strongest predictor was trust in the scientific community (OR = 10.47; 95% CI 7.55–14.52). In Italy, trust in the scientific community and in vaccinations has grown significantly in recent years, indicating a paradigm shift in public opinion compared to the past. Central actions and effective public communication strategies might reduce vaccine hesitancy and could be essential to garner public trust. Full article

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18 pages, 955 KiB

Open AccessArticle

Determinants of COVID-19 Vaccine Hesitancy in Portuguese-Speaking Countries: A Structural Equations Modeling Approach

by Álvaro Francisco Lopes de Sousa, Jules Ramon Brito Teixeira, Iracema Lua, Fernanda de Oliveira Souza, Andrêa Jacqueline Fortes Ferreira, Guilherme Schneider, Herica Emilia Félix de Carvalho, Layze Braz de Oliveira, Shirley Verônica Melo Almeida Lima, Anderson Reis de Sousa, Telma Maria Evangelista de Araújo, Emerson Lucas Silva Camargo, Mônica Oliveira Batista Oriá, Isabel Craveiro, Tânia Maria de Araújo, Isabel Amélia Costa Mendes, Carla Arena Aparecida Ventura, Isabel Sousa, Rodrigo Mota de Oliveira, Manuel Simão and Inês Fronteira Show full author list Hide full author list

Vaccines 2021, 9(10), 1167; https://doi.org/10.3390/vaccines9101167 - 12 Oct 2021

Cited by 20 | Viewed by 4436

Abstract

COVID-19 vaccine hesitancy (VH) has caused concerns due to the possible fluctuations that may occur directly impacting the control of the pandemic. In this study, we aimed to estimate the prevalence and factors associated with COVID-19 VH in Portuguese-speaking countries. We developed a [...] Read more.

COVID-19 vaccine hesitancy (VH) has caused concerns due to the possible fluctuations that may occur directly impacting the control of the pandemic. In this study, we aimed to estimate the prevalence and factors associated with COVID-19 VH in Portuguese-speaking countries. We developed a web survey (N:6,843) using an online, structured, and validated questionnaire. We used Measurement Models, Exploratory Factor Analysis, Exploratory Structural Equation Models, and Confirmatory Factor Analysis for the data analysis. The overall prevalence of COVID-19 VH in Portuguese-speaking countries was 21.1%. showed a statistically significant direct effect for VH: vaccine-related conspiracy beliefs (VB) (β = 0.886), perceived stress (PS) (β = 0.313), COVID-19 Misinformation (MIS) (β = 0.259) and individual responses to COVID-19 (CIR) (β = −0.122). The effect of MIS and CIR for VH was greater among men and of PS and VB among women; the effect of PS was greater among the youngest and of VB and CIR among the oldest. No discrepant differences were identified in the analyzed education strata. In conclusion, we found that conspiracy beliefs related to the vaccine strongly influence the decision to hesitate (not to take or to delay the vaccine). Specific characteristics related to gender, age group, social and cognitive vulnerabilities, added to the knowledge acquired, poorly substantiated and/or misrepresented about the COVID-19 vaccine, need to be considered in the planning of vaccination campaigns. It is necessary to respond in a timely, fast, and accurate manner to the challenges posed by vaccine hesitancy. Full article

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22 pages, 4038 KiB

Open AccessArticle

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey

by Nicole M. Gatto, Jerusha E. Lee, Donatella Massai, Susanna Zamarripa, Bijan Sasaninia, Dhruv Khurana, Kelsey Michaels, Deborah Freund, Judi Nightingale and Anthony Firek

Vaccines 2021, 9(10), 1152; https://doi.org/10.3390/vaccines9101152 - 09 Oct 2021

Cited by 18 | Viewed by 3537

Abstract

Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related [...] Read more.

Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers. Full article

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10 pages, 270 KiB

Open AccessArticle

The Role of Attitudes, Norms, and Efficacy on Shifting COVID-19 Vaccine Intentions: A Longitudinal Study of COVID-19 Vaccination Intentions in New Zealand

by Jagadish Thaker and Somrita Ganchoudhuri

Vaccines 2021, 9(10), 1132; https://doi.org/10.3390/vaccines9101132 - 04 Oct 2021

Cited by 24 | Viewed by 5449

Abstract

While public intentions to get a COVID-19 vaccine have been shifting around the world, few studies track factors that help us understand and improve COVID-19 vaccine uptake. This study focuses on identifying changing public intentions to get a COVID-19 vaccine in New Zealand, [...] Read more.

While public intentions to get a COVID-19 vaccine have been shifting around the world, few studies track factors that help us understand and improve COVID-19 vaccine uptake. This study focuses on identifying changing public intentions to get a COVID-19 vaccine in New Zealand, a country that has been largely successful in containing the pandemic but risks new outbreaks as less than 20% of the population is fully vaccinated by August 2021. Data on COVID-19 intentions were collected just after the vaccine approval and rollout targeting old-age groups in February 2021 and then before the general public rollout in May 2021 (n = 650, 60% reinterview response rate). Results show that intention to get a COVID-19 vaccine increased in three months and was the highest in the last one year. Consistent with the Theory of Planned Behaviour, attitudes and efficacy beliefs were significantly associated with COVID-19 vaccine intentions, in the cross-sectional as well as longitudinal analyses. Findings highlight the persisting influence of attitudes, efficacy beliefs, and past intentions on future decision-making process to get a COVID-19 vaccine. Future research opportunities to understand vaccine intentions and improve public vaccine uptake are highlighted. Full article

10 pages, 263 KiB

Open AccessArticle

Analysis of HPV Vaccination Willingness amongst HIV-Negative Men Who Have Sex with Men in China

by Wei He, Haiying Pan, Bing Lin and Xiaoni Zhong

Vaccines 2021, 9(10), 1069; https://doi.org/10.3390/vaccines9101069 - 24 Sep 2021

Cited by 7 | Viewed by 2457

Abstract

Objective: Men who have sex with men (MSM) are high-risk groups of human papillomavirus (HPV) infection, the best measure to prevent this is the HPV vaccine. However, few studies have investigated HPV vaccination willingness in the MSM population in China. We aimed to [...] Read more.

Objective: Men who have sex with men (MSM) are high-risk groups of human papillomavirus (HPV) infection, the best measure to prevent this is the HPV vaccine. However, few studies have investigated HPV vaccination willingness in the MSM population in China. We aimed to explore the willingness of human immunodeficiency virus (HIV)-negative MSM for HPV vaccination and the factors affecting their willingness to vaccinate. Methods: We adopted a non-probability sampling method to recruit HIV-negative MSM volunteers. Participants completed a questionnaire, including sociodemographic characteristics, sexual behavior characteristics, HPV infection and vaccine-related knowledge, risk perception, and HPV vaccination willingness and promotion attitudes. Results: Of the 406 HIV-negative MSM surveyed, 86.21% were willing to receive HPV vaccine. HPV infection and vaccine-related knowledge (odds ratio [OR] = 2.167, 95% confidence interval [CI] = 1.049–4.474), HPV infection risk perception (OR = 5.905, 95% CI = 1.312–26.580), and HPV vaccine promotion attitude (OR = 6.784, 95% CI = 3.164–14.546) were all related to HPV vaccination willingness. Conclusion: MSM have a high willingness for HPV vaccination. Strengthening health education for MSM, raising their awareness of HPV infection and vaccines, and promoting their risk perception of HPV infection will help increase their willingness for HPV vaccination. Full article

18 pages, 286 KiB

Open AccessArticle

Information Framing Effect on Public’s Intention to Receive the COVID-19 Vaccination in China

by Lihong Peng, Yi Guo and Dehua Hu

Vaccines 2021, 9(9), 995; https://doi.org/10.3390/vaccines9090995 - 07 Sep 2021

Cited by 22 | Viewed by 4027

Abstract

The aims of the study were (1) to explore information framing effect on the public’s intention to receive the COVID-19 vaccination and (2) to understand the key factors influencing the intention of COVID-19 vaccinations in China. An online questionnaire survey was conducted to [...] Read more.

The aims of the study were (1) to explore information framing effect on the public’s intention to receive the COVID-19 vaccination and (2) to understand the key factors influencing the intention of COVID-19 vaccinations in China. An online questionnaire survey was conducted to explore the influence of demographic characteristics, individual awareness, social relationship, risk disclosure, perceived vaccine efficacy, and protection duration under the assumptions of information framing. The results showed that (1) the persuasion effect under loss frame was higher than that under gain frame (B = 0.616 vs. 0.552); (2) there was no significant difference between sex, age, income, occupation, educational background and residence for the participants’ intention to be vaccinated; whether family members/friends were vaccinated had a strong correlation with their vaccination intention under the gain frame; (3) the higher the understanding of COVID-19 and the compliance with government COVID-19 prevention and control measures were, the higher the vaccination intention was; (4) risk disclosure had the greatest impact on people‘s COVID-19 vaccination intention; (5) perceived vaccine effectiveness and duration of protection had little effect on people’s intention to receive vaccination. The influence of information framing on the intention of COVID-19 vaccination is different. The publicity of relevant health information should pay attention to the influence of information framing and contents on the behavior of public vaccination, so as to enhance public health awareness and promote the vaccination of the whole population. Full article

15 pages, 624 KiB

Open AccessArticle

Health Education and Vaccination for the Construction of Inclusive Societies

by Eduardo García-Toledano, Ascensión Palomares-Ruiz, Antonio Cebrián-Martínez and Emilio López-Parra

Vaccines 2021, 9(8), 813; https://doi.org/10.3390/vaccines9080813 - 22 Jul 2021

Cited by 7 | Viewed by 2703

Abstract

Globalization has led to what has happened in a certain part of the world having a significant and rapid impact on other places, causing significant changes in health problems. In the last quarter of the 18th century, the history of vaccination began, becoming [...] Read more.

Globalization has led to what has happened in a certain part of the world having a significant and rapid impact on other places, causing significant changes in health problems. In the last quarter of the 18th century, the history of vaccination began, becoming an effective tool to prevent and control communicable diseases. This paper proposes an observational research with a cross-sectional design to study the importance of health education and vaccination in building inclusive societies. With a sample of 1000 participants from 76 countries, vaccine awareness and regulation were analyzed, considering the following variables: gender, age, sector, Human Development Index (HDI), and continent. The instrument used was a questionnaire (VACUNASEDUCA) developed for this research and timely validated. As a result, it is highlighted that the profiles of women, people under 30 years of age, education sector, high Human Development Index, and European continent are those that most value the importance of raising awareness in society and the regulation of actions for vaccination compliance. The consequences of “vaccine reluctance” are of concern in every country on the planet. Therefore, it is concluded that effective and evidence-based communication is key to allaying fears and promoting acceptance of vaccination around the world, building inclusive societies in which all citizens enjoy the health benefits. Full article

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13 pages, 274 KiB

Open AccessArticle

Prevalence and Determinants of Vaccine Hesitancy and Vaccines Recommendation Discrepancies among General Practitioners in French-Speaking Parts of Belgium

by Cathy Gobert, Pascal Semaille, Thierry Van der Schueren, Pierre Verger and Nicolas Dauby

Vaccines 2021, 9(7), 771; https://doi.org/10.3390/vaccines9070771 - 10 Jul 2021

Cited by 6 | Viewed by 2619

Abstract

General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of [...] Read more.

General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of GPs in the Belgian Wallonia-Brussels Federation (WBF) were to: (1) determine the prevalence and the features of VH, (2) identify the correlates, and (3) estimate the discrepancy in vaccination’s behaviors between the GPs’ children and the recommendations made to their patients. An online survey was carried out among the population of general practitioners practicing in the WBF between 7 January and 18 March 2020. A hierarchical cluster analysis was carried out based on various dimensions of vaccine hesitancy: perception of the risks and the usefulness of vaccines as well as vaccine recommendations for their patients. A total of 251 GPs answered the survey. The average percentage of moderate to high vaccine hesitancy was 50.6%. Three factors were independently associated with increased risk of vaccine hesitancy: an age <50 years old, having no children, and having no contact with selected vaccine-preventable disease (measles, complicated influenza, chronic hepatitis B (HBV), bacterial meningitis, or cervical cancer) in the past 5 years. VH was associated with controversies on vaccines’ safety. GPs who had vaccinated their children against six diseases (MMR, meningococcus C (MenC), HBV, and HPV) tended not to recommend the same vaccines to their patients. Among GPs with all children vaccinated against HBV, only 37.5% recommended catch-up HBV immunization to their patients. In this small cohort of GP, moderate to high VH was associated with controversies on vaccines’ safety and with specific personal characteristics (age <50, no children, and no recent experience with a serious VPD). As previously reported, GPs have different vaccine prescription attitude toward their patients and children. These findings should be confirmed in larger cohorts. Full article

19 pages, 1146 KiB

Open AccessReview

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

by Cheryl Lin, Jewel Mullen, Danielle Smith, Michaela Kotarba, Samantha J. Kaplan and Pikuei Tu

Vaccines 2021, 9(7), 713; https://doi.org/10.3390/vaccines9070713 - 01 Jul 2021

Cited by 63 | Viewed by 7596

Abstract

Despite vaccines’ effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers’ (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, [...] Read more.

Despite vaccines’ effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers’ (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs‘ role as “trusted messengers” to promote vaccine acceptance. Full article

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20 pages, 3097 KiB

Open AccessArticle

Psychological Determinants of COVID-19 Vaccine Acceptance among Healthcare Workers in Kuwait: A Cross-Sectional Study Using the 5C and Vaccine Conspiracy Beliefs Scales

by Mariam Al-Sanafi and Malik Sallam

Vaccines 2021, 9(7), 701; https://doi.org/10.3390/vaccines9070701 - 25 Jun 2021

Cited by 97 | Viewed by 13252

Abstract

Acceptance of coronavirus disease 2019 (COVID-19) vaccination appears as a decisive factor necessary to control the ongoing pandemic. Healthcare workers (HCWs) are among the highest risk groups for infection. The current study aimed to evaluate COVID-19 vaccine acceptance among HCWs in Kuwait, with [...] Read more.

Acceptance of coronavirus disease 2019 (COVID-19) vaccination appears as a decisive factor necessary to control the ongoing pandemic. Healthcare workers (HCWs) are among the highest risk groups for infection. The current study aimed to evaluate COVID-19 vaccine acceptance among HCWs in Kuwait, with identification of the psychological determinants of COVID-19 vaccine hesitancy. The study was conducted using an online anonymous survey distributed between 18 March 2021 and 29 March 2021. The sampling strategy was convenience-based depending on chain-referral sampling. Psychological determinants of COVID-19 vaccine acceptance were assessed using the 5C subscales and the Vaccine Conspiracy Beliefs Scale (VCBS). The total number of study participants was 1019, with the largest group being physicians (28.7%), pharmacists (20.2%), dentists (16.7%), and nurses (12.5%). The overall rate for COVID-19 vaccine acceptance was 83.3%, with 9.0% who were not willing to accept vaccination and 7.7% who were unsure. The highest rate for COVID-19 vaccine acceptance was seen among dentists (91.2%) and physicians (90.4%), while the lowest rate was seen among nurses (70.1%; p < 0.001). A higher level of COVID-19 vaccine hesitancy was found among females, participants with a lower educational level, and HCWs in the private sector. A preference for mRNA vaccine technology and Pfizer-BioNTech COVID-19 vaccine was found among the majority of participants (62.6% and 69.7%, respectively). COVID-19 vaccine hesitancy was significantly linked to the embrace of vaccine conspiracy beliefs. The highest 5C psychological predictors of COVID-19 vaccine acceptance were high levels of collective responsibility and confidence, and lower levels of constraints and calculation. The VCBS and 5C subscales (except the calculation subscale) showed acceptable levels of predicting COVID-19 vaccine acceptance based on receiver operating characteristic analyses. The participants who depended on social media platforms, TV programs, and news releases as their main sources of knowledge about COVID-19 vaccines showed higher rates of COVID-19 vaccine hesitancy. An overall satisfactory level of COVID-19 vaccine acceptance was seen among HCWs in Kuwait, which was among the highest rates reported globally. However; higher levels of vaccine hesitancy were observed among certain groups (females, nurses and laboratory workers, HCWs in the private sector), which should be targeted with more focused awareness programs. HCWs in Kuwait can play a central role in educating their patients and the general public about the benefits of COVID-19 vaccination to halt the spread of SARS-CoV-2, considering the high rates of vaccine hesitancy observed among the general public in Kuwait and the Middle East. Full article

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28 pages, 3106 KiB

Open AccessArticle

Global Vaccine Hesitancy Segmentation: A Cross-European Approach

by Almudena Recio-Román, Manuel Recio-Menéndez and María Victoria Román-González

Vaccines 2021, 9(6), 617; https://doi.org/10.3390/vaccines9060617 - 08 Jun 2021

Cited by 10 | Viewed by 3688

Abstract

Vaccine-preventable diseases are global mainly in a globalized world that is characterized by a continuous movement of people and goods across countries. Vaccine hesitancy, the reluctance or refusal to vaccinate despite the availability of vaccines, is rising worldwide. What if the problem of [...] Read more.

Vaccine-preventable diseases are global mainly in a globalized world that is characterized by a continuous movement of people and goods across countries. Vaccine hesitancy, the reluctance or refusal to vaccinate despite the availability of vaccines, is rising worldwide. What if the problem of vaccine hesitancy could be most effectively managed when treated globally rather than on a national or regional basis? What if a global vaccine-hesitant segment exists and the differences among countries are not so significant? Based on the Global Marketing Strategy paradigm, this paper shows that seven different cross-European segments exist based on the beliefs, attitudes, and behaviors collected in 28 European countries. These pan-European segments are differentiable (people in those segments have similar characteristics that are visibly dissimilar from the ones in other segments) and actionable (organizations would be able to propose interventions to the hesitant segments based on their profiles). With segmentation being the starting point of many public health intervention strategies for avoiding vaccine-hesitancy, the results recommend moderating the full-adaptation strategy that follows the “context matters” principle suggested by several political and public health international organizations. Embracing a more standardized strategy will allow the development of better services and strategies that support and enable desirable vaccination behaviors. Full article

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10 pages, 200 KiB

Open AccessArticle

Maternal Vaccination in Uganda: Exploring Pregnant Women, Community Leaders and Healthcare Workers’ Perceptions

by Phiona Nalubega, Emilie Karafillakis, Lydia Atuhaire, Pamela Akite, Flavia Zalwango, Tracey Chantler, Madeleine Cochet, Janet Seeley and Kirsty Le Doare

Vaccines 2021, 9(6), 552; https://doi.org/10.3390/vaccines9060552 - 25 May 2021

Cited by 3 | Viewed by 4745

Abstract

Background: We investigated pregnant women, community leaders, healthcare workers (HCWs) and programme managers’ perceptions of maternal vaccination in Kampala, Uganda. Methods: We conducted focus group discussions, key informant interviews and in-depth discussions with HCWs (3), community leaders (3), pregnant women (8) and programme [...] Read more.

Background: We investigated pregnant women, community leaders, healthcare workers (HCWs) and programme managers’ perceptions of maternal vaccination in Kampala, Uganda. Methods: We conducted focus group discussions, key informant interviews and in-depth discussions with HCWs (3), community leaders (3), pregnant women (8) and programme managers (10) between November 2019 and October 2020. Data were analysed thematically. Results: Pregnant women, community leaders and some HCWs had limited maternal immunisation knowledge. There was confusion over what constitutes a vaccine. Pregnant women may not receive vaccines because of mistrust of government; use of expired vaccines; reliance on traditional medicine; religious beliefs; fear of side effects; HCWs attitudes; and logistical issues. The key facilitators of maternal vaccination were a desire to prevent diseases, positive influences from HCWs and information about vaccine side effects. Community leaders and some pregnant women highlighted that pregnant women do not make decisions about maternal vaccination independently and are influenced by different individuals, including other pregnant women, older people, partners, relatives (parents), community leaders, HCWs and the government. Conclusions: Our results indicate that public health messaging should target all community members, including partners and parents of pregnant women as well as HCWs, to improve knowledge of and confidence in maternal vaccines. Full article

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