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Special Issue "Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health"

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

Deadline for manuscript submissions: 29 February 2024 | Viewed by 9739

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Special Issue Editors

Dr. Duduzile Ndwandwe
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Guest Editor

South African Medical Research Council (SAMRC), Cape Town 8000, South Africa
Interests: vaccinology; vaccine implementation research; evidence-informed decision; clinical trial registration

Dr. Anelisa Jaca

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Guest Editor

Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa
Interests: vaccinology; vaccine implementation research; evidence-informed decision; clinical trial registration

Special Issue Information

Dear Colleagues,

Low vaccination coverage has resulted in the re-emergence of infectious diseases, especially in regions where the vaccine coverage has been below its 90% national target. The emergence of COVID-19 exacerbated this phenomenon where the pandemic-related hard lockdown disrupted routine health services and saw, among disruptions, a decline in children receiving scheduled vaccines. What added to the low vaccination coverage is vaccine hesitancy and acceptance that resulted in the roll-out of COVID-19 vaccines. The COVID-19 pandemic is now subsiding, but the ripple effect of low vaccination uptake and increased vaccine hesitancy to other immunization services. The emergence of measles cases signifies that more significant outbreaks are imminent if the factors and contributors to vaccine uptake are not addressed.

It is also worth understanding that immunization services need to be considered within the context that the services are implemented to understand the barriers to vaccine uptake. Several tools have been developed to understand socio-behavioural factors relating to vaccine uptake. At the same time, there are tools designed to understand the system's challenges in improving healthcare systems to improve vaccination uptake.

Besides these tools to understand the demand and supply challenges, this Special Issue is focused on the recent scientific and technical progress made in this field. Based on your extensive knowledge and experience, we invite you to contribute with an original report, original observation, or review, to highlight issues relating to the following: i) vaccine hesitancy and acceptance, ii) missed opportunity for vaccination, iii) interventions to improve vaccine uptake, iv) current trends in immunization services impacting vaccination uptake, v) COVID-19 impact on other healthcare services and vi) lessons learned from the COVID-19 pandemic to better prepare for the next pandemic.

Dr. Duduzile Ndwandwe
Dr. Anelisa Jaca
Guest Editors

Manuscript Submission Information

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

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

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

Keywords

vaccine hesitancy
missed opportunity for vaccination

Published Papers (9 papers)

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Research

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Open AccessCommunication

Association between Vaccination Status for COVID-19 and the Risk of Severe Symptoms during the Endemic Phase of the Disease

Verónica Benites-Godínez

Jaime Alberto Bricio-Barrios

Herguin Benjamin Cuevas-Arellano

Eder Fernando Ríos-Bracamontes

Walter Serrano-Moreno

Yolitzy Cárdenas

and

Efrén Murillo-Zamora

Vaccines 2023, 11(10), 1512; https://doi.org/10.3390/vaccines11101512 - 22 Sep 2023

Viewed by 229

Abstract

The global health emergency caused by COVID-19 concluded in May 2023, marking the beginning of an endemic phase. This study aimed to evaluate the association between vaccination status and other patient characteristics and the risk of severe disease during this new endemic period. A nationwide cohort study was conducted in Mexico, where we analyzed data from 646 adults who had received positive confirmation of COVID-19 through PCR testing from May to August 2023. The overall risk of severe symptoms in the study sample was 5.3%. The average time elapsed from the last vaccine shot to symptom onset was over six months in all the immunized groups (1, 2 or 3 vaccine doses). Compared to unvaccinated patients, those with three vaccine doses showed an elevated risk of severe symptoms. Advancing age and various chronic comorbidities (specifically cardiovascular, kidney, and obstructive pulmonary conditions) were associated with a heightened risk of severe COVID-19 manifestations. These findings underscore the ongoing seriousness of COVID-19, even in an endemic phase, underscoring the urgent need for tailored interventions aimed at high-risk patients. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Open AccessArticle

Changes in Confidence, Feelings, and Perceived Necessity Concerning COVID-19 Booster

and

Vaccines 2023, 11(7), 1244; https://doi.org/10.3390/vaccines11071244 - 15 Jul 2023

Viewed by 682

Abstract

The COVID-19 booster first became available to all adults in the U.S. in November 2021 and a bivalent version in September 2022, but a large population remains booster-hesitant; only 17% of Americans have obtained the updated vaccine as of June 2023. We conducted two cross-sectional surveys in 2021 and 2022 (n = 1889 and 1319) to determine whether changes in booster-related feelings or perceptions had occurred and whether they altered vaccination rates over time. We found that both positive and negative emotions had grown stronger between the two years, with the prevalence of annoyance increasing the most (21.5% to 39.7%). The impact of trust on booster intention more than doubled (OR = 7.46 to 16.04). Although perceived risk of infection decreased, more participants in 2022 indicated uncertainty or unwillingness to obtain a new booster than in 2021, while the proportion refusing a booster remained constant at 22.5%. Confidence in the COVID-19 vaccine and feelings of hope from the booster motivated acceptance; both were stronger predictors of booster receptivity than prior vaccination history. Our findings signal a need to rebuild trust by informing people of their continued risk and appealing to positive, especially optimistic emotions to encourage booster uptake. Future research should explore longitudinal trends in behavior and feelings toward new booster doses and the impact of prolonged vaccine hesitancy on infection rates. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Open AccessArticle

The Degree of Acceptance of Cocoon Strategy of Vaccination against Influenza and COVID-19 in Palliative Home Care Professionals and Caregivers

and

Vaccines 2023, 11(7), 1235; https://doi.org/10.3390/vaccines11071235 - 12 Jul 2023

Viewed by 621

Abstract

Palliative care patients are an immunocompromised population, so the cocooning strategy of vaccinating those around them is a suitable protective strategy against infections. This is especially significant for infectious diseases such as influenza and COVID-19, which pose a challenge to the healthcare system. In order to improve the patient’s quality of life, it is necessary to develop research-based, defined strategies. This questionnaire-based study was conducted to determine the level of knowledge about influenza and SARS-CoV-2 coronavirus vaccination among the factual caregivers and medical staff in the palliative care setting. The survey revealed that the sources of knowledge about vaccination varied and depended on one’s role. Doctors and nurses used professional literature, while other medical professionals relied on the Internet, mass media, and information from family and friends. The study also showed that adherence to vaccination guidelines was not associated with COVID-19 incidence. The overall opinion on vaccination was positive, but the degree of acceptance varied by the role. Palliative care nurses and caregivers were the groups that were the least accepting of vaccination. To improve the acceptance of vaccinations, a remedial program based on professional education should be implemented using the sources declared by the respondents. It may help improve the quality of life for palliative care patients and prevent the spread of infectious diseases. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Open AccessArticle

COVID-19 Prevention Behaviours and Vaccine Acceptability, and Their Association with a Behaviour Change Campaign in Somalia: Analysis of a Longitudinal Cohort

and

Vaccines 2023, 11(5), 972; https://doi.org/10.3390/vaccines11050972 - 11 May 2023

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Abstract

Somalia experienced its first wave of COVID-19 infections in March 2020 and has experienced fluctuating infection levels since. Longitudinal data on suspected cases of COVID-19, attitudes, and behaviours were collected by telephone interviews of cash-transfer programme beneficiaries from June 2020–April 2021. A multi-media Social and Behaviour Change Communication (SBCC) campaign was designed and implemented from February 2021 to May 2021. Between the end of the first wave and the onset of the second the perceived threat from COVID-19 increased, with the proportion of respondents viewing it as a major threat increasing from 46% to 70% (p = 0.021). Use of face coverings increased by 24% (p < 0.001) and hand shaking and hugging for social greeting decreased, with 17% and 23% more people abstaining from these practices (p = 0.001). A combined preventative behaviour score (PB-Score) increased by 1.3 points (p < 0.0001) with a higher score in female respondents (p < 0.0001). During wave 2, vaccine acceptance was reported by 69.9% (95% CI 64.9, 74.5), overall. Acceptance decreased with increasing age (p = 0.009) and was higher in males (75.5%) than females (67.0%) (p = 0.015). Awareness of the SBCC campaign was widespread with each of the 3 key campaign slogans having been heard by at least 67% of respondents. Awareness of 2 specific campaign slogans was independently associated with an increased use of face coverings (aOR 2.31; p < 0.0001) and vaccine acceptance (aOR 2.36; p < 0.0001). Respondents reported receiving information on the pandemic from a wide range of sources with mobile phones and radio the most common. Trust in different sources ranged widely. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Open AccessArticle

Vaccination Coverage among Immunocompromised Patients in a Large Health Maintenance Organization: Findings from a Novel Computerized Registry

Shirley Shapiro Ben David

Iris Goren

Vered Mourad

and

Amos Cahan

Vaccines 2022, 10(10), 1654; https://doi.org/10.3390/vaccines10101654 - 02 Oct 2022

Cited by 2 | Viewed by 966

Abstract

Immune-compromised patients (IPs) are at high risk for infections, some of which are preventable by vaccines. Specific vaccines are recommended for IP; however, the vaccination rate is suboptimal. The aim of this study is to describe the development of an IP registry and to assess vaccination rates in this population. A population-based registry of IPs was developed using an automated extraction of patient electronic health-record data in Maccabi Healthcare Services (MHS), an Israeli health maintenance organization serving over 2.4 million members. Included in the registry were patients receiving immunosuppressive therapy (IT); patients living with HIV (PLWH); solid organ and bone marrow transplant recipients (TR); patients with advanced kidney disease (AKD), and asplenic patients. We evaluated the full schedule for each vaccine’s uptake rates for influenza, pneumococcal, meningococcal, and hepatitis B. On 1 October 2019, 32,637 adult immune-compromised patients were identified by the registry. Of them, 1647 were PLWH; 2354 were asplenic; 5317 had AKD; 23,216 were on IT; and 1824 were TR. Their mean age was 57 and 52.4% were females. The crude rate of immune compromise among adult MHS members was 2%. Vaccine coverage rate was overall low for PCV13, with only 11.9% of all IPs in the registry having received one dose. Influenza and PPV23 vaccination rates were higher (45% and 39.4%, respectively). Only 5.3% of all IPs received all three vaccines. Overall, low vaccination coverage was found among IPs. Our registry can serve to identify target-patient populations for interventions and monitor their effectiveness. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Review

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Open AccessReview

The Social Ecological Model: A Framework for Understanding COVID-19 Vaccine Uptake among Healthcare Workers—A Scoping Review

Damian Naidoo

Anna Meyer-Weitz

and

Kaymarlin Govender

Vaccines 2023, 11(9), 1491; https://doi.org/10.3390/vaccines11091491 - 15 Sep 2023

Viewed by 396

Abstract

Vaccination plays a crucial role in combating the global COVID-19 pandemic. Immunizing all healthcare workers (HCWs) is essential for increasing vaccine confidence and acceptance within the general population. Understanding the factors that hinder or facilitate vaccine uptake among HCWs is of utmost importance, considering they are among the first to be vaccinated. This review follows Arksey and O’Malley’s five-stage methodological framework. We searched PubMed, Web of Science, ProQuest, WorldCat Discovery, and Google Scholar for peer-reviewed articles published from 2020 to 2023. A descriptive analysis and narrative synthesis approach were employed to collect and synthesize data. Using the social-ecological model as a framework, the literature was categorized into themes at the intrapersonal, interpersonal, organizational, community, and policy levels. We reviewed a total of fifty-three published academic articles, with the majority of studies conducted in Ethiopia and Nigeria. The intention for vaccine uptake resulted in an unsatisfactory (52%) overall uptake rate among HCWs. Individual-level determinants associated with vaccine uptake included being male, middle-aged, being a physician, having a higher level of education, and having a chronic illness. This review identified significant barriers at each level, such as safety concerns, perceived scientific uncertainty, vaccine ineffectiveness, lack of trust in stakeholders, and religious beliefs. Additionally, we identified facilitators at each level, with the most common factors promoting intention to uptake being the desire to protect oneself and others and a high perceived susceptibility to contracting COVID-19. This review highlights the existence of significant barriers to vaccine uptake on the African continent. Given that HCWs play a crucial role in guiding the public’s vaccination decisions, it is imperative to prioritize education and training efforts about the safety and effectiveness of COVID-19 vaccines. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Open AccessReview

The Role of Faith-Based Organizations in Improving Vaccination Confidence & Addressing Vaccination Disparities to Help Improve Vaccine Uptake: A Systematic Review

Uzma Syed

Olivia Kapera

Aparajita Chandrasekhar

and

Vaccines 2023, 11(2), 449; https://doi.org/10.3390/vaccines11020449 - 15 Feb 2023

Cited by 2 | Viewed by 2838

Abstract

The COVID-19 pandemic underscored the importance of vaccination to support individual health across the life-course, with vaccination playing a central strategy role in mitigating transmission and disease. This required unprecedented mobilization and coordination across all sectors to meet people where they are, enable equitable access, and build vaccination confidence. A literature search was conducted with combinations of the keywords and variations of vaccination and faith-based organizations (FBOs). Search inclusion criteria were: (1) FBO programs that supported public health emergency efforts, including vaccination efforts as the primary outcome; and (2) articles written in English language. A total of 37 articles met inclusion criteria (n = 26 focused on general public health campaigns, n = 11 focused on vaccination efforts). The findings related to public health campaigns fell into four themes: FBO’s ability to (1) tailor public health campaigns; (2) mitigate barriers; (3) establish trust; and (4) disseminate and sustain efforts. The findings related to vaccine uptake efforts fell into three themes: (1) pre-pandemic influenza and HPV vaccination efforts, (2) addressing vaccine disparities in minority communities, and (3) enabling COVID-19 vaccination. This review demonstrated that FBOs have a vital role in both public health campaigns and vaccination initiatives to support high vaccine uptake and confidence. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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Open AccessReview

Global Policy to Reduce the Incidence of Infection Spreading in Non-Vaccinated Healthcare Workers: A Literature Review

and

Vaccines 2022, 10(12), 2058; https://doi.org/10.3390/vaccines10122058 - 30 Nov 2022

Cited by 1 | Viewed by 608

Abstract

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection because of their occupational exposure. Moreover, they can be a vehicle for the virus transmission among patients. The vaccination of healthcare personnel against COVID-19 is crucial in fighting the spread of SARS-CoV-2 infection, together with strict sanitary procedures that aim to limit the risk of contagion. Unfortunately, even if COVID-19 vaccination has been proved one of the most effective tools for protecting against COVID-19, many healthcare professionals are not yet vaccinated. The aim of the current review is to contribute to identifying an effective strategy for COVID-19 prevention especially among non-vaccinated HCWs. In this review, we collected the most recent and relevant findings from literature on the protection of unvaccinated HCWs, identifying three types of measures as principal actions to protect those operators: addressing vaccine hesitancy, improving non-pharmaceutical interventions and promoting actions at personal level (respiratory hygiene, hand hygiene and use of PPE). All these interventions are very effective in preventing contagion, if well respected and conducted; nevertheless, it is essential to promote vaccination, as it is the most effective measure. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

Other

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Open AccessEssay

Towards a More Critical Public Health Understanding of Vaccine Hesitancy: Key Insights from a Decade of Research

Sara Cooper

and

Charles S. Wiysonge

Vaccines 2023, 11(7), 1155; https://doi.org/10.3390/vaccines11071155 - 26 Jun 2023

Viewed by 657

Abstract

Vaccine hesitancy has gained renewed attention as an important public health concern worldwide. Against this backdrop, over the last decade, we have conducted various qualitative, social science studies with the broad shared aim of better understanding this complex phenomenon. This has included various Cochrane systematic reviews of qualitative research globally, systematic reviews of qualitative research in Africa, and primary research studies in South Africa. These studies have also explored vaccine hesitancy for various vaccines, including routine childhood vaccination, HPV vaccination and other routine vaccinations for adolescents, and, most recently, COVID-19 vaccination. In this reflective and critical commentary piece we reflect on seven key overarching insights we feel we have gained about this complex phenomenon from the varying studies we have conducted over the past decade. These insights comprise the following: (1) the relationship between vaccine knowledge and hesitancy is complex and may operate in multiple directions; (2) vaccine hesitancy is driven by multiple socio-political forces; (3) vaccine hesitancy may be many things, rather than a single phenomenon; (4) vaccine hesitancy may be an ongoing ‘process’, rather than a fixed ‘stance’; (5) vaccine hesitancy may sometimes be about a ‘striving’, rather than a ‘resisting’; (6) ‘distrust’ as a driver of vaccine hesitancy needs to be better contextualized and disaggregated; and (7) the ‘demand-side’ versus ‘supply/access-side’ distinction of the drivers of suboptimal vaccination may be misleading and unhelpful. In unpacking these insights, we problematize some of the common assumptions within the vaccine hesitancy literature and flag topics that we think could benefit from further scrutiny and debate. Our hope is that this can provide a platform for further engagement on these issues and ultimately contribute towards fostering a more critical public health understanding of vaccine hesitancy. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Acceptance, Trends and Future Prospects for Public Health)

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