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Vaccination Coverage: Attitudes and Accessibility

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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 19372

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Dr. Georgios Marinos

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Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: COVID-19; vaccination coverage; vaccines hesitancy; health professionals
Special Issues, Collections and Topics in MDPI journals

Dr. Mateusz Babicki

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Department of Family Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland
Interests: vaccines; COVID-19; influezna; epidemiology; viral diseases; primary care; travel medicine
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

Immunization is one of the greatest discoveries of modern medicine. Thanks to population vaccinations, many infectious diseases have been eradicated over the years, and they are now the most important preventive procedure against infectious diseases. However, the availability of effective vaccinations is not synonymous with their use; public acceptance and adequate availability are necessary. In recent years, there has been a decline in confidence in vaccination as well as the development of anti-vaccine movements that undermine the effectiveness and safety of vaccination. This situation has been noted by the United Nations and recognized as one of the greatest threats to public health worldwide. The topic has gained enormous importance in the context of COVID-19 vaccination, which is a topic of discussion for many millions of people around the world. Despite active pro-vaccination campaigns, every day there are more and more people who are skeptical about vaccination. Understanding this problem and identifying the main predictors of vaccine reluctance could be useful for developing appropriate strategies to increase awareness and willingness to vaccinate. Another problem is adequate accessibility to vaccination. This problem has especially gained importance in the era of the ongoing refugee crisis in Europe caused by the Russian–Ukrainian armed conflict. The purpose of this Special Issue is to look for the main factors influencing attitudes toward the vaccination of children, pregnant women, adults, and refugees, including before travel and against COVID-19. In addition, assessments of the availability of vaccinations and papers related to the search for possible solutions to combat inequalities in this area are of interest. Such a broad view of the vaccination issue could contribute to a better understanding of the problem and help to draw conclusions with implications in everyday life.

We look forward to receiving your contributions.

Dr. Georgios Marinos
Dr. Mateusz Babicki
Guest Editors

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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.

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Keywords

vaccine hesitancy
anti-vaccine
COVID-19 vaccinations
refugee vaccinations
influenza vaccinations
travel vaccine
pregnancy vaccination
children's vaccinations
attitudes towards vaccination

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Published Papers (9 papers)

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Research

15 pages, 1286 KiB

Open AccessArticle

Factors Influencing COVID-19 Vaccine Uptake among Spanish-Speaking Pregnant People

by Magali Sanchez, Iveliz Martel, Elizabeth Cox, Isabelle Crary, Carly Baxter, Emma Every, Jeff Munson, Simone Stapley, Alex Stonehill and Kristina M. Adams Waldorf

Vaccines 2023, 11(11), 1726; https://doi.org/10.3390/vaccines11111726 - 17 Nov 2023

Cited by 2 | Viewed by 1777

Abstract

The coronavirus disease 2019 (COVID-19) pandemic exposed the vulnerability of pregnant women to excess morbidity and mortality, as well as the disproportionate disease burden in certain racial, ethnic, and sociodemographic groups. Vaccine hesitancy represents a major threat to public health, and crafting messages that reach vulnerable groups and address their intersectionality remains a weakness for pandemic preparedness. We sought to investigate factors that influenced vaccine acceptance and social media ad response in a mixed-methods study of Spanish-speaking women living in the rural Western United States who were pregnant or recently pregnant between November 2022 and June 2023. Direct interviews were translated, transcribed, and coded, while the ad ratings were analyzed using linear mixed models. Participants most favorably rated ads that featured doctors and text-heavy content describing benefits of vaccination. Qualitative data illustrated how information from trusted medical providers along with generational and cultural history of vaccine acceptance positively impacted perspectives on vaccination. Immigration status had varying influences on vaccination perspectives. Future vaccination campaigns targeting Spanish-speaking pregnant individuals in rural communities should use medical providers as ad messengers and dispel fears that vaccine acceptance may lead to problems with immigration status. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

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9 pages, 262 KiB

Open AccessArticle

Influenza Vaccination of Romanian Medical Students and Resident Physicians—A Matter of Accessibility

by Ana Bălan and Simona Maria Ruță

Vaccines 2023, 11(10), 1551; https://doi.org/10.3390/vaccines11101551 - 29 Sep 2023

Cited by 1 | Viewed by 1731

Abstract

In Romania, influenza vaccination of healthcare professionals is recommended, but not mandatory. This study aims to investigate the attitudes and behaviors of medical students and resident physicians—the youngest healthcare professionals—towards influenza immunization, focusing on the barriers and facilitators, as well as on the impact of the COVID-19 pandemic. An anonymous online survey was conducted during the 2021/2022 influenza season, with responses from332 medical students and resident physicians. The majority (73.5%) were not vaccinated against influenza (68% of the students, 52.3% of the residents), although they were vaccinated against COVID-19 (94% students, 94.8% resident physicians) and believed that the pandemic positively influenced their attitude towards influenza vaccination. Vaccine accessibility (p < 0.001) and the necessity to pay for vaccination (p < 0.001) were identified as barriers in both groups, while lack of recommendation from a medical professional/teacher was significant only for students (p < 0.001). Forgetfulness and lack of prioritizations were the most cited reasons for not being vaccinated. These barriers could be diminished through proactive recommendation and simplification of the vaccination process, with accessible vaccination centers and implementation of vaccine reimbursement policies. Improved vaccination rates in young medical professionals are of the utmost importance both in their professional settings and as a model for the general population. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

13 pages, 986 KiB

Open AccessArticle

COVID-19 Booster Doses: A Multi-Center Study Reflecting Healthcare Providers’ Perceptions

by Hager Salah, Israa Sinan, Omar Alsamani, Lamyaa Samir Abdelghani, May Hassan ElLithy, Nazar Bukamal, Huda Jawad, Raghda R. S. Hussein, Marwa O. Elgendy, Al shaimaa Ibrahim Rabie, Doaa Mahmoud Khalil, Amira S. A. Said, Mohammad M. AlAhmad and Azza Khodary

Vaccines 2023, 11(6), 1061; https://doi.org/10.3390/vaccines11061061 - 4 Jun 2023

Cited by 5 | Viewed by 2471

Abstract

(1) Background: During 2019, the COVID-19 pandemic was threatening healthcare services and workers, and acquiring immunity was an option to stop or limit the burden of this pandemic. Herd immunity was a top priority worldwide as the virus was spreading rapidly. It was estimated that 67% of the total global population should be immunized against COVID-19 to achieve herd immunity. The aim of the current study is to investigate different perceptions of healthcare workers in the Kingdom of Bahrain and Egypt using an online survey in an attempt to evaluate their awareness and concerns regarding new variants and booster doses. (2) Methods: This study conducted a survey on healthcare workers in the Kingdom of Bahrain and Egypt about their perception and concerns on the COVID-19 vaccines. (3) Results: The study found that out of 389 healthcare workers 46.1% of the physicians were not willing to take the booster doses (p = 0.004). Physicians also did not support taking the COVID-19 vaccine as an annual vaccine (p = 0.04). Furthermore, to assess the association between the type of vaccine taken with the willingness of taking a booster vaccine, healthcare workers beliefs on vaccine effectiveness (p = 0.001), suspension or contact with patients (p = 0.000), and infection after COVID-19 vaccination (p = 0.016) were significant. (4) Conclusion: Knowledge about vaccine accreditation and regulation should be dispersed more widely to ensure that the population has a positive perception on vaccine safety and effectiveness. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

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15 pages, 840 KiB

Open AccessArticle

A Behavioural-Theory-Based Qualitative Study of the Beliefs and Perceptions of Marginalised Populations towards Community Volunteering to Increase Measles Immunisation Coverage in Sabah, Malaysia

by Hazeqa Salleh, Richard Avoi, Haryati Abdul Karim, Suhaila Osman, Prabakaran Dhanaraj and Mohd Ali ‘Imran Ab Rahman

Vaccines 2023, 11(6), 1056; https://doi.org/10.3390/vaccines11061056 - 2 Jun 2023

Cited by 2 | Viewed by 2185

Abstract

The development of the measles-containing vaccine (MCV) has rendered measles a largely preventable disease. In the state of Sabah in Malaysia, a complete course of measles immunisation for infants involves vaccinations at the ages of six, nine, and twelve months. However, it is difficult for marginalised populations to receive a complete course of measles immunisation. This present study used behavioural theory (BT) to examine the beliefs and perceptions of a marginalised population towards community volunteering as a method of increasing the immunisation coverage of measles. Marginalised populations living in Kota Kinabalu, Sabah, more specifically, Malaysian citizens living in urban slums and squatter areas, as well as legal and illegal migrants, were extensively interviewed in person for this qualitative study. The 40 respondents were either the parents or primary caregivers of at least one child under the age of five. The components of the Health Belief Model were then used to examine the collected data. The respondents had poor awareness of the measles disease and perceived the disease as not severe, with some even refusing immunisation. The perceived barriers to receiving vaccinations included a nomadic lifestyle; issues with finances, citizenship status, language, and weather; failing to remember immunisation schedules; a fear of health care personnel; having too many children; and a lack of female autonomy in vaccine decision-making. However, the respondents were receptive towards community-based programmes and many welcomed a recall or reminder system, especially when the volunteers were family members or neighbours who spoke the same language and knew their village well. A few, however, found it awkward to have volunteers assisting them. Evidence-based decision making may increase measles immunisation coverage in marginalised populations. The components of the Health Belief Model validated that the respondents lacked awareness of the measles disease and viewed it and its effects as not severe. Therefore, future volunteer programmes should prioritise increasing the receptivity and self-control of marginalised populations to overcome barriers that hinder community involvement. A community-based volunteer programme is highly recommended to increase measles immunisation coverage. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

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14 pages, 266 KiB

Open AccessArticle

Before and After: Attitude and Adverse Effects Induced by the First and Second Doses of mRNA BNT162b2 Vaccine among Healthcare Professionals in the First Weeks after Their Introduction in Poland

by Gerard Pasternak, Karolina Pieniawska-Śmiech, Mateusz Walkowiak, Joanna Sado, Adam Pytel, Paulina Jasińska, Natalia Kierbiedź-Guzik, Paula Bolaczek, Katarzyna Fleischer-Stępniewska, Mateusz Babicki, Katarzyna Pentoś and Aleksandra Lewandowicz-Uszyńska

Vaccines 2023, 11(5), 883; https://doi.org/10.3390/vaccines11050883 - 22 Apr 2023

Viewed by 1721

Abstract

Background: In the last days of December 2020, the SARS-CoV-2 virus vaccine BNT162b2 (Comirnaty, Pfizer-BioNTech) was introduced, for the first time, for wide use in Poland. According to the vaccination schedule, healthcare workers were the first to receive the vaccine. The aim of this study was to analyse the attitudes of those who were determined to be vaccinated, with particular reference to their concerns, attitudes towards vaccination advocacy and sources of knowledge on vaccination, as well as the incidence of adverse reactions. Methods: The study had a three-stage design. Respondents completed a self-administered questionnaire before receiving the 1st and 2nd vaccine doses and 2 weeks after receiving the 2nd dose. A total of 2247 responses were obtained (1340 responses in the first stage, 769 in the second and 138 in the third). Results: The main source of knowledge on vaccination was the Internet (32%; n = 428). Of the respondents, 6% (n = 86) reported anxiety before the 1st dose of the vaccine, which increased to 20% (n = 157) before the 2nd dose. A declaration of willingness to promote vaccination among their families was made by 87% (n = 1165). Among adverse reactions after the 1st dose of the vaccine, respondents most frequently observed pain at the injection site (n = 584; 71%), fatigue (n = 126; 16%) and malaise (n = 86; 11%). The mean duration of symptoms was 2.38 days (SD 1.88). After the 2nd dose of vaccine, similar adverse reactions—pain at the injection site (n = 103; 75%), fatigue (n = 28; 20%), malaise (n = 22; 16%)—predominated among respondents. Those who declared having had a SARS-CoV-2 virus infection (p = 0.00484) and with a history of adverse vaccination reactions (p = 0.00374) were statistically more likely to observe adverse symptoms after vaccination. Conclusions: Adverse postvaccinal reactions are relatively common after Comirnaty vaccination but are usually mild and transient in nature. It is in the interest of public health to increase the knowledge of vaccine safety. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

10 pages, 383 KiB

Open AccessArticle

COVID-19 Vaccine Hesitancy in a Population-Based Study of Minnesota Residents

by Sallee Brandt, Ryan T. Demmer, Sara Walsh, John F. Mulcahy, Evelyn Zepeda, Stephanie Yendell, Craig Hedberg, Angela K. Ulrich and Timothy Beebe

Vaccines 2023, 11(4), 766; https://doi.org/10.3390/vaccines11040766 - 30 Mar 2023

Cited by 1 | Viewed by 1642

Abstract

COVID-19 continues to be a public health concern in the United States. Although safe and effective vaccines have been developed, a significant proportion of the US population has not received a COVID-19 vaccine. This cross-sectional study aimed to describe the demographics and behaviors of Minnesota adults who have not received the primary series of the COVID-19 vaccine, or the booster shot using data from the Minnesota COVID-19 Antibody Study (MCAS) collected through a population-based sample between September and December 2021. Data were collected using a web-based survey sent to individuals that responded to a similar survey in 2020 and their adult household members. The sample was 51% female and 86% White/Non-Hispanic. A total of 9% of vaccine-eligible participants had not received the primary series and 23% of those eligible to receive a booster had not received it. Older age, higher education, better self-reported health, $75,000 to $100,000 annual household income, mask-wearing, and social distancing were associated with lower odds of hesitancy. Gender, race, and previous COVID-19 infection were not associated with hesitancy. The most frequently reported reason for not receiving a COVID-19 vaccination was safety concerns. Mask-wearing and being age 65 or older were the only strong predictors of lower odds of vaccine hesitancy for both the primary series and booster analyses. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

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14 pages, 908 KiB

Open AccessArticle

Global Cross-Sectional Study Evaluating the Attitudes towards a COVID-19 Vaccine in Pregnant and Postpartum Women

by Natalie D. Hernandez, Sally Pairman, Alan C. Fisher, Ru-fong J. Cheng and Shirley Sylvester

Vaccines 2023, 11(2), 390; https://doi.org/10.3390/vaccines11020390 - 8 Feb 2023

Cited by 1 | Viewed by 1991

Abstract

Pregnant and postpartum women have an increased risk of severe complications from COVID-19. Many clinical guidelines recommend vaccination of these populations, and it is therefore critical to understand their attitudes toward COVID-19 vaccines. We conducted a cross-sectional online survey in November 2020 of currently pregnant and ≤1-year postpartum women in Brazil, India, the United Kingdom (UK), and the United States (US) that assessed their openness to COVID-19 vaccines and reasons for vaccine hesitancy. Logistic regression analyses were conducted to evaluate openness to receiving a vaccine. Out of 2010 respondents, 67% were open to receiving a COVID-19 vaccine themselves. Among pregnant and postpartum participants, 72% and 57% were willing to receive a vaccine, respectively. Vaccine openness varied significantly by country: India (87%), Brazil (71%), UK (59%), and US (52%). Across all participants, among the 33% who were unsure/not open to receiving a COVID-19 vaccine, the most common reason cited was safety/side effect concerns (51%). Participants were similarly open to their children/other family members receiving a COVID-19 vaccine. Presence of a comorbidity, a positive COVID-19 test result, and pregnancy were all significantly associated with positive vaccine acceptance. Targeted outreach to address pregnant and postpartum women’s concerns about the COVID-19 vaccine is needed. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

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12 pages, 281 KiB

Open AccessArticle

Fear, Risk Perception, and Engagement in Preventive Behaviors for COVID-19 during Nationwide Lockdown in Nepal

by Ashok Khanal, Sulochan GC, Suresh Panthee, Atmika Paudel, Rakesh Ghimire, Garima Neupane, Amrit Gaire, Rukmini Sitaula, Suman Bhattarai, Shubhechchha Khadka, Bibek Khatri, Aashis Khanal, Bimala Panthee, Sharada P Wasti and Vijay S GC

Vaccines 2023, 11(1), 29; https://doi.org/10.3390/vaccines11010029 - 23 Dec 2022

Cited by 2 | Viewed by 2537

Abstract

The world has faced huge negative effects from the COVID-19 pandemic between early 2020 and late 2021. Each country has implemented a range of preventive measures to minimize the risk during the COVID-19 pandemic. This study assessed the COVID-19-related fear, risk perception, and preventative behavior during the nationwide lockdown due to COVID-19 in Nepal. In a cross-sectional study, conducted in mid-2021 during the nationwide lockdown in Nepal, a total of 1484 individuals completed measures on fear of COVID-19, COVID-19 risk perception, and preventive behavior. A multiple linear regression analysis was used to identify factors associated with COVID-19 fear. The results revealed significant differences in the fear of COVID-19 in association with the perceived risk of COVID-19 and preventive behaviors. Age, risk perception, preventive behavior, and poor health status were significantly positively related to fear of COVID-19. Perceived risk and preventive behaviors uniquely predicted fear of COVID-19 over and above the effects of socio-demographic variables. Being female and unmarried were the significant factors associated with fear of COVID-19 among study respondents. Higher risk perception, poor health status, and being female were strong factors of increased fear of COVID-19. Targeted interventions are essential to integrate community-level mental health care for COVID-19 resilience. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

9 pages, 258 KiB

Open AccessArticle

Will Bivalent Vaccination against COVID-19 Increase the Desire for COVID-19 Vaccination among Poles?

by Mateusz Babicki

Vaccines 2022, 10(10), 1658; https://doi.org/10.3390/vaccines10101658 - 3 Oct 2022

Cited by 1 | Viewed by 1980

Abstract

Tduration of persistent protection after vaccination against COVID-19 is the sum of many factors, including the used formulation, the vaccination schedule, individual predisposition, clinical status and the SARS-CoV-2 variant. (There is a tendency that?) vaccination regimens demonstrate lower levels of immunity against the currently predominant Omicron variant, which results in the need for subsequent booster doses. Thus, bivalent formulations have been recently developed to additionally target the Omicron variant. Accordingly, the purpose of this study was to assess whether bivalent vaccines would increase interest in vaccination among Poles. For this purpose, an original questionnaire distributed via the Internet and targeting Poles over the age of 18 was used. Results: The survey included 594 respondents, the vast majority of whom were women (79.3%), residents of large cities (44.7%) and those with a university education (86.3%). The average age was 36.6 ± 9.67 years. Only 48.7% of respondents had heard of bivalent vaccination against COVID-19. 408 (72.3%) respondents confirmed that if they had the choice, they would opt for the bivalent preparation. People who have already taken at least 1 booster dose are by far the most common group. Among the unvaccinated, the percentage is only 8.9%. For 190 (33.7%) of respondents, the availability of bivalent preparations will help accelerate their decision to vaccinate against COVID-19. Conclusions: Bivalent vaccination is an important part of the fight against the ongoing COVID-19 pandemic. However, it is forecasted that its implementation will not contribute significantly to the increase in vaccination-related interest rate among those previously unvaccinated or only after the basic regimen. Therefore further observations in this direction are necessary. Full article

(This article belongs to the Special Issue Vaccination Coverage: Attitudes and Accessibility)

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