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Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0

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

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 43878

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Special Issue Editor

Dr. Davide Gori

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Guest Editor

Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
Interests: public health; vaccines; prevention; infectious diseases; one health; vaccine hesitancy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Globally, infant and childhood vaccine coverage rates are still not high enough, with outbreaks of vaccine-preventable diseases occurring frequently even in high-income countries. Vaccine hesitancy is one of the factors explaining the suboptimal percentages of vaccination coverage, defined by the SAGE group as a “delay in acceptance or refusal of vaccines despite availability of vaccine services”. The decision not to vaccinate or delay vaccine shots comes from a complex decision-making process influenced by numerous factors related to population, context, environment, historical period, and single vaccine.

This recent worldwide increase in vaccine hesitancy led the World Health Organization to list vaccine hesitancy as one of the top 10 health threats facing the world in 2019. This has led several high-, middle-, and low-income countries to enact, strengthen or contemplate mandatory and/or recommended infant and childhood immunization in order to address this novel gap.

This Special Issue focuses on the knowledge and strategies to reduce vaccine hesitancy and improve vaccination coverage rates in the group of infant and childhood. Submission of original articles, systematic reviews, short communications, and other types of article on related topics is welcome. Manuscripts should follow standard journal peer-review practices, and those accepted for publication will appear in the Special Issue on “Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps”.

Prof. Dr. Davide Gori
Guest Editor

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
Child immunizations
Vaccination coverage rates
Interventions and strategies
Rationales, issues, and knowledge
Vaccine-preventable diseases
Adverse events
Vaccine uptake

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Related Special Issues

Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps in Vaccines (12 articles)
Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps for a Post-pandemic Future (2023) in Vaccines (3 articles)
Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2022 in Vaccines (5 articles)

Published Papers (11 papers)

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Editorial

Jump to: Research, Other

3 pages, 187 KiB

Open AccessEditorial

Vaccine Hesitancy: Lessons Learned and Perspectives for a Post-Pandemic Tomorrow

by Francesca Scognamiglio, Davide Gori and Marco Montalti

Vaccines 2022, 10(4), 551; https://doi.org/10.3390/vaccines10040551 - 1 Apr 2022

Cited by 2 | Viewed by 2496

Abstract

Infectious diseases have always posed a significant threat to mankind, resulting in high mortality and morbidity throughout history [...] Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

Research

Jump to: Editorial, Other

12 pages, 993 KiB

Open AccessArticle

Changing Perspectives on Pediatric Human Papillomavirus (HPV) Vaccination among Dental Students and Residents Reveals Recent Increase in Vaccine Hesitancy

by Rebecca Maginot, Carolina Esteves and Karl Kingsley

Vaccines 2022, 10(4), 570; https://doi.org/10.3390/vaccines10040570 - 6 Apr 2022

Cited by 3 | Viewed by 2070

Abstract

This study was a retrospective analysis of previously collected anonymous survey data regarding vaccine awareness, beliefs, and knowledge among dental (DMD) students and postgraduate (PG) residents. The protocol for this study was approved by the Institutional Review Board (IRB) as exempt. A total of 341 responses were collected from n = 293 DMD students and n = 48 PG residents. Although most respondents agreed that vaccines were necessary, safe, and effective, over the past 4 years (2017–2020) a growing percentage of respondents disagreed. In addition, although most respondents disagreed that there are too many required vaccines, vaccines can make you sick, or are dangerous, a growing percentage of respondents now agreed with these statements. Finally, although most respondents were aware of the HPV vaccine, recently a growing percentage of both students and residents reported they had insufficient information about this vaccine. These results provide novel insights into recent changes in attitudes and beliefs regarding vaccination among this population. Moreover, analysis of these shifts in attitudes and knowledge about HPV vaccination suggests that curricular integration of vaccine research and hesitancy may be needed to answer these questions in a supportive learning environment that fosters critical thinking and evidence-based practice and decision making. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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10 pages, 706 KiB

Open AccessArticle

“Would You Get Vaccinated against COVID-19?” The Picture Emerging from a Study on the Prevalence of SARS-CoV-2 Infection in the General Population of the Veneto Region

by Silvia Cocchio, Giulia Tremolada, Patrizia Furlan, Michele Nicoletti, Federico Zabeo, Marco Fonzo, Michele Tonon, Francesca Russo and Vincenzo Baldo

Vaccines 2022, 10(3), 365; https://doi.org/10.3390/vaccines10030365 - 25 Feb 2022

Cited by 5 | Viewed by 2259

Abstract

COVID-19 disease, caused by the SARS-CoV-2 virus, continues to cause high hospitalization and death rates. Vaccination campaigns have been key to controlling the pandemic, but vaccine hesitancy is on the rise. This study investigated the general population’s attitude to vaccination in Veneto (northeast Italy) in January 2021 as part of a study on the prevalence of SARS-CoV-2 infection. An ad hoc questionnaire collected 4467 respondents’ sociodemographic data and propensity to be vaccinated, and findings were analyzed using logistic multivariable regression. The 48.9% of respondents were male, and the mean age was 46.8 ± 16.0 years. Asked whether they would get vaccinated against COVID-19, 84.3% said yes, 5.0% were uncertain, and 10.7% said no. Vaccine acceptance was higher in males than in females (85.8% vs. 82.8%), in people 70+ years old (92.3%), and among people with more than 14 years of schooling (89.6%). Multivariable analysis with adjOR (95% CI) showed a significantly greater vaccine reluctance in females (0.68 (0.57–0.81)), people 30–49 or 50–69 years old (0.69 (0.54–0.87)), and (0.76 (0.58–0.99)); and those with <9 or 9–13 years of schooling (0.62 (0.46–0.82)), and (0.72 (0.57–0.91)). As people refusing vaccination undeniably hinder efforts to control the pandemic, specific strategies are needed to overcome their doubts. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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11 pages, 561 KiB

Open AccessFeature PaperArticle

Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan

by Majdi M. Sabahelzain, Mohamed Moukhyer, Bart van den Borne and Hans Bosma

Vaccines 2022, 10(2), 205; https://doi.org/10.3390/vaccines10020205 - 28 Jan 2022

Cited by 13 | Viewed by 3560

Abstract

Vaccine uptake is one of the indicators that has been used to guide immunization programs. This study aimed to evaluate whether measles vaccine uptake is predicted by measles vaccine hesitancy. A community-based cross-sectional study was conducted in urban districts in Khartoum state in February 2019. Measles vaccine uptake among children was measured as either fully vaccinated or partially/not vaccinated. The Parent Attitudes about Childhood Vaccines (PACV) scale was used to measure measles vaccine hesitancy. Multivariate logistic regression was run to identify the predictors of measles vaccination uptake, controlling for sociodemographic variables, and the adjusted odds ratios (aORs) with 95% CI were calculated. The receiver operator characteristic (ROC) curve was created, and the area under the curve (AUC) for the PACV was computed. Data were collected from 495 participants. We found that measles vaccine hesitancy (PACV scores) predicts the uptake of measles vaccine after controlling for other potential social confounders, such as the mother’s age and the number of children (aOR 1.055; 95% CI 1.028–1.028). Additionally, the ROC for the PACV yielded an area under the curve (AUC 0.686 (95% CI 0.620–0.751; p < 0.001)). Our findings show that measles vaccine hesitancy in Sudan directly influences the uptake of the measles vaccine. Addressing the determinants of vaccine hesitancy through communication strategies will improve vaccine uptake. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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13 pages, 275 KiB

Open AccessEditor’s ChoiceArticle

Tipping the Fencesitters—The Impact of a Minimal Intervention Enhanced with Biological Facts on Swiss Student Teachers’ Perception of HPV Vaccination Safety

by Alla Keselman and Albert Zeyer

Vaccines 2022, 10(2), 175; https://doi.org/10.3390/vaccines10020175 - 23 Jan 2022

Cited by 6 | Viewed by 3250

Abstract

Not much is known about the role of scientific knowledge in vaccination decision making. This study is based on previous findings that the concern about the human papillomavirus (HPV) agent mutating back to a virulent HPV was common among Swiss student teachers and turned out to be one factor of vaccine hesitancy. The study investigate the impact of a standard public health brochure describing the effectiveness, safety, and importance of HPV vaccination on young student teachers, and the additional effect of supplementing the standard brochure with biological arguments against the mutation concerns. It uses a pre-posttest design and assigns participants randomly to two groups, one reviewing a standard public health brochure, the other the same brochure enhanced with additional biological information. Participants in both groups showed a significant positive change in their beliefs about vaccination safety, effectiveness, and importance in preventing cervical cancer. Post hoc analysis showed significant safety beliefs gain for the subgroup of participants who received the biology-enhanced text and held moderate, rather than high or low, pretest safety beliefs—the so-called fencesitters. We conclude that these fencesitters may particularly profit from even minimal (biologically supplemented) interventions, an effect that should receive more attention in future research. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

11 pages, 517 KiB

Open AccessArticle

COVID-19 Infection in Pregnancy: Obstetrical Risk Factors and Neonatal Outcomes—A Monocentric, Single-Cohort Study

by Antonella Vimercati, Rosalba De Nola, Paolo Trerotoli, Maria Elvira Metta, Gerardo Cazzato, Leonardo Resta, Antonio Malvasi, Archiropita Lepera, Ilaria Ricci, Manuela Capozza, Nicola Laforgia and Ettore Cicinelli

Vaccines 2022, 10(2), 166; https://doi.org/10.3390/vaccines10020166 - 21 Jan 2022

Cited by 28 | Viewed by 4319

Abstract

The effects of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 on pregnant women and neonates are mainly unknown, since limited data are available in the literature. We conducted a monocentric and cross-sectional study enrolling 122 un-vaccinated pregnant women with COVID-19 infection tested by RT-PCR nasopharyngeal swab. Only 4.1% of the patients had severe COVID-19 symptoms together with major respiratory symptoms and intensive care unit admission, whereas 35.25% of women had comorbidities and two-thirds of them were overweight or obese. COVID-19 was detected mainly in the third trimester (98.36%) and multiparous women (59.02%). The mode of delivery was influenced by mild–severe COVID-19 symptoms, with a higher number of urgent or emergent cesarean sections than spontaneous or operative vaginal births. Preterm births were associated with high BMI, mode of delivery (higher among cesarean sections), nulliparity, and severe COVID-19 symptoms. In cases of severe COVID-19 symptoms, there was a higher rate of respiratory distress syndrome among newborns. In the end, only the presence of a severe COVID-19 infection worsened the obstetrical and neonatal outcomes, with higher rates of urgent or emergent cesarean section, preterm births, and neonatal respiratory distress syndrome. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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12 pages, 269 KiB

Open AccessArticle

Determinants of Measles Vaccine Hesitancy among Sudanese Parents in Khartoum State, Sudan: A Cross-Sectional Study

by Majdi M. Sabahelzain, Mohamed Moukhyer, Hans Bosma and Bart van den Borne

Vaccines 2022, 10(1), 6; https://doi.org/10.3390/vaccines10010006 - 22 Dec 2021

Cited by 14 | Viewed by 4366

Abstract

Determinants of vaccine hesitancy are not yet well understood. This study aims to assess measles vaccine hesitancy and characterize its determinants among Sudanese parents in Omdurman in Khartoum State. A community-based cross-sectional quantitative study was conducted in Khartoum State in February 2019. The Parent Attitudes about Childhood Vaccination (PACV) was used to measure measles vaccine hesitancy. Questions about the sociodemographic characteristics of the family, the perception of the parents about the measles vaccine, and the parental exposure to information were asked. Proportions of vaccine hesitancy and coefficients of linear regression were computed. Five hundred parents were recruited for the study. We found that a significant proportion of participants (about 1 in 5 parents) had hesitations regarding the measles vaccine. Significant predictors of measles vaccine hesitancy were parental exposure to anti-vaccination information or materials (β = −0.478, p-value < 0.001), the parents’ perception of the effectiveness of measles vaccines (β = 0.093, p-value = 0.020), the age of the mother (β = 0.112, p-value = 0.017), the birth rank of the child (β = −0.116, p-value = 0.015), and the total number of the children in the family (β = 0.098, p-value = 0.013). Vaccination access issues were the common justification for parental vaccination hesitancy. Our findings indicate that investment in vaccine communication as well as addressing access issues might be an effective intervention for improving measles vaccine acceptance and, ultimately, measles vaccine coverage. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

15 pages, 1350 KiB

Open AccessArticle

Public Interest in Distribution and Determinants of Influenza and Pneumonia Vaccination during the COVID-19 Pandemic: An Infodemiology and Cross-Sectional Study from China

by Liubing Gong, Xu Zhang, Zhiqiang Qu, Mark R. Francis, Kaiyi Han, Cuilin Xu, Enmao Cai, Huilin Shi and Zhiyuan Hou

Vaccines 2021, 9(11), 1329; https://doi.org/10.3390/vaccines9111329 - 15 Nov 2021

Cited by 16 | Viewed by 2553

Abstract

Background: Following the COVID-19 pandemic, global interest in influenza vaccines and pneumonia vaccines has increased significantly. We aimed to examine public interest in and actual market circulation of influenza and pneumonia vaccines before and after the initial outbreak of COVID-19 and estimate the coverage and determinants of influenza and pneumonia vaccination uptake following the COVID-19 pandemic. Methods: We obtained search volume data for vaccines using the Baidu search index and collected the numbers of vaccines issued from the National Institutes for Food and Drug Control. We also conducted a cross-sectional survey among 3346 adult residents to evaluate the coverage and determinants of influenza and pneumonia vaccination uptake in the Yangtze River delta, China, from 29 January to 4 February 2021. Results: Public searches and the number of vaccines issued for the influenza vaccines and pneumonia vaccines obviously increased after the initial outbreak of COVID-19. In the total sample, 12.5% were vaccinated against influenza, and 21.5% had at least one family member vaccinated against pneumonia. A minority of participants perceived that they were highly or very highly susceptible to influenza (15.9%) and COVID-19 (6.7%). A range of socio-economic factors and perceived susceptibility to COVID-19 were associated with influenza and pneumonia vaccination uptake. Conclusions: Public interest in and issued volumes of influenza and pneumonia vaccines increased nationally following the COVID-19 pandemic. Perceptions of high susceptibility to COVID-19 were associated with the uptake of the influenza and pneumonia vaccines. Targeted interventions were needed to improve vaccination coverage. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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9 pages, 259 KiB

Open AccessArticle

Attitudes toward the SARS-CoV-2 and Influenza Vaccination in the Metropolitan Cities of Bologna and Palermo, Italy

by Marco Montalti, Zeno Di Valerio, Flavia Rallo, Lorena Squillace, Claudio Costantino, Francesco Tomasello, Giulia Letizia Mauro, Michela Stillo, Paola Perrone, Davide Resi, Davide Gori, Francesco Vitale and Maria Pia Fantini

Vaccines 2021, 9(10), 1200; https://doi.org/10.3390/vaccines9101200 - 18 Oct 2021

Cited by 24 | Viewed by 2520

Abstract

Vaccine hesitancy (VH) is known to play a relevant role in thwarting the efforts toward reaching satisfactory influenza vaccination coverage, and has caused similar difficulties during the COVID-19 pandemic. This study aims to describe the phenomenon and produce insights on the reasons behind VH. A survey was administered between December 2020 and February 2021 to adults living in the cities of Bologna and Palermo. Of the 443 subjects enrolled, 47.3% were likely to get the influenza vaccination, while 75.6% were willing to receive the COVID-19 vaccination. The most frequent determinants that motivated the willingness to get the COVID-19 vaccine were trust in the safety of vaccines and belief that the vaccine is an effective tool. As for people’s unwillingness to be vaccinated, being exposed to information that produced doubts about the vaccine and lack of trust in a newly developed vaccine were the most frequently involved determinants. Statistically significant positive associations were found between the willingness to be vaccinated and postgraduate education and the propensity towards influenza vaccination. A negative association with being over 40 years old and of female gender was also found. These results might have an impact in better understanding individual reasons behind VH, identifying which categories are more exposed to it and which strategies should be implemented. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

Other

Jump to: Editorial, Research

30 pages, 4292 KiB

Open AccessSystematic Review

Effectiveness of Mandatory and Incentive-Based Routine Childhood Immunization Programs in Europe: A Systematic Review of the Literature

by Lidia Kuznetsova, Giorgio Cortassa and Antoni Trilla

Vaccines 2021, 9(10), 1173; https://doi.org/10.3390/vaccines9101173 - 13 Oct 2021

Cited by 13 | Viewed by 6632

Abstract

There is a lack of comprehensive and systematic data and evidence regarding the effectiveness of mandatory and incentive-based vaccination schemes. The results of such programs in some countries have not been adequately studied. A number of countries have recently introduced tightening vaccination measures, and it is important to analyze and assess the results of these programs. The unprecedented situation due to the COVID-19 pandemic and mass vaccination made the topic of the effectiveness of vaccination policies and mandates even more relevant. The aim of the study is to assess childhood vaccination programs implemented in selected countries. The study focuses on initiatives implemented in the European Region of the World Health Organization (WHO). A total of 466 full-text articles were assessed for eligibility, and 26 articles on seven countries were included in the synthesis. Additionally, we obtained and performed an analysis of data on the impact of COVID-19 on vaccine coverage and incidence of vaccine-preventable diseases, and the implementation of vaccine mandates in the selected countries. The evidence collected and analyzed in this review allowed us to conclude that the introduction of children routine vaccination mandates increases vaccine coverage and reduces the incidence of vaccine-preventable diseases when compared to the situation before the introduction of the mandates. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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26 pages, 902 KiB

Open AccessSystematic Review

Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations

by Maria Giulia Salomoni, Zeno Di Valerio, Elisa Gabrielli, Marco Montalti, Dario Tedesco, Federica Guaraldi and Davide Gori

Vaccines 2021, 9(8), 873; https://doi.org/10.3390/vaccines9080873 - 6 Aug 2021

Cited by 80 | Viewed by 8203

Abstract

Vaccination currently appears to be the only strategy to contain the spread of COVID-19. At the same time, vaccine hesitancy (VH) could limit its efficacy and has, therefore, attracted the attention of Public Health Systems. This systematic review aimed at assessing anti-COVID-19 vaccine acceptance rates worldwide and at identifying populations more prone to vaccine hesitancy, for which specific interventions should be planned. PubMed database was searched using a purposely formulated string. One hundred out of the 9243 studies retrieved were considered pertinent and thus included in the analyses. VH rate was analyzed according to patient geographical origin, ethnicity, age, study setting, and method used for data collection; data from specific populations were separately analyzed. Overall, this study demonstrated significant differences in terms of VH in the general population and in the specific subgroups examined according to geographical, demographic factors, as well as associated comorbidities, underlining the need for purposely designed studies in specific populations from the different countries, to design targeted programs aimed at increasing awareness for confidence and complacency toward COVID-19 vaccines. Full article

(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps 2.0)

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