Vaccines

Research

11 pages, 1389 KiB

Open AccessArticle

Socio-Demographic Factors Influencing Malaria Vaccine Acceptance for Under-Five Children in a Malaria-Endemic Region: A Community-Based Study in the Democratic Republic of Congo

by Arsene Daniel Nyalundja, Patrick Musole Bugeme, Ashuza Shamamba Guillaume, Alain Balola Ntaboba, Victoire Urbain Hatu’m, Jacques Lukenze Tamuzi, Duduzile Ndwandwe, Chinwe Iwu-Jaja, Charles S. Wiysonge and Patrick D. M. C. Katoto

Vaccines 2024, 12(4), 380; https://doi.org/10.3390/vaccines12040380 - 2 Apr 2024

Cited by 1 | Viewed by 2425

Abstract

Two novel vaccines against malaria are proposed as a complementary control tool to prevent and reduce Plasmodium falciparum related disease and death in under-five children from moderate to high malaria transmission regions. The Democratic Republic of Congo (DRC) has committed to eradicate malaria [...] Read more.

Two novel vaccines against malaria are proposed as a complementary control tool to prevent and reduce Plasmodium falciparum related disease and death in under-five children from moderate to high malaria transmission regions. The Democratic Republic of Congo (DRC) has committed to eradicate malaria by 2030, and significant efforts have been deployed to strengthen control and elimination measures. We aimed to understand factors influencing the malaria vaccine acceptability among the general population in eastern DRC. We conducted a survey among adult Congolese in Bukavu in March 2022. The questionnaire was adapted from the Behavioral and Social Drivers of vaccine uptake (BeSD) framework and was administered online and physically. Multivariate logistic regressions were built, and estimates were represented as adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI). Out of 1612 adults (median age: 39 years, 46.15% female) surveyed, only 7.26% were aware of the malaria vaccine. However, 46.53% expressed willingness to vaccinate themselves, and 52.60% were open to vaccinating their under-five children. Adjusting for confounding factors, non-student/non-healthcare worker professions (aOR = 0.58, 95%CI [0.42–0.78]) and middle-income status (aOR = 1.87, 95%CI [1.25–2.80]) were significantly associated with self-vaccination acceptance. Age played a role in under-five child vaccination acceptability, with 25 to over 64 years showing increased acceptability compared to the 18–24 age group. Additionally, non-student/non-healthcare worker professions (aOR = 1.88, 95%CI [1.37–2.59]), medium education levels (aOR = 2.64, 95%CI [1.29–5.79]), and residing in semi-rural areas (aOR = 1.63, 95%CI [1.27–2.10]) were predictors of under-five child vaccination acceptance. The acceptability of the malaria vaccine for self and for under-five children was suboptimal for effective malaria control in this community in the DRC. Our study constitutes a call for the Expanded Program on Immunization to closely work with various stakeholders to strengthen risk communication for community engagement prior to and during the introduction of this novel and lifesaving tool, malaria vaccination. Full article

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

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12 pages, 257 KiB

Open AccessArticle

Influenza Vaccination Coverage among People with Self-Reported Cardiovascular Diseases—Findings from the Hungarian Implementation of the European Health Interview Survey

by Gergő József Szőllősi, Jenifer Pataki, Anett Virágh, Gábor Bányai, Klára Boruzs, Klára Bíró and Viktor Dombrádi

Vaccines 2024, 12(4), 360; https://doi.org/10.3390/vaccines12040360 - 27 Mar 2024

Viewed by 1834

Abstract

Worldwide, cardiovascular diseases are the leading cause of mortality. This has significant implications for public health. Influenza, a common infectious disease, poses an increased risk for individuals with chronic conditions, such as cardiovascular diseases. However, little is known about influenza vaccination coverage in [...] Read more.

Worldwide, cardiovascular diseases are the leading cause of mortality. This has significant implications for public health. Influenza, a common infectious disease, poses an increased risk for individuals with chronic conditions, such as cardiovascular diseases. However, little is known about influenza vaccination coverage in this group. This study utilized data from the Hungarian implementation of the European Health Interview Survey to assess influenza vaccination coverage and its determinants among cardiovascular respondents from 2009 to 2019. The findings reveal a downward trend in the vaccination rates over the years (from 24% to 21%), despite the availability of free vaccination in Hungary for this high-risk population. The main factors influencing low influenza vaccine uptake were identified, as follows: young age, a lower level of education, good self-perceived health status, smoking, a lower frequency of medical visits, and not suffering from respiratory diseases. Addressing these disparities necessitates targeted vaccination strategies supported by enhanced education, better access to healthcare services, and the promotion of preventive healthcare measures. Improving vaccination coverage among patients with cardiovascular diseases is imperative for reducing influenza-related morbidity and mortality. This highlights the importance of comprehensive public health interventions and healthcare provider engagement in promoting vaccination among groups at increased risk. Full article

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

14 pages, 245 KiB

Open AccessArticle

Determinants of an HIV Preventive Vaccine among a Highly Vulnerable Population: African American Men Who Have Sex with Men

by Mia Ann Xu, Jasmin Choi, Joshua G. Rosenberger, Rick S. Zimmerman and Ralph DiClemente

Vaccines 2024, 12(3), 323; https://doi.org/10.3390/vaccines12030323 - 18 Mar 2024

Viewed by 1709

Abstract

African American men who have sex with men (MSM) are disproportionately impacted by HIV and may benefit from the development of an HIV vaccine. African American MSM are adversely affected by discrimination as a function of both their race and sexual behaviors. This [...] Read more.

African American men who have sex with men (MSM) are disproportionately impacted by HIV and may benefit from the development of an HIV vaccine. African American MSM are adversely affected by discrimination as a function of both their race and sexual behaviors. This may further increase the challenges associated with persuading them to adopt an HIV vaccine. Developing a knowledge base characterizing African American MSM HIV vaccine perceptions, attitudes, and concerns may help strengthen how healthcare providers and other health stakeholders describe and discuss the advent of an HIV vaccine. This study assessed the knowledge, attitudes, beliefs, and intentions related to HIV vaccination among African American MSM. This study comprised 432 African American MSM, 18–64 years, residing in the United States. Vaccine intention was defined as how likely it is that an individual would adopt an HIV vaccine if a vaccine was available and it was 90% effective against HIV, easy to obtain, free, and had few side effects. Relative to African American MSM who intend to delay receiving an HIV vaccination, controlling for age, education, and income, early vaccine adopters who had received ≥ 2 COVID-19 vaccinations and who had high WHO HIV Vaccine Positive Attitude Scale scores were, respectively, 3.2 times and 2.4 times more likely to report the intention to vaccinate within one year. Early vaccine adopters were also 2.4 times more likely to feel that HIV prevention support discriminates against African American MSM. Those reporting three or more sexual partners and medical mistrust were, respectively, 60% and 59% more likely to report the intention to delay HIV vaccination. The lack of a knowledge base on HIV vaccine perceptions and acceptability is a missed opportunity to provide guidance on how stakeholders, such as health providers and policymakers, should address HIV vaccine hesitancy once this crucial vaccine is licensed. The key factors affecting vaccine adoption are valuable in developing and implementing campaigns to enhance the HIV vaccine coverage in this vulnerable population. Full article

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

15 pages, 591 KiB

Open AccessArticle

Factors Affecting the Implementation and Acceptance of the Cocoon Strategy in the NICU in a Tertiary Center in Türkiye

by Şeyma Karatekin, Selda Hançerli Törün, Ebru Şenol, Salih Çağrı Çakır and Gülbin Gökçay

Vaccines 2024, 12(3), 319; https://doi.org/10.3390/vaccines12030319 - 18 Mar 2024

Viewed by 1544

Abstract

Pertussis is an important cause of mortality and morbidity in infancy. It is recommended that close contacts of the baby be vaccinated with Tdap, and this practice is called the cocoon strategy. This study aimed to investigate the applicability of the cocoon strategy [...] Read more.

Pertussis is an important cause of mortality and morbidity in infancy. It is recommended that close contacts of the baby be vaccinated with Tdap, and this practice is called the cocoon strategy. This study aimed to investigate the applicability of the cocoon strategy and to determine the factors affecting the process. Mothers of babies who were hospitalized in the neonatal intensive care unit were included in the study. In the first stage, a face-to-face questionnaire was given to the mothers to measure their level of knowledge about whooping cough and its vaccine. In the second stage, written and verbal information about the cocoon strategy was given, and then vaccination intentions for Tdap were learned. In the third stage, all mothers were contacted 3 weeks after and asked whether they had received a Tdap vaccination and why. Of these mothers, 68% could not answer any questions about pertussis disease and vaccines correctly. After the information, 35% (n = 78) of the mothers stated that they were considering getting vaccinated, while only 2% (n = 5) of the mothers were able to get the Tdap vaccine. The most important reasons for not getting vaccinated were a lack of time (24%) and the cost of vaccination (23%). It is predicted that Tdap vaccination rates may increase if the cost of vaccine, availability of vaccine, and the access of mothers to the vaccine application are facilitated. Full article

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

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20 pages, 4814 KiB

Open AccessArticle

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

by Jerome Nyhalah Dinga, Severin Kabakama, Dieudonne Lemuh Njimoh, Julius Ebua Chia, Imran Morhason-Bello and Ivan Lumu

Vaccines 2024, 12(1), 34; https://doi.org/10.3390/vaccines12010034 - 28 Dec 2023

Cited by 3 | Viewed by 3229

Abstract

Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. [...] Read more.

Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72–67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05–35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = −0.11, p < 0.164) or vaccine hesitancy (r = −0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67–212.8), rural setting (OR = 2.53, 95% CI; 0.29–119.33), older (OR = 1.98, 95% CI; 0.99–4.07), higher education (OR = 1.76, 95% CI; 0.85–3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45–30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03–1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92–8.24), complacency (OR = 2.86, 95% CI; 1.02–8.83), pregnancy (OR = 2.3, 95% CI; 0.12–141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52–10.42), being female (OR = 1.53, 95% CI; 0.78–3.01), and safety concerns (OR = 1.29, 95% CI; 0.67–2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19. Full article

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

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17 pages, 1031 KiB

Open AccessArticle

Trends in Vaccine Completeness in Children Aged 0–23 Months in Cape Town, South Africa

by Duduzile Ndwandwe, Musawenkosi Ndlovu, Asanda Mayeye, Nomahlubi Luphondo, Ndivhuwo Muvhulawa, Yonela Ntamo, Phiwayinkosi V. Dludla and Charles S. Wiysonge

Vaccines 2023, 11(12), 1782; https://doi.org/10.3390/vaccines11121782 - 29 Nov 2023

Viewed by 2102

Abstract

Background: We have previously determined that the occurrence of missed vaccination opportunities in children in Cape Town, South Africa, is shaped by both individual and contextual factors. These factors present valuable openings for enhancing quality and implementing broader strategies to enhance the delivery [...] Read more.

Background: We have previously determined that the occurrence of missed vaccination opportunities in children in Cape Town, South Africa, is shaped by both individual and contextual factors. These factors present valuable openings for enhancing quality and implementing broader strategies to enhance the delivery of routine Immunisation services. Methods: Here, we are further reporting regional-level data on the coverage and factors influencing vaccination completion within a similar study population, based on extensive data analysis from the 2016 South African Demographic and Health Survey. Results and discussion: The study reveals commendable vaccination coverage for most vaccines within recommended schedules, with high rates of initial vaccinations at birth and during the primary vaccination schedule. However, there are notable areas for improvement, particularly in ensuring complete coverage for the second measles vaccine and the 18-month vaccine. Socio-demographic factors also play a role, with maternal education and caregiver awareness campaigns showing the potential to positively influence vaccination completeness. This study emphasises the importance of timely vaccinations during the early months of life and underscores the need for interventions to maintain coverage as children age. Specific sub-districts, such as Tygerberg, may require targeted efforts to enhance vaccination completeness. Additionally, assessing caregiver knowledge about child vaccination is deemed vital, as it can impact vaccination decisions and adherence. Conclusions: The findings provide valuable insights for public health interventions in Cape Town, aimed at reducing the burden of vaccine-preventable diseases and ensuring the health of the region’s youngest population. Full article

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

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15 pages, 293 KiB

Open AccessArticle

Attitudes toward COVID-19 and Other Vaccines: Comparing Parents to Other Adults, September 2022

by Matthew Z. Dudley, Holly B. Schuh, Michelle Goryn, Jana Shaw and Daniel A. Salmon

Vaccines 2023, 11(12), 1735; https://doi.org/10.3390/vaccines11121735 - 21 Nov 2023

Viewed by 1288

Abstract

Few analyses of COVID-19 vaccine attitudes also cover routine vaccines or focus on parents. In this cross-sectional study, we surveyed US adults in September 2022, immediately following the authorization of updated bivalent COVID-19 boosters for adults but before their authorization for children. The [...] Read more.

Few analyses of COVID-19 vaccine attitudes also cover routine vaccines or focus on parents. In this cross-sectional study, we surveyed US adults in September 2022, immediately following the authorization of updated bivalent COVID-19 boosters for adults but before their authorization for children. The vaccine attitudes of parents were compared to other adults. Fewer parents were up-to-date on COVID-19 vaccines than other adults (54% vs. 67%), even after adjusting for age, education, and race/ethnicity (Adjusted Odds Ratio: 0.58; 95% Confidence Interval: 0.45–0.76). More parents had concerns about COVID-19 vaccines’ safety in children (67% vs. 58%; aOR: 1.59; 95%CI: 1.23–2.06) and vaccine ingredients (52% vs. 45%; aOR: 1.41; 95%CI: 1.09–1.81), and more parents perceived COVID-19 in children to be no worse than a cold or the flu (51% vs. 38%; aOR: 1.56; 95%CI: 1.22–2.01). Fewer parents supported COVID-19 vaccine school requirements (52% vs. 57%; aOR: 0.75; 95%CI: 0.58–0.97) and perceived high vaccine coverage among their friends (51% vs. 61%; aOR: 0.60; 95%CI: 0.46–0.78). However, three-quarters of parents intended their child to receive all routinely recommended vaccines, whereas only half of adults intended to receive all routinely recommended vaccines themselves. To improve parental informed vaccine decision-making, public health must ensure pediatric providers have updated resources to support their discussions of vaccine risks and benefits with their patients’ parents. Full article

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

9 pages, 510 KiB

Open AccessCommunication

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

by Oliver Mendoza-Cano, Xóchitl Trujillo, Mónica Ríos-Silva, Agustin Lugo-Radillo, 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

Cited by 1 | Viewed by 1438

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. [...] Read more.

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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13 pages, 797 KiB

Open AccessArticle

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

by Cheryl Lin, Brooke Bier, Ann M. Reed, John J. Paat and Pikuei Tu

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

Cited by 6 | Viewed by 2371

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 [...] Read more.

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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12 pages, 701 KiB

Open AccessArticle

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

by Agnieszka Kluczna, Rafał Orzeł, Anna Bardowska and Tomasz Dzierżanowski

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

Cited by 1 | Viewed by 1716

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. [...] Read more.

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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13 pages, 611 KiB

Open AccessArticle

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

by Andrew Seal, Mohamed Jelle, Mohamed Yusuf Hassan, Dek Abdi Farah, Faith Mueni Musili, Janet Micheni, George Samuel Asol, Meena Bhandari and Balint Nemeth

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

Viewed by 2097

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 [...] Read more.

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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9 pages, 637 KiB

Open AccessArticle

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

by Shirley Shapiro Ben David, Iris Goren, Vered Mourad and Amos Cahan

Vaccines 2022, 10(10), 1654; https://doi.org/10.3390/vaccines10101654 - 2 Oct 2022

Cited by 8 | Viewed by 1936

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 [...] Read more.

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

Jump to: Research, Other

22 pages, 732 KiB

Open AccessReview

Vaccine Hesitancy among Immigrants: A Narrative Review of Challenges, Opportunities, and Lessons Learned

by Jason Wong, Crystal Lao, Giancarlo Dino, Roujina Donyaei, Rachel Lui and Jennie Huynh

Vaccines 2024, 12(5), 445; https://doi.org/10.3390/vaccines12050445 - 23 Apr 2024

Cited by 1 | Viewed by 3064

Abstract

(1) Background: Vaccination reluctance is a major worldwide public health concern as it poses threats of disease outbreaks and strains on healthcare systems. While some studies have examined vaccine uptake within specific countries, few provide an overview of the barriers and trends among [...] Read more.

(1) Background: Vaccination reluctance is a major worldwide public health concern as it poses threats of disease outbreaks and strains on healthcare systems. While some studies have examined vaccine uptake within specific countries, few provide an overview of the barriers and trends among migrant groups. To fill this knowledge gap, this narrative review analyzes immunization patterns and vaccine hesitancy among immigrant populations. (2) Methods: Four researchers independently evaluated the quality and bias risk of the 18 identified articles using validated critical appraisal tools. (3) Results: Most studies focused on vaccine hesitancy among migrants in the United States and Canada, with a higher COVID-19 vaccine reluctance than native-born residents. Contributing factors to this hesitancy include demographics, cultural views, obstacles to healthcare access, financial hardship, and distrust in health policies. Additionally, immigrants in North America and Europe face unfair vaccine challenges due to misinformation, safety concerns, personal perspectives, language barriers, immigration status, and restricted healthcare access. (4) Conclusions: Tailored vaccine education programs and outreach campaigns sensitive to immigrants’ diversity should be developed to address this issue. It is also important to investigate community-specific obstacles and assess the long-term sustainability of current efforts to promote vaccination among marginalized migrant groups. Further research into global immunization disparities among immigrant populations is crucial. Full article

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

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13 pages, 522 KiB

Open AccessReview

Mapping the Cognitive Biases Related to Vaccination: A Scoping Review of the Literature

by Amar Raj, Awnish Kumar Singh, Abram L. Wagner and Matthew L. Boulton

Vaccines 2023, 11(12), 1837; https://doi.org/10.3390/vaccines11121837 - 11 Dec 2023

Cited by 1 | Viewed by 2783

Abstract

Introduction: Human behavior and understanding of the vaccine ecosystem play a critical role in the vaccination decision-making process. The objective of this study was to understand different cognitive biases that may lead to vaccine acceptance or hesitancy. Methods: The eligibility criteria for this [...] Read more.

Introduction: Human behavior and understanding of the vaccine ecosystem play a critical role in the vaccination decision-making process. The objective of this study was to understand different cognitive biases that may lead to vaccine acceptance or hesitancy. Methods: The eligibility criteria for this scoping review was vaccination-related cognitive bias studies published in the English language from inception to April 2022 and available on PubMed, Embase, and Google Scholar. It included all geographical locations and individuals of all age groups and excluded studies focusing on (i) clinical trials of vaccines, (ii) vaccine research conduct bias, (iii) cognitive delay, or (iv) statistical biases. The search method also included reviewing references in the retrieved articles. Results: Overall, 58 articles were identified, and after screening, 19 were included in this study. Twenty-one cognitive biases with the potential to affect vaccination decision-making were observed. These biases were further grouped into three broad categories: cognitive biases seen while processing vaccine-related information, during vaccination-related decision-making, and due to prior beliefs regarding vaccination. Conclusions: This review identified critical cognitive biases affecting the entire process of vaccination that can influence research and public health efforts both positively and negatively. Recognizing and mitigating these cognitive biases is crucial for maintaining the population’s level of trust in vaccination programs around the world. Full article

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

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36 pages, 1194 KiB

Open AccessReview

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

by Damian Naidoo, Anna Meyer-Weitz and Kaymarlin Govender

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

Cited by 4 | Viewed by 3132

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, [...] Read more.

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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31 pages, 1004 KiB

Open AccessReview

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

by Uzma Syed, Olivia Kapera, Aparajita Chandrasekhar, Barbara T. Baylor, Adebola Hassan, Marina Magalhães, Farshid Meidany, Inon Schenker, Sarah E. Messiah and Alexandra Bhatti

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

Cited by 26 | Viewed by 6967

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 [...] Read more.

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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11 pages, 280 KiB

Open AccessReview

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

by Cristiana Ferrari, Giuseppina Somma, Lorenzo Ippoliti, Andrea Magrini, Luca Di Giampaolo and Luca Coppeta

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

Cited by 1 | Viewed by 1358

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, [...] Read more.

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)

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20 pages, 4849 KiB

Open AccessSystematic Review

Worldwide Child Routine Vaccination Hesitancy Rate among Parents of Children Aged 0–6 Years: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

by Madina Abenova, Askhat Shaltynov, Ulzhan Jamedinova and Yuliya Semenova

Vaccines 2024, 12(1), 31; https://doi.org/10.3390/vaccines12010031 - 27 Dec 2023

Cited by 11 | Viewed by 3366

Abstract

Routine vaccine hesitancy is a major global health challenge observed in over 190 countries worldwide. This meta-analysis aims to determine the worldwide prevalence of routine vaccination hesitancy among parents of children aged 0–6. An extensive search was conducted in four scientific databases: PubMed, [...] Read more.

Routine vaccine hesitancy is a major global health challenge observed in over 190 countries worldwide. This meta-analysis aims to determine the worldwide prevalence of routine vaccination hesitancy among parents of children aged 0–6. An extensive search was conducted in four scientific databases: PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were included if they reported hesitancy related to WHO-recommended routine immunizations for children under 7 years of age. A single-arm meta-analysis was performed using the OpenMeta[Analyst] software. An initial search retrieved 5121 articles, of which only 23 publications, involving 29,131 parents, guardians, and caregivers from over 30 countries met the inclusion criteria and quality assessment. The cumulative prevalence of parental vaccine hesitancy was found to be 21.1% (95% CI = 17.5–24.7%, I² = 98.86%, p < 0.001). When stratifying the prevalence of vaccine hesitancy per WHO region, significant variations were observed, ranging from 13.3% (95% CI = 6.7–19.9%, I² = 97.72%, p < 0.001) in the Region of the Americas to 27.9% (95% CI = 24.3–31.4%) in the Eastern Mediterranean region. The study findings highlight the need for healthcare providers and governments to develop and improve comprehensive programs with communication strategies to reduce parental 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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10 pages, 265 KiB

Open AccessEssay

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

by Sara Cooper and Charles S. Wiysonge

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

Cited by 7 | Viewed by 2546

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 [...] Read more.

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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