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Social Sciences â€ș Health

Vaccine Coverage and Hesitancy

Works Count: 84304

Description

This cluster of papers explores the multifaceted issue of vaccine hesitancy, including its determinants, impact on immunization coverage, and implications for global health. It delves into factors such as risk perception, herd immunity, and the influence of social media on vaccination attitudes. The research also addresses strategies to improve vaccine acceptance and access, highlighting the importance of trust in vaccination efforts.

Keywords

Vaccine Hesitancy; COVID-19 Vaccine; Health Behavior; Risk Perception; Herd Immunity; Vaccination Intention; Global Access; Social Media; Trust in Vaccination; Immunization Coverage

General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

1994-01-01
Andrew T. Kroger , William Atkinson , Edgar K. Marcuse +1 more
This report is a revision of General Recommendations on Immunization and updates the 2002 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of 
 This report is a revision of General Recommendations on Immunization and updates the 2002 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices and the American Academy of Family Physicians. MMWR 2002;51[No. RR-2]). This report is intended to serve as a general reference on vaccines and immunization. The principal changes include 1) expansion of the discussion of vaccination spacing and timing; 2) an increased emphasis on the importance of injection technique/age/body mass in determining appropriate needle length; 3) expansion of the discussion of storage and handling of vaccines, with a table defining the appropriate storage temperature range for inactivated and live vaccines; 4) expansion of the discussion of altered immunocompetence, including new recommendations about use of live-attenuated vaccines with therapeutic monoclonal antibodies; and 5) minor changes to the recommendations about vaccination during pregnancy and vaccination of internationally adopted children, in accordance with new ACIP vaccine-specific recommendations for use of inactivated influenza vaccine and hepatitis B vaccine. The most recent ACIP recommendations for each specific vaccine should be consulted for comprehensive discussion. This report, ACIP recommendations for each vaccine, and other information about vaccination can be accessed at CDC's National Center for Immunization and Respiratory Diseases (proposed) (formerly known as the National Immunization Program) website at http//:www.cdc.gov/nip.

A simplified general method for cluster-sample surveys of health in developing countries.

1991-01-01
S. Bennett , T. N. Woods , W M Liyanage +1 more
General guidelines are presented for the use of cluster-sample surveys for health surveys in developing countries. The emphasis is on methods which can be used by practitioners with little statistical 
 General guidelines are presented for the use of cluster-sample surveys for health surveys in developing countries. The emphasis is on methods which can be used by practitioners with little statistical expertise and no background in sampling. A simple self-weighting design is used, based on that used by the World Health Organization's Expanded Programme on Immunization (EPI). Topics covered include sample design, methods of random selection of areas and households, sample-size calculation and the estimation of proportions, ratios and means with standard errors appropriate to the design. Extensions are discussed, including stratification and multiple stages of selection. Particular attention is paid to allowing for the structure of the survey in estimating sample size, using the design effect and the rate of homogeneity. Guidance is given on possible values for these parameters. A spreadsheet is included for the calculation of standard errors.Emphasizing methods for practitioners with little expertise and no background in sampling, this paper presents a set of guidelines to follow in planning cluster-sample surveys of appropriate size in developing countries without undue bias. A self-weighting design based upon the World Health Organization's Expanded Program on Immunization is employed. The paper covers the topics of sample design, methods of random selection of areas and households, sample-size calculation, and estimating proportions, ratios, and means with standard errors appropriate to the survey design. Extensions, including stratification and multiple stages of selection, are also discussed. Giving guidance on possible values, the authors pay close attention to allow for survey structure in estimating sample size, using the design effect and the rate of homogeneity. A spreadsheet is finally included to aid in calculating standard errors.

Vaccine hesitancy

2013-07-11
Ève Dubé , Caroline Laberge , Maryse Guay +3 more
Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines 
 Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs. Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and an increasing risk of vaccine-preventable disease outbreaks and epidemics. This review provides an overview of the phenomenon of vaccine hesitancy. First, we will characterize vaccine hesitancy and suggest the possible causes of the apparent increase in vaccine hesitancy in the developed world. Then we will look at determinants of individual decision-making about vaccination.
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Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases

2010-11-09
Preeti Malani
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Acceptance of a pandemic influenza vaccine: a systematic review of surveys of the general public

2011-10-01
Kumanan Wilson , Nguyen , Holdt Henningsen +2 more
Introduction: The effectiveness of pandemic vaccine campaigns such as the H1N1 vaccine rollout is dependent on both the vaccines' effectiveness and the general public's willingness to be vaccinated. It is 
 Introduction: The effectiveness of pandemic vaccine campaigns such as the H1N1 vaccine rollout is dependent on both the vaccines' effectiveness and the general public's willingness to be vaccinated. It is therefore critical to understand the factors that influence the decision of members of the public whether to get vaccinated with new, emergently released vaccines. Methods: A systematic review of English language quantitative surveys was conducted to identify consistent predictors of the decision to accept or decline any (pre)pandemic vaccine, including the H1N1 influenza A vaccine. A total of ten studies were included in this review and all pertained to the 2009 H1N1 influenza A pandemic. Respondents' willingness to receive a pandemic vaccine ranged from 8%–67% across the ten studies. The factors reported to be consistent predictors of the intention to vaccinate were: risk of infection, proximity or severity of the public health event, severity of personal consequences resulting from the illness, harm or adverse events from the vaccine, acceptance of previous vaccination, and ethnicity. Age and sex were the demographic variables examined most frequently across the ten studies and there was no consistent association between these variables and the intention to accept or reject a pandemic vaccine. Conclusion: Some predictors of the intention to accept or decline a (pre)pandemic vaccine or the H1N1 influenza A vaccine are consistently identified by surveys. Understanding the important factors influencing the acceptance of a pandemic vaccine by individual members of the public may help inform strategies to improve vaccine uptake during future pandemics. Keywords: pandemic, H1N1 influenza A, emergent vaccine, personal risk, demographic
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Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review

2013-02-19
RaĂșl Herzog , Ma JosĂ© Álvarez-Pasquin , Camino DĂ­az +3 more
Abstract Background The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers’ knowledge and beliefs about vaccines, and their attitudes towards 
 Abstract Background The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers’ knowledge and beliefs about vaccines, and their attitudes towards them, to increase vaccination coverage. The aim of the study was to compile and analyze the areas of disagreement in the existing evidence about the relationship between healthcare workers’ knowledge, beliefs and attitudes about vaccines and their intentions to vaccinate the populations they serve. Methods We conducted a systematic search in four electronic databases for studies published in any of seven different languages between February 1998 and June 2009. We included studies conducted in developed countries that used statistical methods to relate or associate the variables included in our research question. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. The data were descriptively analyzed. Results Of the 2354 references identified in the initial search, 15 studies met the inclusion criteria. The diversity in the study designs and in the methods used to measure the variables made it impossible to integrate the results, and each study had to be assessed individually. All the studies found an association in the direction postulated by the SIEVE experts: among healthcare workers, higher awareness, beliefs that are more aligned with scientific evidence and more favorable attitudes toward vaccination were associated with greater intentions to vaccinate. All the studies included were cross-sectional; thus, no causal relationship between the variables was established. Conclusion The results suggest that interventions aimed at improving healthcare workers’ knowledge, beliefs and attitudes about vaccines should be encouraged, and their impact on vaccination coverage should be assessed.
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Strategies for addressing vaccine hesitancy – A systematic review

2015-04-18
Caitlin Jarrett , Rose Wilson , Maureen O’Leary +2 more
The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated 
 The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts. A systematic review of peer reviewed (January 2007–October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager. Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions. Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.
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Attitudes to vaccination: A critical review

2014-04-16
Ohid Yaqub , Sophie Castle‐Clarke , Nick Sevdalis +1 more
This paper provides a consolidated overview of public and healthcare professionals' attitudes towards vaccination in Europe by bringing together for the first time evidence across various vaccines, countries and populations. 
 This paper provides a consolidated overview of public and healthcare professionals' attitudes towards vaccination in Europe by bringing together for the first time evidence across various vaccines, countries and populations. The paper relies on an extensive review of empirical literature published in English after 2009, as well as an analysis of unpublished market research data from member companies of Vaccines Europe. Our synthesis suggests that hesitant attitudes to vaccination are prevalent and may be increasing since the influenza pandemic of 2009. We define hesitancy as an expression of concern or doubt about the value or safety of vaccination. This means that hesitant attitudes are not confined only to those who refuse vaccination or those who encourage others to refuse vaccination. For many people, vaccination attitudes are shaped not just by healthcare professionals but also by an array of other information sources, including online and social media sources. We find that healthcare professionals report increasing challenges to building a trustful relationship with patients, through which they might otherwise allay concerns and reassure hesitant patients. We also find a range of reasons for vaccination attitudes, only some of which can be characterised as being related to lack of awareness or misinformation. Reasons that relate to issues of mistrust are cited more commonly in the literature than reasons that relate to information deficit. The importance of trust in the institutions involved with vaccination is discussed in terms of implications for researchers and policy-makers; we suggest that rebuilding this trust is a multi-stakeholder problem requiring a co-ordinated strategy.

Measuring vaccine hesitancy: The development of a survey tool

2015-04-18
Heidi J. Larson , Caitlin Jarrett , W Schulz +6 more
In March 2012, the SAGE Working Group on Vaccine Hesitancy was convened to define the term "vaccine hesitancy", as well as to map the determinants of vaccine hesitancy and develop 
 In March 2012, the SAGE Working Group on Vaccine Hesitancy was convened to define the term "vaccine hesitancy", as well as to map the determinants of vaccine hesitancy and develop tools to measure and address the nature and scale of hesitancy in settings where it is becoming more evident. The definition of vaccine hesitancy and a matrix of determinants guided the development of a survey tool to assess the nature and scale of hesitancy issues. Additionally, vaccine hesitancy questions were piloted in the annual WHO-UNICEF joint reporting form, completed by National Immunization Managers globally. The objective of characterizing the nature and scale of vaccine hesitancy issues is to better inform the development of appropriate strategies and policies to address the concerns expressed, and to sustain confidence in vaccination. The Working Group developed a matrix of the determinants of vaccine hesitancy informed by a systematic review of peer reviewed and grey literature, and by the expertise of the working group. The matrix mapped the key factors influencing the decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine-specific. These categories framed the menu of survey questions presented in this paper to help diagnose and address vaccine hesitancy.
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Addressing the vaccine confidence gap

2011-06-20
Heidi J. Larson , Louis Z. Cooper , Juhani Eskola +2 more

Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement

2011-12-13
Anna Kata

Vaccine hesitancy: Definition, scope and determinants

2015-04-17
Noni E. MacDonald
The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and 
 The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.

Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases

2009-05-06
Saad B. Omer , Daniel A. Salmon , Walter A. Orenstein +2 more
Vaccines are among the most effective prevention tools available to clinicians. However, the success of an immunization program depends on high rates of acceptance and coverage. There is evidence of 
 Vaccines are among the most effective prevention tools available to clinicians. However, the success of an immunization program depends on high rates of acceptance and coverage. There is evidence of an increase in vaccine refusal in the United States and of geographic clustering of refusals that results in outbreaks. Children with exemptions from school immunization requirements (a measure of vaccine refusal) are at increased risk for measles and pertussis and can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but did not have a sufficient immunologic response. Clinicians can play a crucial role in parental decision making. Health care providers are cited as the most frequent source of immunization information by parents, including parents of unvaccinated children. Although some clinicians have discontinued or have considered discontinuing their provider relationship with patients who refuse vaccines, the American Academy of Pediatrics Committee on Bioethics advises against this and recommends that clinicians address vaccine refusal by respectfully listening to parental concerns and discussing the risks of nonvaccination.
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Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases

2015-01-01
edited by Gerald L. Mandell , John E. Bennett , Raphael Dolin

A postmodern Pandora's box: Anti-vaccination misinformation on the Internet

2009-12-31
Anna Kata

"Herd Immunity": A Rough Guide

2011-03-22
P E Fine , Ken Eames , DL Heymann
The term "herd immunity" is widely used but carries a variety of meanings [1–7]. Some authors use it to describe the proportion immune among individuals in a population. Others use 
 The term "herd immunity" is widely used but carries a variety of meanings [1–7]. Some authors use it to describe the proportion immune among individuals in a population. Others use it with reference to a particular threshold proportion of immune individuals that should lead to a decline in incidence of infection. Still others use it to refer to a pattern of immunity that should protect a population from invasion of a new infection. A common implication of the term is that the risk of infection among susceptible individuals in a population is reduced by the presence and proximity of immune individuals (this is sometimes referred to as "indirect protection" or a "herd effect"). We provide brief historical, epidemiologic, theoretical, and pragmatic public health perspectives on this concept.
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Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications

2014-11-06
Ève Dubé , Maryline Vivion , Noni E. MacDonald
Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of parents. Anti-vaccination movements have been implicated 
 Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of parents. Anti-vaccination movements have been implicated in lowered vaccine acceptance rates and in the increase in vaccine-preventable disease outbreaks and epidemics. In this review, we will look at determinants of parental decision-making about vaccination and provide an overview of the history of anti-vaccination movements and its clinical impact.

Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012

2014-03-02
Heidi J. Larson , Caitlin Jarrett , Elisabeth Eckersberger +2 more

Effective Messages in Vaccine Promotion: A Randomized Trial

2014-03-04
Brendan Nyhan , Jason Reifler , Sean Richey +1 more
To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR).A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 
 To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR).A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June-July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group.None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects.Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.

Correlates of Protection Induced by Vaccination

2010-05-13
Stanley A. Plotkin
This paper attempts to summarize current knowledge about immune responses to vaccines that correlate with protection. Although the immune system is redundant, almost all current vaccines work through antibodies in 
 This paper attempts to summarize current knowledge about immune responses to vaccines that correlate with protection. Although the immune system is redundant, almost all current vaccines work through antibodies in serum or on mucosa that block infection or bacteremia/viremia and thus provide a correlate of protection. The functional characteristics of antibodies, as well as quantity, are important. Antibody may be highly correlated with protection or synergistic with other functions. Immune memory is a critical correlate: effector memory for short-incubation diseases and central memory for long-incubation diseases. Cellular immunity acts to kill or suppress intracellular pathogens and may also synergize with antibody. For some vaccines, we have no true correlates, but only useful surrogates, for an unknown protective response.
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Vaccination greatly reduces disease, disability, death and inequity worldwide

2008-01-07
André Fe , Robert Booy , H.L. Bock +7 more
In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. 
 In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. Disease control, elimination or eradication can save billions of US dollars for communities and countries. Vaccines have lowered the incidence of hepatocellular carcinoma and will control cervical cancer. Travellers can be protected against "exotic" diseases by appropriate vaccination. Vaccines are considered indispensable against bioterrorism. They can combat resistance to antibiotics in some pathogens. Noncommunicable diseases, such as ischaemic heart disease, could also be reduced by influenza vaccination. Immunization programmes have improved the primary care infrastructure in developing countries, lowered mortality in childhood and empowered women to better plan their families, with consequent health, social and economic benefits. Vaccination helps economic growth everywhere, because of lower morbidity and mortality. The annual return on investment in vaccination has been calculated to be between 12% and 18%. Vaccination leads to increased life expectancy. Long healthy lives are now recognized as a prerequisite for wealth, and wealth promotes health. Vaccines are thus efficient tools to reduce disparities in wealth and inequities in health.
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Reluctance to vaccinate: Omission bias and ambiguity

1990-10-01
Ilana Ritov , Jonathan Baron
Abstract Subjects are reluctant to vaccinate a (hypothetical) child when the vaccination itself can cause death, even when this is much less likely than death from the disease prevented. This 
 Abstract Subjects are reluctant to vaccinate a (hypothetical) child when the vaccination itself can cause death, even when this is much less likely than death from the disease prevented. This effect is even greater when there is a ‘risk group’ for death (with its overall probability held constant), even though the test for membership in the risk group is unavailable. This effect cannot be explained in terms of a tendency to assume that the child is in the risk group. A risk group for death from the disease has no effect on reluctance to vaccinate. The reluctance is an example of omission bias (Spranca, Minsk & Baron, in press), an overgeneralization of a distinction between commissions and omissions to a case in which it is irrelevant. Likewise, it would ordinarily be prudent to find out whether a child is in a risk group before acting, but in this case it is impossible, so knowledge of the existence of the risk group is irrelevant. The risk‐group effect is consistent with Frisch & Baron's (1988) interpretation of ambiguity.

Access to effective antimicrobials: a worldwide challenge

2015-11-18
Ramanan Laxminarayan , Precious Matsoso , Suraj Pant +4 more

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2014

2015-07-30
Sarah Reagan-Steiner , David Yankey , Jenny Jeyarajah +6 more
Routine immunization is recommended for adolescents aged 11-12 years by the Advisory Committee on Immunization Practices (ACIP) for protection against diseases including pertussis, meningococcal disease, and human papillomavirus (HPV)-associated cancers. 
 Routine immunization is recommended for adolescents aged 11-12 years by the Advisory Committee on Immunization Practices (ACIP) for protection against diseases including pertussis, meningococcal disease, and human papillomavirus (HPV)-associated cancers. To assess vaccination coverage among adolescents, CDC analyzed data collected regarding 20,827 adolescents through the 2014 National Immunization Survey-Teen (NIS-Teen). From 2013 to 2014, coverage among adolescents aged 13-17 years increased for all routinely recommended vaccines: from 84.7% to 87.6% for ≄1 tetanus-diphtheria-acellular pertussis (Tdap) vaccine dose, from 76.6% to 79.3% for ≄1 meningococcal conjugate (MenACWY) vaccine dose, from 56.7% to 60.0% and from 33.6% to 41.7% for ≄1 HPV vaccine dose among females and males, respectively.† Coverage differed by state and local area. Despite overall progress in vaccination coverage among adolescents, HPV vaccination coverage continues to lag behind Tdap and MenACWY coverage at state and national levels. Seven public health jurisdictions achieved significant increases in ≄1- or ≄3-dose HPV vaccination coverage among females in 2014, demonstrating that substantial improvement in HPV vaccination coverage is feasible.
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The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey

2016-09-14
Heidi J. Larson , Alexandre de Figueiredo , Xiahong Zhao +5 more
Public trust in immunization is an increasingly important global health issue. Losses in confidence in vaccines and immunization programmes can lead to vaccine reluctance and refusal, risking disease outbreaks and 
 Public trust in immunization is an increasingly important global health issue. Losses in confidence in vaccines and immunization programmes can lead to vaccine reluctance and refusal, risking disease outbreaks and challenging immunization goals in high- and low-income settings. National and international immunization stakeholders have called for better monitoring of vaccine confidence to identify emerging concerns before they evolve into vaccine confidence crises.We perform a large-scale, data-driven study on worldwide attitudes to immunizations. This survey - which we believe represents the largest survey on confidence in immunization to date - examines perceptions of vaccine importance, safety, effectiveness, and religious compatibility among 65,819 individuals across 67 countries. Hierarchical models are employed to probe relationships between individual- and country-level socio-economic factors and vaccine attitudes obtained through the four-question, Likert-scale survey.Overall sentiment towards vaccinations is positive across all 67 countries, however there is wide variability between countries and across world regions. Vaccine-safety related sentiment is particularly negative in the European region, which has seven of the ten least confident countries, with 41% of respondents in France and 36% of respondents in Bosnia & Herzegovina reporting that they disagree that vaccines are safe (compared to a global average of 13%). The oldest age group (65+) and Roman Catholics (amongst all faiths surveyed) are associated with positive views on vaccine sentiment, while the Western Pacific region reported the highest level of religious incompatibility with vaccines. Countries with high levels of schooling and good access to health services are associated with lower rates of positive sentiment, pointing to an emerging inverse relationship between vaccine sentiments and socio-economic status.Regular monitoring of vaccine attitudes - coupled with monitoring of local immunization rates - at the national and sub-national levels can identify populations with declining confidence and acceptance. These populations should be prioritized to further investigate the drivers of negative sentiment and to inform appropriate interventions to prevent adverse public health outcomes.
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Vaccine hesitancy and healthcare providers

2016-11-01
Pauline Paterson , François Meurice , Lawrence R. Stanberry +3 more
While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review 
 While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations.
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Increasing Vaccination: Putting Psychological Science Into Action

2017-12-01
Noel T. Brewer , Gretchen B. Chapman , Alexander J. Rothman +2 more
Vaccination is one of the great achievements of the 20th century, yet persistent public-health problems include inadequate, delayed, and unstable vaccination uptake. Psychology offers three general propositions for understanding and 
 Vaccination is one of the great achievements of the 20th century, yet persistent public-health problems include inadequate, delayed, and unstable vaccination uptake. Psychology offers three general propositions for understanding and intervening to increase uptake where vaccines are available and affordable. The first proposition is that thoughts and feelings can motivate getting vaccinated. Hundreds of studies have shown that risk beliefs and anticipated regret about infectious disease correlate reliably with getting vaccinated; low confidence in vaccine effectiveness and concern about safety correlate reliably with not getting vaccinated. We were surprised to find that few randomized trials have successfully changed what people think and feel about vaccines, and those few that succeeded were minimally effective in increasing uptake. The second proposition is that social processes can motivate getting vaccinated. Substantial research has shown that social norms are associated with vaccination, but few interventions examined whether normative messages increase vaccination uptake. Many experimental studies have relied on hypothetical scenarios to demonstrate that altruism and free riding (i.e., taking advantage of the protection provided by others) can affect intended behavior, but few randomized trials have tested strategies to change social processes to increase vaccination uptake. The third proposition is that interventions can facilitate vaccination directly by leveraging, but not trying to change, what people think and feel. These interventions are by far the most plentiful and effective in the literature. To increase vaccine uptake, these interventions build on existing favorable intentions by facilitating action (through reminders, prompts, and primes) and reducing barriers (through logistics and healthy defaults); these interventions also shape behavior (through incentives, sanctions, and requirements). Although identification of principles for changing thoughts and feelings to motivate vaccination is a work in progress, psychological principles can now inform the design of systems and policies to directly facilitate action.
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Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination

2018-12-07
Cornelia Betsch , Philipp Schmid , Dorothee Heinemeier +3 more
Monitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy 
 Monitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy and increase vaccine uptake. Existing validated measures assessing vaccine hesitancy focus primarily on confidence in vaccines and the system that delivers them. However, empirical and theoretical work has stated that complacency (not perceiving diseases as high risk), constraints (structural and psychological barriers), calculation (engagement in extensive information searching), and aspects pertaining to collective responsibility (willingness to protect others) also play a role in explaining vaccination behavior. The objective was therefore to develop a validated measure of these 5C psychological antecedents of vaccination.Three cross-sectional studies were conducted. Study 1 uses factor analysis to develop an initial scale and assesses the sub-scales' convergent, discriminant, and concurrent validity (N = 1,445, two German convenience-samples). In Study 2, a sample representative regarding age and gender for the German population (N = 1,003) completed the measure for vaccination in general and for specific vaccinations to assess the potential need for a vaccine-specific wording of items. Study 3 compared the novel scale's performance with six existing measures of vaccine hesitancy (N = 350, US convenience-sample). As an outcome, a long (15-item) and short (5-item) 5C scale were developed as reliable and valid indicators of confidence, complacency, constraints, calculation, and collective responsibility. The 5C sub-scales correlated with relevant psychological concepts, such as attitude (confidence), perceived personal health status and invulnerability (complacency), self-control (constraints), preference for deliberation (calculation), and communal orientation (collective responsibility), among others. The new scale provided similar results when formulated in a general vs. vaccine-specific way (Study 2). In a comparison of seven measures the 5C scale was constantly among the scales that explained the highest amounts of variance in analyses predicting single vaccinations (between 20% and 40%; Study 3). The present studies are limited to the concurrent validity of the scales.The 5C scale provides a novel tool to monitor psychological antecedents of vaccination and facilitates diagnosis, intervention design and evaluation. Its short version is suitable for field settings and regular global monitoring of relevant antecedents of vaccination.
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The COVID-19 vaccine development landscape

2020-04-09
Tung Thanh Le , Zacharias Andreadakis , Arun Kumar +4 more
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Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19

2020-06-26
Sebastian Neumann‐Böhme , Nirosha Elsem Varghese , Iryna Sabat +5 more
In this editorial, we provide some first insights into this willingness to be vaccinated, based on a multi-country European study. In this editorial, we provide some first insights into this willingness to be vaccinated, based on a multi-country European study.
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Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases

2020-07-21
Neha Puri , Eric A. Coomes , Hourmazd Haghbayan +1 more
Despite major advances in vaccination over the past century, resurgence of vaccine-preventable illnesses has led the World Health Organization to identify vaccine hesitancy as a major threat to global health. 
 Despite major advances in vaccination over the past century, resurgence of vaccine-preventable illnesses has led the World Health Organization to identify vaccine hesitancy as a major threat to global health. Vaccine hesitancy may be fueled by health information obtained from a variety of sources, including new media such as the Internet and social media platforms. As access to technology has improved, social media has attained global penetrance. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. Users may self-select content streams, contributing to ideological isolation. As such, there are considerable public health concerns raised by anti-vaccination messaging on such platforms and the consequent potential for downstream vaccine hesitancy, including the compromise of public confidence in future vaccine development for novel pathogens, such as SARS-CoV-2 for the prevention of COVID-19. In this review, we discuss the current position of social media platforms in propagating vaccine hesitancy and explore next steps in how social media may be used to improve health literacy and foster public trust in vaccination.

The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay

2020-07-30
Li Ping Wong , Haridah Alias , Pooi‐Fong Wong +2 more
The development of a vaccine against SARS-CoV-2 infection is on the way. To prepare for public availability, the acceptability of a hypothetical COVID-19 vaccine and willingness to pay (WTP) were 
 The development of a vaccine against SARS-CoV-2 infection is on the way. To prepare for public availability, the acceptability of a hypothetical COVID-19 vaccine and willingness to pay (WTP) were assessed to provide insights into future demand forecasts and pricing considerations.A cross-sectional survey was conducted from 3 to 12 April 2020. The health belief model (HBM) was used to assess predictors of the intent to receive the vaccine and the WTP.A total of 1,159 complete responses was received. The majority reported a definite intent to receive the vaccine (48.2%), followed by a probable intent (29.8%) and a possible intent (16.3%). Both items under the perceived benefits construct in the HBM, namely believe the vaccination decreases the chance of infection (OR = 2.51, 95% CI 1.19-5.26) and the vaccination makes them feel less worry (OR = 2.19, 95% CI 1.03-4.65), were found to have the highest significant odds of a definite intention to take the vaccine. The mean ± standard deviation (SD) for the amount that participants were willing to pay for a dose of COVID-19 vaccine was MYR$134.0 (SD±79.2) [US$30.66 ± 18.12]. Most of the participants were willing to pay an amount of MYR$100 [US$23] (28.9%) and MYR$50 [US$11.5] (27.2%) for the vaccine. The higher marginal WTP for the vaccine was influenced by no affordability barriers as well as by socio-economic factors, such as higher education levels, professional and managerial occupations and higher incomes.The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intention and WTP.
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Vaccine hesitancy: the next challenge in the fight against COVID-19

2020-08-01
Amiel A. Dror , Netanel Eisenbach , Shahar Taiber +5 more
Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. Coincident with the rapid developments of COVID-19 vaccines globally, concerns about the safety of such a vaccine 
 Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. Coincident with the rapid developments of COVID-19 vaccines globally, concerns about the safety of such a vaccine could contribute to vaccine hesitancy. We analyzed 1941 anonymous questionnaires completed by healthcare workers and members of the general Israeli population, regarding acceptance of a potential COVID-19 vaccine. Our results indicate that healthcare staff involved in the care of COVID-19 positive patients, and individuals considering themselves at risk of disease, were more likely to self-report acquiescence to COVID-19 vaccination if and when available. In contrast, parents, nurses, and medical workers not caring for SARS-CoV-2 positive patients expressed higher levels of vaccine hesitancy. Interventional educational campaigns targeted towards populations at risk of vaccine hesitancy are therefore urgently needed to combat misinformation and avoid low inoculation rates.
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Determinants of COVID-19 vaccine acceptance in the US

2020-08-12
Amyn A. Malik , SarahAnn M. McFadden , Jad A. Elharake +1 more
The COVID-19 pandemic continues to adversely affect the U.S., which leads globally in total cases and deaths. As COVID-19 vaccines are under development, public health officials and policymakers need to 
 The COVID-19 pandemic continues to adversely affect the U.S., which leads globally in total cases and deaths. As COVID-19 vaccines are under development, public health officials and policymakers need to create strategic vaccine-acceptance messaging to effectively control the pandemic and prevent thousands of additional deaths.Using an online platform, we surveyed the U.S. adult population in May 2020 to understand risk perceptions about the COVID-19 pandemic, acceptance of a COVID-19 vaccine, and trust in sources of information. These factors were compared across basic demographics.Of the 672 participants surveyed, 450 (67%) said they would accept a COVID-19 vaccine if it is recommended for them. Males (72%) compared to females, older adults (≄55 years; 78%) compared to younger adults, Asians (81%) compared to other racial and ethnic groups, and college and/or graduate degree holders (75%) compared to people with less than a college degree were more likely to accept the vaccine. When comparing reported influenza vaccine uptake to reported acceptance of the COVID-19 vaccine: 1) participants who did not complete high school had a very low influenza vaccine uptake (10%), while 60% of the same group said they would accept the COVID-19 vaccine; 2) unemployed participants reported lower influenza uptake and lower COVID-19 vaccine acceptance when compared to those employed or retired; and, 3) Black Americans reported lower influenza vaccine uptake and lower COVID-19 vaccine acceptance than all other racial groups reported in our study. Lastly, we identified geographic differences with Department of Health and Human Services (DHHS) regions 2 (New York) and 5 (Chicago) reporting less than 50 percent COVID-19 vaccine acceptance.Although our study found a 67% acceptance of a COVID-19 vaccine, there were noticeable demographic and geographical disparities in vaccine acceptance. Before a COVID-19 vaccine is introduced to the U.S., public health officials and policymakers must prioritize effective COVID-19 vaccine-acceptance messaging for all Americans, especially those who are most vulnerable.
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Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated?

2020-08-20
Paul L. Reiter , Michael L. Pennell , Mira L. Katz

Acceptance of COVID-19 Vaccination during the COVID-19 Pandemic in China

2020-08-27
Jiahao Wang , Rize Jing , Xiaozhen Lai +4 more
Background: Faced with the coronavirus disease 2019 (COVID-19) pandemic, the development of COVID-19 vaccines has been progressing at an unprecedented rate. This study aimed to evaluate the acceptance of COVID-19 
 Background: Faced with the coronavirus disease 2019 (COVID-19) pandemic, the development of COVID-19 vaccines has been progressing at an unprecedented rate. This study aimed to evaluate the acceptance of COVID-19 vaccination in China and give suggestions for vaccination strategies and immunization programs accordingly. Methods: In March 2020, an anonymous cross-sectional survey was conducted online among Chinese adults. The questionnaire collected socio-demographic characteristics, risk perception, the impact of COVID-19, attitudes, acceptance and attribute preferences of vaccines against COVID-19 during the pandemic. Multivariate logistic regression was performed to identify the influencing factors of vaccination acceptance. Results: Of the 2058 participants surveyed, 1879 (91.3%) stated that they would accept COVID-19 vaccination after the vaccine becomes available, among whom 980 (52.2%) wanted to get vaccinated as soon as possible, while others (47.8%) would delay the vaccination until the vaccine’s safety was confirmed. Participants preferred a routine immunization schedule (49.4%) to emergency vaccination (9.0%) or either of them (41.6%). Logistic regression showed that being male, being married, perceiving a high risk of infection, being vaccinated against influenza in the past season, believing in the efficacy of COVID-19 vaccination or valuing doctor’s recommendations could increase the probability of accepting COVID-19 vaccination as soon as possible, while having confirmed or suspected cases in local areas, valuing vaccination convenience or vaccine price in decision-making could hinder participants from immediate vaccination. Conclusion: During the pandemic period, a strong demand for and high acceptance of COVID-19 vaccination has been shown among the Chinese population, while concerns about vaccine safety may hinder the promotion of vaccine uptake. To expand vaccination coverage, immunization programs should be designed to remove barriers in terms of vaccine price and vaccination convenience, and health education and communication from authoritative sources are important ways to alleviate public concerns about vaccine safety.
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Attitudes Toward a Potential SARS-CoV-2 Vaccine

2020-09-04
Kimberly A. Fisher , Sarah J. Bloomstone , Jeremy Walder +3 more
Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage. Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage.

Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

2020-09-01
Alexandre de Figueiredo , Clarissa Simas , Emilie Karafillakis +2 more
BackgroundThere is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage 
 BackgroundThere is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019.MethodsIn this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty.FindingsBetween November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake.InterpretationTo our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence.FundingEuropean Commission, Wellcome, and Engineering and Physical Sciences Research Council.
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Social media and vaccine hesitancy

2020-10-01
Steven Lloyd Wilson , Charles Shey Wiysonge
Background Understanding the threat posed by anti-vaccination efforts on social media is critically important with the forth coming need for world wide COVID-19 vaccination programs. We globally evaluate the effect 
 Background Understanding the threat posed by anti-vaccination efforts on social media is critically important with the forth coming need for world wide COVID-19 vaccination programs. We globally evaluate the effect of social media and online foreign disinformation campaigns on vaccination rates and attitudes towards vaccine safety. Methods We use a large-n cross-country regression framework to evaluate the effect of social media on vaccine hesitancy globally. To do so, we operationalize social media usage in two dimensions: the use of it by the public to organize action (using Digital Society Project indicators), and the level of negatively oriented discourse about vaccines on social media (using a data set of all geocoded tweets in the world from 2018-2019). In addition, we measure the level of foreign-sourced coordinated disinformation operations on social media ineach country (using Digital Society Project indicators). The outcome of vaccine hesitancy is measured in two ways. First, we use polls of what proportion of the public per country feels vaccines are unsafe (using Wellcome Global Monitor indicators for 137 countries). Second, we use annual data of actual vaccination rates from the WHO for 166 countries. Results We found the use of social media to organise offline action to be highly predictive of the belief that vaccinations are unsafe, with such beliefs mounting as more organisation occurs on social media. In addition, the prevalence of foreign disinformation is highly statistically and substantively significant in predicting a drop in mean vaccination coverage over time. A 1-point shift upwards in the 5-point disinformation scale is associated with a 2-percentage point drop in mean vaccination coverage year over year. We also found support for the connection of foreign disinformation with negative social media activity about vaccination. The substantive effect of foreign disinformation is to increase the number of negative vaccine tweets by 15% for the median country. Conclusion There is a significant relationship between organisation on social media and public doubts of vaccine safety. In addition, there is a substantial relationship between foreign disinformation campaigns and declining vaccination coverage.
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A global survey of potential acceptance of a COVID-19 vaccine

2020-10-20
Jeffrey V. Lazarus , Scott C. Ratzan , Adam Palayew +5 more
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Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications

2020-12-17
Elise Paul , Andrew Steptoe , Daisy Fancourt
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Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review

2020-12-30
Cheryl Lin , Pikuei Tu , Leslie M. Beitsch
While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and 
 While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing survey design influences and evaluating context to inform policies and practices. Data sources included academic literature (PubMed, Embase, and PsycINFO following PRISMA guidelines), news and official reports published by 20 October 2020. Two researchers independently screened potential peer-reviewed articles and syndicated polls for eligibility; 126 studies and surveys were selected. Declining vaccine acceptance (from >70% in March to <50% in October) with demographic, socioeconomic, and partisan divides was observed. Perceived risk, concerns over vaccine safety and effectiveness, doctors’ recommendations, and inoculation history were common factors. Impacts of regional infection rates, gender, and personal COVID-19 experience were inconclusive. Unique COVID-19 factors included political party orientation, doubts toward expedited development/approval process, and perceived political interference. Many receptive participants preferred to wait until others have taken the vaccine; mandates could increase resistance. Survey wording and answer options showed influence on responses. To achieve herd immunity, communication campaigns are immediately needed, focusing on transparency and restoring trust in health authorities.
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COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment

2021-01-03
Jagdish Khubchandani , Sushil K. Sharma , James H. Price +3 more
Given the results from early trials, COVID-19 vaccines will be available by 2021. However, little is known about what Americans think of getting immunized with a COVID-19 vaccine. Thus, the 
 Given the results from early trials, COVID-19 vaccines will be available by 2021. However, little is known about what Americans think of getting immunized with a COVID-19 vaccine. Thus, the purpose of this study was to conduct a comprehensive and systematic national assessment of COVID-19 vaccine hesitancy in a community-based sample of the American adult population. A multi-item valid and reliable questionnaire was deployed online via mTurk and social media sites to recruit U.S. adults from the general population. A total of 1878 individuals participated in the study where the majority were: females (52%), Whites (74%), non-Hispanic (81%), married (56%), employed full time (68%), and with a bachelor's degree or higher (77%). The likelihood of getting a COVID-19 immunization in the study population was: very likely (52%), somewhat likely (27%), not likely (15%), definitely not (7%), with individuals who had lower education, income, or perceived threat of getting infected being more likely to report that they were not likely/definitely not going to get COVID-19 vaccine (i.e., vaccine hesitancy). In unadjusted group comparisons, compared to their counterparts, vaccine hesitancy was higher among African-Americans (34%), Hispanics (29%), those who had children at home (25%), rural dwellers (29%), people in the northeastern U.S. (25%), and those who identified as Republicans (29%). In multiple regression analyses, vaccine hesitancy was predicted significantly by sex, education, employment, income, having children at home, political affiliation, and the perceived threat of getting infected with COVID-19 in the next 1 year. Given the high prevalence of COVID-19 vaccine hesitancy, evidence-based communication, mass media strategies, and policy measures will have to be implemented across the U.S. to convert vaccines into vaccinations and mass immunization with special attention to the groups identified in this study.
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Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom

2021-01-04
Jamie Murphy , Frédérique ValliÚres , Richard P. Bentall +7 more
Abstract Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland ( N = 
 Abstract Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland ( N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere.
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Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment

2021-02-15
Olivier J. Wouters , Kenneth C. Shadlen , Maximilian Salcher‐Konrad +4 more
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COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates

2021-02-16
Malik Sallam
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to 
 Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≄70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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Vaccine hesitancy in the era of COVID-19

2021-03-05
Gianmarco Troiano , A Nardi

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

2021-07-16
Julio S. SolĂ­s Arce , Shana S. Warren , NiccolĂł Meriggi +7 more
Abstract Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where 
 Abstract Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.

The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change.

1991-01-01
Carlo C. DiClemente , James O. Prochaska , Scott Fairhurst +3 more

Factors associated with lower COVID-19 vaccine uptake among populations with a migration background in the Netherlands

2025-06-24
Bente Smagge , Lisanne Labuschagne , Joyce Pijpers +4 more | Epidemiology and Infection

Perceptions of the safety, development, and approval process of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines among individuals with Affordable Care Act health insurance in Central Texas at the time of initial vaccine availability

2025-06-24
Carlos Lopez Bray , Richard Taylor , Naomi Tamez +2 more | Frontiers in Public Health
Sendero Health Plans, an Affordable Care Act (ACA) health insurance company, conducted a cross-sectional survey in December 2020 to assess individual perceptions of the COVID-19 vaccine development and approval processes 
 Sendero Health Plans, an Affordable Care Act (ACA) health insurance company, conducted a cross-sectional survey in December 2020 to assess individual perceptions of the COVID-19 vaccine development and approval processes and their plan to obtain the COVID-19 vaccine in Central Texas at the time of initial availability. A logistic regression model was developed to identify factors associated with individual plans to obtain a vaccine when it became available. A total of 500 (77.25%) of the 645 respondents in this analysis planned to obtain a COVID-19 vaccine when it became available. The logistic regression model was statistically significant [χ 2 (19) = 314.41, p < 0.001]. Plans to obtain a COVID-19 vaccine were significantly associated with perceptions of vaccine safety (POR: 23.45, p = 0.001, 95% CI: 3.10, 58.34), vaccine protectiveness (POR: 15.55, p < 0.001, 95% CI: 3.55, 68.06), and transparency of the authorization process (POR: 1.33, p = 0.024, 95% CI: 1.15, 7.15). Perceptions regarding the safety, protectiveness, and authorization process of the COVID-19 vaccines are associated with individual plans to obtain the vaccines. This study provides insights into factors that influence vaccination intent and key barriers affecting vaccine hesitancy during a public health crisis.

Meningococcal B vaccine co-administration in older adolescents and young adults and potential missed opportunities for vaccination in the United States: a retrospective claims database analysis

2025-06-24
Oscar Herrera-Restrepo , Jasjit K. Multani , Zifan Zhou +5 more | Current Medical Research and Opinion
In the United States (US), meningococcal serogroup B (MenB) vaccination is currently recommended under shared clinical decision-making for 16-23-year-olds to prevent invasive meningococcal disease; the MenB vaccine may be co-administered 
 In the United States (US), meningococcal serogroup B (MenB) vaccination is currently recommended under shared clinical decision-making for 16-23-year-olds to prevent invasive meningococcal disease; the MenB vaccine may be co-administered with other vaccines recommended for this age group. A retrospective analysis of two US health insurance claims databases was conducted to estimate the proportion of commercially insured and Medicaid-insured 16-23-year-olds with potential missed opportunities for MenB vaccine series initiation via co-administration. Potential missed opportunities were defined as visits with healthcare providers during which other recommended vaccines (MenACWY, Tdap, HPV, influenza, and/or COVID-19) were administered, but not the initial MenB vaccine dose. In 2022, 74.5% of commercially insured and 67.1% of Medicaid-insured 16-23-year-olds had potential missed opportunities for MenB vaccination initiation via co-administration. The proportion of missed opportunities was higher among 19-23-year-olds (versus 16-18-year-olds) and lower for visits with pediatricians (versus internists or general practitioners/family physicians). The most frequently co-administered vaccine was the MenACWY vaccine. Many 16-23-year-olds had potential missed opportunities for MenB series initiation via co-administration. Increasing awareness of the opportunity to initiate the MenB series via co-administration may improve meningococcal vaccination coverage in the United States.

Barriers and enablers to the implementation of infection prevention and control guidance in a Ugandan healthcare facility – a theory-informed qualitative study to guide intervention design

2025-06-24
Andrew Owen Kalule , Kay Currie , Lesley Price | International journal of infection control
Implementing Infection Prevention and Control (IPC) guidance is crucial for reducing healthcare-associated infection (HAI) rates. However, achieving behavioural and organisational change is necessary for successful implementation. To understand these changes, 
 Implementing Infection Prevention and Control (IPC) guidance is crucial for reducing healthcare-associated infection (HAI) rates. However, achieving behavioural and organisational change is necessary for successful implementation. To understand these changes, it is important to identify the barriers and facilitators to IPC implementation, supported by theoretical analysis. This paper presents the second stage of a study conducted in Uganda, aiming to analyse barriers and enablers to IPC guideline implementation and provide preliminary recommendations for intervention design. Interviews with frontline healthcare workers were conducted, and qualitative content analysis helped identify specific barriers and enablers. The Theoretical Domains Framework (TDF) was used to categorise and map these factors to the BCW/COM-B model, enabling the identification of intervention functions supporting IPC implementation. The findings highlighted various important factors influencing IPC implementation, including social influences, environmental context and resources, knowledge, skills, professional role and identity, behavioural regulation, memory, attention and decision processes, goals, beliefs about capabilities, beliefs about consequences, intentions, emotion, and reinforcement. All components of the COM-B model (Capability, Opportunity, Motivation) were deemed significant in IPC implementation. Key intervention functions such as enablement, environmental restructuring, training and education, persuasion, and incentivization were identified as potentially useful for designing interventions to improve IPC implementation. In conclusion, the analysis emphasized the interconnectedness and importance of capability, opportunity, and motivation in adopting IPC guidance in such contexts. The study offers recommendations for future interventions, including education and training programs, leveraging memory and attention, addressing beliefs about consequences, and improving social influences and support systems. These insights can guide the development of effective strategies to enhance IPC implementation.

Exploring interrelationships between structural, social, and biological determinants of vaccine impact in Kenya and Uganda: VAnguard community mixed methods study protocol

2025-06-24
Anthony Etyang , Ludoviko Zirimenya , Maureen Njue +7 more | NIHR Open Research
<ns3:p>Background The key principle underlying the UN Sustainable Development Goals is to “leave no one behind”. However, following the COVID-19 pandemic, sub-optimal vaccine coverage is a continuing concern in low-and 
 <ns3:p>Background The key principle underlying the UN Sustainable Development Goals is to “leave no one behind”. However, following the COVID-19 pandemic, sub-optimal vaccine coverage is a continuing concern in low-and middle-income countries (LMICs) and there is increasing evidence of impaired vaccine immunogenicity and efficacy in LMICs, compared to high-income countries (HICS) and in rural, compared to urban settings. It is documented that countries with the lowest vaccination coverage suffer the highest health inequalities. For vaccines to achieve their full health benefit, structural, social and biological determinants that impair vaccine impact must be concurrently addressed. This study aims to explore how structural, social and biological determinants interact to influence vaccine impact in vulnerable communities across Kenya and Uganda. By understanding these interactions, we can develop strategies to improve vaccine impact in vulnerable populations. Methods The study will utilise a cross-sectional mixed-methods design. It will be conducted in three counties in Kenya (Kilifi, Kwale and Kisumu) and three districts in Uganda (Kampala, Kikuube and Namayingo). We will conduct (i) in-depth interviews, (ii) focus group discussions (FGDs) with key community stakeholders, and (iii) a household-based quantitative survey where blood and stool samples of 1032 participants (172 in each community) will be collected. Samples will be used to measure proxy markers of reduced vaccine coverage and impaired vaccine immunogenicity. Conclusions The results of this study will identify potential determinants of vaccine impact that are modifiable. This evidence will be used in the development of a modelling framework to assess the likely impact of interventions targeting specific determinants of impact, both solely and concertedly, and how these might be tailored to different communities.</ns3:p>

Zorgzaam vaccineren van kinderen. Een nieuwe visie op preventieve zorg!

2025-06-24
Daniël C. M. Huijten , Piet Leroy , Christian J. P. A. Hoebe +1 more | JGZ Tijdschrift voor jeugdgezondheidszorg

Assessment of knowledge and attitudes about vaccination in a population of pregnant women and impact of a training program

2025-06-24
Aslınur Özkaya Parlakay , Bircan Kayaaslan , Gonca TĂŒrker ErgĂŒn +4 more | Human Vaccines & Immunotherapeutics
Vaccination during pregnancy is vital for protecting both maternal and fetal health. A single-center, observational study was conducted with pregnant women attending the antenatal pregnancy school at Ankara City Hospital 
 Vaccination during pregnancy is vital for protecting both maternal and fetal health. A single-center, observational study was conducted with pregnant women attending the antenatal pregnancy school at Ankara City Hospital to assess the effect of maternal immunization training on pregnant women's knowledge and beliefs about vaccines through pre- and post-training evaluations. Participants completed a 26-item, 3-point Likert questionnaire both before and after a 30-minute training session led by specialist physicians. Changes in response rates for each statement were analyzed. Among 583 enrolled women, 308 completed both questionnaires and were included in the analysis. The median age was 28 years, and 90.6% had at least a high school education. The median gestational age was 34 weeks (range: 8-41), with 79.1% in the third trimester, and 49% were primigravida. Vaccination rates during the current pregnancy was reported by 66.6%, with Td (57.8%) as the most common vaccine, followed by Tdap (11.7%), COVID-19 (3.9%), and influenza (1.6%). Healthcare workers were the primary (92.2%) and most trusted (97.4%) source of vaccine information. Significant changes were observed in 23 of 26 post-training questionnaire statements. The most noticeable increase was related to awareness regarding pertussis and influenza vaccines during pregnancy. Concerns about vaccine-related harm during pregnancy also declined. However, general opposition to vaccination remained unchanged. In conclusion, providing education on immunization to pregnant women can improve vaccine knowledge and dispel misconceptions, offering public health benefits. Integrating these educational sessions into routine antenatal care may improve vaccination rates.

Section 230 and social media immunity

2025-06-24
Gregory M. Dickinson | Edward Elgar Publishing eBooks

Impact of the medical briefing and vaccine type on adverse events following COVID-19 vaccination: A randomized clinical trial

2025-06-24
Nora S Beller , Moritz Beller , JĂŒrgen J Murmann +1 more | Vaccine
Adverse events (AE) of varying severity commonly occur after vaccinations, potentially related to the nocebo effect. The randomized single-center clinical trial "LIFe Study" at the Vaccination Center Lichtenfels, Germany, investigates 
 Adverse events (AE) of varying severity commonly occur after vaccinations, potentially related to the nocebo effect. The randomized single-center clinical trial "LIFe Study" at the Vaccination Center Lichtenfels, Germany, investigates AE based on doctor-patient interaction and administered vaccine type following COVID-19 vaccination. Vaccinees receiving first or second doses were randomized: the control group (n=1,006) received in-depth medical briefings elaborating all possible AE; the experimental group (n=937) concise medical briefings comprising only medically relevant facts to the. Nocebo effects were quantified by self-reported AE frequency and severity; then AE across vaccine types and vaccinee demographics were compared including vaccinees receiving third (booster) doses. Questionnaires allowed rating 12 listed AE from absent, mild, moderate, to severe (valued as {0,1,2,3}, respectively), and summed to yield a score ranging from 0 to 36. Most AE were mild with no significant difference in mean AE (mAE) score between control (3.95, σ = 4.70) and experimental groups (3.96, σ = 4.75), nor in the number of participants reporting drug use for symptom relief (ncontrol = 208, nexperimental = 192; p = 0.54), or sick leave (ncontrol = 82, nexperimental = 82; p = 0.32). Higher mAE were associated with follow-up doses of Spikevax compared to Comirnaty, young age (r = -0.15, 95% CI [-0.19; -0.11], p = 9×10-12), and female gender (mAE 5.00, σ = 5.32 vs male 3.05, σ = 3.93). These findings suggest that the nocebo effect was not a significant factor in COVID-19 vaccinations and allow optimization of future vaccination strategies.

Leveraging Community Drug Outlets for Vaccination Delivery in Tanzania: A Qualitative Study to Inform Future Implementation

2025-06-24
George M. Bwire , Goodluck G. Nyondo , Tusaligwe Mbilinyi +3 more
<title>Abstract</title> Objective A prior pre-implementation survey in Tanzania identified moderate feasibility and low acceptability of integrating vaccination services into community drug outlets (CDOs). The qualitative review was conducted to gain 
 <title>Abstract</title> Objective A prior pre-implementation survey in Tanzania identified moderate feasibility and low acceptability of integrating vaccination services into community drug outlets (CDOs). The qualitative review was conducted to gain deeper insight into the factors influencing the feasibility and acceptability of integrating vaccination services into CDOs, such as community pharmacies and Accredited Drug Dispensing Outlets (ADDOs). Methods A descriptive qualitative design was employed as part of an explanatory sequential mixed-methods approach. Interviews were conducted with purposively sampled stakeholders, guided by findings from the prior survey. Interviews were audio-recorded and transcribed verbatim, then thematically analyzed using implementation science frameworks, with coding supported by Nvivo software. Results Six themes emerged: feasibility, acceptability, training, policy, infrastructure, and economics. Community pharmacies were viewed as more feasible and better equipped than ADDOs, which face more severe challenges related to limited space, inadequate cold chain capacity, and insufficient staffing. Acceptability was higher for pharmacies, though both settings (pharmacy and ADDO) require policy, training, and infrastructure improvements. Conclusion Community pharmacies show greater readiness than ADDOs for vaccine delivery due to better infrastructure, professional staffing, and regulatory alignment. However, both face challenges requiring policy reform, training, and support systems. Future studies should assess operational readiness and develop national standards to guide safe, equitable, and sustainable pharmacy-based immunization services.

Preserving Scientific Integrity in Vaccine Policy: The Role of, and Risk to, the CDC's Advisory Committee on Immunization Practices

2025-06-24
Jason M. Goldman , Sandra Adamson Fryhofer | Annals of Internal Medicine

Serologische bepaling mazelen-antistoffen heeft weinig zin

2025-06-24
M. FINOULST , P. VANKRUNKELSVEN , Pierre Van Damme | Tijdschrift voor Geneeskunde

Vaccines and voices

2025-06-23
| Nursing

Vaccines and voices

2025-06-23
Christopher Bynum , Jennifer R. Bail , Suzanne S. Prevost | Nursing
ABSTRACT: Vaccine hesitancy among the adult population may be influenced by sociocultural factors such as socioeconomic status, education level, age, sex, ethnicity, and political affiliation. In this systematic literature review, 
 ABSTRACT: Vaccine hesitancy among the adult population may be influenced by sociocultural factors such as socioeconomic status, education level, age, sex, ethnicity, and political affiliation. In this systematic literature review, the authors explored the impact of sociocultural factors on the acceptance of recommended vaccines in adults.

Hesitação vacinal infantil: fatores contribuintes e a atuação do enfermeiro

2025-06-23
Samla Sena da Silva Souza , Denise Soares de Alcñntara , Daniel L.G. Borges +5 more | OBSERVATÓRIO DE LA ECONOMÍA LATINOAMERICANA
Introdução: A vacinação infantil Ă© uma das estratĂ©gias mais eficazes para a prevenção de doenças e redução da mortalidade, porĂ©m, nos Ășltimos anos, o Brasil tem enfrentado um preocupante queda 
 Introdução: A vacinação infantil Ă© uma das estratĂ©gias mais eficazes para a prevenção de doenças e redução da mortalidade, porĂ©m, nos Ășltimos anos, o Brasil tem enfrentado um preocupante queda na cobertura vacinal. Diversos fatores contribuem para esse cenĂĄrio, sendo a hesitação vacinal um dos principais desafios enfrentados pelos serviços de saĂșde. Objetivo: Identificar os principais fatores que contribuem para a hesitação vacinal infantil e a atuação do enfermeiro frente a essa problemĂĄtica. MĂ©todo: Trata-se de uma revisĂŁo integrativa da literatura, realizada entre abril e maio de 2025. Os dados foram obtidos atravĂ©s das bases de dados LILACS e SciELO por meio da Biblioteca Virtual em SaĂșde (BVS) e Google School e analisados por meio da sĂ­ntese de informaçÔes dos artigos. Resultados: A hesitação vacinal estĂĄ relacionada Ă  desinformação, fake News, barreiras de acesso aos serviços de saĂșde e questĂ”es culturais. A atuação do enfermeiro, por meio de açÔes educativas, busca ativa e fortalecimento do vĂ­nculo com a comunidade, mostra-se essencial para superar esses desafios e ampliar a cobertura vacinal. ConclusĂŁo: O enfermeiro tem papel fundamental na promoção da saĂșde infantil e no enfrentamento da hesitação vacinal.

One Health clinic challenges and evolution: increasing access to care for people and pets in a rural community in Northern California

2025-06-23
Kristin Jankowski , Kimberly Aguirre Siliezar , Jeannie A. Knuchell +3 more | Frontiers in Veterinary Science
A student-run, free One Health clinic (OHC) improves access to care for people and pets while providing increased training opportunities for interprofessional students in the areas of spectrum of care, 
 A student-run, free One Health clinic (OHC) improves access to care for people and pets while providing increased training opportunities for interprofessional students in the areas of spectrum of care, contextualized care, cultural humility, ethical community engagement, and relationship-centered communication when clinical instruction is provided. The coordination and implementation of a community-based student-run free clinic (SRFC) that is also an OHC is complex. Programmatic challenges can include coordination with the leaders of multiple training programs, seasonal variation of student and clinical instructor schedules, and the need to balance student experiential learning with positive client and patient outcomes. Internal evaluations of the clinic's scope of care, patient and provider safety, and student preparedness has led to the development of policies and procedures that consider both student training and the client-patient experience. Widening the OHC provider and student partnership to include human nursing was a novel and effective method to enhance care for the bonded family and create opportunities for interprofessional education (IPE) for students from multiple training programs at a single clinical site.

Vaccination for older people in post-COVID-19 era: challenges and strategies for improvement

2025-06-23
Chit Wai Wong | Asian Journal of Gerontology and Geriatrics

Social Media Users’ Hesitancy Towards Children’s COVID-19 Vaccination

2025-06-23
Hasan Mahmud Faisal , Rubaiya Zannat , Zahedur Rahman Arman | Oxford University Press eBooks
Abstract A growing number of people seek health advice online, adding to vaccine hesitancy and an increase in nonmedical exemptions, despite immunizations demonstrated public health benefits. This study analyzes 196 
 Abstract A growing number of people seek health advice online, adding to vaccine hesitancy and an increase in nonmedical exemptions, despite immunizations demonstrated public health benefits. This study analyzes 196 posts and over 40,000 (41,718) public comments from the CDC Facebook page, exploring the themes, keywords, and sentiment patterns in public discourse concerning COVID-19 vaccines for children. The CDC’s posts exhibit a comprehensive strategy that addresses vaccine availability, safety, benefits, and preventive actions. Conversely, user comments reveal mixed sentiments, reflecting participation, skepticism, and endorsement. Positive engagement emerged in discussions about vaccination and vaccine benefits. However, hesitancy and stakeholder trust featured prominently, with terms like “lie” and “risk” indicating mistrust and resistance fueled by misinformation and safety concerns. Sentiment analysis showed a predominantly positive and trust-oriented narrative in the CDC’s posts, aligning with their goal of promoting vaccine confidence. However, public comments were dominated by negative emotions, with fear, anger, and disgust reflecting significant anxiety and skepticism. Trust and anticipation were less pronounced, indicating a gap in public confidence. Theoretical and practical implications were discussed.

Participant motivators and perceptions of risks and benefits in adult Phase 2/3 COVID-19 vaccine clinical trials

2025-06-23
Bettina Wunderlich , Brittany Feijoo , Rupali J. Limaye +2 more | Human Vaccines & Immunotherapeutics
During the COVID-19 pandemic, recruitment for vaccine clinical trials was conducted quickly and in large numbers. This study was conducted to analyze participant sentiments that were unique in such a 
 During the COVID-19 pandemic, recruitment for vaccine clinical trials was conducted quickly and in large numbers. This study was conducted to analyze participant sentiments that were unique in such a situation. A cross-sectional self-administered electronic survey was completed between May and July 2022 by 163 participants in Phase 2/3 COVID-19 vaccine clinical trials at the Center for Immunization Research in Baltimore, Maryland. Descriptive statistics of participant characteristics, their study experiences, and retrospective perceived risks before and after the study were analyzed. Approximately half of participants were female (52.1%), greater than 55 years old (50.9%), and had a masters or doctoral level degree (58.9%). The majority were White or Caucasian (71.2%) and not of Hispanic, Latino, or Spanish origin (92.6%). 44.2% earned more than $99,999 each year. Most participants joined to obtain protection against COVID-19 (42.3%) or to help others/contribute to science (38.7%). Only 4.3% joined for the money. There was a significant reduction in perceived risk of the study once participants had completed it; 81 (49.7%) participants considered the study less risky at the end compared to before joining, whereas only 2 (1.2%) considered it more risky. Participants in COVID-19 vaccine trials tend to be whiter, more educated, and wealthier than the general population, and perceived the trials riskier prior to participating than once they had completed. While limited by low response rate and recall error, this study suggests that in future emergency situations, messaging should be prioritized to improve understanding of trials and vaccines.

Knowledge, attitude, practice about pneumococcal conjugate vaccines for adults in Vietnam: Where should we start?

2025-06-22
Lindberg Ha , Huu Thang Nguyen , Thanh The Van +5 more | International Journal of Healthcare Management

Multiple deprivations as drivers of suboptimal basic child vaccination in Latin America and the Caribbean: cross-sectional analysis of household survey data for 18,136 children across 211 regions in 15 countries

2025-06-22
Fato Fene , Mira Johri , Murielle Michel +2 more | International Journal for Equity in Health
Latin America and the Caribbean (LAC) maintained high childhood vaccination coverage for 17 years but faced setbacks, increasing vulnerability to vaccine-preventable diseases. Despite signs of recovery, geographic inequalities and social 
 Latin America and the Caribbean (LAC) maintained high childhood vaccination coverage for 17 years but faced setbacks, increasing vulnerability to vaccine-preventable diseases. Despite signs of recovery, geographic inequalities and social deprivations persist. This study provides an up-to-date cross-sectional analysis of prevalence, subnational variation, and key determinants of suboptimal basic child vaccination (BCV). We produced weighted estimates of suboptimal BCV prevalence at the national and subnational levels via harmonized data from household surveys spanning a 12-year period (2011-2022) in the LAC region. Six BCV-related outcomes were analysed: completely unvaccinated, no BCG, no DTP, no OPV, no MCV and not fully vaccinated. We employed a four-level mixed-effects logistic regression to analyse determinants of suboptimal BCV and to partition the total outcome variation over country, region, primary sample units (PSUs) and child‒mother‒household levels. Choropleth maps were used to illustrate the weighted mean prevalence of subnational regions for each outcome. Additionally, sensitivity analyses were performed to validate the findings and assess robustness. A total of 18,136 children aged 12-23 months across 211 subnational regions in 15 LAC countries were analysed. The prevalence of suboptimal BCV ranged from 0.99% completely unvaccinated to 66% not fully vaccinated. Significant subnational disparities were observed: while all subnational regions in Cuba and Costa Rica had consistently low rates of completely unvaccinated children (< 3%), subnational regions or states such as Upper Takutu-Upper Essequibo and Mahaica-Berbice (Guyana) reported much higher rates, reaching 30.23% (95% CI: 9.52-50.94) and 26.56% (95% CI: 11.39-41.73), respectively. Maternal deprivation increased the risk of suboptimal BCV. The prevalence of completely unvaccinated children was significantly greater among those whose mothers did not have institutional delivery (3.35%; 95% CI: 3.07-3.63) than among those whose mothers had institutional delivery (0.74%; 95% CI: 0.70-0.79). The likelihood of suboptimal BCV outcomes increased as health services and socioeconomic deprivation intensified and intersected. In LACs, geographic inequalities and multiple deprivations increase the risk of suboptimal BCV. These countries should prioritize efforts to vaccinate children whose mothers lack access to one or more key health services, especially those from poor families.

Breaking barriers: Implementing pharmacy-based immunisation training in an unauthorised country for preparedness of potential workforce and enhancing public health

2025-06-22
C.H. Kim , See-Won Seo , Hoai-An Truong +3 more | Pharmacy Education
Introduction: In South Korea, pharmacists lack authorisation for immunisation. The imperative for vaccine administration workforce readiness was emphasised by the COVID-19 pandemic. This report aims to share the experiences of 
 Introduction: In South Korea, pharmacists lack authorisation for immunisation. The imperative for vaccine administration workforce readiness was emphasised by the COVID-19 pandemic. This report aims to share the experiences of implementing pharmacy-based immunisation training with other countries contemplating similar endeavors. Methods: Systematic and stepwise approach was applied to implement pharmacy-based immunisation training, which included international faculty collaboration, needs assessment, task force and local support, programme implementation, and feedback assessments. Results: Forty-eight participants were certified and expressed high satisfaction with educational content, speaker engagement, and practical training of injection techniques. They also mentioned the opportunity broadened their insights on global pharmacy activity and advocate expanding the scope of pharmacy practice. Conclusion: This initiative represents significant efforts in advancing pharmacy education and public health preparedness. The aim is to share the experience and insights from this project to provide a model to the pharmacy community of other countries contemplating similar endeavors.

The Role of Personal Social Networks in Parental Decision-Making for HPV Vaccination: Examining Support and Norms Among Florida Parents

2025-06-21
Georges E. Khalil , Carla L. Fisher , Xiaofei Chi +4 more | Vaccines
Background: Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers, yet vaccination rates remain suboptimal, particularly in Florida. Social influence, including family and peer support, may shape parental decisions 
 Background: Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers, yet vaccination rates remain suboptimal, particularly in Florida. Social influence, including family and peer support, may shape parental decisions to vaccinate their children. In this study, we examined the role of social networks (online and offline) in parental intention to vaccinate their 11- to 12-year-old children against HPV. Methods: We conducted a cross-sectional survey among 746 parents in Florida as part of the Text &amp; Talk trial (2022–2023). Among other questions, parents reported on their intention to vaccinate, perceived social norms, and support received from up to three reported confidants. We performed logistic regression and multivariable analyses to assess the relationship between network support, social norms, and vaccination intent. Results: Seventy percent of parents intended to vaccinate their children. Greater support from the first reported confidant was significantly associated with higher vaccination intention (OR = 1.30, p &lt; 0.0001). Perceived norms among friends (p = 0.01) and higher overall network support (p &lt; 0.0001) were also predictive of intent. The higher the percentage of reported family members, the higher the support received for the vaccine (p = 0.04). Conclusions: Social support, particularly from close confidants and peers, plays a critical role in shaping parental HPV vaccination decisions while accounting for perceived social norms. Public health interventions can leverage peer networks alongside family support to enhance HPV vaccine uptake.

Bakuna Eskwela School-Based Immunization Program: Its Implementation and Challenges

2025-06-21
Lyn Caseñas | International Journal of Innovative Research in Engineering & Multidisciplinary Physical Sciences
Abstract The Bakuna Eskwela School-Based Immunization Program aims to increase vaccination coverage among schoolchildren by delivering immunization services within schools, addressing barriers such as limited access to health facilities and 
 Abstract The Bakuna Eskwela School-Based Immunization Program aims to increase vaccination coverage among schoolchildren by delivering immunization services within schools, addressing barriers such as limited access to health facilities and low vaccination rates. This study assessed the program’s implementation level and the challenges encountered by 94 key implementers in Pagadian City, using a descriptive-correlational design with a researcher-made questionnaire. Data were analyzed using mean, standard deviation, and Spearman’s rho. Findings revealed a high overall level of implementation (mean = 3.676), with program design and strategy rated highest, followed by monitoring and evaluation, stakeholder engagement, and capacity building. Challenges encountered were generally low (mean = 2.372), with social and behavioral factors being the most notable. Structural, human resource, and policy/governance challenges were rated low. Statistical analysis showed no significant relationship between the level of implementation and the challenges encountered (Spearman’s rho = 0.014, p = 0.894), indicating that the challenges did not significantly affect program effectiveness. In conclusion, the Bakuna Eskwela program was effectively implemented despite moderate social and behavioral challenges, while other challenges posed minimal disruption. The absence of a significant relationship between challenges and implementation suggests resilience in program execution. These insights can guide stakeholders to enhance support, address social barriers, and improve coordination to sustain and strengthen school-based immunization efforts.

EXPRESS: Fit to Persuade: The Role of Source–Appeal Congruence in Cancer Screening Decisions

2025-06-21
Vedha Ponnappan , Anima Nivsarkar , Prakash Satyavageeswaran +1 more | Journal of Marketing
Despite being preventable and curable, cervical cancer (CC) claimed 350,000 lives globally in 2024 due to the low adoption of CC screening (CCS). An analysis of the institutional context in 
 Despite being preventable and curable, cervical cancer (CC) claimed 350,000 lives globally in 2024 due to the low adoption of CC screening (CCS). An analysis of the institutional context in India revealed a lack of awareness and disempowering sociocultural stigma and norms as two critical barriers. Simultaneously, trustworthy spokespersons emerged as key enablers of CCS adoption. Three incentive-compatible randomized field experiments were conducted to evaluate the fit and effectiveness of message sources ( doctors vs. peers ) and appeal ( informative , highlighting the disease’s mortality risk, vs. empowering , addressing health/CCS-related sociocultural taboos) on CCS adoption. While doctors and peers drive greater adoption than infographics when delivering informational messages, willingness to pay is highest for doctors. However, the highest adoption occurs when peers convey empowering messages. The authors also find that doctors and peers reduce the price sensitivity for CCS, a preventive service, relative to infographics. The research underscores the importance of congruence between credible sources and context-specific message appeals in enhancing adoption. Policymakers can prioritize low-cost, context-specific interventions that address sociocultural barriers by using peers as credible messengers. In India alone, this approach could boost adoption by 36.5% and enable 21.07 million more women to undergo CCS.

Uptake of the COVID-19 vaccine and its association with vaccine information and misinformation in Malawi

2025-06-21
John Songo , Hannah Whitehead , Khumbo Phiri +7 more | Communications Medicine
The information environment may be an important determinant of vaccination and other health behaviors including in low-income countries. We administered a survey to 895 Malawian adults, asking about people's COVID-19 
 The information environment may be an important determinant of vaccination and other health behaviors including in low-income countries. We administered a survey to 895 Malawian adults, asking about people's COVID-19 vaccination history and their exposure to information (information sources and tone of this information) and misinformation (exposure to and belief in conspiracy theories) about the COVID-19 vaccine. Just under half (43%) of respondents had received at least one dose of the COVID-19 vaccine. Respondents heard about the COVID-19 vaccine from a median of 7 sources, most commonly from friends and neighbors, health care workers, and radio (each reported by >90%). Social media are the least positively- or neutrally-framed sources of information; and traditional medicine practitioners are the most common negatively-framed source of information. There is less information access among women, rural residents, and people with lower educational attainment. Many people hear conspiracy theories but say that they do not believe them. Hearing more COVID-19 vaccine information is positively associated with COVID-19 vaccination (aOR 1.09, 95% CI [1.03-1.15]), while believing COVID-19 vaccine misinformation is negatively associated (aOR 0.78, 95% CI [0.68-0.89]). Vaccination programs should communicate through multiple information sources and find ways to reach groups with less information exposure.

Communication interventions to reduce parental vaccine hesitancy: A systematic review

2025-06-21
Sinchul Jwa , Yousuke Imanishi , Marie Ascher +1 more | Vaccine
Vaccine hesitancy among parents and caregivers is a growing issue that can lead to reduced vaccine coverage and corresponding outbreaks of disease. Different interventions to reduce vaccine hesitancy have been 
 Vaccine hesitancy among parents and caregivers is a growing issue that can lead to reduced vaccine coverage and corresponding outbreaks of disease. Different interventions to reduce vaccine hesitancy have been developed, including the use of remote online communication that has become more common during the COVID-19 pandemic, but their impacts and effectiveness are unclear. In this systematic review, we aimed to identify effective types of communication that reduce vaccine hesitancy. Multiple online databases were searched on April 1st, 2022 as well as March 18th, 2024. Included articles studied the impact of communication interventions aiming to reduce vaccine hesitancy among parents and caregivers of young children. Interventions targeting adolescent or adult vaccines were excluded. Potential biases or limitations that may affect the results of each study were evaluated. Out of 3873 identified articles, 33 studies were included in this review, and 25 showed effectiveness. Among the 25 effective communication interventions, 11 were in-person and interactive, 11 were neither in-person nor interactive, 3 were interactive but not in-person, and 2 were in-person but not interactive. Communication interventions can reduce vaccine hesitancy and increase childhood vaccine coverage. Although different types of interventions can reduce vaccine hesitancy and increase childhood vaccine coverage, especially by in-person and interactive communication interventions, further research is needed to elucidate the components that make such interventions impactful in different settings. These findings are particularly relevant for clinicians and public health officials striving to reduce vaccine hesitancy and increase vaccine uptake among children.

Investigation into Knowledge and Adherence To Vaccination and Screening Campaigns among Immigrants in the Marche Region, Central Italy

2025-06-21
Alice Lanari , Emilia Prospero , Inna Kozii +4 more | Journal of Immigrant and Minority Health

Decentralized Immunization Monitoring: Lessons Learnt from a Pilot Implementation in Kumbotso LGA, Kano State, Nigeria

2025-06-20
Adam Attahiru , Yahaya Mohammed , Fiyidi Mikailu +7 more | Vaccines
Background: Immunization coverage in Nigeria is low, with many children missing out on important lifesaving vaccines. To enable a better understanding of contextual factors towards increasing uptake, we piloted a 
 Background: Immunization coverage in Nigeria is low, with many children missing out on important lifesaving vaccines. To enable a better understanding of contextual factors towards increasing uptake, we piloted a Decentralized Immunization Monitoring (DIM) approach in the Kumbotso local government area (LGA) of Kano state, Nigeria, to identify wards with low vaccination rates and understand why this is happening. The findings were used to improve routine immunization (RI) programs and reduce the number of unvaccinated children and children yet to receive their first dose of diphtheria–pertussis–tetanus (DPT) vaccine, referred to as Zero-Dose children (ZD). Methods: This study adopted a cross-sectional design approach using the Behavioural and Social Drivers of Vaccination (BeSD) framework and the Lot Quality Assurance Sampling (LQAS). The study population comprised caregivers of children aged 0–11 months and 12–23 months across the 11 wards in Kumbotso District, Kano State, Nigeria, using a segmentation sampling approach. The study covered 209 settlements selected using probability proportionate to size (PPS) sampling from the wards. Univariate and bivariate analyses were performed to show patterns and relations across variables. Results: Out of 418 caregivers surveyed, 98.1% were female. Delayed vaccination was experienced by 21.9% of children aged 4.5–11 months, while the prevalence of ZD was estimated at 26.8% amongst the older cohort (12–23 months). A total of 71.4% of the delayed group and 89.1% of the ZD group remained unvaccinated. Caregiver education, rural residence, and home births correlated with delayed/ZD status (p &lt; 0.05). Logistic regression associated higher caregiver education with reduced delayed vaccination odds (OR:0.34, p &lt; 0.001) and urban residence with lower ZD odds (OR:1.89, p = 0.036). The antigen coverages of BCG (81.5%), DPT3 (63.6%), and measles 1 (59.7%) all surpassed the national dropout thresholds. Kumbotso, Unguwar Rimi, and Kureken Sani wards were all identified as underperforming and therefore targeted for intervention. Negative vaccine perceptions (50% delayed, 53.6% ZD) and distrust in health workers (46.4% delayed, 48.2% ZD) were significant barriers, though the caregiver intent to vaccinate was protective (OR: 0.27, p &lt; 0.001). The cost of accessing immunization services appeared to have a minor effect on coverage, as the majority of caregivers of delayed and ZD children reported spending less than 200 Naira (equivalent to USD 0.15) on transport. Conclusions: This pilot study highlighted the utility of LQAS and BeSD in identifying low-performing wards, barriers, and routine immunization gaps. Barriers included low caregiver education, rural residence, and negative vaccine perceptions/safety. Caregiver education and urban residence were protective factors against delayed and ZD vaccination, suggesting social and systemic barriers, particularly in rural and less educated populations. Antigen-specific coverage showed disparities, with dropouts for multi-dose vaccines exceeding the national thresholds of 10%. Targeted measures addressing education, trust, and systemic issues are needed. Findings emphasize decentralized monitoring, community engagement, and context-specific strategies to reduce ZD children and ensure equitable vaccination in Nigeria.

Vaccines Against COVID-19 in Peru

2025-06-20
Jose Armando Gonzales Zamora | Infectious Diseases in Clinical Practice

The complex landscape of vaccine hesitancy and hesitant adopters: Quantitative predictors and thematic insights into COVID-19 vaccine attitudes

2025-06-20
Gabriella Annandale , Susanna Kola , Éilish Duke | Human Vaccines & Immunotherapeutics
Vaccine hesitancy is one of the top 10 threats to public health. The COVID-19 pandemic and associated vaccinations marked a watershed moment for vaccine hesitancy, with highly publicized anti-vaccine protests, 
 Vaccine hesitancy is one of the top 10 threats to public health. The COVID-19 pandemic and associated vaccinations marked a watershed moment for vaccine hesitancy, with highly publicized anti-vaccine protests, and widespread misinformation and distrust of the novel vaccines. This mixed-method survey sought to provide a nuanced understanding of vaccine hesitancy and hesitant vaccine adopters in the context of the COVID-19 vaccination. N = 410 participants completed an online survey comprising a battery of psychometric measures of vaccine hesitancy, personality, conspiracy belief, and political affiliation. N = 134 participants, who identified as vaccine hesitant toward the novel vaccine, provided additional written qualitative responses detailing the reasons they were hesitant about accepting the COVID-19 vaccination. Quantitative findings point to higher hesitancy among males, those with high-school and undergraduate levels of education, mixed- and minoritized ethnic groups (Black, Asian), and those higher in Right-Wing Authoritarian and Conspiracy beliefs. Qualitative data unveiled six themes underpinning hesitancy: side-effect concerns; Covid risk perception; conspiracy and religious beliefs; psychological reactance against perceived coercion; a perceived lack of information; and distrust of Government/medical establishments. Crucially, an acknowledgment of the benefits of the vaccine, e.g. in terms of protecting others, distinguished vaccine hesitant adopters from refusers. Implications of the findings are discussed with a view to informing policy and public health campaigns targeting vaccine hesitant adopters.

Truth, Opinions and Beliefs. Can They be Harmonized? An Interview With Dr Thomas Green

2025-06-20
| American Journal of Health Promotion
Are we slipping into a post truth world? Congressional hearings to confirm the appointments of our nation’s top leaders in public health and healthcare were rife with accusations that these 
 Are we slipping into a post truth world? Congressional hearings to confirm the appointments of our nation’s top leaders in public health and healthcare were rife with accusations that these nominees had a history of spreading falsehoods and, worse, they presented with an antipathy toward science writ large. Science organizations, academics and major media outlets alike are debating whether the cost of free speech has become too high. In this editorial, I interview Dr Thomas Green who parses between truths and beliefs and describes the criticality of access to reviewable evidence. Green reviews the genesis of vaccines and vaccine resistance to illustrate how discoveries can be positively transformational but how, even then, truth can and should be challenged when new evidence is found.

Badger vaccination hits record high

2025-06-20
Arabella Gray | Veterinary Record

Perceptions of COVID-19 Vaccines Among the Arab Minority in Israel: A Qualitative Study

2025-06-19
Anwar Khatib , Fareeda Abo‐Rass , Ahmad Khatib | Research Square (Research Square)
<title>Abstract</title> <bold>Background </bold>The COVID-19 pandemic posed substantial challenges globally, with minority populations often disproportionately affected. In Israel, while the national vaccination campaign was widely implemented, vaccination rates among the Arab 
 <title>Abstract</title> <bold>Background </bold>The COVID-19 pandemic posed substantial challenges globally, with minority populations often disproportionately affected. In Israel, while the national vaccination campaign was widely implemented, vaccination rates among the Arab minority remained notably low. This disparity is attributed to a combination of socio-economic disadvantage, cultural barriers, and deep-seated mistrust in governmental institutions. Despite these challenges, limited qualitative research has explored the specific perceptions and lived experiences of this population regarding COVID-19 vaccination. <bold>Methods </bold>This qualitative study employed semi-structured, in-depth interviews with 36 Arab citizens of Israel, selected via snowball sampling across diverse regions. Data collection adhered to a rigorously developed interview protocol and was conducted by trained interviewers. Analysis was based on a combined approach of thematic analysis and content analysis to identify both nuanced themes and frequency-based patterns. The analytical process followed Braun and Clarke’s framework and included measures to ensure validity, including peer debriefing, reflexivity, and back-translation of quotes. <bold>Results </bold>Three distinct perception profiles emerged from the data. The first group held highly positive views of vaccination, citing trust in medical authorities and a sense of civic responsibility. The second group expressed ambivalence, driven by concerns over vaccine safety, the speed of development, and mixed public messaging. The third group displayed overtly negative perceptions, rooted in mistrust toward state institutions, cultural influences, and misinformation. These attitudes were shaped by demographic factors such as age, education, and socio-economic status. <bold>Conclusions </bold>The findings highlight a continuum of vaccine perceptions among the Arab minority in Israel, shaped by intersecting cultural, structural, and informational factors. Trust—both institutional and interpersonal—emerged as a key determinant of vaccine acceptance. To enhance public health outcomes, future interventions must incorporate culturally sensitive strategies, ensure Arabic-language accessibility, and engage trusted community leaders. This study underscores the need for inclusive, equity-focused public health policies that address systemic barriers to vaccination in minority populations.

Connaissances, attitudes et pratiques des parents d’enfants de 12 Ă  24 mois sur la vaccination dans la RĂ©gion Maritime au Togo en 2023

2025-06-19
Yao Kataa , Kokou Ayamekpe , M. Assih +7 more | Journal of Interventional Epidemiology and Public Health
Introduction : La baisse des couvertures vaccinales notifiĂ©es dans la RĂ©gion Maritime ces trois derniĂšres annĂ©es constitue un vĂ©ritable problĂšme de santĂ© publique. L’étude vise Ă  dĂ©crire les Connaissances, Attitudes 
 Introduction : La baisse des couvertures vaccinales notifiĂ©es dans la RĂ©gion Maritime ces trois derniĂšres annĂ©es constitue un vĂ©ritable problĂšme de santĂ© publique. L’étude vise Ă  dĂ©crire les Connaissances, Attitudes et Pratiques des parents d’enfants de 12 -24 mois sur la vaccination dans la RĂ©gion Maritime au Togo en 2023. MĂ©thodes : Une enquĂȘte transversale analytique menĂ©e auprĂšs de 709 parents d’enfants a Ă©tĂ© rĂ©alisĂ©e dans la rĂ©gion Maritime du 24 fĂ©vrier au 8 juin 2023.Un questionnaire conçu sur KoboCollect a Ă©tĂ© administrĂ© pour collecter les donnĂ©es et la mĂ©thodologie de VARKEVISSER : « Bonne Connaissance » pour une proportion ≄ 80% et ˂ 80% = « Mauvaise Connaissance » ; une « Bonne Attitude/Pratique » lorsque la proportion ≄ 60% et « Mauvaise Attitude/Pratique » pour des valeurs &lt; 60%. Nous avons calculĂ© les proportions avec leurs intervalles de confiance Ă  95% et la moyenne avec son Ă©cart type. Les facteurs associĂ©s avec un p≀0,2 ont Ă©tĂ© introduits dans le modĂšle de rĂ©gression logistique ascendant. Une association Ă©tait considĂ©rĂ©e comme statistiquement significative pour une valeur de p˂0,05. RĂ©sultats : Au total, 709 parents/tuteurs d’enfants ont participĂ© Ă  notre enquĂȘte. L’ñge moyen Ă©tait de 32 ± 10 ans. La plupart des enquĂȘtĂ©s ont le niveau secondaire (36,8%), mariĂ©s (92,7%) et exerçant une profession libĂ©rale (66,3%). Parmi 65,7% des participants, 86,8% avaient une bonne connaissance de la vaccination et 38,8% connaissaient l’ñge de la fin du calendrier vaccinal. Avoir plus de 40 ans est associĂ© Ă  la meilleure pratique vaccinale (ORa=0,7 ; IC Ă  95% : 0,60-0,93) ; p &lt; 0,011). Conclusion : La faible couverture vaccinale est induite par la nĂ©gligence des parents d’enfants bien qu’ils aient une bonne connaissance et une attitude positive face Ă  la vaccination. English Abstract Introduction: The decline in vaccination coverage reported in the Maritime Region over the past three years is a serious public health issue. The study aims to describe the knowledge, attitudes and practices of parents of children aged 12–24 months regarding vaccination in the Maritime Region of Togo in 2023. Methods: A cross-sectional analytical survey of 709 parents of children was conducted in the Maritime Region from 24 February to 8 June 2023. A questionnaire designed on KoboCollect was administered to collect data, using the VARKEVISSER methodology: ‘Good Knowledge’ for a proportion ≄ 80% and ˂ 80% = ‘Poor Knowledge’; ‘Good Attitude/Practice’ when the proportion ≄ 60% and ‘Poor Attitude/Practice’ for values &lt; 60%. We calculated the proportions with their 95% confidence intervals and the mean with its standard deviation. Factors associated with p≀0.2 were introduced into the ascending logistic regression model. An association was considered statistically significant for a p˂0.05 value. Results: A total of 709 parents/guardians of children participated in our survey. The average age was 32 ± 10 years. Most respondents had a secondary education (36.8%), were married (92.7%) and were self-employed (66.3%). Among 65.7% of participants, 86.8% had good knowledge of vaccination and 38.8% knew the age at which the vaccination schedule ends. Being over 40 years of age is associated with better vaccination practices (ORa=0.7; 95% CI: 0.60-0.93); p &lt; 0.011). Conclusion: Low vaccination coverage is caused by the negligence of parents of children, even though they have good knowledge and a positive attitude towards vaccination. Keywords: Knowledge, Attitudes and Practices, Parents/guardians, childhood vaccination, vaccination coverage, Togo

The lived experience of guatemalan lay midwives’ interaction with communities and families regarding COVID and the vaccine

2025-06-19
Kimberly Garcia , Cheryl A. Armstrong , Eli Iacob +1 more | Health Care For Women International
Misinformation about COVID and the vaccine are rampant in Guatemala. Insights are needed from community leaders regarding public perceptions of the pandemic to inform effective interventions. Thus, 210 lay midwives 
 Misinformation about COVID and the vaccine are rampant in Guatemala. Insights are needed from community leaders regarding public perceptions of the pandemic to inform effective interventions. Thus, 210 lay midwives participated in 11 focus groups. Participants shared the knowledge, practices, and attitudes of their families and communities about COVID-19 and the vaccine. Five themes emerged. Myths about the vaccine abound. Guatemalans use traditional remedies to treat COVID, have faith in God to cure them, and mistrust hospital care. The virus impacted cities more than rural areas. Integrating cultural viewpoints with modern information would build trust among Guatemalans regarding COVID-19.

Evaluation of Interventions to Improve Vaccination Coverage Among Children Aged 12–23 Months in Urban Slum Areas of Bangladesh Using the WHO Interactive Evidence to Decision (iEtD) Framework: A Stakeholder Perspective

2025-06-19
Kazi Fayzus Salahin , Wit Wichaidit , Quazi Monirul Islam +1 more | Evaluation & the Health Professions
Childhood vaccination is the most cost-effective public health intervention; however, coverage in slum-like areas remains a significant challenge because of unique socio-economic disparities and logistical barriers. We aimed to evaluate 
 Childhood vaccination is the most cost-effective public health intervention; however, coverage in slum-like areas remains a significant challenge because of unique socio-economic disparities and logistical barriers. We aimed to evaluate the interventions from the literature on improving vaccination coverage among children aged 12-23 months in slum areas using the WHO iEtD framework and the TOPSIS-Entropy method for decision-making in Bangladesh and identify stakeholders ranks and felt needs of interventions across study slums. This cross-sectional study was conducted in six slums in two city corporation areas in Dhaka, Bangladesh involving 67 demand-side and 35 supply-side stakeholders. Rating scores ranged from 0 to 1, indicating priority interventions. Our study highlights that demand-side stakeholders favour incentive interventions, whereas supply-side stakeholders support multicomponent strategies. For all stakeholders, educational interventions were ranked highest with a score of 0.745, followed by multicomponent interventions (score 0.666), incentive (score 0.651), and reminder/recall scoring (score 0.305). Educational interventions were identified as a shared priority (common ground), addressing the felt needs of both demand- and supply-side stakeholders. These findings support tailored context-specific approaches to enhance vaccination coverage and child health in vulnerable communities.

Somalia reinforces routine immunisation

2025-06-19
Manjulika Das | The Lancet Infectious Diseases

New vaccine panelists have published little on vaccines

2025-06-19
Martin Enserink , Meredith Wadman | Science
RFK Jr.’s purge of key advisory committee represents a major loss of expertise, as measured by scientific papers RFK Jr.’s purge of key advisory committee represents a major loss of expertise, as measured by scientific papers

Corrigendum: Examining psychological correlates of vaccine hesitancy: a comparative study between the US and Israel

2025-06-19
Nicolle Simonovic , Anat Gesser‐Edelsburg , Jennifer M. Taber | Frontiers in Public Health

The Australian Immunisation Register (AIR): Insights from working with AIR data

2025-06-19
Brynley Hull , A. Hendry , Frank Beard +1 more | Health Information Management Journal
Background: The Australian Childhood Immunisation Register (ACIR), established in 1996, captures details of vaccinations given to children aged &lt;7 years, expanded in 2016 to the whole-of-life Australian Immunisation Register (AIR). 
 Background: The Australian Childhood Immunisation Register (ACIR), established in 1996, captures details of vaccinations given to children aged &lt;7 years, expanded in 2016 to the whole-of-life Australian Immunisation Register (AIR). Objective: Overview of ACIR/AIR, how health information captured is managed and how AIR data facilitate insights into vaccination reporting trends. Method: The authors, with 58 years of collective experience in analysing and interpreting ACIR/AIR data, reviewed formal and grey literature relevant to ACIR/AIR and their operation and use. We analysed AIR data to document how data transmission to AIR and vaccination provider settings has evolved. Results: We describe policy and program changes instrumental to the ACIR-AIR expansion, AIR data fields, methodology for measuring population-level vaccination coverage, and ways data are used for: monitoring and evaluation of immunisation programs; public health surveillance; linked data analyses; vaccine effectiveness studies and other research. We show evidence of changing vaccination landscape including increasing trends in electronic data transmission (e.g. proportion of vaccinations given to children aged &lt;10 years and notified to ACIR/AIR using practice management software increased from 56% in 2014 to 89% in 2023) and increase in vaccinations given in pharmacies (e.g. proportion of influenza vaccinations given to adults aged 20–64 years in pharmacies increased from 0.9% in 2017 to 26.9% in 2023). Conclusion: The AIR has been instrumental in monitoring and evaluating the reach and impact of Australia’s publicly funded immunisation programs across the life course. Implications for health information management practice: Health information managers working with vaccination data contribute to the AIR through data management and upload to the AIR.

Improving human papillomavirus vaccination coverage in France: a need to act but not to rush

2025-06-19
Nathalie Thilly , Morgane Michel , SĂ©bastien Bruel +7 more | Nature Communications

Drivers of HPV vaccine hesitancy in New York and Florida

2025-06-19
Kaitlin Quirk Brumbaugh , Alexandre de Figueiredo , Frances R Gellert +4 more | Vaccine
This study aimed to identify drivers of HPV vaccine hesitancy and effective public health interventions to increase HPV vaccination rates in two U.S. states (New York and Florida) and 12 
 This study aimed to identify drivers of HPV vaccine hesitancy and effective public health interventions to increase HPV vaccination rates in two U.S. states (New York and Florida) and 12 counties within each state. The findings provide insights into the impact of demographics, state policies, and vaccine confidence on HPV vaccination. We utilized a mixed-method approach, integrating quantitative analysis of county-level surveys, qualitative interviews, and secondary data on HPV vaccine coverage. Surveys, adapted from the Vaccine Confidence Project (VCP) and the World Health Organization (WHO), assessed HPV vaccine confidence, socio-demographics, and behavioral determinants. Interviews explored barriers, interventions, and policies related to HPV vaccination. Parents and providers have not prioritized HPV vaccination compared to other vaccines, with less concern about HPV than other vaccine-preventable diseases. Socio-demographic factors, such as race, age, gender, religion, employment, and income impacted children's vaccination status. Female parents aged 35-44 and those with a professional degree were more likely to vaccinate their children. Perceptions of the vaccine's importance and safety significantly influenced vaccination. Identifying socio-demographic determinants and behavioral motivators can guide targeted interventions. Our study highlights complex factors influencing HPV vaccination at the state and county level, offering policymakers strategies to tailor interventions addressing barriers and hesitancy in areas with lower vaccination rates.

Attitudes towards conventional and non-conventional medical approaches and their relation to COVID-19 vaccination: Insights from Germany

2025-06-18
Alexander Patzina , Miriam TrĂŒbner , Judith Lehmann +3 more | Vaccine
The main objective of this study is to investigate whether different medical attitudes relate to COVID-19 vaccination uptake and approval of vaccine mandates. The theory of planned behavior and the 
 The main objective of this study is to investigate whether different medical attitudes relate to COVID-19 vaccination uptake and approval of vaccine mandates. The theory of planned behavior and the health belief model suggest that individual attitudes towards medical approaches are important for vaccination uptake. We use data from a German online cross-sectional study comprising 4065 respondents conducted between September and October in 2022 on the use and acceptance of five pre-defined medical approaches: conventional medicine, Traditional European Medicine (Naturheilkunde), complementary medicine, integrative medicine, and alternative medicine. The two main outcome measures are: (1) COVID-19 vaccination uptake, differentiating between (a) rejected, (b) socially pressured and (c) endorsed vaccination; (2) attitudes towards mandatory COVID-19 vaccination, i.e., whether or not individuals endorse vaccination mandates. We employ logistic and multinomial logistic regressions to calculate average marginal effects (AME) and to account for the influence of different medical attitudes and for confounding variables. While vaccination uptake in general is high (91.0 % in the analytical sample), our multivariate results reveal that individuals with a positive disposition towards Traditional European Medicine (AME = 0.05; p < 0.01) and alternative medicine (AME = 0.02; p < 0.10) were, comparatively, more likely to reject COVID-19 vaccination. A positive disposition towards conventional medicine is associated with higher vaccination uptake (AME = 0.17; p < 0.001). Positive attitudes towards alternative medicine correlate with increased levels of feeling socially pressured into accepting the vaccination (AME = 0.05; p < 0.01). Approval levels for universal mandatory vaccination are low (43.9 %). Positive attitudes towards alternative (AME = -0.03; p < 0.1) and Traditional European Medicine (AME = -0.04; p < 0.05) negatively correlate with approval of vaccination mandates, while positive attitudes towards conventional medicine (AME = 0.05; p < 0.01) increase approval. Our findings suggest that different medical attitudes are simultaneously associated with vaccination uptake and mandate approval. This provides important knowledge for policy makers when designing vaccination schemes and for health professionals when consulting their heterogeneous group of patients.

[Factors influencing COVID-19 vaccine hesitancy among healthcare workers in Switzerland].

2025-06-18
Adélia Gschwend , Valentine Mach-Perrot , Gina Sobral +4 more | PubMed
During the COVID-19 pandemic, Switzerland adopted a strongly recommended but non-mandatory vaccination policy, respecting self-determination. Healthcare professionals (HCPs) were among the first to receive the vaccine. This literature review highlighted 
 During the COVID-19 pandemic, Switzerland adopted a strongly recommended but non-mandatory vaccination policy, respecting self-determination. Healthcare professionals (HCPs) were among the first to receive the vaccine. This literature review highlighted individual (gender, age, vaccination history, risk perception, social norms, and moral convictions) and contextual factors (trust in the government, recommendations from other HCPs, and media information) influencing HCPs' vaccination decisions in Switzerland. Understanding these factors offers opportunities to tailor vaccination measures during health crises.