scholarly journals Understanding hesitancy around vaccines and vaccination: an umbrella review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Giannakou ◽  
E Vachtsioli

Abstract Background Vaccination has been evaluated and was found to be the most successful and cost-effective interventions to preventing illness and improve health outcomes. However, internationally, an increase in vaccine hesitancy has led to a decrease in vaccination uptake. We conducted an umbrella review to assess the factors related to under-vaccination and non-vaccination from a global perspective. Methods PubMed, EMBASE and Science Direct were searched from inception to December 2019 for systematic reviews and meta-analyses that examined the factors affecting vaccination choices. No restrictions on language, publication date, vaccination type, setting, or population were applied. Narrative and extensive reviews were excluded. A narrative synthesis was undertaken to present the results thematically. Results Twenty-two systematic reviews met the inclusion criteria. The published evidence on this topic shows that, overall, a variety of complex factors exist related to vaccine hesitancy. Across all articles included, the main areas of concern were around vaccine safety and efficacy. Mistrust towards vaccine-related bodies (e.g. pharmaceutical companies, health professionals, researchers etc.), inconvenience, cost, and overall lack of information/knowledge were also identified as major barriers to vaccine uptake. Barriers vary depending on population, place and vaccines. Conclusions Our results show a variety of complex factors influencing the decision to accept, delay or reject some or all vaccines, indicating the necessity of a multi-faceted approach to address them in order to improve vaccine coverage. Key messages The results of this review show that concerns regarding vaccine safety and efficacy were the most significant barriers. Further research, policies, programs, and community-driven initiatives are needed to enhance acceptability and uptake of vaccination.

2021 ◽  
Author(s):  
L.D. Willems ◽  
Vernandi Dyzel ◽  
Paula Sterkenburg

Background: A worldwide vaccination program is the chosen strategy against the COVID-19 pandemic. Vaccine hesitancy however, forms a threat because vaccine uptake is voluntary in most countries. Care-professionals of people with intellectual disabilities are exposed to greater risks than other healthcare workers due to the vulnerable group they attend to and the assisted-living facilities in which they often work. Little is still known of the reasons for vaccine hesitancy in this specific group in contrast to those of other healthcare workers. Objective: To provide insight in the intentions and attitudes on COVID-vaccination of healthcare workers, including those who care for people with intellectual disabilities, by means of a scoping review. Methods: The databases that were searched for papers are CINAHL, APA PsycArticles, APA PsycInfo, Web of Science, Semantic Scolar, Prospero, Outbreak Science, Cochrane and Scopus. The search was broadened to healthcare workers in general because only two papers were found on those caring for people with intellectual disabilities. A total of 26 papers were identified concerning the vaccine intentions of 43,199 healthcare workers worldwide. Data were gathered both quantitively and qualitatively. The papers were analysed for all themes regarding vaccine willingness and vaccine hesitancy.Results: The themes that came to light included: percentages of vaccine willingness, predictors of willingness differentiated by 11 sub-themes (mainly profession, age, gender and past vaccine behaviour), attitudes of willingness and hesitancy differentiated by 19 sub-themes (perceived COVID treat and protecting others for willingness, concerns on vaccine safety and efficacy for hesitancy), sources of vaccination information, contextual factors and changes in COVID-19 vaccine acceptance over time and finally, future strategies for interventions. Conclusions: There was overlap in the percentages of vaccination, predictors of vaccine willingness and the attitudes of vaccine willingness and hesitancy between healthcare workers and those caring for people with intellectual disabilities. Vaccine safety and efficacy are the most prominent concerns with regard to vaccine hesitancy. Therefore, future strategies for interventions should address vaccine safety and efficacy. Furthermore, interventions are recommended to be interactive in order to facilitate exchange. Discussion groups that are able to address specific concerns and personal experiences, show to be effective in addressing vaccine hesitancy. Accurate information can also be made more accessible to target groups by promoting videos on social media platforms. Hence, further research is necessary to specify more precisely the attitudes of healthcare workers caring for people with intellectual disabilities and in more countries worldwide.


Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 31
Author(s):  
Celia B. Fisher ◽  
Aaliyah Gray ◽  
Isabelle Sheck

On 29 October 2021, the U.S. FDA authorized the Pfizer-BioNTech COVID-19 (SARS-CoV-2) vaccine for emergency use in children ages 5–11 years. Racial/ethnic minorities have born the greatest burden of pediatric COVID-19 infection and hospitalization. Research indicates high prevalence of parental vaccine hesitancy among the general population, underscoring the urgency of understanding how race/ethnicity may influence parents’ decision to vaccinate their children. Two weeks prior to FDA approval, 400 Hispanic and non-Hispanic Asian, Black, and White parents of children 5–10 years participated in an online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Compared to 31% Black, 45% Hispanic, and 25% White parents, 62% of Asian parents planned to vaccinate their child. Bivariate and multivariate ordinal logistic regression demonstrated race/ethnicity, parental vaccine status, education, financial security, perceived childhood COVID-19 susceptibility and severity, vaccine safety and efficacy concerns, community support, and FDA and physician recommendations accounted for 70.3% of variance for vaccine hesitancy. Findings underscore the importance of multipronged population targeted approaches to increase pediatric COVID-19 vaccine uptake including integrating health science literacy with safety and efficacy messaging, communication efforts tailored to parents who express unwillingness to vaccinate, and interventions developed in partnership with and delivered through existing trusted community coalitions.


2021 ◽  
Author(s):  
Majdi Sabahelzain ◽  
Rik Crutzen ◽  
Mohamed Moukhyer ◽  
Hans Bosma ◽  
Bart van den Borne

BACKGROUND WHO described Vaccine hesitancy in 2019 as one of the top 10 threats to global health in high, and low, and middle-income countries. Various communication approaches have been used to engage the public about vaccines and immunization such as mass media and e-health strategies. With the expansion in the use of communication technologies in health in recent years, websites have increasingly been used to support vaccine acceptance and demand and thus increase vaccine uptake. We recently established a web-based intervention called the Tat3im initiative website in Sudan. It aims to increase uptake of vaccines in Sudan by increasing knowledge and addressing issues related to vaccine hesitancy and vaccine safety in the Arabic language OBJECTIVE This article describes the processes that we used to develop and improve this website including the creation of its content. METHODS These processes were informed by using and combining three sources including, Garrett’s user experience framework as a basis for the development, the WHO Vaccine Safety Net's (VSN) criteria for good information practices (i.e. credibility, content (quality and quantity), design and accessibility criteria), and previous relevant research that assessed the local context in Sudan. RESULTS We found that using such evidence as well as combining the VSN's criteria and previous research findings in the five planes of Garrett's framework enabled us to cover many essential elements of user experience and to address issues related to the website’s strategy and content. CONCLUSIONS As the website may be limited due to the high rates of illiteracy as well as relatively low internet use in Sudan, we suggest using social marketing to promote the use of the website as well as monitoring and evaluating the website and users’ experience using different approaches such as visitor traffic and qualitative measures.


Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1362
Author(s):  
Elena Petrova ◽  
Timothy Farinholt ◽  
Tejas P. Joshi ◽  
Hannah Moreno ◽  
Mayar Al Mohajer ◽  
...  

Vaccine uptake is a multifactor measure of successful immunization outcomes that includes access to healthcare and vaccine hesitancy for both healthcare workers and communities. The present coronavirus disease (COVID-19) pandemic has highlighted the need for novel strategies to expand vaccine coverage in underserved regions. Mobile clinics hold the promise of ameliorating such inequities, although there is a paucity of studies that validate environmental infection in such facilities. Here, we describe community-based management of COVID-19 through a Smart Pod mobile clinic deployed in an underserved community area in the United States (Aldine, Harris County, TX, USA). In particular, we validate infection control and biological decontamination of the Smart Pod by testing surfaces and the air-filtration system for the COVID-19 virus and bacterial pathogens. We show the Smart Pod to be efficacious in providing a safe clinical environment for vaccine delivery. Moreover, in the Smart Pod, up-to-date education of community healthcare workers was provided to reduce vaccine hesitancy and improve COVID-19 vaccine uptake. The proposed solution has the potential to augment existing hospital capacity and combat the COVID-19 pandemic locally and globally.


2021 ◽  
Author(s):  
Linda C. Karlsson ◽  
Anna Soveri ◽  
Stephan Lewandowsky ◽  
Linnea Karlsson ◽  
Hasse Karlsson ◽  
...  

The behavioral immune system is considered to be a psychological adaptation that decreases the risk of infection. Research suggests that, in the current environment, this system can produce attitudes with negative health consequences, such as increased vaccine hesitancy. In three studies, we investigated whether two facets of the behavioral immune system—contamination aversion (i.e., avoiding potential contamination) and perceived infectability (i.e., perceived susceptibility to disease)—predicted intentions to accept COVID-19, influenza, and measles or general childhood vaccinations. Both contamination aversion and perceived infectability were higher during than before the pandemic. In contrast to previous research, those with higher contamination aversion during the pandemic perceived vaccines to be safer and had higher intentions to accept vaccination. Contamination aversion before the pandemic was not associated with perceived vaccine safety or vaccination intentions during the pandemic. Individuals who perceived themselves as more susceptible to diseases were slightly more willing to accept vaccination. We conjecture that high disease threat reverses the relationship between the behavioral immune system response and vaccination. As the associations were weak, individual differences in contamination aversion and perceived infectability are of little practical relevance for vaccine uptake.


Author(s):  
Youssef Ali Alqahtani ◽  
Khalid Hussein Almutairi ◽  
Yahya Mohammed Alqahtani ◽  
Ahmed Hussein Almutlaq ◽  
Anas Ali Asiri

Objectives: Vaccination is the provision of a vaccine to initiate immunity trough stimulating immune system to develop protection from a certain disease. When a sufficiently large proportion of a population has been vaccinated, herd immunity initiated. The effectiveness of vaccination has been widely studied and verified. Although the harsh vaccine safety systems, some parents remain minded regarding the safety of the childhood vaccines and immunization schedule. These hesitations pushed some parents to not allow their children to receive some or all the scheduled vaccines.  The aim of the study is to assess the general population awareness regarding vaccines and to detect prevalence of vaccine hesitancy in Aseer region, southern of Saudi Arabia. Methods: A descriptive cross-sectional approach was used targeting all parents in Aseer region. Data were collected using structured questionnaire which developed by the researchers after intensive literature review and expert’s consultation. The questionnaire data included parents’ socio-demographic data, parents’ awareness regarding child vaccines safety and efficacy, parents’ attitude and adherence to children vaccination and hesitancy towards vaccines. Results: The survey included 796 participants whose ages ranged from 18 to 55 years old. Two thirds (63.4%) of the participants were females. Regarding vaccination adherence and hesitancy among participants, more than three quarters were completely adherent to the child vaccination schedule and only 3.9% were non adherent. As for participants awareness regarding child vaccination safety and efficacy, 89.3% of the respondents agreed on that vaccination keep child healthy, 84.2% reported that child vaccine is safe and effective, 83.4% said that all Saudi scheduled vaccines are effective. Conclusion: In conclusion, the study revealed that vaccine hesitancy among participants was not low and should be considered irrespective of their high awareness level. The recorded antivaccine action was mostly related to vaccines safety not efficacy. Keywords: Vaccine hesitancy, antivaccine movement, parents, awareness, adherence


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Noura Altulahi ◽  
Shouq AlNujaim ◽  
Azzam Alabdulqader ◽  
Abdullah Alkharashi ◽  
Assaf AlMalki ◽  
...  

Abstract Background The coronavirus disease 2019 (COVID-19) has spread worldwide, and the vaccine remains the ultimate cornerstone to overcoming its long-term impact. Vaccine hesitancy might obstruct the effort to achieve herd immunity and eradicate the virus. We assessed Saudi Arabian individuals’ willingness, beliefs, and barriers regarding the COVID-19 vaccine and their adherence to preventive measures during and after the pandemic. Methods A self-administered electronic validated questionnaire was distributed among the five major regions in Saudi Arabia between November and December 2020. The questionnaire addressed the sociodemographic data, beliefs, potential barriers, parents’ acceptance of COVID-19 vaccination for their children, and adherence to protective measures during and after the pandemic. Results Of 8,056 participants, 4,218 (52.4%) of a non-representative sample were willing to be vaccinated against COVID-19. Being a young adult, male, having less than a high school degree, being a smoker, having a chronic disease, and having a history of seasonal influenza vaccine uptake were positive predictors of COVID-19 vaccine acceptance. Hesitant participants reported concerns about vaccine side effects and safety as the main barriers to accepting the COVID-19 vaccine. Some refusers (26.1%) declared that they would reconsider vaccination only if the safety and effectiveness of the vaccine were reported by more studies. Conclusions Our study revealed a promising willingness to accept the vaccine among the population, with positive beliefs and attitudes toward COVID-19 vaccination. However, a considerable proportion of the population was reluctant to accept the vaccine. Thus, publicly providing information about vaccine safety and implementing health education programs is crucial for increasing the public’s confidence in the vaccine.


Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 4
Author(s):  
Amy B. Middleman ◽  
Judy Klein ◽  
Jane Quinn

To assess attitudes and intentions related to the COVID-19 vaccine during the pandemic, we surveyed adolescents aged 13–18 years and the parents of 13–18-year-olds using national research panels on three occasions or “waves”: before the COVID-19 vaccine was available, after it was available for adults, and after it was available for ages ≥12 years. Data on experiences with COVID-19, the importance of adolescent vaccines, and intentions regarding COVID-19 vaccination were analyzed across time points. We found that parental concerns about vaccine safety significantly increased from Wave 1 to 2. Social media had a negative influence on parents’ and adolescents’ opinions about vaccine safety. Demographic variables were associated with vaccination rates reported in Wave 3, consistent with known inequities related to vaccine access. Parents (70%) were supportive of concomitant COVID-19 vaccination with other adolescent vaccines for teens. It is important to address variables associated with vaccine hesitancy to increase COVID-19 vaccine coverage rates in the US.


2021 ◽  
Author(s):  
Gina S. Ogilvie ◽  
Shanlea Gordon ◽  
Laurie W. Smith ◽  
Arianne Albert ◽  
C. Sarai Racey ◽  
...  

AbstractObjectiveThe success of any COVID-19 vaccine program ultimately depends on high vaccine uptake. This study determined overall intention to receive a COVID-19 vaccine and identified factors that predict intentions to be vaccinated against COVID-19 in Canada.MethodsIndividuals from research cohorts from the general population of British Columbia aged 25-69 were invited complete an online survey based on validated scales and theoretical frameworks to explore intention to receive a COVID-19 vaccine. Two multivariable logistic regression models were conducted to determine factors associated with intention to receive the COVID-19 vaccine.ResultsOf 4,528 respondents, 79.8% intended to receive a COVID-19 vaccine. In multivariable modeling, respondents who intended to receive the vaccine had higher vaccine attitudinal scores (p <0.001), reported greater influence of direct social norms (p = 0.001), and indirect social norms, including their family physician (p = 0.024), and Provincial Health Officer (p = 0.011). Older individuals (>60 years) were more likely to intend to receive the vaccine, while females (95%CI 0.57,0.93), those with less than high school education (95%CI 0.5,0.76), those who self-identified as non-white (95%CI 0.60,0.92), self-identified as Indigenous (95%CI 0.36,0.84) and essential non-health care workers (95%CI 0.59,0.86) had lower adjusted odds of intending to receive a COVID-19 vaccine.ConclusionsTo optimize vaccine coverage, public health should focus on key messages around vaccine safety and benefit, and leverage trusted practitioners for messaging. As certain key populations report a lower intention to vaccinate, there is a need for in-depth education and support for these communities to ensure optimal uptake.


2021 ◽  
Vol 9 ◽  
Author(s):  
Rajeev Kumar ◽  
Majid Alabdulla ◽  
Nahid M. Elhassan ◽  
Shuja Mohd Reagu

Introduction: Healthcare workers are the critical frontline workforce of the COVD-19 pandemic and are considered a target group for vaccination. Hesitancy to vaccinate is a major concern that can jeopardize the vaccination programme. The hesitancy rates in the general population and healthcare workers (HCWs) vary globally, and more importantly, hesitancy in HCWs is of particular concern, as it can influence the wider population.Materials and Methods: The present study evaluated the vaccine hesitancy rate and its sociodemographic and attitudinal factors among the HCWs in the state of Qatar. We conducted a national cross-sectional survey using a validated hesitancy measurement tool between October 15 and November 15, 2020. A total of 7,821 adults above the age of 18 years out of the 2.3 million adult Qatari residents completed the survey. While majority of the participants were from the general public, 1,546 participants were HCWs. Sociodemographic data, along with attitudes and beliefs around COVID-19 vaccination, were collected from the respondents.Results: We found that 12.9% of the study participants showed vaccine hesitancy, defined as definitely or probably will not take the vaccine if offered, and 25.31% reported that they were unsure about the uptake of the COVID-19 vaccine. Female respondents were more hesitant toward the vaccine. Safety and efficacy concerns of vaccine were the significant predictors of vaccine hesitancy. The primary predictor for vaccine acceptance was a better understanding of the disease and vaccine.Discussion: Overall, 1 in 8 HCWs were reluctant to get vaccinated against COVID-19, mainly due to concerns about the vaccine's efficacy and safety. Education about the vaccine's safety and efficacy can potentially improve acceptance among healthcare workers.


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