Are midwives ready to fight vaccine hesitancy? First results from an Italian cross-sectional study

Abstract Background Pregnancy is widely recognized as a ’teachable moment’ since attitudes and beliefs about childhood vaccines are not completely structured. Among healthcare workers (HCWs), midwives play a pivotal role in the maternal care pathway and should have a key role also in promoting opportunities of discussion and correct information about vaccinations. Methods We conducted a cross-sectional survey to assess knowledge and attitudes of a sample of Italian midwives towards vaccinations. A questionnaire was designed ad hoc and sent electronically to midwives members of the professional register of Rome. Results Preliminary results on data collected from 140 midwives (mean age 37.32, DS ± 11.61; mean years on the job: 11.94 DS ± 12.78) who completed the survey showed a heterogeneous level of knowledge: only 50% of the sample indicated the correct threshold of vaccination coverage for herd immunity, while safety of multiple shots and of the additives contained in vaccines was reported by 61% and 31% of respondents, respectively. Only 41% of midwives had identified the pertussis vaccine as one of the vaccinations recommended during pregnancy. Attitudes were generally positive: 84% of respondents recognized recommended vaccines as effective and 86% as one of the safest health interventions. However, vaccinations against MMR and Varicella were perceived as useful by 86% and 71% of the midwives, while 89% and 77%, respectively, would recommend them to parents (compared to 96% in case of hexavalent). Globally, 79% of respondents would agree with the introduction of mandatory vaccinations for HCWs in maternity wards. Conclusions Midwives show some gaps in the knowledge on vaccinations. The final results of this study will be used to build specific and tailored training programs directed to midwives involved in pregnancy management. This may help them to transfer the correct vaccination information for the empowerment and the growth of vaccine literacy. Key messages Pregnancy is a strategic teachable moment to influence attitudes regarding childhood vaccinations and healthcare professionals must be trained to be the vehicle of the most accurate information. Specific under- and post-graduate training courses on vaccinations directed to midwives are strongly needed to ensure good level of knowledge on this topic.

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1172. SARS-CoV-2 Vaccine Hesitancy in Caregivers of Hospitalized Children

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1365 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S677-S677

Author(s):

Marisa Orbea ◽

Rachel Cunningham ◽

C Mary Healy ◽

Julie A Boom ◽

Claire Bocchini

Keyword(s):

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Hospitalized Children ◽

Parent Attitudes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Acceptance ◽

And Behaviors ◽

Childhood Vaccines ◽

To Receive

Abstract Background SARS-CoV-2 vaccine hesitancy (VH) is hindering nationwide vaccination efforts; little is known about caregiver SARS-CoV-2 vaccine acceptance for children. We aimed to identify associations with SARS-CoV-2 VH in caregivers of hospitalized children. Methods We conducted a prospective cross-sectional survey in English and Spanish of caregiver COVID-19 knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months - 18 years at a large pediatric medical institution. Parents were approached daily, averaging 4-5 days/week, from 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey; PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Responses were categorized. Results 295/307 (96%) of approached caregivers enrolled; 79% were ≥ 30 years, 68% were married/ living with a partner, and 57% had at least some college. 36% identified as white, 19% Black, and 46% Hispanic/ Latino. 53% of caregiver children had public insurance. 91% of caregivers self-reported their children were up to date with routine vaccines. 17% of caregivers were vaccine-hesitant overall. 50% of caregivers were willing to receive COVID-19 vaccine themselves. Figure 1 shows intention to vaccinate their child by PACV score. 65% knew someone who was hospitalized for COVID-19. 67% were scared of their child getting COVID-19. However, 49% were scared of their child getting the vaccine, 28% did not want to vaccinate their child and 27% were neutral in the intention to vaccinate their child. Caregivers who did not intend to vaccinate their child were more likely to be Black (27% vs. 16%, p=0.04) and less likely to be Hispanic/ Latino (33% vs. 49%, p=0.02). Table 1 shows attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and vaccine in caregivers who did or did not intend to vaccinate their child. Figure 1 COVID-19 vaccine uptake by PACV score Table 1 Caregiver attitudes, beliefs, and behaviors surrounding the COVID-19 pandemic and the COVID-19 vaccine Conclusion The majority of caregivers believe that SARS-CoV-2 vaccine will help control the pandemic, but less than half plan to vaccinate their children. A quarter of caregivers expressed uncertainty regarding the vaccine and therefore may be amenable to education and discussion. COVID-19 VH is different from VH towards routine vaccinations. More research is needed to address COVID-19 specific VH. Disclosures C. Mary Healy, MD, Dexcom (Shareholder)Intuitive (Shareholder)Quidel Corporation (Shareholder)Up to Date (Other Financial or Material Support, Honorarium)Vapotherm (Shareholder)

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Parental concerns and uptake of childhood vaccines in rural Tanzania – a mixed methods study

BMC Public Health ◽

10.1186/s12889-020-09598-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lavanya Vasudevan ◽

Joy Noel Baumgartner ◽

Sara Moses ◽

Esther Ngadaya ◽

Sayoki Godfrey Mfinanga ◽

...

Keyword(s):

Mixed Methods ◽

Vaccine Coverage ◽

Mitigation Strategies ◽

Mixed Methods Study ◽

Sub Saharan Africa ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Parental Concerns ◽

Childhood Vaccines

Abstract Background Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania. Methods Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. Vaccination information was obtained from government-issued vaccination cards. Results In the cross-sectional survey, 72% of mothers reported missed or delayed receipt of vaccines for their child. Although vaccine coverage was high, timeliness of vaccinations was lower and varied by vaccine. Rural mothers reported more vaccine-related concerns compared to urban mothers; literacy and access to information were identified as key drivers of the difference. Mothers participating in FGDs indicated high perceived risk of vaccine-preventable illnesses, but expressed concerns related to poor geographic accessibility, unreliability of services, and missed opportunities for vaccinations resulting from provider efforts to minimize vaccine wastage. Conclusions Findings from our cross-sectional survey indicate the presence of vaccination delays and maternal concerns related to childhood vaccines in Tanzania. In FGDs, mothers raised issues related to convenience more often than issues related to vaccine confidence or complacency. Further research is necessary to understand how these issues may contribute to the emergence and persistence of vaccine hesitancy and to identify effective mitigation strategies.

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Prevalence and Determinants of Vaccine Hesitancy in Aseer Region, Saudi Arabia

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.4.2021.023 ◽

2021 ◽

Author(s):

Youssef Ali Alqahtani ◽

Khalid Hussein Almutairi ◽

Yahya Mohammed Alqahtani ◽

Ahmed Hussein Almutlaq ◽

Anas Ali Asiri

Keyword(s):

Saudi Arabia ◽

Demographic Data ◽

Herd Immunity ◽

Vaccine Safety ◽

Vaccination Schedule ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Safety And Efficacy ◽

Childhood Vaccines ◽

Child Vaccination

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

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Factors Associated with COVID-19 Vaccine Intentions in Eastern Zimbabwe: A Cross-Sectional Study

Vaccines ◽

10.3390/vaccines9101109 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1109

Author(s):

Lauren McAbee ◽

Oscar Tapera ◽

Mufaro Kanyangarara

Keyword(s):

Herd Immunity ◽

Vaccine Safety ◽

World Health ◽

Vaccine Hesitancy ◽

Prevention Measures ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Attitudes And Behaviors ◽

And Behaviors

Vaccines are one of the most effective public health strategies to protect against infectious diseases, yet vaccine hesitancy has emerged as a global health threat. Understanding COVID-19 knowledge and attitudes and their association with vaccine intentions can help the targeting of strategies to increase vaccination uptake and achieve herd immunity. The goal of this study was to assess COVID-19 knowledge, attitudes, and behaviors, and identify factors associated with COVID-19 vaccine intentions among heads of households in Manicaland Province, Zimbabwe. A cross-sectional survey was conducted in May 2021 among 551 randomly selected households. Data were collected on socio-demographic characteristics, and knowledge, attitudes, and behaviors regarding COVID-19 and the vaccines. More than half (55.7%) of the respondents reported intending to vaccinate themselves or their households. Multivariate logistic regression indicated that the likelihood of vaccine intentions was most strongly associated with confidence in vaccine safety. Additionally, the odds of intending to get vaccinated were significantly higher among heads of households who were male, had a higher level of education, and identified vaccination and face mask usage as prevention measures. Among perceived motivators to vaccinate, recommendations from the World Health Organization and availability of the vaccine free of charge increased the likelihood of vaccine intentions, while country of vaccine manufacturer posed a barrier to vaccine intentions. As the vaccine rollout in Zimbabwe continues, efforts to increase COVID-19 vaccination coverage and achieve herd immunity should target females and less educated populations and be tailored to address concerns about vaccine safety and country of manufacturer.

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Understanding perception and acceptance of Sinopharm vaccine and vaccination against COVID–19 in the UAE

BMC Public Health ◽

10.1186/s12889-021-11620-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Faheem Ahamed ◽

Subhashini Ganesan ◽

Anila James ◽

Walid Abbas Zaher

Keyword(s):

Survey Design ◽

Herd Immunity ◽

Motivational Factors ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Family Doctors ◽

Health Authorities ◽

The People ◽

Government Websites

Abstract Background In the current COVID-19 pandemic, the world has reached an important milestone where vaccinations are discovered and are proven to be effective against SARS-COV-2 infections. Though vaccines against COVID-19 are now available, around the globe there is some hesitancy in getting the vaccine. This hesitancy to get vaccinated against COVID-19 is a complex phenomenon with various factors playing a role. This study aims at understanding the perception and expectations of the people about COVID-19 vaccine and the factors influencing the vaccine acceptance. This information is crucial to challenge vaccine hesitancy and to win the combat against the COVID-19 Pandemic through voluntary vaccine efforts. Methods A cross-sectional survey among the residents of the UAE to understand the expectations and perception on vaccination against COVID-19. The survey was conducted online, and the survey design included participant samples to be representative of UAE’s demographics. The results of the survey were analysed with various demographical variables of interest. Results The survey showed that people were more likely to get vaccinated when vaccines are (i) endorsed by trusted government health authorities, (ii) recommended by physicians and family doctors, and (iii) the merits are effectively communicated through government websites and trusted news channels. Availability of vaccines at multiple sites and providing vaccines free of charges are likely to improve the rate of vaccination. The perceptions, expectations and the motivational factors needed for people to get vaccinated differed with age, gender, marital status, income level, and employment status. Conclusion To attain herd immunity against COVID-19, a large proportion of the population needs to be vaccinated and to achieve this the vaccination campaigns should target on specific expectations and motivational factors pertaining to each target group to successfully overcome the challenge of vaccine hesitancy.

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Parent attitudes about childhood vaccines: a vaccine hesitancy point prevalence study.

10.1101/2021.07.26.21261018 ◽

2021 ◽

Author(s):

Sarah Marshall ◽

Anne C Moore ◽

Laura J Sahm ◽

Aoife Fleming

Keyword(s):

Side Effects ◽

Vaccine Safety ◽

Vaccination Schedule ◽

Survey Study ◽

Vaccine Hesitancy ◽

Parent Attitudes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Number Of Children ◽

Childhood Vaccines

Abstract Objectives The aim of this study was to measure the prevalence of vaccine hesitancy using Parent Attitudes about Childhood Vaccines (PACV) survey regarding paediatric vaccines for their children, in a population of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Cork, Ireland. Study design Cross-sectional survey study. Methods This study was conducted in November 2018 at the Community Festival of Science STEM event. Eligible attendees were invited to read the participant information leaflet, provide written informed consent, and complete the validated Parent Attitudes about Childhood Vaccines (PACV) survey. Each of the 15 PACV survey items was scored. A score ≥50 identified vaccine hesitant parents. Results A total of 105 parents participated in the study. A small number of participants (6.7%, n = 7) were identified as vaccine hesitant. There were no statistically significant differences between the vaccine hesitant and non-hesitant groups based on age, education, or number of children. Parents had concerns around vaccine side effects (36.2%, n=38) and vaccine safety (20%, n=21). Parents trusted the information they received on vaccines (85.6%, n=90) and 81.9% (n=86) believed that the vaccine schedule was good for their child. Conclusions The findings of this research indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines. Parents had concerns regarding vaccine side effects and the number of vaccines on the paediatric immunisation schedule. Further research is necessary to understand how these issues may contribute to vaccine hesitancy, and to develop evidence-based interventions to build on parents existing trust in the vaccination schedule.

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COVID-19 vaccine hesitancy in perinatal women: a cross sectional survey

Journal of Perinatal Medicine ◽

10.1515/jpm-2021-0069 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Suruchi Mohan ◽

Shuja Reagu ◽

Stephen Lindow ◽

Majid Alabdulla

Keyword(s):

Herd Immunity ◽

Population Group ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Trials ◽

Spss Software ◽

Potential Factors ◽

General Populations ◽

Perinatal Women

Abstract Objectives To explore attitudes to COVID-19 vaccination among perinatal women. Methods A nationwide online, cross-sectional survey was conducted in Qatar from 15th October 2020 to 15th November 2020 with voluntary participation open to all adult residents. Of the respondents, the population group for this study comprised the 341 pregnant and breastfeeding participants. The survey utilized a composite questionnaire incorporating a validated instrument to measure vaccine attitudes. The responses were recorded and analysed with statistical analysis being performed with SPSS software. Outcome measures included intentions towards vaccination and potential factors influencing vaccine hesitancy (contextual factors, vaccine specific concerns and group/individual influences). Results Perinatal women exhibited a vaccine hesitancy rate of 25% towards COVID-19 immunisation. The main concerns of the group were of infection risks and main factor determining vaccine hesitancy was of vaccine specific safety concerns. Previous vaccine “acceptors” showed vaccine hesitancy to COVID-19 immunisation. A third of the group cited non availability of the vaccine as a concern. Conclusions COVID-19 vaccine trials amongst pregnant and lactating women have lagged behind those for general populations and this has compounded concerns around safety in this special group. Perinatal women constitute a vulnerable group and play an important role in vaccination of wider family members. This study highlights the need for trials and data for COVID-19 vaccine in this group to be able to achieve appreciable numbers needed for herd immunity and ultimately control of the pandemic.

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A Cross-Sectional Survey on COVID-19 Vaccine Hesitancy Among Parents From Shandong vs. Zhejiang

Frontiers in Public Health ◽

10.3389/fpubh.2021.779720 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yunyun Xu ◽

Dongjuan Xu ◽

Liyan Luo ◽

Fengqiao Ma ◽

Ping Wang ◽

...

Keyword(s):

Risk Factors ◽

Online Survey ◽

Parental Attitudes ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Safety And Efficacy ◽

Childhood Vaccines ◽

Household Incomes

Introduction: With the approval of COVID-19 vaccinations for children and adolescents in China, parental vaccine hesitancy will emerge as a new challenge with regard to the administration of these vaccines. However, little is known regarding this hesitancy as well as regional differences that may exist between parents from Shandong vs. Zhejiang.Methods: To assess these issues, an online survey was conducted via a Wenjuanxing platform over the period from July 22 to August 14, 2021. Parents from Shandong and Zhejiang were recruited from Wechat groups and results from a total of 917 subjects were analyzed. Factors evaluated in this survey included socio-demographic variables, parental vaccine hesitancy, Parental Attitudes toward Childhood Vaccines (PACV) domains (behavior, safety and efficacy, general attitudes) and social support.Results: Compared with those from Shandong (N = 443), parents from Zhejiang (N = 474) showed significantly higher prevalence rates of COVID-19 vaccine hesitancy (19.4 vs. 11.7%, p = 0.001). Multivariate logistic regression showed that yearly household incomes of ≥120,000 RMB (p = 0.041), medical workers (p = 0.022) and general attitudes of PACV (p = 0.004) were risk factors for vaccine hesitancy among parents from Shandong, while behavior (p = 0.004), safety and efficacy (p < 0.001) and general attitudes of PACV (p = 0.002) were risk factors for parents from Zhejiang. Among parents with vaccine hesitancy (N = 144), concerns over side effects (91.0%) and unknown effects (84.0%) of the COVID-19 vaccine were the most prevalent reasons for hesitancy. Evidence providing proof of vaccine safety (67.4%) and assurance of a low risk of being infected by COVID-19 (60.4%) were the two most effective persuasive factors.Conclusion: Parents from Zhejiang showed a higher prevalence of COVID-19 vaccine hesitancy as compared with those from Shandong. Behavior, safety and efficacy, and general attitudes of PACV were the risk factors associated with this hesitancy in these parents from Zhejiang. Given the identification of the various reasons for parental vaccine hesitancy, different strategies as well as regional adjustments in these strategies will be required for an effective and convincing protocol for childhood vaccinations.

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Misinformation in Germany during the COVID-19 pandemic

10.31234/osf.io/cw2jn ◽

2021 ◽

Author(s):

Christina Leuker ◽

Nadine Fleischhut ◽

Ralph Hertwig ◽

Anastasia Kozyreva ◽

John Gubernath

Keyword(s):

Social Interactions ◽

Vaccine Hesitancy ◽

Strong Increase ◽

Online Media ◽

Accurate Information ◽

Far Right ◽

Cross Sectional Survey ◽

Cross Sectional ◽

High Quality Information ◽

Lower Education

During the COVID-19 pandemic, citizens have been exposed to vast amounts of mis- and disinformation. This “infodemic” has undermined key behavioural and pharmacological measures to contain the pandemic—for instance, by increasing vaccine hesitancy. In a cross-sectional survey of residents of Germany, we investigated citizens’ perceptions of and ability to deal with misinformation across three Waves of data collection in 2020/21 (Ntotal = 3324). We observed three main results. First, there was a strong increase in the perceived prevalence of misinformation in classic and online media and in social interactions over the course of the pandemic. Second, some—but by no means all—respondents knew how to identify misinformation. Third, higher susceptibility to misinformation was associated with support for the far-right AFD party, reliance on tabloids, neighbours and social media for information and news, lower education, as well as migration background. To help people navigate the challenges of the infodemic, we propose a two-pronged approach, namely, to boost individuals’ abilities to discern false from accurate information, and to enrich citizens’ proximate environments (e.g., neighbourhoods with high rates of migration) with reliable, accessible and high-quality information.

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Caregiver Willingness to Vaccinate Their Children against COVID-19 after Adult Vaccine Approval

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910224 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10224

Author(s):

Ran D. Goldman ◽

Danna Krupik ◽

Samina Ali ◽

Ahmed Mater ◽

Jeanine E. Hall ◽

...

Keyword(s):

Regression Models ◽

Vaccination Campaign ◽

Herd Immunity ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Initial Survey ◽

Strategy Design ◽

Near Future

Vaccines against COVID-19 are likely to be approved for children under 12 years in the near future. Understanding vaccine hesitancy in parents is essential for reaching herd immunity. A cross-sectional survey of caregivers in 12 emergency departments (ED) was undertaken in the U.S., Canada, and Israel. We compared reported willingness to vaccinate children against COVID-19 with an initial survey and post-adult COVID-19 vaccine approval. Multivariable logistic regression models were performed for all children and for those <12 years. A total of 1728 and 1041 surveys were completed in phases 1 and 2, respectively. Fewer caregivers planned to vaccinate against COVID-19 in phase 2 (64.5% and 59.7%, respectively; p = 0.002). The most significant positive predictor of willingness to vaccinate against COVID-19 was if the child was vaccinated per recommended local schedules. Fewer caregivers plan to vaccinate their children against COVID-19, despite vaccine approval for adults, compared to what was reported at the peak of the pandemic. Older caregivers who fully vaccinated their children were more likely to adopt vaccinating children. This study can inform target strategy design to implement adherence to a vaccination campaign.

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