scholarly journals ‘I don’t know anybody who said, “oh great, let’s get measles”’: a qualitative study of responses to childhood vaccinations (MMRV) among Orthodox Jews in Jerusalem following the 2018-19 measles outbreaks

2022 ◽  
Author(s):  
Ben Kasstan
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Religious Beliefs ◽  
Childhood Vaccination ◽  
Orthodox Jewish ◽  
Religious Minorities ◽  
Vaccination Uptake ◽  
Household Heads ◽  
Measles Outbreaks ◽  
Vaccine Decision Making

AbstractMeasles outbreaks have emerged among religious minorities in the global north, which cross regional and national boundaries and raise implications for measles elimination targets. Yet, studies are ambiguous about the reasons that underlie non-vaccination in religious populations, and whether and how religious “beliefs” influence vaccine decision-making among populations with suboptimal vaccination coverage. In 2018-19, Israel experienced the largest measles outbreaks in a quarter century – the burden of which disproportionately affected Orthodox Jewish neighbourhoods in Jerusalem. The objective of this study was to explore how Orthodox Jewish households in Jerusalem responded to the measles outbreaks in their neighbourhoods and how they viewed childhood vaccination (MMRV) during a public health emergency.Research methods primarily consisted of 25 in-depth semi-structured interviews conducted with 23 household heads, and 2 public health professionals involved in planning and implementation of vaccination services. Thematic analysis generated five key themes, i) where the issue of sub-optimal vaccination uptake was perceived to be located; ii) how responsive people and services were to the measles outbreaks; iii) the sources of information used in vaccine decisions by religious parents; vi) whether vaccination was deemed a religious issue; and v) how vaccination influenced social relations within religious neighbourhoods.Results demonstrate parental investment in protecting child health, with decisions around vaccination reflecting vaccine efficacy and safety, and the risk of measles transmission. Household heads across all Orthodox Jewish backgrounds were not apathetic towards measles transmission. No religious “beliefs” were identified for non-vaccination among the household heads in this cohort. Rather than relegating suboptimal vaccination uptake among religious minorities and populations as an issue of religious “beliefs,” quality social science research should examine – and clearly convey – how religion influences vaccine decision-making. Such clarity can help to avoid stigmatizing religious minorities and populations, and to plan for appropriate vaccination programmes and promotion campaigns.

scholarly journals Localising Vaccination Services: Qualitative Insights on an Orthodox Jewish Collaboration with Public health during the UK coronavirus Vaccine Programme

2021 ◽  
Author(s):  
Ben Kasstan ◽  
Sandra Mounier-Jack ◽  
Louise Letley ◽  
Katherine M Gaskell ◽  
Chrissy H Roberts ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Implementation Strategies ◽  
Childhood Vaccination ◽  
Orthodox Jewish ◽  
Public Health Services ◽  
Structured Interviews ◽  
Religious Minorities ◽  
Context Specific ◽  
The Uk

AbstractEthnic and religious minorities have been disproportionately affected by the SARS-CoV-2 pandemic and are less likely to accept coronavirus vaccinations. Orthodox (Haredi) Jewish neighbourhoods in England experienced high incidences of SARS-CoV-2 in 2020-21 and measles outbreaks (2018-19) due to suboptimal childhood vaccination coverage. The objective of our study was to explore how the coronavirus vaccination programme (CVP) was co-delivered between public health services and an Orthodox Jewish health organisation.Methods included 28 semi-structured interviews conducted virtually with public health professionals, community welfare and religious representatives, and household members. We examined CVP delivery from the perspectives of those involved in organising services and vaccine beneficiaries. Interview data was contextualised within debates of the CVP in Orthodox (Haredi) Jewish print and social media. Thematic analysis generated five considerations: i) Prior immunisation-related collaboration with public health services carved a role for Jewish health organisations to host and promote coronavirus vaccination sessions, distribute appointments, and administer vaccines ii) Public health services maintained responsibility for training, logistics, and maintaining vaccination records; iii) The localised approach to service delivery promoted vaccination in a minority with historically suboptimal levels of coverage; iv) Co-delivery promoted trust in the CVP, though a minority of participants maintained concerns around safety; v) Provision of CVP information and stakeholders’ response to situated (context-specific) challenges and concerns.Drawing on this example of CVP co-delivery, we propose that a localised approach to delivering immunisation programmes could address service provision gaps in ways that involve trusted community organisations. Localisation of vaccination services can include communication or implementation strategies, but both approaches involve consideration of investment, engagement and coordination, which are not cost-neutral. Localising vaccination services in collaboration with welfare groups raises opportunities for the on-going CVP and other immunisation programmes, and constitutes an opportunity for ethnic and religious minorities to collaborate in safeguarding community health.

Legitimising a ‘Zombie idea’: childhood vaccines and autism

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Rizzi ◽  
K Attwell ◽  
V Casigliani ◽  
J Taylor ◽  
F Quattrone ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Media Coverage ◽  
Economic Benefits ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Childhood Vaccination ◽  
Vaccine Hesitancy ◽  
Scientific Authority ◽  
Immunization Rates

Abstract Background In June 2017 the Italian government made childhood vaccination mandatory following a drop in immunization rates. In the years preceding, two court judgments affirmed a causal link between vaccines and autism. Studies have linked these decisions to internet searches about vaccine-autism, the popularity of 'no-vax' theories, and drops in immunization rates. This paper provides an in-depth case study of both decisions and their impact. Methods We use a synthetic research design reliant on: (i) a systematic collection of primary sources (publicly available and obtained via official access to information requests); (ii) interviews with key actors prominently involved in the two cases or privy to the Italian vaccine-injury compensation regime (iii) a systematic analysis of media coverage. Results Circumstantial and systemic flaws enabled these decisions. Poor trial strategies, insufficient resources and laborious communication practices between arms of government were facilitators. Lack of awareness of the social sensitivity of vaccine issues, underestimation of the phenomenon of vaccine hesitancy, and a tendency to 'think in silos' informed the lack of attention dedicated to the cases. The decisions created false expectations of economic benefits and vindication for families with autistic children, resulting in increased litigation. Systemic flaws exist in the process of appointment of expert consultants acting for the court leading to judicial reliance on false data. Conclusions Lessons learned include greater levels of attention to vaccine cases by the administration and a matured attitude of adjudicating bodies. Two issues remain: (i) the inability of government lawyers to disseminate positive results to counteract unfounded narratives; (ii) flaws in the process of appointing expert consultants advising courts, which remains focused on the fiduciary nature of the relationship, rather than scientific authority. Key messages The Milan and Rimini decisions that directly affected vaccine governance stemmed from a combination of circumstantial decision-making and systemic flaws that still lurk in public health governance. Strategic decision-making that overlooks lower levels of the adjudicative system can lead to significant public health consequences as courts of law and courts of public opinion obey different logics.

The end of religious exemptions from immunisation requirements?

2019 ◽  
Vol 46 (2) ◽  
pp. 114-117
Author(s):  
Gregory L Bock
Keyword(s):  
Public Health ◽  
Religious Beliefs ◽  
Religious Liberty ◽  
The Other ◽  
Middle Ground ◽  
Health Concerns ◽  
Vaccination Rates ◽  
Measles Vaccination ◽  
The One ◽  
Measles Outbreaks

The purpose of this paper is to propose a middle ground in the debate over religious exemptions from measles vaccination requirements. It attempts to strike a balance between public health concerns on the one hand and religious objections on the other that avoids two equally serious errors: (1) making religious liberty an absolute and (2) disregarding religious beliefs altogether. Some think that the issue is straightforward: science has spoken and the benefits to public health outweigh any other concerns. The safety of the community, they say, demands that everybody be vaccinated so that measles outbreaks can be prevented, but such voices often ignore the freedom of religion, which is a mistake. Using Martha Nussbaum’s work on religious liberty, this paper claims that the exemptions should be preserved if a certain level of vaccination rates can be maintained.

scholarly journals Use of Apps to Promote Childhood Vaccination: Systematic Review

10.2196/17371 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e17371 ◽  
Author(s):  
Caroline de Cock ◽  
Michelle van Velthoven ◽  
Madison Milne-Ives ◽  
Mary Mooney ◽  
Edward Meinert
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Mobile Apps ◽  
Information Provision ◽  
Risk Of Bias ◽  
Childhood Vaccination ◽  
Cochrane Central Register ◽  
Mobile Platforms ◽  
Vaccination Rates ◽  
Vaccination Uptake

Background Vaccination is a critical step in reducing child mortality; however, vaccination rates have declined in many countries in recent years. This decrease has been associated with an increase in the outbreak of vaccine-preventable diseases. The potential for leveraging mobile platforms to promote vaccination coverage has been investigated in the development of numerous mobile apps. Although many are available for public use, there is little robust evaluation of these apps. Objective This systematic review aimed to assess the effectiveness of apps supporting childhood vaccinations in improving vaccination uptake, knowledge, and decision making as well as the usability and user perceptions of these apps. Methods PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Education Resources Information Center (ERIC) databases were systematically searched for studies published between 2008 and 2019 that evaluated childhood vaccination apps. Two authors screened and selected studies according to the inclusion and exclusion criteria. Data were extracted and analyzed, and the studies were assessed for risk of bias. Results A total of 28 studies evaluating 25 apps met the inclusion criteria and were included in this analysis. Overall, 9 studies assessed vaccination uptake, of which 4 reported significant benefits (P<.001 or P=.03) of the implementation of the app. Similarly, 4 studies indicated a significant (P≤.054) impact on knowledge and on vaccination decision making. Patient perceptions, usability, and acceptability were generally positive. The quality of the included studies was found to be moderate to poor, with many aspects of the methodology being unclear. Conclusions There is little evidence to support the use of childhood vaccination apps to improve vaccination uptake, knowledge, or decision making. Further research is required to understand the dichotomous effects of vaccination-related information provision and the evaluation of these apps in larger, more robust studies. The methodology of studies must be reported more comprehensively to accurately assess the effectiveness of childhood vaccination apps and the risk of bias of studies. International Registered Report Identifier (IRRID) RR2-10.2196/16929

scholarly journals Use of Apps to Promote Childhood Vaccination: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Caroline de Cock ◽  
Michelle van Velthoven ◽  
Madison Milne-Ives ◽  
Mary Mooney ◽  
Edward Meinert
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Mobile Apps ◽  
Information Provision ◽  
Risk Of Bias ◽  
Childhood Vaccination ◽  
Cochrane Central Register ◽  
Mobile Platforms ◽  
Vaccination Rates ◽  
Vaccination Uptake

BACKGROUND Vaccination is a critical step in reducing child mortality; however, vaccination rates have declined in many countries in recent years. This decrease has been associated with an increase in the outbreak of vaccine-preventable diseases. The potential for leveraging mobile platforms to promote vaccination coverage has been investigated in the development of numerous mobile apps. Although many are available for public use, there is little robust evaluation of these apps. OBJECTIVE This systematic review aimed to assess the effectiveness of apps supporting childhood vaccinations in improving vaccination uptake, knowledge, and decision making as well as the usability and user perceptions of these apps. METHODS PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Education Resources Information Center (ERIC) databases were systematically searched for studies published between 2008 and 2019 that evaluated childhood vaccination apps. Two authors screened and selected studies according to the inclusion and exclusion criteria. Data were extracted and analyzed, and the studies were assessed for risk of bias. RESULTS A total of 28 studies evaluating 25 apps met the inclusion criteria and were included in this analysis. Overall, 9 studies assessed vaccination uptake, of which 4 reported significant benefits (<i>P</i>&lt;.001 or <i>P</i>=.03) of the implementation of the app. Similarly, 4 studies indicated a significant (<i>P</i>≤.054) impact on knowledge and on vaccination decision making. Patient perceptions, usability, and acceptability were generally positive. The quality of the included studies was found to be moderate to poor, with many aspects of the methodology being unclear. CONCLUSIONS There is little evidence to support the use of childhood vaccination apps to improve vaccination uptake, knowledge, or decision making. Further research is required to understand the dichotomous effects of vaccination-related information provision and the evaluation of these apps in larger, more robust studies. The methodology of studies must be reported more comprehensively to accurately assess the effectiveness of childhood vaccination apps and the risk of bias of studies. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16929

The role of vaccines and vaccine decision-making to achieve the goals of the Grand Convergence in public health

Vaccine ◽  
2017 ◽  
Vol 35 ◽  
pp. A10-A15 ◽  
Author(s):  
David C. Kaslow ◽  
Jorge Kalil ◽  
David Bloom ◽  
Gianluca Breghi ◽  
Anna Maria Colucci ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Vaccine Decision Making

Voluntary food fortification policy in Australia: did ‘formal’ stakeholder consultation influence the outcome?

2021 ◽  
Author(s):  
Bronwyn Ashton ◽  
Cassandra Star ◽  
Mark Lawrence ◽  
John Coveney
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Process ◽  
Policy Development ◽  
Food Fortification ◽  
Policy Debate ◽  
Stakeholder Consultation ◽  
Regulatory Decision ◽  
Food Regulation ◽  
Ministerial Council

Summary This research aimed to understand how the policy was represented as a ‘problem’ in food regulatory decision-making in Australia, and the implications for public health nutrition engagement with policy development processes. Bacchi’s ‘what’s the problem represented to be?’ discourse analysis method was applied to a case study of voluntary food fortification policy (VFP) developed by the then Australia and New Zealand Food Regulation Ministerial Council (ANZFRMC) between 2002 and 2012. As a consultative process is a legislated aspect of food regulatory policy development in Australia, written stakeholder submissions contributed most of the key documents ascertained as relevant to the case. Four major categories of stakeholder were identified in the data; citizen, public health, government and industry. Predictably, citizen, government and public health stakeholders primarily represented voluntary food fortification (VF) as a problem of public health, while industry stakeholders represented it as a problem of commercial benefit. This reflected expected differences regarding decision-making control and power over regulatory activity. However, at both the outset and conclusion of the policy process, the ANZFRMC represented the problem of VF as commercial benefit, suggesting that in this case, a period of ‘formal’ stakeholder consultation did not alter the outcome. This research indicates that in VFP, the policy debate was fought and won at the initial framing of the problem in the earliest stages of the policy process. Consequently, if public health nutritionists leave their participation in the process until formal consultation stages, the opportunity to influence policy may already be lost.

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