Compulsory vaccinations for children: Balancing the competing human rights at stake

Vaccination for children has been a controversial topic for decades and lately it has regained particular importance. We have seen an increase in vaccine hesitancy and decrease in vaccine confidence throughout Europe, particularly due to vaccine-safety concerns by parents. Consequently, vaccination rates for children have dropped and this in turn has led to an increased spread of vaccine-preventable infectious diseases, such as measles. As a reaction to this phenomenon of vaccine hesitancy, several European countries have introduced, while others are in the process of introducing, laws making vaccinations compulsory for children for a number of vaccine-preventable childhood diseases. The introduction of such laws affects and gives rise to several competing interests of the parents, the child and the State. Against this background, this article seeks to determine how the European Court of Human Rights should balance the competing human rights that are at stake in cases concerning compulsory vaccinations for children.

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Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

Vaccines ◽

10.3390/vaccines9070713 ◽

2021 ◽

Vol 9 (7) ◽

pp. 713

Author(s):

Cheryl Lin ◽

Jewel Mullen ◽

Danielle Smith ◽

Michaela Kotarba ◽

Samantha J. Kaplan ◽

...

Keyword(s):

Disease Risk ◽

Healthcare Providers ◽

Vaccine Safety ◽

Survey Study ◽

Vaccine Hesitancy ◽

Attitudes And Practices ◽

Inadequate Knowledge ◽

Vaccine Confidence ◽

And Behavior ◽

Demographic Impact

Despite vaccines’ effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers’ (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs‘ role as “trusted messengers” to promote vaccine acceptance.

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Abortion for Foetal Abnormalities in Ireland; The Limited Scope of the Irish Government’s Response to the A, B and C Judgment

European Journal of Health Law ◽

10.1163/15718093-12341260 ◽

2013 ◽

Vol 20 (2) ◽

pp. 117-143 ◽

Cited By ~ 2

Author(s):

Stephen Donoghue ◽

Claire-Michelle Smyth

Keyword(s):

Human Rights ◽

European Convention ◽

Legal Abortion ◽

Member States ◽

Non Invasive ◽

European Court ◽

Margin Of Appreciation ◽

Controversial Topic ◽

The Government ◽

Limited Scope

Abstract Abortion has been a controversial topic in Irish law and one which the Government has been forced to address following the decision of the European Court of Human Rights in A, B and C v. Ireland. The Working Group established to make recommendations have specifically been instructed to deal only with the issues raised in the A, B and C judgment and legislate on the basic of the ‘X case’. This restricted approach calls for legalisation of abortion only where the life of the mother is at risk, a position unique only to Ireland and Andorra within Europe. The vast majority of member states to the European Convention on Human Rights allow for legal abortion on the basis of foetal abnormality and with this emerging consensus the margin of appreciation hitherto afforded by the European Court to member states is diminishing. The advancement and availability of non-invasive genetic tests that can determine foetal abnormalities together with the ruling in R. R. v. Poland leaves Ireland in a precarious position for omitting any reference to foetal abnormalities in any proposed legislation.

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Perceived vaccine safety over time in a vaccine hesitant sample: Impact of pausing due to safety concerns

10.31234/osf.io/csfte ◽

2021 ◽

Author(s):

Thomas Rodebaugh ◽

Madelyn Frumkin ◽

Rachel Garg ◽

Laura LaGesse ◽

Amy McQueen ◽

...

Keyword(s):

Longitudinal Data ◽

Low Income ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Current Effort ◽

Vaccination Rates ◽

Intensive Longitudinal Data ◽

Perceptions Of Safety ◽

Vaccine Availability ◽

Over Time

In the current effort to vaccinate as many people as possible against COVID-19, it has been suggested that events such as the pause in the use of the Janssen vaccine would have a large effect on perceptions of vaccine safety. Further, as vaccination rates slow, there is concern that hesitancy may be stable and difficult to change among those still unvaccinated. We examined both of these issues in our ongoing study of low-income participants. We modeled the intensive longitudinal data provided by 53 individuals. We found the negative, not statistically significant effect of the Janssen pause would be overwhelmed within weeks by the statistically significant increasing perceptions of safety across time. We also observed strong variability in vaccine hesitancy in many participants. Frequent reminders about vaccine availability might catch more people when they are less hesitant, helping increase vaccination rates.

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What Barriers Exist in the Minds of Vaccine-Hesitant Parents, and How Can We Address Them?

Family Medicine ◽

10.22454/fammed.2020.432940 ◽

2020 ◽

Vol 52 (9) ◽

pp. 626-630

Author(s):

Andrew R. Kerrigan ◽

Imane Aitnouri ◽

Jessica Mar ◽

Wayne Altman

Keyword(s):

Vaccine Safety ◽

The United States ◽

Descriptive Statistics ◽

Vaccine Hesitancy ◽

Vaccination Rates ◽

Risks And Benefits ◽

Vaccine Schedule ◽

Study Population ◽

Risk Of Disease ◽

Sexual Concerns

Background and Objectives: Despite substantial health benefits and prolific research efforts to demonstrate safety and increase uptake, vaccine hesitancy has increased dramatically. This study aimed to systematically analyze available literature on vaccine hesitancy in the United States and determine the rationale behind vaccine-hesitant parents and potential interventions. Methods: We conducted a literature search and identified 232 articles; we included 90 after screening. We pulled information from each article using standardized questions for “type of study,” “population,” “specific vaccine,” “reasons for hesitancy,” “hesitancy prevalence,” “attempt at change,” “results of intervention,” and “future interventions.” We created recurrent themes from the data and analyzed these themes via descriptive statistics. Results: Vaccine safety was the most commonly identified reason for vaccine hesitancy amongst studies (50%), followed by not enough information (30%), side effects (26%), low risk of disease (26%), social norms (22%), vaccine schedule (21%), not recommended by doctor (21%), efficacy (18%), cost/access (13%), sexual concerns (12%) and distrust of establishment (7%). Only 20% of papers documented an intervention, and <50% of these reported increased vaccination rates or intent. More research was the most commonly identified next step (49%). Conclusions: Despite large amounts of research on vaccination rates, patients are still reporting not enough information and safety as the most common reasons for vaccine hesitancy. Interventions were few and without promising results. More research was the most suggested intervention. Such research must address concerns of the vaccine-hesitant community, comparing risks and benefits of each vaccination in a longitudinal, coherent, and transparently unbiased fashion.

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Vaccine Hesitancy in the Time of COVID-19: Attitudes and Intentions of Teens and Parents Regarding the COVID-19 Vaccine

Vaccines ◽

10.3390/vaccines10010004 ◽

2021 ◽

Vol 10 (1) ◽

pp. 4

Author(s):

Amy B. Middleman ◽

Judy Klein ◽

Jane Quinn

Keyword(s):

Vaccine Coverage ◽

Vaccine Safety ◽

Negative Influence ◽

Demographic Variables ◽

Vaccine Hesitancy ◽

Vaccination Rates ◽

Time Points ◽

Parental Concerns ◽

The Us ◽

Coverage Rates

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.

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Vaccine hesitancy among healthcare providers during COVID-19 pandemic

European Journal of Public Health ◽

10.1093/eurpub/ckab164.101 ◽

2021 ◽

Vol 31 (Supplement_3) ◽

Author(s):

F Algabbani ◽

A Algabbani

Keyword(s):

Healthcare Providers ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Web Based ◽

Global Health Issue ◽

Vaccine Confidence ◽

And Control

Abstract Public trust in vaccines is a major global health issue. This study aims to assess the vaccine acceptance among healthcare workers and their confidence and hesitancy of the COVID19 vaccine. This was a multicenter cross-sectional survey conducted among healthcare providers in Riyadh, the capital of Saudi Arabia. Data collection was carried out between October and November of 2020 through a web-based survey. COVID19 vaccine hesitancy was assessed using eight structured items adapted from the 5Cs. About 34.6% (95% CI: 27.6%-42.4%) of participants were willing to vaccinate against COVID-19 and 44% (95% CI: 36.5%-51.9%) will recommend the vaccine to their patients. About 45% of participants were neutral regarding vaccine safety and 40% were neutral regarding vaccine effectiveness. Almost 70% believe that the duration of clinical studies of the COVID-19 vaccines affects their confidence in the efficacy and safety of the vaccine. Those who never hesitated or delayed taking any of the recommended vaccination were more likely to be willing to vaccinate COVID-19 (OR 5.46, 95% CI: 2.49-11.98). Assessing the level of vaccine confidence in the population and associated factors will help implement an effective national vaccine program to enhance vaccination uptake and control COVID19 spread during this pandemic. Key messages Vaccine hesitancy is challenging vaccination goals at the national and global level. Hesitancy from the population toward vaccine and concerns regarding its safety and efficacy was observed with the development of a novel vaccine for COVID19 a newly emerged infection.

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Social media and vaccine hesitancy

BMJ Global Health ◽

10.1136/bmjgh-2020-004206 ◽

2020 ◽

Vol 5 (10) ◽

pp. e004206

Author(s):

Steven Lloyd Wilson ◽

Charles Wiysonge

Keyword(s):

Social Media ◽

Vaccination Coverage ◽

Vaccine Safety ◽

Two Dimensions ◽

Vaccine Hesitancy ◽

Annual Data ◽

Data Set ◽

Digital Society ◽

Vaccination Rates ◽

Society Project

BackgroundUnderstanding 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.MethodsWeuse a large-n cross-country regression framework to evaluate the effect ofsocial 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 negative lyoriented 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 ofthe 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.ResultsWe 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.ConclusionThere 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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The anti-vaccination infodemic on social media: a behavioral analysis

10.1101/2020.12.07.20223370 ◽

2020 ◽

Author(s):

Federico Germani ◽

Nikola Biller-Andorno

Keyword(s):

Vaccine Safety ◽

Modern Medicine ◽

Communication Strategy ◽

Vaccine Hesitancy ◽

Donald Trump ◽

Community Based ◽

Health Organizations ◽

Conspiracy Theories ◽

Vaccination Rates ◽

Effective Strategies

AbstractVaccinations are without doubt one of the greatest achievements of modern medicine, and there is hope that they can constitute a solution to halt the ongoing COVID-19 pandemic. However, the anti-vaccination movement is currently on the rise, spreading online misinformation about vaccine safety and causing a worrying reduction in vaccination rates worldwide. In this historical time, it is imperative to understand the reasons of vaccine hesitancy, and to find effective strategies to dismantle the rhetoric of anti-vaccination supporters. For this reason, we analyzed the behavior of anti-vaccination supporters on the platform Twitter. Here we identify that anti-vaccination supporters, in comparison to pro-vaccination supporters, share conspiracy theories and make use of emotional language. We demonstrate that anti-vaccination supporters are more engaged in discussions on Twitter and share their contents from a pull of strong influencers. We show that the movement’s success relies on a strong sense of community, based on the contents produced by a small fraction of profiles, with the community at large serving as a sounding board for anti-vaccination discourse to circulate online. Surprisingly, our data demonstrate that Donald Trump, together with members of his entourage and his closest supporters, are the main drivers of vaccine misinformation on Twitter. Based on these results, we propose to strategically target the anti-vaccination community online through policies that aim at halting the circulation of false information about vaccines. Based on our data, we also propose solutions to improve the communication strategy of health organizations and build a community of engaged influencers that support the dissemination of scientific insights, including issues related to vaccines and their safety.

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Physicians’ Experience with COVID-19 Vaccination: A Survey Study

Healthcare ◽

10.3390/healthcare9121746 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1746

Author(s):

Alina Dima ◽

Ciprian Jurcut ◽

Daniel Vasile Balaban ◽

Valeriu Gheorghita ◽

Ruxandra Jurcut ◽

...

Keyword(s):

Side Effects ◽

Safety Profile ◽

Vaccine Dose ◽

Vaccine Safety ◽

Survey Study ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Rates ◽

Additional Information

Background: COVID-19 vaccine hesitancy remains high in the general population and is the main determinant of low vaccination rates and of the fourth pandemic wave severity in Romania. Additional information is needed to raise awareness over vaccine efficiency and the safety profile. Objective: To assess self-reported experience related to COVID-19 vaccination in Romanian physicians. Design, Setting, and Participants: A cross-sectional, self-administered questionnaire-based survey, distributed online in the period 24 March to 24 May 2021. The survey included 30 cascade questions with skip logic filters. All physicians included filled in the questionnaire voluntarily and anonymously. Not all respondents filled in all questions. Main outcome and measure: Primary outcomes addressed were related to the COVID-19 vaccine safety profile. Results: 407/467 (87.15%) of the respondents’ physicians were fully vaccinated, mostly with the Pfizer—BioNTech (Comirnaty)—BNT162b2 vaccine, with the peak of immunization in January 2021, with almost four-fifths of the study participants. Regarding COVID-19, almost 20% physicians had the infection and one declared COVID-19 re-infection. A number of 48/420 (11.42%) and 47/419 (11.22%) of the vaccinated physicians did not report any side effects after the first or second vaccine dose. However, most of the side effects reported were minor. Only 50/360 (13.88%) physicians reported the vaccine side effects on the dedicated online national platform. Approximately 40% respondents checked the anti-spike SARS-CoV2 antibodies’ titer after complete vaccination, of which two cases reported indeterminate levels. Lower anti-spike SARS-CoV2 antibodies’ titer of 100–1000 times the laboratory limit was more frequent in naive physicians (36.95% versus 14.28%, p = 0.012), moderate titers were similar, while very high levels, more than 10,000 times laboratory limit, were more frequent in physicians with previous COVID-19 infection (2.17% versus 42.85%, p < 0.001). Conclusions and relevance: In this cross-sectional survey study on the COVID-19 vaccination among Romanian physicians, we describe a safety vaccination profile among Romanian physicians.

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Assessing the level and determinants of COVID-19 Vaccine Confidence in Kenya

10.1101/2021.06.11.21258775 ◽

2021 ◽

Author(s):

Stacey Orangi ◽

Jessie Pinchoff ◽

Daniel Mwanga ◽

Timothy Abuya ◽

Mainga Hamaluba ◽

...

Keyword(s):

Public Health ◽

Economic Loss ◽

Vaccine Safety ◽

Cross Sectional Study ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Major Barrier ◽

The Government ◽

Vaccine Confidence ◽

Context Specific

The government of Kenya has launched a phased rollout of COVID-19 vaccination. A major barrier is vaccine hesitancy; the refusal or delay of accepting vaccination. This study evaluated the level and determinants of vaccine hesitancy in Kenya. We conducted a cross-sectional study administered through a phone-based survey in February 2021 in four counties of Kenya. Multivariate logistic regression was used to identify individual perceived risks and influences, context-specific factors, and vaccine-specific issues associated with COVID-19 vaccine hesitancy. COVID-19 vaccine hesitancy in Kenya was high: 60.1%. Factors associated with vaccine hesitancy included: older age, lower education level, perceived difficulty in adhering to government regulations on COVID-19 prevention, less adherence to wearing of face masks, not having ever been tested for COVID-19, no reported socio-economic loss as a result of COVID public-health restriction measures, and concerns regarding vaccine safety and effectiveness. There is a need for the prioritization of interventions to address vaccine hesitancy and improve vaccine confidence as part of the vaccine roll-out plan. These messaging and/or interventions should be holistic to include the value of other public health measures, be focused and targeted to specific groups, raise awareness on the risks of COVID-19 and effectively communicate the benefits and risks of vaccines.

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