Political Ideologies, Government Trust, and COVID-19 Vaccine Hesitancy in South Korea: A Cross-Sectional Survey

This study aimed to assess the correlation between political ideologies, government trust, and COVID-19 vaccine hesitancy in South Korea during the COVID-19 pandemic. A cross-sectional survey was conducted among South Korea’s general population and 1000 respondents (aged 18 years and older) were included. We used multivariate logistic regression models to identify the factors associated with vaccine hesitancy. Respondents who self-identified as liberal or held “no political opinion” had higher rates of vaccine hesitancy than conservative respondents. People’s trust in the government’s countermeasures was associated with vaccination. Respondents who had risk perceptions (affective and cognitive) of COVID-19 had lower rates of vaccine hesitancy. Perceptions that the vaccine was not safe and being aged 18–29, 30–39, or 40–49 were associated with a higher probability of vaccine hesitancy. This study found that even if vaccine safety and risk perceptions toward COVID-19 were adjusted, self-rated political ideologies and government trust was associated with COVID-19 vaccine hesitancy. More effort to communicate with those who are conservative, younger, and have lower level of trust in the government are required to dissolve vaccine hesitancy. Further studies should analyze the mechanism of COVID-19 vaccine uptake for effective herd immunity.

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COVID-19 vaccine hesitancy among Ethiopian healthcare workers

PLoS ONE ◽

10.1371/journal.pone.0261125 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261125

Author(s):

Rihanna Mohammed ◽

Teklehaimanot Mezgebe Nguse ◽

Bruck Messele Habte ◽

Atalay Mulu Fentie ◽

Gebremedhin Beedemariam Gebretekle

Keyword(s):

Healthcare Workers ◽

Addis Ababa ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

International Firms ◽

The Government ◽

Regional Health Authorities

Introduction COVID-19 poses significant health and economic threat prompting international firms to rapidly develop vaccines and secure quick regulatory approval. Although COVID-19 vaccination priority is given for high-risk individuals including healthcare workers (HCWs), the success of the immunization efforts hinges on peoples’ willingness to embrace these vaccines. Objective This study aimed to assess HCWs intention to be vaccinated against COVID-19 and the reasons underlying vaccine hesitancy. Methods A cross-sectional survey was conducted among HCWs in Addis Ababa, Ethiopia from March to July 2021. Data were collected from eligible participants from 18 health facilities using a pre-tested semi-structured questionnaire. Data were summarized using descriptive statistics and multivariable logistic regression was performed to explore factors associated with COVID-19 vaccine hesitancy. A p<0.05 was considered statistically significant. Results A total of 614 HCWs participated in the study, with a mean age of 30.57±6.87 years. Nearly two-thirds (60.3%) of HCWs were hesitant to use the COVID-19 vaccine. Participants under the age of 30 years were approximately five times more likely to be hesitant to be vaccinated compared to those over the age of 40 years. HCWs other than medical doctors and/or nurses (AOR = 2.1; 95%CI; 1.1, 3.8) were more likely to be hesitant for COVID-19 vaccine. Lack of believe in COVID-19 vaccine benefits (AOR = 2.5; 95%CI; 1.3, 4.6), lack of trust in the government (AOR = 1.9; 95%CI; 1.3, 3.1), lack of trust science to produce safe and effective vaccines (AOR = 2.6; 95%CI; 1.6, 4.2); and concern about vaccine safety (AOR = 3.2; 95%CI; 1.9, 5.4) were also found to be predictors of COVID-19 vaccine hesitancy. Conclusion COVID-19 vaccine hesitancy showed to be high among HCWs. All concerned bodies including the ministry, regional health authorities, health institutions, and HCWs themselves should work together to increase COVID-19 vaccine uptake and overcome the pandemic.

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Willingness, beliefs, and barriers regarding the COVID-19 vaccine in Saudi Arabia: a multiregional cross-sectional study

BMC Family Practice ◽

10.1186/s12875-021-01606-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Noura Altulahi ◽

Shouq AlNujaim ◽

Azzam Alabdulqader ◽

Abdullah Alkharashi ◽

Assaf AlMalki ◽

...

Keyword(s):

Saudi Arabia ◽

Herd Immunity ◽

Vaccine Safety ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Considerable Proportion ◽

Cross Sectional ◽

High School Degree ◽

Validated Questionnaire

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.

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Assessment of COVID-19 vaccine hesitancy among Zimbabweans: A rapid national survey

10.1101/2021.06.24.21259505 ◽

2021 ◽

Author(s):

Paddington T Mundagowa ◽

Samantha N Tozivepi ◽

Edward T Chiyaka ◽

Fadzai Mukora-Mutseyekwa ◽

Richard Makurumidze

Keyword(s):

Chronic Disease ◽

Healthcare Worker ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Effective Vaccine ◽

Multivariable Logistic Regression Analysis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government ◽

Vaccine Information

Background: To minimize the devastating effects of the coronavirus disease 2019 (COVID 19) pandemic, scientists hastily developed a vaccine. However, the scaling up of the vaccination is likely to be hindered by the widespread social media misinformation. We, therefore, conducted a study to assess the COVID 19 vaccine hesitancy among Zimbabweans. Methods: We conducted a descriptive online cross-sectional survey using a self administered questionnaire among adults. The questionnaire assessed willingness to be vaccinated; sociodemographic characteristics, individual attitudes and perceptions, effectiveness, and safety of the vaccine. Multivariable logistic regression analysis was utilized to examine the independent factors associated with vaccine uptake. Results: We analyzed data for 1168 participants, the age range of 19 to 89 years with the majority being females (57.5%). Half (49.9%) of the participants reported that they would accept the COVID 19 vaccine. The majority were uncertain about the effectiveness of the vaccine (76.0%) and its safety (55.0%). About half lacked trust in the government s ability to ensure the availability of an effective vaccine and 61.0% mentioned that they would seek advice from a healthcare worker to vaccinate. Age 55 years and above [vs 18 to 25 years Adjusted Odds Ratio (AOR): 2.04, 95% Confidence Interval (CI): 1.07 to 3.87], chronic disease [vs no chronic disease AOR: 1.72, 95%CI: 1.32 to 2.25], males [vs females AOR: 1.84, 95%CI: 1.44 to 2.36] and being a healthcare worker [vs not being a health worker AOR: 1.73, 95%CI: 1.34 to 2.24] were associated with increased likelihood to vaccinate. History of COVID 19 infection [vs no history - AOR: 0.45, 95%CI: 0.25 to 0.81) and rural residence [vs urban - AOR: 0.64, 95%CI: 0.40 to 1.01] were associated with reduced likelihood to vaccinate. Conclusion: We found half of the participants willing to vaccinate against COVID-19. The majority lacked trust in the government and were uncertain about vaccine effectiveness and safety. The policymakers should consider targeting geographical and demographic groups which were unlikely to vaccinate with vaccine information, education, and communication to improve uptake.

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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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Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin

Vaccines ◽

10.3390/vaccines9060682 ◽

2021 ◽

Vol 9 (6) ◽

pp. 682

Author(s):

Nicolas Vignier ◽

Kepha Brureau ◽

Sybille Granier ◽

Jacques Breton ◽

Céline Michaud ◽

...

Keyword(s):

Public Health ◽

French Guiana ◽

Medical Profession ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Health Concern ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Negative Attitudes

Background: In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (Gamma) variant of concern (VOC), mRNA vaccines have been made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimed to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods: A cross-sectional survey was conducted from January 22 to March 26, 2021 among a sample of HCWs in French Guiana. They were asked about their willingness to get vaccinated against COVID-19 and vaccine hesitancy, vaccine uptake and vaccines attitudes. Factors associated with willingness to get vaccinated have been analyzed with ordinal logistic regression, using Stata software. Results: A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. HCWs were more willing to get vaccine if they were older, were worried about COVID-19 and were confident in the management of epidemic. Conversely, participants were less likely to have been vaccinated or willing to if they were nurses or of another non-medical profession, born in French Guiana, feared adverse effects, or if they did not trust pharmaceutical companies and management of the epidemic by authorities. Conclusion: Negative attitudes towards vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with Gamma VOC. General vaccine hesitancy and concerns about future side effects in particular represent important barriers. Low confidence in government and science are significant in COVID-19 vaccine refusal among non-medical staffs. Public health messaging with information on vaccine safety should be tailored to address these concerns. The specific challenges of HCWs from French Guiana must be taken into account.

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COVID-19 vaccine acceptances and barriers to vaccination in the context of Kerala: a cross-sectional survey

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20212587 ◽

2021 ◽

Vol 8 (7) ◽

pp. 3352

Author(s):

Sreemol Sunil ◽

Anish K. R. ◽

Sreekutty M. J.

Keyword(s):

Vaccine Safety ◽

Cross Sectional Study ◽

Vaccine Hesitancy ◽

Perceived Benefits ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Government Websites ◽

The Government ◽

Trusted Platform

Background: The long-term control of the pandemic COVID-19 pandemic hinges on the uptake of vaccine and high immunization uptake is critical but barriers to immunization exists. Vaccine hesitancy is one of the top 10 threats to global health. Hesitancy will be a challenge to curbing this pandemic. Apt vaccination strategies are very essential to increase vaccine acceptance.Methods: A cross‐sectional study among the population in Kerala where data was collected through an online questionnaire using Google forms and was distributed using social media platforms. Total of 213 data was collected. Study focused on aspects of vaccine communication, preference of COVID-19 vaccine, perceived benefits, and barriers of COVID-19 vaccine acceptance and cues of vaccine.Results: 80.2% of the respondents were willing to get vaccinated. 78.9% of the respondents have taken previous vaccinations by the government. 70 of them trust government health care departments and media (82.2%) is the least trusted platform regarding vaccination. 56.3% are not getting enough information on COVID vaccine safety, while 81.2% of the respondents did not receive negative information. A majority of them (64.3%) relied on official government websites for information. Majority agrees to the perceived benefits of COVID-19. 80.3% are willing to take free vaccination. 46.9 % are willing to pay for COVID vaccine.Conclusions: The scenario in Kerala is positive towards the vaccination drive and majority of them are willing to get vaccinated. But strategies must be made effective in terms of elevating the barriers to vaccination.

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COVID-19 Vaccine Hesitancy Among Medical Students: The Next COVID-19 Challenge in Wuhan, China

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.291 ◽

2021 ◽

pp. 1-22

Author(s):

Xudong Gao ◽

Haiyan Li ◽

Wenjie He ◽

Wen Zeng

Keyword(s):

Medical Students ◽

Health Department ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge Questionnaire ◽

Demographic Questionnaire ◽

Vaccination Decision ◽

The Government

Abstract Objective: The purpose of this study was to explore the level of coronavirus disease 2019 (COVID-19) vaccine hesitancy among medical students in Wuhan, China, and to identify the factors and barriers associated with their vaccination decision. Methods: A cross-sectional survey was launched with 612 medical students recruited by convenience sampling from six universities. Data collection measures mainly included a demographic questionnaire, COVID-19 vaccine knowledge questionnaire, and the vaccine hesitancy scale. Results: A total of 58.2% of medical students reported vaccine hesitancy. The most common reasons for this were worrying about the side effects of vaccines (44.4%), uncertainty about vaccine safety (40.4%), and underestimating the risk of exposure to COVID-19 (27.9%). The main factors associated with COVID-19 vaccine hesitancy among participants were their knowledge about COVID-19 vaccine, training related to COVID-19 vaccines, family address, and education level (P<0.05). Conclusions: The government, health department and universities in China need to work together and actively communicate with vaccine-hesitant students, establish a standardized COVID-19 vaccine course, and provide on-campus vaccination services.

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COVID-19 vaccine hesitancy in underserved communities of North Carolina

PLoS ONE ◽

10.1371/journal.pone.0248542 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0248542

Author(s):

Irene A. Doherty ◽

William Pilkington ◽

Laurin Brown ◽

Victoria Billings ◽

Undi Hoffler ◽

...

Keyword(s):

North Carolina ◽

Health Care Providers ◽

Vaccine Safety ◽

The United States ◽

Vaccine Hesitancy ◽

Care Providers ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Underserved Communities ◽

Safety Concerns

Background In the United States, underserved communities including Blacks and Latinx are disproportionately affected by COVID-19. This study sought to estimate the prevalence of COVID-19 vaccine hesitancy, describe attitudes related to vaccination, and identify correlates among historically marginalized populations across 9 counties in North Carolina. Methods We conducted a cross-sectional survey distributed at free COVID-19 testing events in underserved rural and urban communities from August 27 –December 15, 2020. Vaccine hesitancy was defined as the response of “no” or “don’t know/not sure” to whether the participant would get the COVID-19 vaccine as soon as it became available. Results The sample comprised 948 participants including 27.7% Whites, 59.6% Blacks, 12.7% Latinx, and 63% female. 32% earned <$20K annually, 60% owned a computer and ~80% had internet access at home. The prevalence of vaccine hesitancy was 68.9% including 62.7%, 74%, and 59.5% among Whites, Blacks, and Latinx, respectively. Between September and December, the largest decline in vaccine hesitancy occurred among Whites (27.5 percentage points), followed by Latinx (17.6) and only 12.0 points among Blacks. 51.2% of respondents reported vaccine safety concerns, 23.7% wanted others to get vaccinated first, and 63.1% would trust health care providers about the COVID-19 vaccine. Factors associated with hesitancy in multivariable logistic regression included being female (OR = 1.90 95%CI [1.36, 2.64]), being Black (OR = 1.68 1.16, 2.45]), calendar month (OR = 0.76 [0.63, 0.92]), safety concerns (OR = 4.28 [3.06, 5.97]), and government distrust (OR = 3.57 [2.26, 5.63]). Conclusions This study engaged the community to directly reach underserved minority populations at highest risk of COVID-19 that permitted assessment of vaccine hesitancy (which was much higher than national estimates), driven in part by distrust, and safety concerns.

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

European Journal of Public Health ◽

10.1093/eurpub/ckz187.154 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Massimi ◽

A Rosso ◽

C De Vito ◽

C Marzuillo ◽

V Baccolini ◽

...

Keyword(s):

Ad Hoc ◽

Care Pathway ◽

Herd Immunity ◽

Vaccine Hesitancy ◽

Accurate Information ◽

Teachable Moment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Level Of Knowledge ◽

Childhood Vaccines

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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