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

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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Predictors of COVID-19 Vaccine Acceptance, Intention, and Hesitancy: A Scoping Review

Frontiers in Public Health ◽

10.3389/fpubh.2021.698111 ◽

2021 ◽

Vol 9 ◽

Author(s):

Ashish Joshi ◽

Mahima Kaur ◽

Ritika Kaur ◽

Ashoo Grover ◽

Denis Nash ◽

...

Keyword(s):

Risk Perception ◽

General Population ◽

Vaccine Coverage ◽

Average Rate ◽

Vaccine Safety ◽

Demographic Variables ◽

Vaccine Hesitancy ◽

Vaccine Acceptance ◽

Large Variability ◽

Tailored Interventions

COVID-19 vaccine is regarded as the most promising means of limiting the spread of or eliminating the pandemic. The success of this strategy will rely on the rate of vaccine acceptance globally. The study aims to examine the factors that influence COVID-19 vaccine acceptance, intention, and hesitancy. PubMed was searched comprehensively for articles using the keyword “COVID-19 vaccine surveys.” Of the 192 records, 22 studies were eligible for the review. Eighty-two percent of these studies were conducted among the general population. Gender, age, education, and occupation were some of the socio-demographic variables associated with vaccine acceptance. Variables such as trust in authorities, risk perception of COVID-19 infection, vaccine efficacy, current or previous influenza vaccination, and vaccine safety affected vaccine acceptance. Globally, in March 2020, the average vaccine acceptance observed was 86% which dropped to 54% in July 2020 which later increased to 72% in September 2020. Globally, the average rate of vaccine hesitancy in April 2020 was 21%, which increased to 36% in July 2020 and later declined to 16% in October 2020. Large variability in vaccine acceptance and high vaccine hesitancy can influence the efforts to eliminate the COVID-19. Addressing the barriers and facilitators of vaccines will be crucial in implementing effective and tailored interventions to attain maximum vaccine coverage.

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Faster than warp speed: early attention to COVD-19 by anti-vaccine groups on Facebook

Journal of Public Health ◽

10.1093/pubmed/fdab093 ◽

2021 ◽

Author(s):

Seth C Kalichman ◽

Lisa A Eaton ◽

Valerie A Earnshaw ◽

Natalie Brousseau

Keyword(s):

Social Media ◽

Vaccine Development ◽

Rapid Development ◽

Development Program ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Conspiracy Theories ◽

The Us ◽

Us Government ◽

Vaccine Information

Abstract Background The unprecedented rapid development of COVID-19 vaccines has faced SARS-CoV- (COVID-19) vaccine hesitancy, which is partially fueled by the misinformation and conspiracy theories propagated by anti-vaccine groups on social media. Research is needed to better understand the early COVID-19 anti-vaccine activities on social media. Methods This study chronicles the social media posts concerning COVID-19 and COVID-19 vaccines by leading anti-vaccine groups (Dr Tenpenny on Vaccines, the National Vaccine Information Center [NVIC] the Vaccination Information Network [VINE]) and Vaccine Machine in the early months of the COVID-19 pandemic (February–May 2020). Results Analysis of 2060 Facebook posts showed that anti-vaccine groups were discussing COVID-19 in the first week of February 2020 and were specifically discussing COVID-19 vaccines by mid-February 2020. COVID-19 posts by NVIC were more widely disseminated and showed greater influence than non-COVID-19 posts. Early COVID-19 posts concerned mistrust of vaccine safety and conspiracy theories. Conclusion Major anti-vaccine groups were sowing seeds of doubt on Facebook weeks before the US government launched its vaccine development program ‘Operation Warp Speed’. Early anti-vaccine misinformation campaigns outpaced public health messaging and hampered the rollout of COVID-19 vaccines.

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Practical Approaches to Optimize Adolescent Immunization

10.1542/9781610022774-practical ◽

2018 ◽

pp. 146-165

Author(s):

Henry H. Bernstein ◽

Joseph A. Bocchini

Keyword(s):

American Academy ◽

Health Care Providers ◽

Vaccine Hesitancy ◽

Clinical Report ◽

Immunization Schedule ◽

Vaccination Rates ◽

Immunization Rates ◽

Parental Concerns ◽

Control And Prevention ◽

Adolescent Vaccination

With the expansion of the adolescent immunization schedule during the past decade, immunization rates notably vary by vaccine and by state. Addressing barriers to improving adolescent vaccination rates is a priority. Every visit can be viewed as an opportunity to update and complete an adolescent’s immunizations. It is essential to continue to focus and refine the appropriate techniques in approaching the adolescent patient and parent in the office setting. Health care providers must continuously strive to educate their patients and develop skills that can help parents and adolescents overcome vaccine hesitancy. Research on strategies to achieve higher vaccination rates is ongoing, and it is important to increase the knowledge and implementation of these strategies. This clinical report focuses on increasing adherence to the universally recommended vaccines in the annual adolescent immunization schedule of the American Academy of Pediatrics, the American Academy of Family Physicians, the Centers for Disease Control and Prevention, and the American Congress of Obstetricians and Gynecologists. This will be accomplished by (1) examining strategies that heighten confidence in immunizations and address patient and parental concerns to promote adolescent immunization and (2) exploring how best to approach the adolescent and family to improve immunization rates.

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

Netherlands Quarterly of Human Rights ◽

10.1177/0924051919861797 ◽

2019 ◽

Vol 37 (3) ◽

pp. 245-267

Author(s):

Francesca Camilleri

Keyword(s):

Human Rights ◽

Infectious Diseases ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Childhood Diseases ◽

Vaccination Rates ◽

Competing Interests ◽

European Court ◽

Controversial Topic ◽

Vaccine Confidence

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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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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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: An overview on parents' opinions about vaccination and possible reasons of vaccine refusal

Journal of Public Health Research ◽

10.4081/jphr.2019.1436 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 11

Author(s):

Alessio Facciolà ◽

Giuseppa Visalli ◽

Annalisa Orlando ◽

Maria Paola Bertuccio ◽

Pasquale Spataro ◽

...

Keyword(s):

Developed Countries ◽

Vaccine Hesitancy ◽

Vaccine Preventable Diseases ◽

Vaccination Rates ◽

Vaccine Refusal ◽

Italian City ◽

Real Composition ◽

Coverage Rates ◽

Low Coverage ◽

Design And Methods

Background. Vaccine hesitancy has increased worldwide with a subsequent decreasing of vaccination rates and outbreaks of vaccine-preventable diseases (i.e. measles, poliomyelitis and pertussis) in several developed countries, including Italy. Design and Methods. We conducted a survey to investigate the attitudes of a parents’ sample about vaccinations by the distribution of questionnaires in six lower secondary schools of the Italian city of Messina. Results. Regarding vaccinations carried out on children, the declared vaccination coverage rates ranged widely between good coverage percentages for some vaccinations (Measles-Mumps-Rubella, Diphtheria-Tetanus-Pertussis), and very low coverage rates for others, especially for “new” vaccinations (HPV, meningococcal, pneumococcal). The vaccinations carried out correlated negatively with both parents’ age and their level of education. Moreover, a favourable parents’ opinion was strongly influenced by a favourable opinion of the physician, while an unfavourable parents’ opinion seemed conditioned by a direct or indirect knowledge of people harmed by vaccines. In addition, our data show that parents do not often know or partially know the real composition of the vaccines and the diseases prevented by vaccinations. Conclusions. Data analysis shows that parents are, theoretically, favourable towards vaccinations but have little knowledge of such practices, sometimes not being unaware of the types of vaccines administrated to their children. Health education and communication of correct information are certainly the cornerstones to improve the situation and to fight the widespread and non-grounded fears about vaccines.

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1388. DTaP-containing combination vaccines use and adherence to the recommended infant-toddler vaccination series among privately insured children in the US

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1570 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S704-S704

Author(s):

Matthew M Loiacono ◽

Vitali Pool ◽

Robertus Van Aalst

Keyword(s):

Odds Ratio ◽

Logistic Regression Model ◽

Vaccine Coverage ◽

Combination Vaccine ◽

Infants And Toddlers ◽

Data Mart ◽

The Us ◽

Combination Vaccines ◽

Coverage Rates ◽

Adherence Outcome

Abstract Background Despite universal recommendation of the 3 + 1 diphtheria, tetanus, and pertussis (DTaP) vaccine series in infants and toddlers, adherence (i.e. coverage and timeliness) remain suboptimal in the US. DTaP-containing combination vaccines are presumed to improve vaccine coverage rates and timeliness, but research on this topic is limited. The purpose of this study was to compare adherence to the recommended infant-toddler vaccination series between recipients of DTaP-containing combination vaccines (i.e. quadrivalent/pentavalent) and stand-alone vaccines (i.e. trivalent). Methods We used the Optum de-identified Clinformatics Data Mart database to create a cohort of children born between 2009 and 2016 with > 24 months of continuous enrollment from birth, and records of > 1 DTaP vaccine receipt. Patients were classified by DTaP-containing vaccine receipt: combination vaccines only, stand-alone vaccines only, or a mixture of both. The primary adherence outcome was completion of the 4-dose series within 20 months of life. We adjusted outcomes for gender, birth year, race, and socioeconomic status via a logistic regression model. Results The cohort contained 200,568 female (48.6%) and 211,882 male (51.4%) children. Of these children, 167,091 received combination vaccines only (40.5%), 61,342 received stand-alone vaccines only (14.9%), and 184,017 received a mixture of both (44.6%). Completion of the 4-dose series was highest among children who received combination vaccines only (75.5%), followed by those who received a mixture of vaccines (72.7%) and those who received stand-alone vaccines only (54.5%). Relative to those who received stand-alone vaccines only, adjusted odds of completion were approximately 2.9 times higher among combination vaccine recipients (odds ratio, OR = 2.93 [95% CI: 2.87, 2.98]) and 2.5 times higher among those who received a mixture of vaccines (OR = 2.54 [2.49, 2.59]). Conclusion DTaP-containing combination vaccine use was associated with significantly greater adherence. Although these results warrant further investigation to better understand the determinants of infant vaccination adherence, such evidence may further support preferential recommendations for combination vaccine use. Disclosures Matthew M. Loiacono, MSc, Sanofi Pasteur (Employee) Vitali Pool, MD, Sanofi Pasteur (Employee) Robertus Van Aalst, MSc, Sanofi Pasteur (Employee)

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Vaccine Education in the Library: Lessons Learned from a Hot Topic Program

Children and Libraries ◽

10.5860/cal.18.2.21 ◽

2020 ◽

Vol 18 (3) ◽

pp. 21

Author(s):

Katherine Hickey ◽

Annie Emmons

Keyword(s):

Human Services ◽

Lessons Learned ◽

World Health ◽

Vaccine Hesitancy ◽

Vaccination Rates ◽

Health And Human Services ◽

Department Of Health ◽

The Us ◽

The World ◽

Health Organization

Recent data from the US Department of Health and Human Services indicate a small but growing number of unvaccinated children under the age of two. Low vaccination rates can result in outbreaks of preventable diseases and even death. The World Health Organization (WHO) identified vaccine hesitancy as one of the top ten threats to global health in 2019.

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