Prevalence and Determinants of Vaccine Hesitancy and Vaccines Recommendation Discrepancies among General Practitioners in French-Speaking Parts of Belgium

General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of GPs in the Belgian Wallonia-Brussels Federation (WBF) were to: (1) determine the prevalence and the features of VH, (2) identify the correlates, and (3) estimate the discrepancy in vaccination’s behaviors between the GPs’ children and the recommendations made to their patients. An online survey was carried out among the population of general practitioners practicing in the WBF between 7 January and 18 March 2020. A hierarchical cluster analysis was carried out based on various dimensions of vaccine hesitancy: perception of the risks and the usefulness of vaccines as well as vaccine recommendations for their patients. A total of 251 GPs answered the survey. The average percentage of moderate to high vaccine hesitancy was 50.6%. Three factors were independently associated with increased risk of vaccine hesitancy: an age <50 years old, having no children, and having no contact with selected vaccine-preventable disease (measles, complicated influenza, chronic hepatitis B (HBV), bacterial meningitis, or cervical cancer) in the past 5 years. VH was associated with controversies on vaccines’ safety. GPs who had vaccinated their children against six diseases (MMR, meningococcus C (MenC), HBV, and HPV) tended not to recommend the same vaccines to their patients. Among GPs with all children vaccinated against HBV, only 37.5% recommended catch-up HBV immunization to their patients. In this small cohort of GP, moderate to high VH was associated with controversies on vaccines’ safety and with specific personal characteristics (age <50, no children, and no recent experience with a serious VPD). As previously reported, GPs have different vaccine prescription attitude toward their patients and children. These findings should be confirmed in larger cohorts.

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Prevalence and correlates of vaccine hesitancy among general practitioners: a cross-sectional telephone survey in France, April to July 2014

Eurosurveillance ◽

10.2807/1560-7917.es.2016.21.47.30406 ◽

2016 ◽

Vol 21 (47) ◽

Cited By ~ 29

Author(s):

Pierre Verger ◽

Fanny Collange ◽

Lisa Fressard ◽

Aurélie Bocquier ◽

Arnaud Gautier ◽

...

Keyword(s):

Cluster Analysis ◽

General Practitioners ◽

Health Professionals ◽

Private Practice ◽

Telephone Survey ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Vaccine Preventable Diseases ◽

Attitudes And Practices ◽

Vaccine Recommendations

This article sought to estimate the prevalence of vaccine hesitancy (VH) among French general practitioners (GPs) and to study its demographic, professional and personal correlates. We conducted a cross-sectional telephone survey about GPs’ vaccination-related attitudes and practices in 2014 in a national panel of 1,712 GPs in private practice, randomly selected from an exhaustive database of health professionals in France. A cluster analysis of various dimensions of VH (self-reported vaccine recommendations, perceptions of vaccine risks and usefulness) identified three clusters: 86% of GPs (95% confidence interval (CI): 84–88) were not or only slightly vaccine-hesitant, 11% (95% CI: 9–12) moderately hesitant and 3% (95% CI: 3–4) highly hesitant or opposed to vaccination. GPs in the latter two clusters were less frequently vaccinated and reported occasional practice of alternative medicine more often than those in the first cluster; they also described less experience with vaccine-preventable diseases and more experience with patients who they considered had serious adverse effects from vaccination. This study confirms the presence of VH among French GPs but also suggests that its prevalence is moderate. Given GPs’ central role in vaccination, these results nevertheless call for a mobilisation of stakeholders to address VH among GPs.

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Predicting COVID-19 Vaccination Intention: The Determinants of Vaccine Hesitancy

Vaccines ◽

10.3390/vaccines9101161 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1161

Author(s):

Nuno Fernandes ◽

Daniela Costa ◽

Diogo Costa ◽

José Keating ◽

Joana Arantes

Keyword(s):

Psychological Factors ◽

Online Survey ◽

Herd Immunity ◽

Personal Characteristics ◽

Policy Decision ◽

Vaccine Hesitancy ◽

Attitudes And Beliefs ◽

Linear Regression Models ◽

Domain Specific ◽

Main Determinants

Do people want to be vaccinated against COVID-19? Herd immunity is dependent on individuals’ willingness to be vaccinated since vaccination is not mandatory. Our main goal was to investigate people’s intention to be vaccinated and their intentions to vaccinate their children. Moreover, we were interested in understanding the role of the personal characteristics, psychological factors, and the lockdown context on that decision. Therefore, we conducted an online survey during the lockdown in Portugal (15 January 2021 until 14 March 2021). Participants completed a socio-demographic questionnaire, questions about their intentions of being vaccinated, concerns about the vaccine, a COVID-19 attitudes and beliefs scale, a COVID-19 vaccine attitudes and beliefs scale, and the Domain-Specific Risk-Taking (DOSPERT) Scale. Our results showed that from the 649 participants, 63% of the participants reported being very likely to have the vaccine, while 60% reported being very likely to vaccinate their children. We conducted two linear regression models, explaining 65% of the variance for personal vaccination and 56% of the variance for children vaccination. We found that the COVID-19 vaccine general beliefs and attitudes were the main determinants of vaccination intention. Additionally, our proposed artificial neural network model was able to predict with 85% accuracy vaccination intention. Thus, our results suggest that psychological factors are an essential determinant of vaccination intention. Thus, public policy decision makers may use these insights for predicting vaccine hesitancy and designing effective vaccination communication strategies.

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Coronavirus disease 2019 (COVID-19) vaccine hesitancy among physicians, physician assistants, nurse practitioners, and nurses in two academic hospitals in Philadelphia

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.410 ◽

2021 ◽

pp. 1-9

Author(s):

Safa K. Browne ◽

Kristen A. Feemster ◽

Angela K. Shen ◽

Judith Green-McKenzie ◽

Florence M. Momplaisir ◽

...

Keyword(s):

Nurse Practitioners ◽

Critical Role ◽

Physician Assistants ◽

Medical Doctor ◽

Vaccine Hesitancy ◽

Healthcare Personnel ◽

Clinical Exposure ◽

Academic Hospitals ◽

Increased Risk ◽

To Receive

Abstract Objective: To evaluate coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare personnel (HCP) with significant clinical exposure to COVID-19 at 2 large, academic hospitals in Philadelphia, Pennsylvania. Design, setting, and participants: HCP were surveyed in November–December 2020 about their intention to receive the COVID-19 vaccine. Methods: The survey measured the intent among HCP to receive a COVID-19 vaccine, timing of vaccination, and reasons for or against vaccination. Among patient-facing HCP, multivariate regression evaluated the associations between healthcare positions (medical doctor, nurse practitioner or physician assistant, and registered nurse) and vaccine hesitancy (intending to decline, delay, or were unsure about vaccination), adjusting for demographic characteristics, reasons why or why not to receive the vaccine, and prior receipt of routine vaccines. Results: Among 5,929 HCP (2,253 medical doctors [MDs] and doctors of osteopathy [DOs], 582 nurse practitioners [NPs], 158 physician assistants [PAs], and 2,936 nurses), a higher proportion of nurses (47.3%) were COVID-vaccine hesitant compared with 30.0% of PAs and NPs and 13.1% of MDs and DOs. The most common reasons for vaccine hesitancy included concerns about side effects, the newness of the vaccines, and lack of vaccine knowledge. Regardless of position, Black HCP were more hesitant than White HCP (odds ratio [OR], ∼5) and females were more hesitant than males (OR, ∼2). Conclusions: Although most clinical HCP intended to receive a COVID-19 vaccine, intention varied by healthcare position. Consistent with other studies, hesitancy was also significantly associated with race or ethnicity across all positions. These results highlight the importance of understanding and effectively addressing reasons for hesitancy, especially among frontline HCP who are at increased risk of COVID exposure and play a critical role in recommending vaccines to patients.

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Hesitancy of Arab Healthcare Workers towards COVID-19 Vaccination: A Large-Scale Multinational Study

Vaccines ◽

10.3390/vaccines9050446 ◽

2021 ◽

Vol 9 (5) ◽

pp. 446

Author(s):

Eyad Qunaibi ◽

Iman Basheti ◽

Mohamed Soudy ◽

Iyad Sultan

Keyword(s):

Role Models ◽

Large Scale ◽

Online Survey ◽

Arab World ◽

Arab Countries ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Increased Risk ◽

Vaccine Type ◽

Arabic Speaking

Background: Health care workers (HCWs) are at increased risk of acquiring and transmitting COVID-19 infection. Moreover, they present role models for communities with regards to attitudes towards COVID-19 vaccination. Hence, hesitancy of HCWs towards vaccination can crucially affect the efforts aiming to contain the pandemic. Previously published studies paid little attention to HCWs in Arab countries, which have a population of over 440 million. Objectives: To assess the rates of COVID-19 vaccine hesitancy in Arabic-speaking HCWs residing in and outside Arab countries, and their perceived barriers towards vaccination. Methods: A cross-sectional study based on an online survey was conducted from 14–29 January 2021, targeting Arabic-speaking HCWs from all around the world. Results: The survey recruited 5708 eligible participants (55.6% males, 44.4% females, age 30.6 ± 10 years) from 21 Arab countries (87.5%) and 54 other countries (12.5%). Our analysis showed a significant rate of vaccine hesitancy among Arabic-speaking HCWs residing in and outside of Arab countries (25.8% and 32.8%, respectively). The highest rates of hesitancy were among participants from the western regions of the Arab world (Egypt, Morocco, Tunisia, and Algeria). The most cited reasons for hesitancy were concerns about side effects and distrust of the expedited vaccine production and healthcare policies. Factors associated with higher hesitancy included age of 30–59, previous or current suspected or confirmed COVID-19, female gender, not knowing the vaccine type authorized in the participant’s country, and not regularly receiving the influenza vaccine. Conclusion: This is the first large-scale multinational post-vaccine-availability study on COVID-19 vaccine hesitancy among HCWs. It reveals high rates of hesitancy among Arab-speaking HCWs. Unless addressed properly, this hesitancy can impede the efforts for achieving widespread vaccination and collective immunity.

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Védőoltásokkal kapcsolatos kételyek és elkötelezettség a magyarországi egészségügyi alapellátásban dolgozók körében

Orvosi Hetilap ◽

10.1556/650.2019.31538 ◽

2019 ◽

Vol 160 (48) ◽

pp. 1904-1914 ◽

Cited By ~ 4

Author(s):

Eszter Kun ◽

Angéla Benedek ◽

Zsófia Mészner

Keyword(s):

Primary Care ◽

General Practitioners ◽

Online Survey ◽

Vaccine Hesitancy ◽

Age Related ◽

Primary Care Nurses ◽

Primary Care Doctors ◽

Similar Survey ◽

Vaccine Scares ◽

And Control

Abstract: Introduction: The attitude to immunization and the issue of vaccine hesitancy in health care workers (HCWs) have been studied in a former survey performed by ECDC (European Centre for Disease Prevention and Control). Aim: Our aim was to study the immunization attitude of primary care paediatricians, general practitioners and primary care nurses in Hungary. Method: We studied vaccine hesitancy in HCWs by way of a questionnaire, developed on the basis of a recent similar survey by ECDC in four countries. The online survey has been performed between May and July 2017. Altogether 765 questionnaires have been returned: 189 primary care paediatricians, 375 general practitioners working in adult or mixed practices, and 201 primary care nurses. The sample has been weighted to the country-specific features – e.g., location of the practice, residence and age of the HCWs – within each of the three groups, so from this aspect it can be considered representative. Results: Our results did not differ substantially from the international ECDC data. Approximately 2/3 of the primary care doctors and about 50% of the primary care nurses were convinced of the benefit and value of vaccines. Data on vaccine hesitancy were consolingly low, though the data on recommended vaccines were somewhat higher compared to the age related/NIP (National Immunization Plan) vaccines. The well-known vaccine scares – e.g., autism–MMR, etc., known also from the literature – could hardly been detected, and it can be explained by the voluntary participation in the study. The least supported vaccine is BCG, while the highest hesitancy rates are related to MMR in Hungary. Conclusion: The need to improve immunization-related communication among primary HCWs could clearly been detected – both in gradual and in post-gradual training programs. Orv Hetil. 2019; 160(48): 1904–1914.

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Hesitancy of Arab Healthcare Workers Towards COVID-19 Vaccination: A Large-Scale Multinational Study

10.20944/preprints202104.0236.v2 ◽

2021 ◽

Author(s):

Eyad Qunaibi ◽

Iman Basheti ◽

Mohamed Soudy ◽

Iyad Sultan

Keyword(s):

Role Models ◽

Large Scale ◽

Online Survey ◽

Arab World ◽

Arab Countries ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Increased Risk ◽

Vaccine Type ◽

Arabic Speaking

Background: Health Care Workers (HCWs) are at increased risk of acquiring and transmitting COVID-19 infection. Also, they present role models for communities with regards to attitudes towards COVID-19 vaccination. Hence, hesitancy of HCWs towards vaccination can crucially affect the efforts aiming to contain the pandemic. Previously published studies paid little attention to HCWs in Arab countries, which has a population of over 440 million. Objectives: to assess the rates of COVID-19 vaccine hesitancy in Arabic-speaking HCWs residing in and outside the Arab countries, and their perceived barriers towards vaccination. Methods: a cross-sectional study based on an online survey was conducted from 14-Jan 2021 to 29-Jan 2021, targeting Arabic-speaking HCWs from all around the world. Results: the survey recruited 5,708 eligible participants (55.6% males, 44.4% females, age 30.6±10 years) from 21 Arab countries (87.5%) and 54 other countries (12.5%). Our analysis shows a significant rate of vaccine hesitancy among Arabic-speaking HCWs residing in and outside Arab countries (25.8% and 32.8%, respectively). The highest rates of hesitancy were among participants from the west region of the Arab world (Egypt, Morocco, Tunisia, and Algeria). The most cited reasons for hesitancy were concerns about side effects and distrust in vaccine expedited production and healthcare policies. Factors associated with higher hesitancy included age of 30-59, previous or current suspected or confirmed COVID-19, female gender, not knowing the vaccine type authorized in the participant’s country, and not regularly receiving the influenza vaccine. Conclusion: this is the first large-scale, multinational, post-vaccine-availability study on COVID-19 vaccine hesitancy among HCWs. It reveals high rates of hesitancy among Arab-speaking HCWs. Unless addressed properly, this hesitancy can impede the efforts for achieving widespread vaccination and collective immunity.

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Hesitancy of Arab Healthcare Workers Towards COVID-19 Vaccination: A Large-Scale Multinational Study

10.20944/preprints202104.0236.v1 ◽

2021 ◽

Author(s):

Eyad Qunaibi ◽

Iman Basheti ◽

Mohamed Soudy ◽

Iyad Sultan

Keyword(s):

Role Models ◽

Large Scale ◽

Online Survey ◽

Arab World ◽

Arab Countries ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Increased Risk ◽

Vaccine Type ◽

Arabic Speaking

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BRAZILIAN PHYSICIANS’ PRACTICES ON THE MANAGEMENT OF SYMPTOMS SUGGESTING GASTROESOPHAGEAL REFLUX DISEASE: A MULTIDISCIPLINARY SURVEY

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202000000-74 ◽

2020 ◽

Vol 57 (4) ◽

pp. 404-408

Author(s):

Decio CHINZON ◽

Joaquim Prado P MORAES-FILHO ◽

Gerson DOMINGUES ◽

Fabiana ROVEDA ◽

Abner Augusto LOBÃO NETO ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

General Practitioners ◽

Reflux Disease ◽

Clinical Guidelines ◽

Online Survey ◽

Lifestyle Modifications ◽

Medical Expense ◽

Medical Specialties ◽

Average Percentage

ABSTRACT BACKGROUND: Clinical guidelines are available to steer decisions regarding diagnosis, management and treatment of gastrointestinal disorders. Despite this, variations in physician’s practices regarding gastroesophageal reflux disease (GERD) symptoms are well described in the literature. OBJECTIVE: To describe practices of physicians from different specialties on the management of patients with typical symptoms of GERD (heartburn and regurgitation) in a Brazilian sample. METHODS: National online survey enrolling a sample of general practitioners, gastroenterologists, cardiologists and otolaryngologists. The survey was conducted from August 6th to September 12th, 2018. Subjects answered a structured questionnaire addressing variables regarding physicians’ profile (age, sex, specialty, practice setting, years in practice, type of medical expense reimbursement), their patients characteristics and prescribing behaviors. RESULTS: The final weighted sample was comprised of 400 physicians, 64% male, with an average of 15 years of experience. Physicians’ estimates of gastroesophageal symptoms prevalence among their pool of patients was 37.6% for the total sample, reaching 70.3% among gastroenterologists. The medical specialty with lower average percentage of patients presenting gastroesophageal symptoms was otolaryngology (24.5%). Physicians reported that they request ancillary tests for 64.5% of patients with GERD typical symptoms. The most common diagnostic test was endoscopy (69.4%), followed by video nasolaryngoscopy (16.6%). The percentage of patient to whom endoscopy is performed was significantly higher among gastroenterologists and general practitioners as compared to otolaryngologists and cardiologists, while video nasolaryngoscopy is markedly more frequent among otolaryngologists. In terms of therapeutic options, the most frequently reported strategy was lifestyle modifications followed by proton pump inhibitors. CONCLUSION: Overall patients’ profile and patterns of GERD diagnosis and management seem different between gastroenterologists, general practitioners, otolaryngologists, and cardiologists. Clinical guidelines should address this variability and include other medical specialties besides gastroenterologists in their scope.

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DNA methylome signatures of prenatal exposure to synthetic glucocorticoids in hippocampus and peripheral whole blood of female guinea pigs in early life

Translational Psychiatry ◽

10.1038/s41398-020-01186-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Aya Sasaki ◽

Margaret E. Eng ◽

Abigail H. Lee ◽

Alisa Kostaki ◽

Stephen G. Matthews

Keyword(s):

Dna Methylation ◽

Whole Blood ◽

Guinea Pigs ◽

Critical Role ◽

Methylation Status ◽

Peripheral Tissues ◽

Epigenetic Biomarkers ◽

Differentially Methylated Genes ◽

Increased Risk ◽

Synthetic Glucocorticoids

AbstractSynthetic glucocorticoids (sGC) are administered to women at risk of preterm delivery, approximately 10% of all pregnancies. In animal models, offspring exposed to elevated glucocorticoids, either by administration of sGC or endogenous glucocorticoids as a result of maternal stress, show increased risk of developing behavioral, endocrine, and metabolic dysregulation. DNA methylation may play a critical role in long-lasting programming of gene regulation underlying these phenotypes. However, peripheral tissues such as blood are often the only accessible source of DNA for epigenetic analyses in humans. Here, we examined the hypothesis that prenatal sGC administration alters DNA methylation signatures in guinea pig offspring hippocampus and whole blood. We compared these signatures across the two tissue types to assess epigenetic biomarkers of common molecular pathways affected by sGC exposure. Guinea pigs were treated with sGC or saline in late gestation. Genome-wide modifications of DNA methylation were analyzed at single nucleotide resolution using reduced representation bisulfite sequencing in juvenile female offspring. Results indicate that there are tissue-specific as well as common methylation signatures of prenatal sGC exposure. Over 90% of the common methylation signatures associated with sGC exposure showed the same directionality of change in methylation. Among differentially methylated genes, 134 were modified in both hippocampus and blood, of which 61 showed methylation changes at identical CpG sites. Gene pathway analyses indicated that prenatal sGC exposure alters the methylation status of gene clusters involved in brain development. These data indicate concordance across tissues of epigenetic programming in response to alterations in glucocorticoid signaling.

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Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake During the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey

Vaccines ◽

10.3390/vaccines9070765 ◽

2021 ◽

Vol 9 (7) ◽

pp. 765

Author(s):

Amel Ahmed Fayed ◽

Abeer Salem Al Shahrani ◽

Leenah Tawfiq Almanea ◽

Nardeen Ibrahim Alsweed ◽

Layla Mohammed Almarzoug ◽

...

Keyword(s):

Saudi Arabia ◽

Perceived Risk ◽

Online Survey ◽

Seasonal Influenza ◽

Vaccination Campaign ◽

Vaccine Uptake ◽

Influenza Vaccines ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

To Receive

This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk.

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