The Evaluation of Vaccine Hesitancy and Refusal for Childhood Vaccines and the COVID-19 Vaccine in Individuals Aged Between 18 and 25 Years

The role of parents’ emotional competencies on vaccine hesitancy and decision making has been seldom examined. Two studies investigated the relationship between parents’ attitudes towards childhood vaccines and self-reported behavior (Study 1) and between parents’ emotional competence and attitudes towards vaccines (Study 2). In Study 1, predictors of temporal, partial, or complete vaccine refusal (having voluntarily postponed/forgone some/all vaccines) were examined in 2778 parents. In Study 2, psychological predictors of the attitude towards vaccines were examined in 593 parents, using the Profile of Emotional Competence and the valence of mental images spontaneously associated with the term “vaccine”. In Study 1, attitudes were aggregated in three independent factors (concerns about vaccine safety; diseases prevented by vaccines; and naturalistic views) that independently predicted vaccine refusal. In Study 2, a significant mediational analysis showed a positive indirect effect of intrapersonal emotional competences on attitudes towards vaccines, through mental images associated with the word “vaccine”. Parents’ intrapersonal emotional competences affected all dimensions of attitudes towards vaccines, suggesting that being able to manage, identify, and recognize one’s own emotions is central to vaccine acceptance. These findings suggest that intervention strategies, rather than stressing the pro-social benefits of vaccinating, should focus on aspects related to one’s own emotions.

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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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Parents and health professionals’ opinions on information tools on mandatory childhood vaccines

European Journal of Public Health ◽

10.1093/eurpub/ckz187.103 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C H Hennequin ◽

C V Vergelys ◽

L C Chauvet ◽

S C Cortaredona ◽

E D Dube ◽

...

Keyword(s):

Health Professionals ◽

Economic Status ◽

Qualitative Evaluation ◽

Vaccine Hesitancy ◽

Scientific Language ◽

Individual Interviews ◽

Patient Profile ◽

Information Tools ◽

Qualitative Survey ◽

Childhood Vaccines

Abstract Background South-eastern France is marked by insufficient vaccination coverage for several vaccines and some mistrust of its population towards vaccination. In this context and given the application of new vaccination obligations for early childhood, we carried out a qualitative survey to study opinions of parents and health professionals (HPs) on information tools on vaccination (ITV). Methods An inventory of French existing ITV was conducted to select a diverse set of 17 ITV for our qualitative evaluation. In 2018, we carried out 26 individual interviews with parents of young children (recruited in nurseries and kindergartens) and 5 focus groups with HPs (nurses, general practitioners, midwives and pediatricians; n = 33). Results Most parents appreciated videos for their convenience: they used them to discover new/complex subjects in an entertaining way. Paper ITV remained essential mostly among parents with high socio-economic status (SES) or marked vaccine hesitancy, who also requested detailed information and scientific sources. Some parents of low SES considered ITV difficult to understand because of their length, quantity of information and scientific language. For HPs, giving their patients a paper ITV is a way to show the importance they attach to their patient’s questions. HPs reported reluctance using videos during consultations. Some HPs stated their need for guidance on two aspects: 1) key discussion points to use when giving an ITV to parents and 2) most appropriate timing to give ITVs: prescription, injection… Conclusions In the pool of tested ITV, articulation and formatting of arguments are not always optimal for HP and parents use. Tailored ITV should be available for the different needs of HP and parents, especially, for the latter, according to their SES and hesitancy profiles. ITV adapted to use during consultation are necessary. Key messages Information tools on vaccination (ITV) are not always optimal for HP and parents use. ITV should be tested and better adapted to the patient profile and consultation context.

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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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Demographics of Vaccine Hesitancy in Chandigarh, India

Frontiers in Medicine ◽

10.3389/fmed.2020.585579 ◽

2021 ◽

Vol 7 ◽

Author(s):

Abram L. Wagner ◽

Abigail R. Shotwell ◽

Matthew L. Boulton ◽

Bradley F. Carlson ◽

Joseph L. Mathew

Keyword(s):

Vaccine Hesitancy ◽

Childhood Immunization ◽

Middle Income ◽

Universal Immunization Program ◽

Middle Income Countries ◽

Scheduled Castes ◽

Systematic Sample ◽

Childhood Vaccines ◽

The Impact ◽

To Receive

The impact of vaccine hesitancy on childhood immunization in low- and middle-income countries remains largely uncharacterized. This study describes the sociodemographic patterns of vaccine hesitancy in Chandigarh, India. Mothers of children <5 years old were sampled from a two-stage cluster, systematic sample based on Anganwadi child care centers in Chandigarh. Vaccine hesitancy was measured using a 10-item Vaccine Hesitancy Scale, which was dichotomized. A multivariable logistic regression assessed the association between socioeconomic factors and vaccine hesitancy score. Among 305 mothers, >97% of mothers thought childhood vaccines were important, effective, and were a good way to protect against disease. However, many preferred their child to receive fewer co-administered vaccines (69%), and were concerned about side effects (39%). Compared to the “other caste” group, scheduled castes or scheduled tribes had 3.48 times greater odds of vaccine hesitancy (95% CI: 1.52, 7.99). Those with a high school education had 0.10 times the odds of vaccine hesitancy compared to those with less education (95% CI: 0.02, 0.61). Finally, those having more antenatal care visits were less vaccine hesitant (≥4 vs. <4 visits OR: 0.028, 95% CI: 0.1, 0.76). As India adds more vaccines to its Universal Immunization Program, consideration should be given to addressing maternal concerns about vaccination, in particular about adverse events and co-administration of multiple vaccines.

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Prevalence and Determinants of Vaccine Hesitancy in Aseer Region, Saudi Arabia

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.4.2021.023 ◽

2021 ◽

Author(s):

Youssef Ali Alqahtani ◽

Khalid Hussein Almutairi ◽

Yahya Mohammed Alqahtani ◽

Ahmed Hussein Almutlaq ◽

Anas Ali Asiri

Keyword(s):

Saudi Arabia ◽

Demographic Data ◽

Herd Immunity ◽

Vaccine Safety ◽

Vaccination Schedule ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Safety And Efficacy ◽

Childhood Vaccines ◽

Child Vaccination

Objectives: Vaccination is the provision of a vaccine to initiate immunity trough stimulating immune system to develop protection from a certain disease. When a sufficiently large proportion of a population has been vaccinated, herd immunity initiated. The effectiveness of vaccination has been widely studied and verified. Although the harsh vaccine safety systems, some parents remain minded regarding the safety of the childhood vaccines and immunization schedule. These hesitations pushed some parents to not allow their children to receive some or all the scheduled vaccines. The aim of the study is to assess the general population awareness regarding vaccines and to detect prevalence of vaccine hesitancy in Aseer region, southern of Saudi Arabia. Methods: A descriptive cross-sectional approach was used targeting all parents in Aseer region. Data were collected using structured questionnaire which developed by the researchers after intensive literature review and expert’s consultation. The questionnaire data included parents’ socio-demographic data, parents’ awareness regarding child vaccines safety and efficacy, parents’ attitude and adherence to children vaccination and hesitancy towards vaccines. Results: The survey included 796 participants whose ages ranged from 18 to 55 years old. Two thirds (63.4%) of the participants were females. Regarding vaccination adherence and hesitancy among participants, more than three quarters were completely adherent to the child vaccination schedule and only 3.9% were non adherent. As for participants awareness regarding child vaccination safety and efficacy, 89.3% of the respondents agreed on that vaccination keep child healthy, 84.2% reported that child vaccine is safe and effective, 83.4% said that all Saudi scheduled vaccines are effective. Conclusion: In conclusion, the study revealed that vaccine hesitancy among participants was not low and should be considered irrespective of their high awareness level. The recorded antivaccine action was mostly related to vaccines safety not efficacy. Keywords: Vaccine hesitancy, antivaccine movement, parents, awareness, adherence

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Understanding Vaccine Hesitancy Among Parents of Children With Autism Spectrum Disorder and Parents of Children With Non-Autism Developmental Delays

Journal of Child Neurology ◽

10.1177/08830738211000505 ◽

2021 ◽

pp. 088307382110005

Author(s):

Noël E. Mensah-Bonsu ◽

Sarah S. Mire ◽

Leila C. Sahni ◽

Leandra N. Berry ◽

Lauren R. Dowell ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Developmental Delays ◽

Illness Perception ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Childhood Vaccination ◽

Vaccine Hesitancy ◽

Children With Asd ◽

Childhood Vaccines

Parents of children with autism spectrum disorder (ASD) may be at greater risk for developing antivaccine beliefs that lead to vaccine delays and/or refusals for their children. We investigated current parental vaccine hesitancy, parents’ beliefs about causes of children’s developmental delays, and children’s vaccination histories among parents of children with ASD or non-ASD developmental delays. Data were analyzed from 89/511 parents (17.4%) who completed the Parent Attitudes About Childhood Vaccines questionnaire and the Revised Illness Perception Questionnaire; 46.1% had childhood vaccination records available. Overall, 21/89 (23.6%, 95% confidence interval [CI]: 15.0-34.0) of parents were vaccine hesitant (ASD n = 19/21 [90.5%], non-ASD n = 2/21 [9.5%]). Parents of children with ASD were significantly more likely to agree with “toxins in vaccines” as a cause of their child’s developmental delays (28.4% vs 5.0%, P = .034). The odds of being vaccine hesitant were 11.9 times (95% CI 2.9-48.0) greater among parents who agreed versus disagreed that toxins in vaccines caused their children’s developmental delays. Rates of prior vaccine receipt did not differ between hesitant and nonhesitant groups.

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Vaccine hesitancy and non-vaccination in an Irish paediatric outpatient population

10.1101/2020.10.26.20219964 ◽

2020 ◽

Author(s):

SO Whelan ◽

F Moriarty ◽

L Lawlor ◽

K Gorman ◽

J Beamish

Keyword(s):

Sociodemographic Factors ◽

Cross Sectional Study ◽

Autism Spectrum ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Paediatric Hospital ◽

Significant Difference ◽

High Negative Predictive Value ◽

Paediatric Outpatient ◽

Childhood Vaccines

AbstractObjectiveTo administer the Parent Attitudes Childhood Vaccines (PACV) questionnaire to assess vaccine hesitancy and its relationship with non-vaccination.DesignA cross-sectional study using the 15-item PACV questionnaire, with sociodemographic questions.SettingOutpatient department in a tertiary paediatric hospital, Dublin, Ireland.ParticipantsParents/caregivers of children attending general paediatric clinics.Main outcome measuresPACV score and reported non-vaccination. We assessed sociodemographic factors associated with PACV score and accuracy of the PACV in predicting non-vaccination.ResultsIn total, 436 participants completed the questionnaire. 5.5% of our population reported non-vaccination. HPV and MMR vaccines were the most commonly cited vaccines of concern (11.5% and 6.7% respectively) and autism spectrum disorder was the most commonly side effect of concern (4.3%). Mean PACV score was 26.9 (SD 19.1), with a significant difference between non-vaccinators and vaccinators (53.2 vs 25.3, p<0.001). Safety and efficacy concerns were the major contributor to non-vaccination. 14.4% of our population were vaccine-hesitant using the conventional cut-off score, which increased to 22% when using an optimal cut-off which maximised sensitivity and specificity. The accuracy of the PACV score to identify non-vaccination was good (area under the ROC curve = 0.827) and the optimal cut-off had a high negative predictive value (98.5%).ConclusionsPACV identified non-vaccination with high accuracy in our population. It may be useful to screen vaccine hesitant parents who could benefit from interventions to improve uptake.

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Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey

Frontiers in Public Health ◽

10.3389/fpubh.2021.752323 ◽

2021 ◽

Vol 9 ◽

Author(s):

Mohamad-Hani Temsah ◽

Abdullah N. Alhuzaimi ◽

Fadi Aljamaan ◽

Feras Bahkali ◽

Ayman Al-Eyadhy ◽

...

Keyword(s):

Side Effects ◽

Parental Attitudes ◽

Safety Information ◽

Significant Proportion ◽

Multivariate Logistic Regression Analysis ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Advisory Group ◽

Routine Childhood ◽

Childhood Vaccines

Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines.Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia.Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels.Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents.

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