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BACKGROUND: Vaccine hesitancy is an urgent public health threat. While tools have been developed to monitor vaccine hesitancy among parents and the general adult population, no such tool exists for adolescents. METHODS: We modified an existing adult Vaccine Hesitancy Scale to create a teen COVID-19 Vaccine Hesitancy Scale (tVHS-COVID) for adolescents and their parents. To validate our scale, we conducted a nationally representative survey of 764 parent-teen dyads. We performed exploratory factor analysis (EFA) to determine the factor structure followed by confirmatory factor analysis (CFA) to test the factor structure validity using two random subsets. We evaluated internal consistency by Cronbach alpha values and construct validity by comparing tVHS-COVID scores to intention to receive future COVID-19 doses. RESULTS: EFA suggested a three-factor structure with 13-items. CFA indicated good fit for adolescents (CFI = 1.00; RMSEA = 0.023; SRMR = 0.062; NNFI-TLI = 0.998) and for parents (CFI = 1.00, RMSEA = 0.031; SRMR = 0.028; NNFI-TLI = 1.00). Internal consistency exceeded 0.79 for adolescents and 0.78 for parents. As tVHS-COVID scores increased, the percent of adolescent and parent respondents who reported they were willing to receive a COVID-19 vaccine decreased. DISCUSSION: The tVHS-COVID offers a unique tool that can be used to monitor COVID-19 vaccine hesitancy among adolescents and their parents. As adolescents take on more proactive roles in medical decision-making, monitoring vaccine hesitancy among this population becomes increasingly important.

Shared clinical decision-making (SCDM) about HPV vaccination has been recommended for U.S. mid-adults aged 27-45 since 2019. To explore barriers and facilitators to HPV vaccination in this population, we conducted 14 virtual focus groups with 86 unvaccinated mid-adults (34 men and 52 women) in Californias medically underserved Inland Empire between September 2020 and January 2021. We systematically analyzed the focus group data using the rigorous and accelerated data reduction (RADaR) technique to identify key themes. Identified barriers included: lack of awareness, vaccine hesitancy, and perceived unaffordability (cited in 14 groups); lack of healthcare provider communication and insufficient time (13 groups); fear of moral judgment (12 groups); lack of motivation and information needs (10 groups); and lack of reliable transportation and foregone care during the COVID-19 pandemic (3 groups). Proposed facilitators included: tailored HPV vaccine information for mid-adults, cost mitigation, and improved vaccine accessibility (12 groups); healthcare provider-initiated conversations (6 groups); and vaccine reminders (4 groups). These findings highlight challenges to HPV vaccination among U.S. mid-adults eligible for SCDM and point to actionable strategies for improvement. Specifically, tailored educational interventions, decision-making tools for pharmacists, and integrating HPV vaccination into other healthcare encounters may enhance vaccination efforts in areas with limited primary care resources.

BACKGROUND: The COVID-19 pandemic has underscored the significance of immunizations, particularly among susceptible populations such as children. This study examines the factors that influence parents decision to accept or hesitate in vaccinating their children in an urban environment. METHODS: A one-year cross-sectional study was carried out at a paediatric hospital in Tehran, Iran. The objective is to target a demographic of 226 children, aged 5 to 18, residing in metropolitan locations, over the period of June to August 2023. An extensive survey, built upon previous research, analyzed the variables that influence the reluctance and acceptance of vaccines. Data on demographics, vaccination status, and variables influencing hesitation or acceptance were collected. RESULTS: Out of the 226 participants, 22.1% of the children had received vaccinations. There was a correlation between parents getting vaccinated and greater rates of child vaccination (100% vs. 92.9%, p = 0.073). Significant relationships were seen between age, parental education, and past COVID-19 hospitalizations. The main motivations for vaccination were to guarantee safety (66%) and to avert serious illness (60%). The primary reasons for hesitancy were primarily attributed to worries regarding potential harmful effects (58%), lack of trust in the vaccine (19.9%), and uncertainties regarding its efficacy (15.9%). CONCLUSIONS: The research emphasizes key factors that have a significant impact on the COVID-19 vaccination of children, such as age, previous hospitalization experiences, and parental attitudes. To boost vaccination rates in this demographic, it would be beneficial to address parental concerns regarding vaccine safety and enhance educational outreach regarding the advantages of vaccines. Public health programs should prioritize clear and open information and precise treatments to decrease vaccine reluctance.

The aim of this project was to increase willingness to receive the influenza vaccine to the optimal rate of ≥ 70%. Low acuity adult patients who visited an Emergency Department (ED) were assessed regarding their willingness to receive the influenza vaccine before and after an educational intervention that included a provider recommendation and an educational handout. A total of seventy-six patients (n = 76) were assessed. Patients willingness to receive the influenza vaccine rose from 29% pre-intervention to 72% post-intervention without disrupting the clinical flow in a busy ED. Similar vaccine educational strategies can be applied to influenza and other vaccines in EDs  to increase vaccination willingness in patients, including those who use the ED as a primary point of contact for healthcare, decreasing the burden of influenza illness in the community.

Background: Complete vaccination coverage is recommended by multiple sclerosis (MS) societies for patients with multiple sclerosis (pwMS) to mitigate infection risks associated with disease-modifying therapies (DMTs). Objectives: To analyze vaccination coverage and its determinants in pwMS compared to healthy controls, considering vaccination hesitancy, MS-specific vaccination beliefs, trust in information sources, and the role of general practitioners (GPs). Methods: This cross-sectional multicenter observational study was conducted in six German MS centers. The primary endpoint was a vaccination index (VI) comprising eight standard vaccinations (range 0–1, with higher VI indicating better vaccination coverage). Secondary endpoints included validated measures of general vaccination hesitancy, MS-specific vaccination beliefs, and trust in information sources. Data were collected through questionnaires, vaccination card analysis, and a survey of GPs who vaccinate pwMS. Results: VI tended to be lower in pwMS (n = 397) compared to healthy controls (n = 300; 0.58 ± 0.30 vs 0.62 ± 0.31, p = 0.057). In pwMS receiving highly effective DMTs, VI did not differ significantly from those on no/platform DMTs. Vaccination hesitancy was comparably low, with no differences between pwMS and controls. Vaccination hesitancy, beliefs, and trust in information sources explained only 10%–16% of the variance in VI. Among 109 GPs, 82% cited reluctance to vaccinate pwMS due to concerns about MS-related side effects or interactions with DMTs. Conclusion: Despite clear recommendations from MS societies for full vaccination of all pwMS, vaccination coverage remains worryingly low. Approximately half of the patients lack standard vaccination coverage, even those on highly effective DMTs. In fact, vaccination coverage in pwMS tended to be even lower than in healthy controls. Vaccination hesitancy and other intrinsic factors do not sufficiently explain the low vaccination rates. Inconsistent vaccination recommendations from GPs due to uncertainties about vaccine safety and DMT interactions likely contribute. Plain language summary: Vaccination coverage in multiple sclerosis patients: what influences it and why it matters Vaccinations are crucial for people with multiple sclerosis (MS) to protect them from infections that may worsen their condition, especially during certain treatments. However, many MS patients are not fully vaccinated. This study examines vaccination rates and factors that affect whether MS patients receive vaccines. We found that general practitioners often hesitate to recommend vaccines due to concerns about safety and treatment interactions. Our results suggest that vaccinations should be administered by specialized vaccination centers to ensure patients receive the appropriate care. [ABSTRACT FROM AUTHOR]

Optimizing vaccine uptake is a public health challenge that requires the implementation of effective strategies. The asymmetric dominance (or decoy) effect describes the increasing likelihood of selecting an option when a clearly inferior alternative is offered. Therefore, we aimed to test the impact of offering decoy alternatives—less convenient vaccination appointments—on vaccination intentions. Participants aged 18–33 years, residing in England, and initially not intending to get vaccinated, completed three online experiments. Participants were randomly assigned to either a control or an experimental condition in each experiment. The asymmetrically dominated options were: an appointment in two weeks at a distant location (experiment 1); a later time at the participant's local GP, pharmacy, or community centre (experiment 2); and a later time at a distant location (experiment 3). The primary outcome was vaccination intention, while secondary outcomes included an active interest in reading additional information about the vaccination procedure, perceived difficulty and cognitive effort. Initial analysis revealed no evidence of an asymmetric dominance effect. However, further subgroup analysis, supported by formative research, indicated that ensuring decoy alternatives are clearly perceived as inferior could enhance the effectiveness of this approach for certain individuals. [ABSTRACT FROM AUTHOR]

Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the Gram-negative bacterium Bordetella pertussis. Although traditionally associated with children, pertussis is increasingly prevalent among adults, particularly those with comorbidities or weakened immune systems, where it can lead to severe complications. Diagnosing pertussis in adults can be challenging due to its nonspecific symptoms, underreporting, and the limited sensitivity of available diagnostic tests. While treatment with macrolides is generally effective, it may not significantly alter the clinical course of the disease, and growing concerns about macrolide resistance are emerging. Vaccination remains the cornerstone of prevention, offering proven immunogenicity, efficacy, and safety. However, vaccination uptake remains low, partly due to limited patient awareness and insufficient prioritization by healthcare professionals. This review aims to provide clinicians with critical insights into pertussis epidemiology, vaccination strategies, and the latest guideline recommendations, empowering them to engage in meaningful discussions with adult patients and advocate for increased vaccination to combat this often-overlooked infection. [ABSTRACT FROM AUTHOR]

Background: In most countries, lower rates of COVID-19 vaccination have been observed in foreign-born individuals, yet little is known about the underlying reasons, especially as reported by these individuals themselves. This exploratory interview study investigated lack of information access and hesitancy towards taking the COVID-19 vaccine among foreign-born individuals in Sweden. Methods: We used purposive sampling to recruit foreign-born adults who expressed being hesitant towards getting vaccinated, as well as health guides and doulas who were assigned to spread COVID-19 related information in immigrant-dense urban areas. Data were collected using semi-structured focus group interviews, which were transcribed verbatim and analysed according to systematic text condensation. Results: Three focus group interviews were conducted with altogether eleven participants. One group consisted of health guides/doulas, while the participants in the other groups were gainfully employed in other jobs, or full-time students, or housewives. Four main themes emerged: (1) Language barriers and sociocultural differences, (2) Consequences of not using official Swedish information, (3) Decision-making on COVID-19 vaccination, and (4) Suggestions to improve information dissemination. The lack of information in other languages than Swedish and lack of effective information channels resulted in that most participants barely used information from official Swedish health care and public health institutions. Instead, they relied on social media, social contacts and international media, through which contradictive and negative information about the vaccine was spread. The decision to get vaccinated or not became a process fraught with insecurities about the effectiveness and side effects of the vaccine, which was balanced against wishing to be protected and to contribute to the battle against COVID-19. The participants suggested that information dissemination could be improved by producing a multilingual information outreach and to increase the use of transmission through social interaction with trusted persons and platforms. Conclusions: An inadequately adapted information strategy prevented some members of the society from making fact-based decisions about getting vaccinated. Several suggestions for improving dissemination were brought forth that can be tested in future communication strategies. [ABSTRACT FROM AUTHOR]

Background: On 11 March 2020, COVID-19 was declared a global health pandemic by the World Health Organization (WHO). Vaccinating populations is paramount in changing the course of a pandemic. The rapid spread of (mis) and disinformation online from celebrities, politicians, and media influencers creates a corrosion of trust in public health interventions. Methods: Given the importance of the spread of information during a public health crisis, the current study uses risk orders theory with a constructivist grounded theory approach to analyze an episode of a popular podcast available on YouTube, titled, 'Aaron Rodgers Tells Pat McAfee His Side of Vaccine Situation.' Results: Findings illuminated three themes concerning COVID-19 medical interventions from celebrity discourse: (1) misinterpreting medical terminology; (2) conflating bodily autonomy and altruism; and (3) political ideology as an impetus for misinformation. Conclusions: The discussion offers implications for healthcare practitioners in debunking mis- and disinformation. Foremost, lack of transparency concerning autonomy, liberty, freedom, and choice from public health experts who design messages during a public health crisis creates a space for non-medical influencers to promote pseudoscience, misinformation, and disinformation. This leads to public distrust of medical experts and confuses the public's understanding of best practices based upon standard of medical evidence and care. [ABSTRACT FROM AUTHOR]

This study proposes and empirically tests an alternative information adoption model to investigate how information quality and religiosity impact people's intake of user-generated COVID vaccination information posted on social media. Our results based on 359 survey responses suggest that the two constructs examined significantly impact the perceived usefulness of the user-generated vaccination information and the subsequent vaccination intention. Furthermore, our model shows that religiosity exerts a supplementary partial mediating impact through the information evaluation process, adding empirical evidence to clarify the inconsistency of direct and indirect effects from extant studies. This theory-guided applied study aims to decipher vaccination intention specifically and contributes to building knowledge about user-generated content and the online information adoption process in general. [ABSTRACT FROM AUTHOR]

Background/Objectives: Healthcare professionals (HCPs) hold significant influence over public attitudes toward vaccinations. Studies suggest that HCPs are hesitant towards the coronavirus disease 2019 (COVID-19) vaccines. This hesitancy could lead to lower vaccination rates in the community. Therefore, this scoping review aimed to assess the extent of hesitancy towards COVID-19 booster doses among HCPs and identify the associated factors. Methods: A comprehensive search was conducted in the PubMed and Scopus databases from April to August 2024, using keywords related to COVID-19, vaccine hesitancy, HCPs, and booster vaccination. Studies that had been peer-reviewed, published in English after 2022, and focused on the hesitancy of the COVID-19 booster dose hesitancy among HCPs were included. Out of the 6703 studies screened, 24 studies were included. Results: Most of the HCPs have received their initial series of COVID-19 vaccinations. However, there is a lower rate of uptake for booster doses, with hesitancy rates ranging from 12% to 66.5%. Hesitancy rates varied significantly across continents, with Asia, Africa, and Europe ranging from 19.7% to 66.5%, 27% to 46.1%, 14% to 60.2%, respectively. Hesitancy was reported to be influenced by various factors, including concerns about vaccine safety, necessity, and effectiveness of these vaccines. In addition, the hesitancy regarding booster doses was also found to be influenced by factors like age, gender, profession, and previous COVID-19. Physicians, nurses, and pharmacists exhibited vaccine hesitancy rates ranging from 12.8% to 43.7%, 26% to 37%, and 26% to 34.6%, respectively. Conclusions: Our review underscores the hesitancy among HCPs towards receiving booster doses across countries around the world and explores the underlying factors. These findings provide valuable insights for the design of future pandemic vaccination programs. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to investigate the sociodemographic and behavioral factors related to increased influenza vaccination uptake during the COVID-19 pandemic in South Korea, particularly among adults not eligible for free vaccination. Methods Analyzing data from 78,815 participants in the Korea National Health and Nutrition Examination Survey (2010–2021), we assessed trends in influenza vaccination coverage. Various sociodemographic factors, behavioral aspects, and psychological stress levels were assessed using multivariable logistic regression to evaluate the difference in vaccination response during pre-/post-COVID-19 periods. Results Lowest income quartile households exhibited decreased influenza vaccination uptake during the pandemic (adjusted odds ratio 0.67, p = 0.011), whereas higher income quartiles exhibited increased uptake. In the lowest income households, unemployed status of household was additionally associated with decreased influenza vaccine uptake (adjusted odds ratio 0.50, p = 0.003). Conclusions This study identified income-based disparities in the responsive increase of influenza vaccination during the COVID-19 pandemic. Lower-income households exhibited a disproportionate reduction in influenza vaccine uptake, emphasizing the need for targeted support systems and expanded free vaccination for prioritized groups to address these disparities.

BackgroundPublic health crises, such as the COVID-19 pandemic, have prompted a need for health agencies to improve their disease preparedness strategies, informing their communities of new information and promoting preventive behaviors to help curb the spread of the virus.MethodsWe ran unsupervised machine learning and emotion analysis, validated with manual coding, on posts of health agencies (N = 1588) and their associated public comments (N = 7813) during a crucial initial period of the COVID-19 pandemic (January 2020 to February 2021) among nine different counties with a higher proportion of vaccine-hesitant communities in Northern California. In addition, we explored differences in concerns and expressed emotions by two key group-level factors, county-level COVID-19 death rate and political party affiliation.ResultsWe consistently find that while health agencies primarily disseminated information about COVID-19 and the vaccine, they failed to address the concerns of their communities as expressed in public comment sections. Topics among public audiences focused on concerns with the COVID-19 vaccine safety and rollout, state mandates, flu vaccination, and frustration with politicians, and they expressed more positive and more negative emotions than health agencies. Further, there were several differences in primary topics and emotions expressed among public audiences by county-level COVID-19 death rate and political party affiliation.ConclusionWhile this research serves as a case study, findings indicate how local health agencies, and their audiences, discuss their perceptions and concerns regarding the COVID-19 pandemic and may inform health communication researchers and practitioners on how to prepare and manage for emerging health crises.

BACKGROUND: The COVID-19 pandemic has created substantial and profound barriers to several forms of health care engagement. For Black sexual minority men, this may include engagement with pre-exposure prophylaxis (PrEP) to prevent HIV infection, with significant implications for HIV disparities. Our study explored how the COVID-19 pandemic affected Black sexual minority men, with a focus on relationships between COVID-19 and PrEP engagement. SETTING: We sampled 24 Black sexual minority men attending HIV prevention-related events in the greater D.C. Metropolitan area (D.C., Maryland, Virginia). METHODS: We conducted qualitative phone interviews among our sample. Questions were primarily focused on the COVID-19 pandemic and how it affected engagement and considerations of PrEP use. Interviews were transcribed and qualitatively analyzed using the 6 stages of thematic analysis. RESULTS: We identified 3 major themes from our thematic analysis: Changes in the health care system, changes in sexual and relationship contexts, and COVID-19 vaccine hesitancy and misinformation. Relationships between COVID-19 vaccine hesitancy and PrEP hesitancy were especially prevalent, with participants describing that COVID-19 hesitancy can directly deter PrEP use through eroding medical trust further. CONCLUSIONS: We identified changes in the health care system, sexual and relationship contexts, and COVID-19 vaccine hesitancy as important issues driven by COVID-19 with significant implications for PrEP use. The COVID-19 pandemic has changed the health care and social landscape in profound ways that affect PrEP access, sexual networks, and associated HIV vulnerability. Future research further exploring relationships between specific pandemic stressors and HIV prevention among Black sexual minority men is recommended .

Abstract Vaccines, like the Corona Virus Disease-2019 (COVID-19) vaccines, can control diseases, but vaccine hesitancy reduces their use. It is important to assess the intention to use COVID-19 vaccines boosters and the determinants of this intention to help in developing programs to promote the uptake of boosters. An online survey collected data from adults in Egypt between March and June 2022 using a questionnaire that assessed demographic characteristics, and constructs of the Theory of Planned Behaviour (TPB) and the Health Belief Model (HBM). The survey was uploaded to SurveyMonkey and the links were posted on social media platforms. Binary regression analysis was used and the dependent variable was intention to use boosters of COVID-19 vaccines. The independent variables were indicators of the HBM including perceived susceptibility to COVID-19 infection (medical history) and possibility of disease prevention (awareness of the availability of types of COVID-19 vaccines); and indicators of the TPB including attitude toward COVID-19 vaccines (that they are harmful, that they may lead to death and confidence in locally and foreign manufactured vaccines), perceived norms (the percentage of vaccinated persons in one’s circle) and perceived control over booster uptake (presence of government mandates for COVID-19 vaccination). The confounders were sociodemographic factors (age, sex, education, and place of residence). Complete responses were available from 1113 out of 1401 participants (79.4%), with mean (SD) age = 25 (9.5) years, of whom, 66.7% (n = 742) were females and 68.6% (n = 764) were university students. About 39.4% and 31.2% indicated that they would get or would definitely get the booster dose of the COVID-19 vaccines. In multiple regression, intention to use a booster dose was significantly related to not agreeing (AOR = 4.87, P

Abstract Background This study aimed to explore the reasons adults in the general population, influenza risk groups (RGs) and health care workers (HCWs) in Norway give for their vaccination choices and whether these reasons vary between groups or over time in order to further improve influenza vaccination coverage. Methods Respondents of a nationally representative telephone survey conducted by Statistics Norway were asked “What was the most important reason why you did/did not get vaccinated?”. The question on influenza non-vaccination was included in 2016 and in 2020 to 2023 and the question on influenza vaccination in 2021 to 2023. Results The study included 9 705 individuals aged 18–79 years. Influenza vaccination coverage in the RGs increased from 20.6% in 2016 to 63.1% in 2022, before a reduction to 58.3% in 2023. Common reasons for non-vaccination were similar in all groups. The most cited reasons were “no need” for the vaccine and “no specific reason”, followed by “not recommended/offered the vaccine”, “worry about side effects” and “vaccine refusal”. The most frequent reasons for vaccination among the general population and RGs were protection against influenza and belonging to a RG, while the most frequent responses among HCWs were being offered the vaccine at work/work in health care, followed by a desire for protection against influenza. Receiving a vaccine recommendation from a health professional was mentioned in all groups. We also observed that the proportion reporting “no need” for the vaccine decreased over time, especially among HCWs, and that the proportions reporting vaccine refusal and worry about side effects as reasons for non-vaccination were temporarily reduced during the COVID-19 pandemic. Conclusions The general population and RGs cite protection against influenza as their primary incentive for vaccination, while HCWs mainly refer to their professional role or workplace vaccination. For non-vaccination we see a similar pattern in all groups, with “no need” and “no specific reason” as the main reasons. Of note, worry about side effects and vaccine refusal is as frequent among HCWs as in other groups. Continued efforts to maintain and increase vaccine confidence are needed.

Abstract Background Hesitancy rates for childhood vaccines are increasing on a global scale. It was reported in previous studies that many factors affect vaccine hesitancy. The present study was designed to determine the prevalence of childhood vaccination hesitancy in parents and to determine the factors affecting it. Methods This descriptive, cross-sectional study was conducted with 350 parents who had at least one child aged two years and younger, who applied to Family Health Centers in the city of Mardin in the Southeastern Anatolia Region of Turkey, between January and March 2022. The “Parental Attitudes Towards Childhood Vaccines (PATCV) Questionnaire” was used to collect the data, which were analyzed by using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. The Logistic Regression Analysis was used to determine the factors affecting parental attitudes toward childhood vaccines. Results A total of 32.0% of the parents were found to be hesitant about vaccinations and 3.4% did not have at least one vaccination for their children. Significant relationships were detected between income status, education status, thoughts about vaccinations, parents having adult vaccinations, hesitant to have self-vaccination, considering vaccine necessary, and parental attitudes towards childhood vaccinations (p

Background: Despite the advent of vaccines against COVID‐19, there is considerable variation in the acceptance and hesitancy towards the vaccination program across different countries. The objective of this study was to ascertain the prevalence of hesitancy and acceptance regarding the use of the vaccine against the novel coronavirus, also known as COVID‐19, and to identify the factors that influence these attitudes. Materials and Methods: All the cross‐sectional studies were retrieved from the PubMed databases, the Web of Science ISI, Scopus, and the Cochrane Library. Papers published in English between 2 November 2019 and 23 May 2023 were subjected to further assessment based on their title, abstract, and main text, with a view to ensuring their relevance to the present study. Results: Following an exhaustive investigation, 59 studies were selected for screening in this systematic review. The most frequently employed method of data collection was the online survey. The study sample comprised 59.12% women and 40.88% men, with ages ranging from 16 to 78 years. The proportion of individuals accepting the vaccine ranged from 13% to 96%, while the proportion of those exhibiting hesitancy ranged from 0% to 57.5%. The primary reasons for accepting the COIVD‐19 vaccine were a heightened perception of risk associated with the virus and a general trust in the healthcare system. The most frequently cited reasons for vaccine hesitancy in the context of the ongoing pandemic include concerns about the potential dangers of the vaccines, the rapid pace of their development, the possibility of adverse effects (such as infertility or death), and the assumption that they have been designed to inject microchips. Discussion: A variety of socio‐demographic factors are implicated in determining the rate of vaccine acceptance. A number of socio‐demographic factors have been identified as influencing vaccine acceptance. These include high income, male gender, older age, marriage, the presence of older children who have been vaccinated and do not have chronic diseases, high education, and health insurance coverage. Conclusion: Eliminating vaccine hesitancy or increasing vaccine acceptance is a crucial factor that should be addressed through various means and in collaboration with regulatory and healthcare organizations. [ABSTRACT FROM AUTHOR]

• Potential connection between parent decision style and vaccination decision. • Successful use of the Decision Style Inventory in a parent sample. • The Decision Style Inventory can be utilized in future vaccine research studies. • A new immunization screening for parents would allow for targeted interventions. Cases of preventable diseases continue to occur globally. Much literature is present about barriers and factors that influence vaccination, but little is known about psychologically ingrained decision-making styles and their relationship with vaccination decisions. This quantitative descriptive cross-sectional pilot study aimed to explore using an established tool, the Decision Style Inventory (Rowe & Mason, 1987), in parents/guardians of children 2 months to 20 years old. Nineteen parents/guardians participated in this study and provided positive feedback on the Decision Style Inventory (Rowe & Mason, 1987). Descriptive statistics revealed vaccination decisions occurred more frequently with certain decision styles. Further research examining associations between decision styles and vaccination decisions is warranted. The findings of such research could lead to new tool development that integrates external factors and parental decision-making style. This new tool could allow healthcare providers to select targeted interventions that holistically address parental vaccination decisions. [ABSTRACT FROM AUTHOR]

Introduction: Vaccination readiness refers to psychological motives and beliefs that decisively determine individual and collective vaccination prevention behavior. Readiness to be vaccinated depends on expected individual and social benefits and harms. Differences exist in the perception of the threat of potential influenza vs. COVID-19 infection and its significance for the social environment. The study aimed to compare the 7C components of vaccination readiness for influenza and COVID-19 vaccination in adulthood. Methods: A total of 317 adults answered the 7C vaccination readiness scale in two vaccination-specific versions (influenza vs. COVID-19) in an online survey from September 2022 to March 2023. Data were analyzed using repeated measures, including analysis of covariance, correlations, and multiple regression. Results: For COVID-19, there is a higher readiness to be vaccinated compared to influenza regarding complacencyR (ηp = 0.683), constraintsR (ηp = 0.684), collective responsibility (ηp = 0.782), and compliance (ηp = 0.365). However, confidence (ηp = 0.161) and conspiracyR (ηp = 0.256) indicate an enhanced readiness for influenza vaccination (interaction scales × vaccination type: ηp = 0.602). Individual influenza vaccination recommendations and age do not or only marginally moderate these effects (interaction vaccination type × recommendation: ηp = 155). Discussion: The 7C subscales reveal a differentiated pattern of readiness for the two vaccination types. This emphasizes the relevance of the multidimensional structure of the construct of vaccination readiness as well as the relevance of moderating effects of the respective vaccination type on the underlying motives and beliefs. Vaccination attitudes are influenced by cultural and social conditions as well as medical standards of care. Comparing attitudes to different vaccinations in different countries thus represents an important research desideratum in order to understand the concept of vaccination readiness more comprehensively. [ABSTRACT FROM AUTHOR]

Objectives: Seasonal influenza vaccination rates among the elderly in the Czech Republic are alarmingly low, making it one of the least vaccinated countries in Europe. This study explored the role of vaccine literacy and insurance coverage on vaccination status. Methods: An analytical cross-sectional study was conducted in Summer 2023 using a self-administered questionnaire covering vaccine literacy (functional, interactive, and critical skills), negative perceptions towards influenza vaccination, and the 5C model (confidence, complacency, constraints, calculation, and collective responsibility). Individuals aged 55 and older were included in the study. Mediation analyses assessed the indirect effects of insurance coverage on vaccination status. Results: Significant differences were noted in vaccination rates based on insurance coverage, chronic diseases, regular medication use, and previous COVID-19 and pneumococcal vaccinations. Vaccine literacy, especially interactive and critical skills, was higher among vaccinated individuals. Confidence and collective responsibility were significant promoters, while complacency and constraints were barriers to vaccination. Mediation analyses indicated that negative perceptions, confidence, and collective responsibility significantly mediated the relationship between insurance coverage and vaccination status. Conclusion: Enhancing vaccine literacy and addressing psychological antecedents are crucial for improving influenza vaccination rates among the elderly. Policy measures should include improving vaccine literacy, building public confidence, and addressing negative perceptions. [ABSTRACT FROM AUTHOR]

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Background: Hesitancy rates for childhood vaccines are increasing on a global scale. It was reported in previous studies that many factors affect vaccine hesitancy. The present study was designed to determine the prevalence of childhood vaccination hesitancy in parents and to determine the factors affecting it. Methods: This descriptive, cross-sectional study was conducted with 350 parents who had at least one child aged two years and younger, who applied to Family Health Centers in the city of Mardin in the Southeastern Anatolia Region of Turkey, between January and March 2022. The "Parental Attitudes Towards Childhood Vaccines (PATCV) Questionnaire" was used to collect the data, which were analyzed by using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. The Logistic Regression Analysis was used to determine the factors affecting parental attitudes toward childhood vaccines. Results: A total of 32.0% of the parents were found to be hesitant about vaccinations and 3.4% did not have at least one vaccination for their children. Significant relationships were detected between income status, education status, thoughts about vaccinations, parents having adult vaccinations, hesitant to have self-vaccination, considering vaccine necessary, and parental attitudes towards childhood vaccinations (p < 0.05). According to the Regression Analysis, parents who had adult vaccinations had reduced hesitation about childhood vaccines 0.506 times (p = 0.032; OR = 0.506; 95%CI = 0.271–0.943). Considering the vaccine necessary reduced the hesitation about childhood vaccines by 0.440 times (p = 0.011; OR = 0.440; 95%CI = 0.234–0.828). Conclusions: The hesitations of parents about childhood vaccines were found to be high. The reasons for vaccine hesitancy must be examined in detail and strategies must be developed in this regard. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organization identified vaccine hesitancy as one of the top 10 threats to global health. Vaccine hesitancy is defined as a delay in acceptance or refusal of vaccination despite the availability of vaccination services. Because vaccine safety concerns are important contributors to hesitancy, people who have experienced adverse events following immunization (AEFI) may be at especially high risk for subsequent vaccine hesitancy. The Defense Health Agency Immunization Healthcare Division (DHA IHD) provides specialized vaccine care to persons who have experienced AEFI. The impact of this specialized vaccine care on subsequent vaccine hesitancy has not been fully explored. Materials and Methods A cohort of patients (n = 146) was identified among those who received consultative care from DHA IHD clinicians for AEFI concerns between April 2017 and September 2022. Analyses were restricted to non-uniformed beneficiaries of the Military Health System (MHS). Uniformed beneficiaries of the MHS were excluded from this analysis since vaccination mandates preclude the use of vaccine uptake as a measure of vaccine hesitancy. Outcomes were evaluated by reviewing MHS vaccination records after initial AEFI consultation through January 2023. Vaccine acceptance was considered the inverse of hesitancy, and was defined by: (a) receipt of any subsequent vaccination, (b) receipt of seasonal influenza vaccine, (c) receipt of subsequent doses of the AEFI-associated vaccine, if clinically recommended, and (d) receipt of COVID-19 vaccine. Results A diverse group of patients with a wide range of AEFI concerns received specialized vaccine care from DHA IHD clinicians during this period. Among the cohort, 78% of patients received any subsequent vaccination, 55.2% received seasonal influenza vaccine, 57.8% received a subsequent dose of their AEFI-associated vaccine when the vaccine was clinically recommended, and 48.9% received COVID-19 vaccine. The proportion of patients who received influenza vaccine exceeded the reported rate of influenza vaccine uptake by the general population during this time period. Conclusion Specialized vaccine care after AEFI concerns was associated with relatively high acceptance of subsequent vaccinations. The experiences of DHA IHD clinicians, in providing specialized vaccine care to AEFI patients, may serve as a model for other organizations that are working to reduce vaccine hesitancy, even beyond the MHS. [ABSTRACT FROM AUTHOR]

Following the World Health Organization's declaration that the COVID-19 pandemic is no longer a public health emergency of international concern (PHEIC), COVID-19 remains an ongoing threat to human health and healthcare systems. Vaccination plays a crucial role in reducing the disease's incidence, mitigating its severity, and limiting transmission, contributing to long-term public health resilience. However, incomplete vaccination coverage and vaccine hesitancy exist. This narrative review investigates strategies at the system and physician levels aimed at sustaining awareness and uptake of COVID-19 vaccination in a post-PHEIC era. Through an examination of the existing literature, this review explores the effectiveness of diverse approaches utilized by healthcare systems and individual providers. These approaches address every component of the 5C model of vaccine hesitancy: confidence, complacency, constraints/convenience, calculation, and collective responsibility. Physician-level approaches include appropriate message framing, persuasive communication containing safety and personal/social benefit information, sharing of personal stories, creating a safe space for discussion, harnessing co-administration with annual influenza vaccines, and use of decision aids and visual messages. System-level approaches include messaging, mass media for health communication, on-site vaccine availability, pharmacist delivery, healthcare protocol integration, incentives, and chatbot use. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the demographic characteristics of vaccine refusals in Malatya province, identify reasons for vaccine hesitancy, and guide future intervention efforts. Data for this descriptive study were collected through face-to-face interviews using a socio-demographic form developed by researchers, reasons for non-vaccination, and the short form of the "Turkish Vaccine Hesitancy Scale" and "Parental Attitudes towards Childhood Vaccinations" (PACV) scales. Statistical analysis included chi-square test, Mann-Whitney U test, and Spearman correlation test. Vaccine hesitancy was found in 86.0% of parents who did not vaccinate their children. The most common reasons for non-vaccination were "lack of confidence in vaccine content" (65.1%), "observation of side effects in others after vaccination" (19.8%), and "exposure to negative statements about vaccines on social media". As the educational level of both parents increased, nonvaccination due to a lack of confidence in vaccine content was more common. There was no relationship found between the presence of vaccine hesitancy and socio-demographic characteristics. Parents who do not vaccinate have low confidence in vaccines, and the influence of media, particularly press and social media, is significant in vaccination decision-making. Efforts should be made by both healthcare professionals and policymakers to increase confidence in vaccines and prevent access to misinformation about vaccines, thus minimizing vaccine hesitancy. [ABSTRACT FROM AUTHOR]

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PurposeThe purpose of this study was to assess differences in COVID-19 vaccine willingness and uptake between rural and nonrural adults, and within rural racial-ethnic groups.MethodsWe utilized data from the COVID-19's Unequal Racial Burden online survey, which included 1,500 Black/African American, Latino, and White rural adults (n = 500 each). Baseline (12/2020-2/2021) and 6-month follow-up (8/2021-9/2021) surveys were administered. A cohort of nonrural Black/African American, Latino, and White adults (n = 2,277) was created to compare differences between rural and nonrural communities. Multinomial logistic regression was used to assess associations between rurality, race-ethnicity, and vaccine willingness and uptake.FindingsAt baseline, only 24.9% of rural adults were extremely willing to be vaccinated and 28.4% were not at all willing. Rural White adults were least willing to be vaccinated, compared to nonrural White adults (extremely willing: aOR = 0.44, 95% CI = 0.30-0.64). At follow-up, 69.3% of rural adults were vaccinated; however, only 25.3% of rural adults who reported being unwilling to vaccinate were vaccinated at follow-up, compared to 95.6% of adults who were extremely willing to be vaccinated and 76.3% who were unsure. Among those unwilling to vaccinate at follow-up, almost half reported distrust in the government (52.3%) and drug companies (46.2%); 80% reported that nothing would change their minds regarding vaccination.ConclusionsBy August 2021, almost 70% of rural adults were vaccinated. However, distrust and misinformation were prevalent among those unwilling to vaccinate at follow-up. To continue to effectively combat COVID-19 in rural communities, we need to address misinformation to increase COVID-19 vaccination rates.

BACKGROUND: Vaccination misinformation can contribute to vaccine hesitancy and decreased vaccination. Previous immunization events at various K-12 schools carried out by Idaho State University L.S. Skaggs College of Pharmacy have noticed a small turn out of teachers and staff getting immunized during these events. Given the prominent role that teachers/staff serve in communities, we surveyed K-12 teachers and staff to determine their perceptions, knowledge, and reasons surrounding vaccine hesitancy. Our survey focused on the influenza vaccine, but also inquired about vaccine knowledge in general. METHODS: A Qualtrics survey was distributed online throughout the West Ada School District, located in southwestern Idaho. Demographics, receipt of vaccine, influenza vaccination motivation, knowledge and reasons for hesitancy were collected. Surveys were distributed July 2020 and analyzed using descriptive statistics. Response differences between those who most recently received their influenza vaccine and those who did not were also compared using chi-square or Mann-Whitney U tests when appropriate. RESULTS: A total of 503 surveys were completed, with all respondents college educated and teaching throughout the K-12 curriculum. A majority of respondents (n=409;81%) received a yearly influenza vaccination. Reasons for vaccination included: avoidance of flu, reduction of spread, and prevention of complications. Reasons against vaccination included: lack of efficacy, side effects, and numerous “other” responses. When comparing general influenza vaccine knowledge between those who received their influenza vaccine vs. those that did not, those who had been vaccinated displayed responses that more closely coincided with scientific data. CONCLUSIONS: The majority of surveyed K-12 teachers/staff received their influenza vaccine during the 2019-2020 season. However, ~20% of teachers/staff are still hesitant due to misinformation regarding vaccinations. Resources and partnerships between health organizations and school districts may increase vaccine acceptance.

Summary: Background: Vaccination hesitancy poses a serious threat to mpox vaccination programs. Historically, vaccine uptake in the African region has been low, and this trend may impact future vaccination efforts. Our aim was to investigate the relationships between mpox vaccination hesitancy, immunisation coverage for other vaccines, and vaccination readiness among African adults. Methods: A multinational commercial web panel survey was conducted among 1832 African adults across six countries (Uganda, Nigeria, Morocco, Egypt, Kenya, and South Africa) from October 1 to October 10, 2024. Mpox vaccination hesitancy for themselves and children was defined as the reluctance to receive vaccines against mpox (if vaccines were available) for themselves and for children (if they had children). Vaccination readiness was assessed via the 7Cs model, which includes confidence, complacency, constraints, calculation, collective responsibility, compliance, and conspiracy. Weighted logistic regression models with the set of calibration sampling weights were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CIs). The analysis explored the effects of immunisation coverage for other vaccines and vaccination readiness on hesitancy toward mpox vaccination, including mediation and joint relationships. DerSimonian-Laird random-effects meta-analyses were utilised to pool the results from six countries. Findings: The pooled weighted rate of mpox vaccination hesitancy among participants was 32.7% (95% CI: 25.4–40.0, I2 = 91.5%, p

IntroductionThe COVID-19 (COronaVIrus Disease-2019) pandemic highlighted the importance of assessing the rationales behind vaccine hesitancy for the containment of pandemics. In this nationwide study, representative of the Luxembourgish population, we identified hesitant groups from adolescence to late adulthood and explored motivations both for and against vaccination.MethodsWe combined data collected via online surveys for the CON-VINCE (COvid-19 National survey for assessing VIral spread by Non-affected CarriErs) study, 1865 respondents aged 18–84, and for the YAC (Young people And Covid-19) study, 3740 respondents aged 12–29. Data from both studies were harmonized and weighted to ensure a sample representative of Luxembourg’s resident population. The surveys included information on demographic and socio-economic factors as well as vaccination hesitancy.ResultsAt the time of the survey, 67.0% of respondents had been vaccinated against SARS-CoV-2 (Severe Acute Respiratory Syndrome COronaVirus-2), while 33.0% of the respondents had not yet been vaccinated. Of those not yet vaccinated, 41.8% of respondents were vaccine hesitant. The most important concerns against vaccination were that the vaccine had not been tested sufficiently (59.4%) and the fear of side effects (52.4%). The most frequent reasons for vaccination were to help society overcome the pandemic (74.8%), and to protect oneself from the consequences of infection with the virus (69.3%). The proportion of unvaccinated respondents unwilling or undecided to get vaccinated was higher in the younger age groups compared to the higher age groups.ConclusionOur findings contribute to improving public health policy communications, not only for future pandemics but also for routine vaccination campaigns. This will help reach those who are unwilling (26.7%) or undecided (15.1%) about vaccination and reinforce strategies that have successfully increased vaccination willingness.

ABSTRACT Objective To estimate measles-mumps-rubella vaccination coverage, delay and loss to follow-up in children up to 24 months old living in Brazilian cities. Methods Surveys and questionnaires with a retrospective cohort of live births in 2017-2018, analyzing vaccination coverage and sociodemographic data of children and families, based on vaccination card records and interviews. Results Valid coverage of first dose was 90.0% (95%CI 88.9;91.0) and 81.1% for the second dose (95%CI 79.8;82.4). Delay for both doses was 23.2% (95%CI 21.9;24.5) and loss to follow-up was 10.8% (95%CI 9.9;11.8). Socioeconomic stratum A had the lowest vaccination coverage and the higher the child’s birth order, the lower the vaccination coverage for the second dose. Children whose mothers had 13 to 15 years of education had higher vaccination coverage. Conclusion Coverage did not meet the recommended target. Differentiated strategies to resolve difficulties in access, misinformation, and vaccination hesitancy will help improve vaccination coverage.

The role of immunization in public health is crucial, offering widespread protection against infectious diseases and underpinning societal well-being. However, achieving optimal vaccination coverage is impeded by vaccine hesitancy, a significant challenge that necessitates comprehensive strategies to understand and mitigate its effects. We propose the integration of Population Health Management principles with Immunization Information Systems (IISs) to address vaccine hesitancy more effectively. Our approach leverages systematic health determinants analysis to identify at-risk populations and tailor interventions, thereby promoting vaccination coverage and public health responses. We call for the development of an enhanced version of the Italian National Vaccination Registry, which aims to facilitate real-time tracking of individuals’ vaccination status while improving data accuracy and interoperability among healthcare systems. This registry is designed to overcome current barriers by ensuring robust data protection, addressing cultural and organizational challenges, and integrating behavioral insights to foster informed public health campaigns. Our proposal aligns with the Italian National Vaccination Prevention Plan 2023–2025 and emphasizes proactive, evidence-based strategies to increase vaccination uptake and contrast the spread of vaccine-preventable diseases. The ultimate goal is to establish a data-driven, ethically sound framework that enhances public health outcomes and addresses the complexities of vaccine hesitancy within the Italian context and beyond.

This study aimed to assess the level of knowledge regarding influenza viruses and vaccines among different professional groups to investigate the reasons for vaccine hesitancy. We collected 2190 questionnaires regarding influenza vaccines in China in 2022. The respondents were categorized into the general population (GP), foreign affairs workforce population (FAWP), and veterinary workforce population (VWP) according to their job positions. Linear regression was used to assess the association between multiple factors and influenza vaccination rates. The association between work and influenza vaccination rates was also assessed by grouping different workforce populations. The vaccination rate of the GP was higher than that of the VWP (odds ratio: 1.342, 95% confidence interval: 1.025–1.853), surpassing the rates reported in previous studies. This may be attributed to heightened concerns about infectious diseases influenced by the ongoing coronavirus disease 2019 pandemic. Despite the VWP’s more in-depth knowledge of the VWP on zoonotic diseases and their recognition of their importance, there was no significant difference in influenza knowledge among the three populations. This discrepancy contrasts with the observed differences in vaccination rates. Further investigation revealed that, compared with FAWP, the price of vaccines emerged as a primary influencing factor for vaccination rates (odds ratio:0.398, 95%CI; 0.280–0.564). General concerns regarding the protective effects and side effects of vaccines were also noted.

Introduction: Immunization is one of the most cost-effective nursing interventions aimed at reducing ill health and premature death among children. Despite tremendous efforts by governments, vaccination coverage remains low, especially in developing countries. Masvingo district is one of the districts with low vaccination coverage in the country. Objectives: This study sought to assess immunization coverage, identify determinants of vaccination coverage and assess factors associated with low full immunization coverage in Masvingo district, Zimbabwe. Methods: An analytical cross-sectional study design was conducted between January 2019 and February 2019. Masvingo province was purposively selected due to its low vaccination coverage (60.3%) according to the Zimbabwe Demographic and Health Survey 2015. WHO cluster sampling was used to select households. A total of 354 children and their mothers residing in Masvingo district were recruited for the study. Pre-tested interviewer-administered questionnaires were used to collect data. Bivariate analysis was employed to assess factors associated with low vaccination coverage. Results: An estimated 89.5% of children aged 12-23 months were fully vaccinated by card or mothers’ recall. Factors significantly associated with full vaccination coverage rates (P