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Aim: To explore the attitudes of healthcare workers towards COVID‐19 vaccines. Design: A qualitative descriptive design was used. Methods: Five focus groups were conducted between October and November 2021, with a total of 30 nurses from different contexts in Northern Italy. Thematic analysis was used to analyse the transcripts. Results: Three main themes were identified: 'favourable', 'unsure' and 'contrary to' COVID‐19 vaccines. The favourable position was underpinned by trust in science, research and vaccination; protection for themselves, their families, patients and the population; duty as professionals; necessity to set an example for others. Participants who were unsure had doubts about the composition, safety and efficacy of the vaccine and were sometimes afraid that media provided incomplete information. The main reason why nurses were against was the feeling that being forced to vaccinate perceived as blackmail. Favourable or unsure nurses struggled to deal with those who were against and developed a series of emotions that ranged from respect and attempt to rationalize, to frustration and defeat. Conclusions: Identifying the areas of hesitation is essential to understand what affects the choices of acceptance, delay or refusal of vaccination. The issues that emerged regarding proper communication within the vaccination campaign highlights the key importance of adequate vaccination strategies. Implication for the Profession and/or Patient Care: Understanding attitudes towards vaccine and related motivations among healthcare workers could help develop more specific and targeted vaccination campaigns that can ensure proper vaccination coverage rates and avoid hesitancy or refusal. Impact: Healthcare workers experiences of COVID‐19 vaccines, their views and know how they feel during COVID‐19 vaccinations.Healthcare workers had three different positions in COVID‐19 vaccination.This research will guide and target future vaccination campaigns. Reporting Method: The study is reported using the Standards for Reporting Qualitative Research (SRQR). Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy was a major challenge during the COVID-19 pandemic. A common but sometimes ineffective intervention to reduce vaccine hesitancy involves providing information on vaccine effectiveness, side effects, and related probabilities. Could biased processing of this information contribute to vaccine refusal? We examined the information inspection of 1200 U.S. participants with anti-vaccination, neutral, or pro-vaccination attitudes before they stated their willingness to accept eight different COVID-19 vaccines. All participants—particularly those who were anti-vaccination—frequently ignored some of the information. This deliberate ignorance, especially toward probabilities of extreme side effects, was a stronger predictor of vaccine refusal than typically investigated demographic variables. Computational modeling suggested that vaccine refusals among anti-vaccination participants were driven by ignoring even inspected information. In the neutral and pro-vaccination groups, vaccine refusal was driven by distorted processing of side effects and their probabilities. Our findings highlight the necessity for interventions tailored to individual information-processing tendencies. [ABSTRACT FROM AUTHOR]

Preparing for the new school year is an exciting and busy time. An important task for parents and caregivers during the back-to-school season is to ensure that their child or adolescent is up to date with their vaccines. NPs play a vital role in guiding parents and caregivers through the vaccination process, thereby ensuring that school-aged children and adolescents' health requirements are met. This article provides NPs with resources to assist in making decisions about child and adolescent immunizations. It also explores effective communication strategies to convey the benefits of vaccination to parents and caregivers, equipping NPs with the necessary knowledge and tools to navigate vaccination complexities and advocate for the health and safety of school-aged children and adolescents. [ABSTRACT FROM AUTHOR]

There are both theoretical accounts and empirical evidence for the fact that, in health communication, narratives (story telling) may have a persuasive advantage when compared with information (the provision of facts). The dominant explanation for this potential advantage is that narratives inhibit people's resistance to persuasion, particularly in the form of counterarguing. Evidence in this area to date has most often been gathered through lab or field experiments. In the current study we took a novel approach, gathering our data from naturally-occurring, non-experimental and organically evolving online interactions about vaccinations. We focus on five threads from the parenting forum Mumsnet Talk that centered on indecision about the HPV vaccination. Our analysis revealed that narratives and information were used by posters in similar quantities as a means of providing vaccination-related advice. We also found similar frequencies of direct engagement with both narratives and information. However, our findings showed that narratives resulted in a significantly higher proportion of posts exhibiting supportive engagement, whereas information resulted in posts exhibiting a significantly higher proportion of challenges, including counterarguing and other manifestations of posters' resistance to persuasion. The proportions of supportive versus challenging engagement also varied depending on the topic and vaccine stance of narratives. Notwithstanding contextual explanations for these patterns, our findings, based on this original approach of using naturalistic data, provide a novel kind of evidence for the potential of narratives to inhibit counterarguing in authentic health-related discourse. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination reduces the risk of severe disease, in children as well as adults. We studied COVID-19 vaccination coverage among children, parental COVID-19 vaccination intent for their children and determinants of vaccination among children to inform communication strategies. We invited parents of children aged 6 months–11 years in Munich, Germany, to an anonymous online survey between 13.10.2022 and 15.01.2023. Parents reported COVID-19 vaccination status and, for unvaccinated children, vaccination intent per child. We determined vaccination coverage (≥ 1 dose) and parental intent, and subsequently used logistic regression to identify determinants of vaccination, including the 5C psychological antecedents of vaccination (confidence, complacency, constraints, calculation, collective responsibility). In total, 339 parents reported on 591 children. Vaccination coverage was 7% (6/86) amongst 6-months–4-year-olds and 59% (295/498) amongst 5–11-year-olds. For unvaccinated 6-months–4-year-olds, 31% of parents reported high, 13% medium, 56% low vaccination intent; for 5–11-year-olds 8% reported high, 20% medium, 71% low intent. Positive determinants of vaccination were older child age, child belonging to a clinically vulnerable group, as well as parental COVID-19 vaccination, higher education level, country of birth Germany, and high level of trust in official guidelines; a negative determinant was previous vaccination refusal. For 5–11-year-olds, additional positive determinants were higher confidence and lower complacency. Conclusion: While a substantial proportion of 5–11-year-olds were vaccinated against COVID-19, coverage was low among 6-months–4-year-olds. Parental vaccination intent for unvaccinated children was low. Vaccination communication should take into account parental socio-demographic characteristics and specifically address individual risks and benefits of child vaccination. What is Known: • COVID-19 vaccination lowers severe disease risk in all ages. • Germany recommends vaccination for 5–11-years-olds since December 2021 and for 6 months–4 year-olds since November 2022. What is New: • In Munich, vaccine uptake was high in 5–11-year-olds but parental intent for not yet vaccinated children was low; the opposite was the case for 6-months–4-year-olds; vaccination determinants were eligibility, parental education, birth country and general vaccination hesitancy; psychological antecedents were confidence and complacency. • Tailored interventions should address guidelines, health literacy, cultural sensitivity, and boost confidence in vaccines and institutions while raising awareness of COVID-19 risks for children. [ABSTRACT FROM AUTHOR]

Objective: Vaccines are the most effective tools in preventing childhood infectious diseases. Parents’ knowledge and attitudes about vaccines are fundamental factors influencing vaccination rates. While there are numerous studies about mothers, research examining fathers’ knowledge and attitudes on vaccines is limited. Our study aims to assess fathers’ knowledge and attitudes about vaccines administered in our country, determine their approach to vaccination, and understand their views on vaccine hesitancy. Methods: A cross-sectional and analytical study evaluating fathers’ knowledge and attitudes about vaccines was conducted between May and July 2022 among fathers visiting the pediatric clinic. After obtaining ethical approval, fathers were administered a questionnaire covering sociodemographic information, income, education level, number of children, fathers’ vaccine attitude, knowledge level, and non-routine vaccine considerations to assess their knowledge and attitudes about vaccines. Results: While 33% of participating fathers considered their vaccine knowledge good, 14.1% didn’t know their children’s vaccines, and 23% were unaware of vaccination timing. The majority of fathers used healthcare institutions and physicians for information about vaccines. While 17.3% experienced hesitancy about vaccinating their children, none outright refused. The most common reason for vaccine hesitancy (78.1%) was the fear of vaccine side effects. As parental education levels increased, the positive attitudes of fathers towards childhood vaccinations also increased. Conclusion: Vaccination plays a crucial role in maintaining public health. Providing accurate information to families is important to reduce vaccine hesitancy and increase vaccination rates. Healthcare professionals offering reliable information is an effective factor in fostering positive attitudes toward vaccines and increasing vaccination rates.

Background Despite the availability of a vaccine to combat COVID-19 disease, vaccine hesitancy is still a major concern, notably in countries with developing healthcare systems such as Pakistan. Hence, this study considered the rationale for vaccine hesitancy in Pakistani university students and support staff, and the impact of gender, age, and education on vaccination hesitancy. Methods A cross-sectional study was conducted with randomly selected university students and supportive staff. An anonymous questionnaire collected data covering socio-demographic characteristics, vaccination status, current beliefs, and past vaccination history. Responses were assessed using descriptive analysis (p-value estimation and correlation/regression) and machine learning models applied to classify individuals based on their acceptance or vaccine hesitancy behavior and then used to predict the important variables associated with vaccine hesitancy. Results The survey of 847 participants revealed that 43% were vaccinated and 57% were vaccine hesitant; of which 37%, 38%, and 25% had safety and efficacy concerns, were afraid of side effects, or exhibited other complacency behavior regarding vaccination, respectively. Non-university educated people were significantly more hesitant than university-educated people (p = 0.033). Vaccine refusal was significantly higher in students than in supportive staff (p = 0.01). Correlation analysis revealed a strong association between key independent variables (the fear of side effects, mistrusted information, and low perceived disease risk without vaccination) and vaccine acceptance (dependent variable), as revealed by linear regression and a Structure Model Equation. Machine learning classified vaccine-hesitant and vaccine-acceptant individuals with commutative accuracy of 96% and 97%, respectively, using random forest and logistic regression. Logistic regression identified five predictors for vaccine hesitancy: low perceived disease risk without vaccination, mistrusted information, the fear of side effects, occupation, and education. Conclusion Education campaigns that cover the safety, efficacy, and importance of vaccination are needed to increase vaccination take-up to protect from COVID-19 disease.

AbstractCount data with complex features arise in many disciplines, including ecology, agriculture, criminology, medicine, and public health. Zero inflation, spatial dependence, and non-equidispersion are common features in count data. There are currently two classes of models that allow for these features—the mode-parameterized Conway–Maxwell–Poisson (COMP) distribution and the generalized Poisson model. However both require the use of either constraints on the parameter space or a parameterization that leads to challenges in interpretability. We propose spatial mean-parameterized COMP models that retain the flexibility of these models while resolving the above issues. We use a Bayesian spatial filtering approach in order to efficiently handle high-dimensional spatial data and we use reversible-jump MCMC to automatically choose the basis vectors for spatial filtering. The COMP distribution poses two additional computational challenges—an intractable normalizing function in the likelihood and no closed-form expression for the mean. We propose a fast computational approach that addresses these challenges by, respectively, introducing an efficient auxiliary variable algorithm and pre-computing key approximations for fast likelihood evaluation. We illustrate the application of our methodology to simulated and real datasets, including Texas HPV-cancer data and US vaccine refusal data. Supplementary materials for this article are available online. [ABSTRACT FROM AUTHOR]

Background: Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. Methods: From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9–17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. Results: Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02–1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. Conclusions: These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls. [ABSTRACT FROM AUTHOR]

Background: COVID-19 vaccine hesitancy is a major public health challenge with the potential to prevent communities from achieving the coverage level necessary for herd immunity against the COVID-19 virus. Objective/aim: The study determined COVID-19 vaccine acceptance and associated factors among residents of the Afadzato South District of Ghana. Methods: A descriptive cross-sectional study was conducted among 422 respondents aged 18 years and above using a self-administered and interviewer administered structured questionnaires for persons who could read and with no formal education respectively. The study was conducted and reported in line with the Strobe statement for cross sectional studies. Data analysis was done using the Stata-17.0 software. The association between the dependent and independent variables was examined using a logistic regression analysis, with a p-value of < 0.05 considered statistically significant. Results: More than half of the respondents (n = 291, 68.96%) were below 25 years old. Majority of the respondents were females (n = 218, 51.66%) and had attained secondary education (n = 291, 68.96%). Less than half of the respondents 35.5% (151) indicated acceptance of the COVID-19 vaccine and more than half (n = 271, 64.22%) indicated non-acceptance of the COVID-19 vaccine. The results showed that education level, information source, overall knowledge of COVID-19 vaccine, and misconception of COVID-19 vaccine were significantly associated with acceptance of the COVID-19 vaccine. Conclusion: The study found high vaccine hesitancy among the respondents. Important significant predictors of COVID-19 vaccine hesitancy were education level, information source, overall knowledge of COVID-19 vaccine, and misconception of COVID-19 vaccine. In the attempt to address vaccine hesitancy by health agencies, it is important to take into consideration the varying educational backgrounds of the population in context and their diversified sources of information. This may ensure that everyone in the community is reached with important information on COVID-19 and its vaccines to reduce misconceptions and misinformation. [ABSTRACT FROM AUTHOR]

Context: In 2021, French health authorities strongly promoted vaccination against COVID-19. The authors assumed that refusing this vaccine became a stigma, and they investigated potential public stigma toward unvaccinated people among the French population. Methods: A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. The authors focused on participants who were already vaccinated against COVID-19 or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and the authors investigated associated factors with logistic regressions. Findings: Regarding attitudes toward unvaccinated people, a majority of respondents supported several pejorative statements, and a significant minority also endorsed social rejection attitudes. The authors found four contrasting attitudinal profiles: moral condemnation only (32% of respondents), full stigma (26%), no stigma (26%), and stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes, and being aged 65 or older were the main factors associated with stigmatizing attitudes toward unvaccinated people. Conclusions: The authors found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. The authors discuss their results with reference to the concept of "folk devils" and from a public health perspective. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has lasted for over 2 years and has resulted in more than 486 million cases and over 6 million deaths worldwide. Pregnant women are a special group of society exposed to severe or unpredictable course of infection. Purpose of work: Assessment of awareness and willingness to vaccinate pregnant women against COVID-19 and reasons influencing this decision. Materials and methods: The proprietary online survey addressed to women in Poland during pregnancy and women who were pregnant in the period from December 27, 2020 (introduction of the vaccine in Poland) to 20.03.2022. The study included a total of 518 respondents of reproductive age, among which 398 have a university degree and 108 have secondary education. 376 respondents got vaccinated against COVID-19 -- 120 before getting pregnant, 199 during pregnancy and 57 after giving birth. Summary: Most of the surveyed women (321) hadn't had a positive PCR test for COVID-19 until the day of the survey, but 38% had a positive PCR test. Asked about reasons for getting vaccinated during pregnancy, most of the respondents stated that people should get vaccinated against COVID-19 in general, they got vaccinated because of the baby's health, and that they acted according to the recommendations of The Polish Society of Gynecologists and Obstetricians and the World's Health Organization. On the other hand, most of the women didn't get vaccinated because they were afraid of the side effects, there is not enough research on the topic, and they believe that the vaccination is ineffective. Additionally, 154 respondents were encouraged by the doctors to get vaccinated in opposite to 21 who were discouraged by the doctor. The majority of the respondents are aware of the great risk of COVID-19 infection during pregnancy. Therefore, they got vaccinated against COVID-19 to minimize the risks of the infection. [ABSTRACT FROM AUTHOR]

Using a questionnaire, this study investigated the numerous factors affecting the Jordanian population's rejection of COVID-19 vaccines. The data were collected in 2020 to 2021. Using the chi-square test, t -test, Cramer's V -test, and analysis of variance, we found that most of the Sample (72.6%) obtained information on COVID-19 and its vaccines from social media, radio, and television. In comparison, 31.1% and 35.4% of the Sample obtained from government/official sources or health specialists, respectively, with a lesser share relying on colleagues (13.7%) and scientific lectures (17.5%). Furthermore, depending on the participants' characteristics, there were significant differences in the information sources or abstinence factors. Several factors were associated with vaccine refusal and hesitancy, including contradictory/conflicting information, lack of trust in vaccines/manufacturers, doubt about the vaccines' effectiveness, and the belief that the risks of COVID-19 are minimal. Based on these findings, we present several recommendations for policymakers. Plain Language Summary: Vaccine Refusal Factors associated with vaccination refusal among a sample of the Jordanian population This study aimed to comprehend what causes Jordanians to refuse vaccinations. Most participants of the present study learned about COVID-19 and vaccines from radio, television, and social media. Fewer of them turned to official and professional sources. Conflicting information about COVID-19, skepticism about the effectiveness of vaccines and potential side effects, skepticism toward vaccine manufacturers and media sources, uncertainty regarding the efficacy of vaccines, and mistrust in information sources regarding the virus and vaccines have led to confusion and resistance to following health recommendations. These factors resulted in vaccine rejection by considerable percentages of the Jordanian population. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic continues to spread throughout the world causing serious morbidity and mortality. Health care professionals (HCP) are on the front line in the face of this pandemic and are identified as priorities for COVID-19 vaccination. This study aimed to estimate the acceptability rate of the COVID-19 vaccination among HCP and to identify their predisposing factors. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire including a randomized sample of HCP in Southern Tunisia, on March–April 2021. Results: Among 300 participants, the COVID-19 vaccine acceptability rate was 65.3%. Factors independently associated with vaccine acceptability were age groups <30 years [Adjusted Odds Ratio (AOR)=4.36; p = 0.002)], urbanity of residence (AOR = 3.44; p = 0.027), medical professional category (AOR = 2.69; p = 0.023) and caring for coronavirus infected patients (AOR = 2.32; p = 0.047). Belief that COVID-19 vaccination is important to work safely as a health care provider (AOR = 3.26; p = 0.013), should be available for all HCP (AOR = 17.98; p = 0.004) and has been quickly developed before it has been thoroughly vetted and tested for efficacy and safety (AOR = 5.88; p < 0.01) were independently associated with willingness to accept vaccine. Planning to get a COVID-19 vaccine for the next years and recommending it to the family were independent predictive factors of accepting COVID-19 vaccine ((AOR = 6.88; p < 0.001) and (AOR = 25.03; p < 0.001), respectively).Conclusion: The acceptance rate of vaccination against COVID-19 among Tunisian HCP is still low in South Tunisian hospitals. Socio-demographic, cultural and professional factors predisposing to the vaccination willingness were highlighted. Combating the vaccine hesitancy of HCP through enhancing sensibilization campaigns is essential to promote vaccination in general population. [ABSTRACT FROM AUTHOR]

Background: At the time of the emergence of COVID-19, denialist and anti-vaccine groups have also emerged and are shaking public confidence in vaccination. Methods: A qualitative study was conducted using online focus groups. Participants had not received any doses of vaccination against the disease. A total of five focus group sessions were conducted with 28 participants. They were recruited by snowball sampling and by convenience sampling. Results: The two major topics mentioned by the participants were adverse effects and information. The adverse effects described were severe and included sudden death. In the case of information, participants reported: (1) consultation of websites on which scientists posted anti-vaccination content; and (2) distrust. Conclusions: At a time when anti-vaccine groups pose a major challenge to public health in general, and to COVID-19 vaccination campaigns in particular, this study is a first step towards gaining deeper insight into the factors that lead to COVID-19 vaccine refusal. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic reached its second year, and vaccine mandates to return to work or school became a contested debate among leaders in health care organizations and universities, nursing academic and hospital leadership had to consider which health and safety requirements, including COVID-19 vaccines, were needed to return students, nurses, and nurse faculty to more typical clinical and classroom activities. In this context, this mixed-methods study surveyed and analyzed data from a large national sample of students, nurses, and faculty about their vaccine status, and reasons for their decisions to be vaccinated or not. Study findings point clearly to the need for better messaging in all public health campaigns, emphasizing the protection of others as the strongest predictor for vaccine uptake. [ABSTRACT FROM AUTHOR]

Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Community & Physician / Toplum ve Hekim is the property of Turk Tabipleri Birligi / Turkish Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States of America (USA). Cervical cancer is the most common HPV-related cancer, which leads to approximately 4000 deaths yearly in women. Despite the nationwide availability of the HPV vaccine, the coverage and series-completion rates have been historically low due to multiple barriers. Previous systematic literature reviews emphasize global quantitative studies regarding parents of pediatric populations. This study aimed to evaluate qualitative studies conducted in the USA to characterize the facilitators and barriers to HPV uptake among eligible women. Four databases, including PubMed/MEDLINE, Embase, Scopus, and the Cumulative Index for Nursing and Allied Health Literature (CINAHL), were utilized to search the literature for comprehensive qualitative studies from 2014 to 2023 with pre-selected inclusion criteria. This review was conducted in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After detailed full-text extraction, 26 studies met the inclusion criteria, and two authors extracted the data. Three themes emerged from the data: (1) facilitators perceived by women to uptake the HPV vaccine, (2) barriers perceived by women to uptake the HPV vaccine, and (3) barriers and facilitators perceived by women to uptake the HPV vaccine. These themes highlighted different barriers and facilitators to HPV vaccines uptake, such as the lack of healthcare provider recommendation, cost, and safety concerns as barriers to receiving the vaccine. To change the norms towards HPV vaccine hesitancy, the healthcare team has a important opportunity to impart the knowledge and skills known to elicit behavior change. [ABSTRACT FROM AUTHOR]

Copyright of TSG: Tijdschrift Voor Gezondheidswetenschappen is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The worldwide elimination of measles and rubella is feasible, but not without overcoming the substantial challenge of vaccine hesitancy. This challenge is complicated by the spread of misinformation and disinformation fueled by rapidly progressing technologies and evolving forms of online communication. The recent COVID-19 pandemic has only added further complexity to this challenge. However, considerable progress has been made in understanding the scope of the problem and the complex factors that influence vaccine hesitancy. Our understanding of evidence-based strategies for addressing vaccine hesitancy has grown significantly, including evidence for effective communication and behavioral interventions. In this article, we review measles and rubella vaccines and vaccine hesitancy. We then provide an overview of evidence-based strategies for addressing vaccine hesitancy, including communication strategies and behavioral interventions. This article is relevant to healthcare professionals, health system leaders, public health professionals, policymakers, community leaders, and any individuals who have a role in addressing vaccine hesitancy in their communities. Finally, we review future directions and major areas of research need. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic presented an unprecedented challenge to public health as well as an extraordinary burden on health systems worldwide. COVID-19 vaccines were attributed as a key tool to control the pandemic, with healthcare workers (HCWs) as a priority group to receive the vaccine. Healthcare workers are considered one of the most trusted sources of information on vaccines and vaccination. This study was conducted to evaluate the acceptability of the COVID-19 vaccine among HCWs in four different provinces of Indonesia. An anonymous cross-sectional study was conducted online among HCWs between December 2020 and February 2021. Out of 2732 participants, 80.39% stated that they would accept the COVID-19 vaccine, while 19.61% were hesitant to receive the vaccine. Concerns about the safety profile of COVID-19 vaccines and potential side-effects after vaccination were the main reasons among the participants to refuse the vaccine. Male gender, single status, higher education level, and higher risk perception increased the acceptability of the COVID-19 vaccine. Other motivators of COVID-19 vaccine acceptance include a high level of trust in the government and increased confidence in vaccine safety and efficacy studies. Dissemination of information in a timely manner as well as training programs for HCWs are crucial to increasing confidence in the COVID-19 vaccination program. [ABSTRACT FROM AUTHOR]

Poliomyelitis is a contagious disease that still remains in Pakistan, despite efforts to ensure full vaccination coverage, but, in counterpart, refusal is prevailing. Therefore, the present study was conducted to assess refusal factors to polio vaccination. A cross-sectional approach was followed for the present study which was conducted in the North Waziristan Tribal District (polio endemic area) between January 2023 to July 2023. Data were collected on a self-developed questionnaire. The study participants were from the general public and were recruited through simple random sampling. The data were analyzed using Statistical package for social sciences SPSS. A total of 387 respondents completed the survey, amongst which most of the respondents were male (90.7%), living in a joint family (87.1%), and had primary education (48.3%). Most of the respondents showed poor knowledge regarding polio disease (58.7%). Religious extremism, poor knowledge regarding the disease and joint family culture were the significant predictors of the refusal of polio vaccination. This refusal may cause the re-emergence of polio outbreaks.

IntroductionVaccination practice is a well-known individual protective measure for biological risk in healthcare. During the COVID-19 pandemic vaccine hesitancy has grown among healthcare workers (HCWs). The study aims to investigate how vaccine hesitancy influences the psychological burden experienced by healthcare workers.MethodsThis study aimed to explore attitudes of HCWs in acceptance or refusal of vaccinations related to the risk of psychological impairment (PI) and describe the associated occupational factors, during the seasonal flu/COVID-19 vaccination campaign of 2022–2023. 302 HCWs were enrolled in the study. A questionnaire was self-administered, including two scales on the risk of psychological impairment (Psychological Injury Risk Indicator, PIRI) and vaccine hesitancy (Adult Vaccine Hesitancy Scale, AVHS).ResultsPIRI scores revealed that 29.8% of participants were at risk of PI. Differences in sex, age, occupational seniority, professional category, and night shifts were found between HCWs at risk of PI and those not at risk. Females registered a four-fold higher risk than males (85.6% vs. 14.4%, χ2 = 4.450, p

This article aims to analyze several issues of the implementation of the regulation of vaccination in Indonesia, encompassing the issues of the imposition of criminalization following the vaccination refusal, discussion on its objective, and practical challenges that potentially emerge. As qualitative research, this article employed a normative legal approach and social contextualization to comprehend regulations, legal interpretations, and arguments. This article finds that the government has amended the Presidential Regulation No. 99 of 2020 on the Procurement and Implementation of Vaccination to the Presidential Regulation No. 14 of 2021 on the Change of the Presidential Regulation No. 99 of 2020 in dealing with the issue of punishment imposed on those refusing the vaccination. From the perspective of utilitarian humanism, the regulation aims to ensure the success of the vaccination and is expected to result in the herd immunity of society that determines the social welfare in the country. The implementation of the regulation is being criticized on the practical level because it is claimed to raise the likelihood of the violation of human rights and overlook the public trust on account of excessive criminalization. This article argues that support from society is vital in the implementation of the regulation, while a positive campaign over public vaccinations need to be massively urged.

Background: Vaccines play a crucial role in eradicating and containing disease outbreaks. Therefore, understanding the reasons behind vaccine refusal and associated factors is essential for improving vaccine acceptance rates. Our objective was to examine the determinants of COVID-19 vaccine non-uptake and explore the reasons for non-uptake among healthcare workers (HCWs) in Uganda. Methods: Between July and August 2021, we conducted a cross-sectional study among healthcare workers in primary healthcare facilities (private and government) in Entebbe Municipality, Uganda. Participants were recruited using convenience sampling, and consenting individuals received credentials to access an electronic database and complete a structured questionnaire. There were no established HCWs contact registers in the municipality, and the study was conducted during a national lock down, therefore, the HCWs who were on duty at the time of the study were approached. The survey questions were based on the '3Cs' model of vaccine hesitancy and focused on confidence, convenience, and complacency factors. Non-uptake of vaccines was defined as not having received any of the available vaccines in the country. We employed counts, percentages, and simple logit models to summarize the reasons for non-uptake of COVID-19 vaccines and to identify associated factors. Results: The study recruited 360 HCWs, 61.7% of whom were female, with an average age of 31 years (SD = 7.9). Among them, 124 (34.4%) healthcare workers did not receive any COVID-19 vaccine. Non-uptake of COVID-19 vaccines was independently associated with several factors, including age [35 + years adjusted odds ratio (aOR) = 0.30, 95% CI: 0.13–0.66 compared with 18–24 years], facility ownership [government, aOR = 0.22 (0.10–0.49) compared with private not-for-profit], previous testing for coronavirus [yes, aOR = 0.35 (0.19–0.65)], and previous involvement in COVID-19 vaccine activities [yes, aOR = 0.17 (0.10–0.29)]. The primary reasons cited for non-uptake of COVID-19 vaccines were related to a lack of confidence in the vaccines, such as concerns about side effects (79.8%) and the need for more time to understand the vaccines (89.5%), as well as the importance of weighing benefits and risks (84.7%) before being vaccinated. A smaller proportion, approximately 23%, cited reasons related to complacency and lack of convenience in accessing vaccination services. Conclusion: The high proportion of non-uptake of COVID-19 vaccines among this population primarily stems from a lack of confidence and trust in the vaccines, coupled with insufficient time allowed for users to make informed decisions. This underscores the urgent need for ongoing monitoring and trend analysis of vaccine non-uptake to guide the development and implementation of strategies aimed at building and sustaining vaccine confidence. Adequate time should be allowed to explain benefits of vaccination to the population to allay fears that might exist before actual vaccination is rolled out. [ABSTRACT FROM AUTHOR]

Anti‐science attitudes can be resilient to scientific evidence if they are rooted in psychological motives. One such motive is trait reactance, which refers to the need to react with opposition when one's freedom of choice has been threatened. In three studies, we investigated trait reactance as a psychological motivation to reject vaccination. In the longitudinal studies (n = 199; 293), we examined if trait reactance measured before the COVID‐19 pandemic was related to people's willingness to get vaccinated against COVID‐19 up to 2 years later during the pandemic. In the experimental study (n = 398), we tested whether trait reactance makes anti‐vaccination attitudes more resistant to information and whether this resistance can be mitigated by framing the information to minimize the risk of triggering state reactance. The longitudinal studies showed that higher trait reactance before the COVID‐19 pandemic was related to lower willingness to get vaccinated against COVID‐19. Our experimental study indicated that highly reactant individuals' willingness to vaccinate was unaffected by the amount and framing of the information provided. Trait reactance has a strong and durable impact on vaccination willingness. This highlights the importance of considering the role of trait reactance in people's vaccination‐related decision‐making. [ABSTRACT FROM AUTHOR]

The COVID-19 vaccine was initially offered to frontline health care workers (HCWs), due to the high risk of contracting COVID-19 through occupational exposure to patients. Low HCW vaccine uptake can impact overall community-level vaccine uptake. This study used the Diffusion of Innovation (DOI) Theory to understand factors related to COVID-19 vaccine uptake in HCWs. We surveyed Pennsylvanian HCWs (excluding Philadelphia) from August 2022 to February 2023. Survey questions inquired about demographics, COVID-19 vaccination status, reasons for receiving/declining the COVID-19 vaccine, and sources of information about the vaccine. Participants (n = 3,490) were 85% female, 89% White, and 93% (n = 3,255) reported receiving at least one dose of a COVID-19 vaccine. HCWs were categorized into adopter categories of the DOI Theory: innovators (56%), early adopters (9%), early majority (11%), late majority (7%), and laggards (17%). The major reason that prompted participants to get the vaccine was to protect them against COVID-19 infection (78%), while the major reason for declining the vaccine was due to concern about possible side effects from the vaccine (78%). We applied the DOI Theory to characterize adopters and identify factors related to COVID-19 vaccine uptake in HCWs. As updated COVID-19 vaccines are approved for the United States market, our findings may be used to improve vaccine education and communication among HCWs to support vaccine uptake. • The Diffusion of Innovation Theory was used to characterize COVID-19 vaccine uptake. • Most health care workers were categorized as innovators and early adopters. • Factors related to COVID-19 vaccine uptake vary by category of adoption. [ABSTRACT FROM AUTHOR]

As COVID-19 vaccinations rolled out globally from late 2020, rules and recommendations regarding vaccine use in pregnancy shifted rapidly. Pre-registration COVID-19 vaccine trials excluded those who were pregnant. Initial Australian medical advice did not routinely recommend COVID-19 vaccines in pregnancy, due to limited safety data and little perceived risk of local transmission. Advice from local medical authorities changed throughout 2021, however, with recommendations and priority access during pregnancy. In Western Australia (WA), recommendations became requirements as the State government mandated vaccines for some workers, with brief availability of pregnancy exemptions. Through an examination of 10 in-depth interviews with WA pregnant women, we explore their decision-making and complex emotions regarding COVID-19 vaccinations, and how they balanced mandates, recommendations, and shifting considerations and perceptions of risk. Changing recommendations and rules—and media and popular interpretation and communications of these—led to confusion, including for medical professionals. Expectant parents had to negotiate the risks of COVID-19 disease, potential benefits and risks of vaccination, professional and personal costs of vaccine refusal, and interpret mixed medical advice. Our findings can inform the development and communication of public health policies and medical advice, and contribute to our understanding of bodily autonomy, risk, and decision-making beyond the pandemic. [ABSTRACT FROM AUTHOR]

Background: The global health landscape is increasingly challenged by the rejection of childhood vaccines. This study investigates vaccination reservations and refusal among pregnant women. Methods: A cross-sectional study was conducted in Kahramanmaraş, Türkiye, spanning January to March 2019, entailing face to face interviews with 938 pregnant women. The questionnaire collected sociodemographic data and probed vaccination attitudes. The decision to vaccinate the baby was treated as the dependent variable, analyzed alongside sociodemographic factors and other variables. Data underwent evaluation via descriptive analysis, the Chi-square test, and binary logistic regression. Results: Participants had a mean age of 27.6 years. Among them 20 (2.1%) expressed intent to either abstain from or partially vaccinate their babies, with 70% citing apprehensions regarding potential vaccine-related harm. Statistical analysis unveiled that higher economic income, elevated parental education level, fewer than two children, reliance on the Internet for vaccination information, and a lack of trust in physicians significantly correlated with vaccine refusal among pregnant women (p < 0.05). Conclusions: The study concludes that dissemination of vaccination information by the healthcare professionals, complemented by the enactment of pro-vaccine internet policies holds promise in shaping vaccination behavior. [ABSTRACT FROM AUTHOR]

Aim: This study investigated childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Kayseri, Turkey. Subject and methods: The study population consisted of all people over 18 years of age admitted to two family health centers (No 65 and 103) in a city center for any reason. Results: Participants living in the high socioeconomic status (SES) region had a significantly lower mean rating on the CVHQ (Childhood Vaccine Hesitancy Questionnaire - see below) than those living in the low SES region. Conclusion: Vaccine hesitancy is the main reason for vaccine refusal. Therefore, authorities should provide adequate and accurate information about the significance of vaccines to raise public awareness [ABSTRACT FROM AUTHOR]

With the progress of the vaccination campaign against the SARS-COV-2, we are ever closer to reaching that part of the population that refuses or is hesitant about vaccination. This study investigated the association between critical thinking motivation factors (i.e., intrinsic value of critical thinking and expectancy of one's critical thinking ability), conspiracy mentality, intolerance of uncertainty and hesitancy toward vaccination. A sample of 390 participants completed an online survey during April 2021. Across participants, results indicate that conspiracy mentality and expectancy about personal ability as a critical thinker positively predict vaccine hesitancy. On the contrary, the intrinsic value attributed to critical thinking, intolerance of uncertainty, and education are negatively associated with hesitancy. While the findings confirm existing evidence, particularly on the detrimental role of conspiracy mentality on vaccine acceptance, they also shed light on the double-faced role exercised by critical thinking. Practical implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Vaccine hesitancy was declared as one of the ten threats to global public health by the World Health Organization in 2019. It undermines the effort towards eradication of vaccinepreventable diseases. Healthcare providers, who are directly involved in vaccination services and vaccine advocacies, are important in combating vaccine hesitancy. Studies have shown that vaccine refusers have various reasons for refusal including distrust towards healthcare providers. Hence, it is important to understand healthcare providers' perspectives. This study aimed to explore primary healthcare providers (PHCPs)' experiences in dealing with vaccine hesitancy. Methods: This qualitative study was conducted among public PHCPs across six states in Malaysia. Purposive and snowball sampling methods were used. Fifteen primary healthcare doctors and nurses underwent in-depth interviews. Recruitment was stopped when data saturation was achieved. Data were thematically analysed. Results: Four themes emerged: 1) views towards vaccination and vaccine hesitancy, 2) disparity in strategies and resources used among PHCPs, 3) fixed-minded vaccine deniers and religious incompatibility: the two towering hurdles and 4) negative impact after encounters with vaccine hesitancy. Conclusion: Malaysian PHCPs encounter negative experiences with vaccine hesitancy, impacting them negatively. These experiences are attributed to the challenges and lack of standardised resources for reference. These findings suggest the development of a more flexible policy, a training module inclusive of all professional roles and a standardised repository of resources for managing vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Low rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs. We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status. Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated , a sense of professional responsibility , and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated , perceived risks from non-vaccination and whether vaccination is a healthy choice. These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted. [ABSTRACT FROM AUTHOR]

COVID-19 vaccine acceptance among refugees in the Arab region remains low. This study aimed to examine the prevalence, reasons and predictors of intention to refuse the COVID-19 vaccine among older Syrian refugees in Lebanon. A nested cross-sectional study within a longitudinal study among older Syrian refugees in Lebanon. The sampling frame was a complete listing of beneficiary households of a humanitarian organization with at least one adult aged 50 years or older. Telephone surveys were completed at months 1 starting September 2020 (wave 1), months 2 (wave 2), months 5 (wave 3), months 6 (wave 4) and months 17 (wave 5) in March 2022. Logistic regression models were used to identify predictors of intention to refuse the COVID-19 vaccine. Models were internally validated using bootstrap methods and the models' calibration and discrimination were presented. Of 3167 Syrian refugees, 61.3% intended to receive the COVID-19 vaccine, 31.3% refused, and 7.4% were undecided. Reasons for vaccine refusal were: preference to follow preventive measures (27.4%) and belief that the vaccine is not essential (20.7%). Furthermore, 57.1% of participants registered to take the COVID-19 vaccine in wave 5. Irrespective of vaccination intention, reasons for not registering included: not wanting to receive the vaccine, and being unsure whether to take it. Predictors of intention to refuse the COVID-19 vaccine included: being a female, older age, having elementary education or above, living outside informal tented settlements, perceiving COVID-19 as not severe and vaccines as not safe or effective, and using social media for information on COVID-19. After adjusting for optimization, the final model showed moderate discrimination (C-statistic: 0.651 (95% CI:0.630–0.672)) and good calibration (C-slope: 0.93 (95% CI: 0.823–1.065)). This study developed a predictive model for vaccination intention with a moderate discriminative ability and good calibration. Prediction models in humanitarian settings can help identify refugees at higher risk of not intending to receive the COVID-19 vaccine for public health targeting. [ABSTRACT FROM AUTHOR]

For college students who are exposed to multimedia, the sources of COVID-19 vaccine information and their trust in these sources may play a role in shaping the vaccine acceptance spectrum (refusal, hesitancy, and acceptance). Based on an online survey among 1,062 college students in South Carolina, we investigated vaccine information sources among college students and examined how COVID-19 vaccine acceptance was associated with information source and trust level in each source. The top three sources of COVID-19 vaccine information were health agencies, mass media, and personal social networks. Trust in mass media, health agencies, scientists, and pharmaceutical companies was negatively associated with vaccine refusal. Trust in government and scientists was negatively associated with vaccine hesitancy. Our findings highlight the importance of restoring trust in government, healthcare system, scientists, and pharmaceutical industries in the COVID-19 era. [ABSTRACT FROM AUTHOR]

Introduction: Although the vaccine has many individual and social benefits, 'Vaccine Hesitancy' has led to an increase in the number of vaccine-preventable diseases. The aim of our study is to determine the effect of ideas that cause vaccine hesitancy to comply with traditional medicine practices and drugs and to determine the ratio of parents' preference for complementary and alternative medicine (CAM) methods. Materials and Methods: This study was performed on the parents who refused vaccination in their children under the age of 8 between the years 2017-2022. Parents of the vaccinated children who were matched for age and gender were determined as the control group. Demographic characteristics of families, education levels, compliance ratios for well-child follow-up and pregnancy follow-up, preference ratios for traditional medicine and/or CAM applications were compared. Results: A total of 123 families, 61 of whom were vaccine refusal and 62 of the control group, were included in the study. It was determined that the ratio of parents who refuse vaccination have increased in the last five years. The education level was found to be higher in the study group (p=0.019). The most common reasons for vaccine refusal were distrust of the vaccine content (72.1%) and noncompliance with religious beliefs (49.1%). It was also found that the ratios of prophylactic vitamin use and tetanus vaccination of mothers during pregnancy were lower in the study group (p<0.01). While the rate of compliance with vitamin D and iron prophylaxis for infants was lower in the vaccine refusal group (p<0.01), the ratio of preference for CAM was higher (p<0.01). Conclusion: Vaccine hesitancy is a complex issue that affects public health, in which many individual, religious, political and sociological factors play a role. As with recent studies, this research shows that the most important reason for vaccine rejection is "lack of trust". The higher education level in the vaccine refusal group may also be a sign of this distrust. Not only the rejection of the vaccine, but also the lack of use of vitamin drugs seems to be related to lack of trust. This may also cause CAM methods to be preferred more. These results show that providing trust in vaccination is the biggest step in the fight against vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Research suggests that partisanship and social media usage correlate with belief in COVID-19 misinformation and that misinformation shapes citizens' willingness to get vaccinated. However, this evidence comes overwhelmingly from frequent internet users in rich, Western countries. We run a panel survey early in the pandemic leveraging a prepandemic sample of urban middle-class Nigerians, many of whom do not use the internet. Analysis shows that opposition party support and social media usage are correlated with belief in antigovernment misinformation but not other types of COVID-19 misinformation. Surprisingly, we find no relationship between overall belief in misinformation and willingness to be vaccinated several weeks later. Partisanship and ethnicity are predictive of vaccine hesitancy, while men are both more likely to believe misinformation and more willing to be vaccinated. These findings have significant implications for understanding vaccine hesitancy in Nigeria and beyond. [ABSTRACT FROM AUTHOR]

Background: Vaccination is probably the most effective approach to prevent and control COVID-19. Studies assessing acceptance towards vaccination showed huge regional variations. Objective: To find out the rate of acceptance of Covid 19 vaccine and its associated factors as well as to explore out both the most frequent reasons behind acceptance or refusal of this vaccine and the most received and preferred type. Patients and Methods: In this cross-sectional study, a convenience sample of 1000 visitors to primary health care centers (PHCCs) in Erbil/Iraq, aged 18 years and older, were collected from December 2021 to December 2022. A structured questionnaire was used for data collection through a direct interview. Results: The study showed that 43.9% of the participants accepted the vaccine. The main reason behind refusal (53.8%) was not trusting its development, while the main reasons for receiving were to protect themselves (44.2%), majority of those vaccinated (76.5%) received Pfizer, which was the most preferred type (67.4%), 10.3% of them were not completing the recommended dose and the most common reasons behind this were neglect and shortage of time (31%), and afraid from side effects (31%). A significant association found between vaccination practice with gender, education, occupation, family income and socioeconomic status. Vaccinated persons were less likely to be infected with COVID19 (20.7%) than nonvaccinated ones (62.7%). Conclusion: Less than half of the participants were accepted the vaccine and the acceptance rate significantly associated with male gender, education, occupation, family income, and socioeconomic status. [ABSTRACT FROM AUTHOR]

COVID-19 vaccine hesitancy and its enablers shape community uptake of non-covid vaccines such as the oral cholera vaccine (OCV) in the post-COVID-19 era. This study assessed the impact of COVID-19 vaccine hesitancy and its drivers on OCV hesitancy in a cholera-endemic region of the Democratic Republic of Congo. We conducted a community-based survey in Bukavu. The survey included demographics, intention to take OCV and COVID-19 vaccines, reasons for COVID-19 hesitancy, and thoughts and feelings about COVID-19 vaccines. Poisson regression analyses were performed. Of the 1708 respondents, 84.66% and 77.57% were hesitant to OCV alone and to both OCV and COVID-19, respectively. Hesitancy to COVID-19 vaccines rose OCV hesitancy by 12% (crude prevalence ratio, [cPR] = 1.12, 95%CI [1.03–1.21]). Independent predictors of OCV hesitancy were living in a semi-urban area (adjusted prevalence ratio [aPR] = 1.10, 95%CI [1.03–1.12]), religious refusal of vaccines (aPR = 1.06, 95%CI [1.02–1.12]), concerns about vaccine safety (aPR = 1.05, 95%CI [1.01–1.11]) and adverse effects (aPR = 1.06, 95%CI [1.01–1.12]), as well as poor vaccine literacy (aPR = 1.07, 95%CI [1.01–1.14]). Interestingly, the belief in COVID-19 vaccine effectiveness reduced OCV hesitancy by 24% (aPR = 0.76, 95%CI [0.62–0.93]). COVID-19 vaccine hesitancy and its drivers exhibited a significant domino effect on OCV uptake. Addressing vaccine hesitancy through community-based health literacy and trust-building interventions would likely improve the introduction of novel non-COVID-19 vaccines in the post-COVID-19 era. [ABSTRACT FROM AUTHOR]

Despite well-established evidence supporting vaccination efficacy in reducing morbidity and mortality among infants and children, there is a global challenge with an increasing number of childhood vaccination refusals. This issue has intensified, especially during the COVID-19 pandemic. Our study aims to forecast mandatory childhood vaccination refusal trends in Kazakhstan until 2030, assessing the impact of mass COVID-19 vaccination on these rates. Utilizing annual official statistical data from 2013 to 2022 provided by the Ministry of Health of Kazakhstan, the study reveals a significant surge in refusals during the pandemic and post-pandemic periods, reaching record levels of 42,282 cases in 2021 and 44,180 cases in 2022. Notably, refusal rates sharply rose in specific regions, like Aktobe (13.9 times increase) and Atyrau (4.29 times increase), emphasizing the need for increased public healthcare attention in these areas. However, despite a decade of data, our forecasting analysis indicates a lack of volatility in childhood vaccine refusal trends for all vaccine types up to 2030, highlighting the statistical significance of the obtained results. The increasing trend in vaccine refusals underscores the necessity to enhance crisis response and support health initiatives, particularly in regions where a substantial rise in refusals has been observed in recent years. [ABSTRACT FROM AUTHOR]

In the realm of antenatal care, vaccinations serve as a cornerstone, crucial for safeguarding the health of both the mother and the fetus, while also extending protection to the newborn against communicable diseases. Nevertheless, vaccine adherence among pregnant women remains very low. The aim of our study was to evaluate the uptake of vaccines (influence, pertussis, and COVID-19) among women during pregnancy and to understand pregnant women's knowledge of vaccines and the diseases they protect against. The purpose was to investigate the reasons why pregnant women chose not to be vaccinated and to develop effective strategies for informing them about the importance of vaccination for both maternal and fetal safety. A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, "Ospedale Santa Maria della Misericordia" in Udine, from 1 December 2021 to 30 June 2022. During this period, a self-completed paper questionnaire was administered to women at the end of pregnancy or during the puerperium. A total of 161 questionnaires were collected. Higher educational level was found to be significantly associated with influenza vaccination uptake (p = 0.037, OR = 2.18, 95% CI 1.05–4.51). Similarly, for pertussis vaccination, adherence was mainly associated with higher educational level (p = 0.014, OR = 2.83, 95% CI 1.24–6.47), but also with Italian nationality (p = 0.003, OR = 3.36, 95% CI 1.56–8.43) and pregnancy attended by a midwife or private gynecologist (p = 0.028, OR = 0.39, 95% CI 0.17–0.90). Regarding the COVID-19 vaccine, the only factor positively influencing uptake was Italian nationality (p = 0.044, OR = 2.66, 95% CI 1.03–6.91). Women's fear that vaccines would endanger the fetus appeared to be the most important reason for refusing vaccinations. Simultaneously, patients also exhibited a desire to receive more information about maternal vaccination, particularly from their general physician or gynecologist. For this reason, it is imperative to enhance maternal vaccination counselling, making it a routine step in prenatal care from the first antenatal visit until the postpartum period. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 outbreak devastated the fragmented health system in Syria, a war-torn country, and exaggerated the demands for humanitarian assistance. COVID-19 vaccination was rolled out in Northwest Syria, an area out of government control, in May 2021. However, vaccine acceptance rates are still minimal, which is reflected in the meager percentage of vaccinated people. The study aims to investigate the effectiveness of the humanitarian actors' plans to address the COVID-19 vaccine hesitancy and conclude practical strategies for boosting vaccine uptake in Northwest Syria. Methods and materials: Two questionnaires were developed to collect data from humanitarian organizations involved in the COVID-19 vaccination campaign and people from northwest Syria. Data analysis was performed using SPSS 22 data analysis program. Results: According to the findings, 55.5% of people refused the COVID-19 vaccine. The results showed a knowledge gap and lack of evidence regarding humanitarian actors' strategies to address the vaccine's low uptake. Besides, it was found that doctors and medical workers were reliable sources of information about the vaccine. However, they were not systematically engaged in community mobilization and risk communication to promote people's perspectives on the vaccine. Conclusion: Risk communication and community engagement programs were not significantly associated with increasing the COVID-19 acceptance rate. Humanitarian actors must reconsider their strategies to address vaccine hesitancy in Northwest Syria. These strategies should engage medical professionals through dialogue sessions on the realities of the pandemic and vaccine development mechanism based on a compelling and evidence-based approach. [ABSTRACT FROM AUTHOR]

Purpose: The Covid-19 pandemic has persisted for almost three years. States have since then enforced laws, policies and measures believed to be the most effective to handle the global pandemic. Along this line, the Indonesian Government opted to implement mandatory vaccination and refusal of which entails monetary penalties. Hence, this study aims to analyze two legal issues that touch upon the realm of International Human Rights Law: first, whether state has the authority to implement the said mandatory vaccine program to those who refuse to be vaccinated, and second, how is the more appropriate legal policy to obligate vaccination but without coercive sanction. Design/methodology/approach: This is a normative legal research that uses a qualitative method with case studies, conceptual, historical and comparative approaches. A descriptive-analytical deduction process was used in analyzing the issue. Findings: The results present, as part of state's right to regulate, it has the authority to enact mandatory vaccination with monetary penalties to fulfil its obligation to protect public health in times of emergency; this is legal and constitutional but only if it satisfies the requirements under the International Human Rights Law: public health necessity, reasonableness, proportionality and harm avoidance. Alternatively, herd immunity is achievable without deploying unnecessary coercive sanctions, such as improving public channels of communication and information, adopting legal policies that incentivize people's compliance like exclusion from public services, subsidies revocation, employment restrictions, higher health insurance premiums, etc. Research limitations/implications: This study analyzes in depth the following issues: of whether the government has the authority to apply mandatory vaccination laws enforced through monetary penalties for those who refused to be vaccinated and how does the government implement the appropriate legal policy to enforce mandatory vaccination without imposing penalties for non-compliance while maintaining a balance between the interests of protecting public health and the human rights of individuals to choose medical treatment for themselves, including whether they are willing to be vaccinated. Hence, the political affairs, economic matters and other non-legal related issues are excluded from this study. Originality/value: This paper hence offers a suggestive insight for state in formulating a policy relating to the mandatory vaccination program. Although the monetary penalties do not directly violate the rule of law, a more non-coercive approach to the society would be more favorable. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 vaccine has faced increased hesitancy in Ghana and the Volta region in particular since its rollout. Acceptance of the vaccine among intercity commercial drivers is crucial, especially in the Volta region, as they transport people within and outside the country and could fuel the transmission of the virus if not vaccinated. Objective: We therefore established lay beliefs surrounding COVID-19 vaccine refusal among intercity commercial drivers in the Volta region of Ghana, as well as their recommendations for improved vaccine uptake. Methods: We purposively interviewed twenty-five (25) intercity commercial drivers who had not been vaccinated for COVID-19 in the Volta region of Ghana using a semi-structured interview guide and analysed their responses thematically using the ATLAS.ti software. Results: Various (ten) beliefs surrounding COVID-19 vaccine refusal were identified. These include the nonexistence of COVID-19, being immune to COVID-19, and the belief in the nonexistence of vaccines and vaccines being meant for the sick. Other beliefs identified were the belief that the COVID-19 vaccine is meant to reduce Africa's population, that the vaccine triggers other health complications leading to death, the belief that vaccination could cause financial loss, political mistrust, that the COVID-19 vaccine is not permitted by God, and the belief that prayer prevents COVID-19 infection. They also suggested that the adoption of persuasive communication techniques, the publication of information on those who died of COVID-19, providing evidence of tests conducted on the vaccine, testing people before vaccination, provision of care to those who may experience side effects from the vaccine, and being able to explain why varied vaccines are used for the same virus could help improve vaccine uptake. Conclusion: Our findings show that there is a general lack of understanding and mistrust surrounding the COVID-19 vaccine among intercity commercial drivers in the Volta region. Hence, health promotion officers and communicators in the region need to be knowledgeable on the vaccine as well as on the conspiracy theories thwarting its uptake to provide comprehensive education to the public and intercity commercial drivers to improve its uptake. [ABSTRACT FROM AUTHOR]

Poliomyelitis is a contagious disease that still remains in Pakistan, despite efforts to ensure full vaccination coverage, but, in counterpart, refusal is prevailing. Therefore, the present study was conducted to assess refusal factors to polio vaccination. A cross-sectional approach was followed for the present study which was conducted in the North Waziristan Tribal District (polio endemic area) between January 2023 to July 2023. Data were collected on a self-developed questionnaire. The study participants were from the general public and were recruited through simple random sampling. The data were analyzed using Statistical package for social sciences SPSS. A total of 387 respondents completed the survey, amongst which most of the respondents were male (90.7%), living in a joint family (87.1%), and had primary education (48.3%). Most of the respondents showed poor knowledge regarding polio disease (58.7%). Religious extremism, poor knowledge regarding the disease and joint family culture were the significant predictors of the refusal of polio vaccination. This refusal may cause the re-emergence of polio outbreaks.

BackgroundThe United States Food and Drug Administration authorized COVID-19 vaccines for children ages 5–11 years in October 2021 during the Omicron predominant period. Parental vaccine hesitancy was prevalent during this time, resulting in low childhood COVID-19 vaccine uptake. Most studies exploring factors influencing parental vaccine hesitancy have focused on racial and ethnic minorities and lower socioeconomic populations; however, there is little knowledge of the drive drivers of vaccine hesitancy among White parents with higher education and socioeconomic statuses.MethodsWe conducted semi-structured interviews with a sample of 15 White mothers of children ages 5–11 years in Atlanta, GA, between October–December 2021. Thematic analysis was performed using NVivo 12.ResultsMothers were college-educated, homeowners, and fully vaccinated against COVID-19. Key findings included decreased pediatrician’s recommendations for COVID-19 vaccines, reliance on information from specialized doctors and scientists, distrust in public health authorities, high risk-perception of COVID-19 vaccines, and low risk-perception of COVID-19 disease. Factors related to vaccine acceptance were altruism and practicality.ConclusionThis study adds to the sparse literature on reasons for vaccine hesitancy among White mothers of children ages 5–11 years with higher educational and socioeconomic status. Improving vaccine uptake among this group is critical for protecting the health of their children and other vulnerable populations. Tailored vaccine messaging and intervention are warranted to address their unique attitudes, beliefs, and behaviors. An enhanced understanding of the factors influencing subpopulations of parents can help vaccine policymakers and healthcare providers improve efforts to reduce vaccine hesitancy, particularly for new vaccines.

Background: The vaccines recommended during pregnancy are the Tdap, the influenza vaccine, and, during the SARS-CoV-2 pandemic, the vaccine against COVID-19. This survey aimed at determining vaccination coverage among pregnant women and adverse events, reasons for vaccine refusal, and factors associated with vaccine uptake. Methods: A single-center cross-sectional study was conducted on women who delivered between March and April 2022 at Careggi University Hospital in Florence, Italy. Information on the vaccinations (Tdap, influenza and COVID-19) received during pregnancy were collected through in-person interviews. Results: Among 307 enrolled women (response rate 99 % on a study population of 310 eligible women), 74 % of patients were vaccinated with Tdap, 82 % against COVID-19, and only 33 % against influenza. Vaccination coverage for Tdap and COVID-19 was significantly higher among Italian than foreign patients (80 % vs 51 %, p