Address Vaccine Hesitancy Research Articles

Characterizing discourses about COVID-19 vaccines on Twitter: a topic modeling and sentiment analysis approach

ABSTRACT Background Evidence-based health communication is crucial for facilitating vaccine-related knowledge and addressing vaccine hesitancy. To that end, it is important to understand the discourses about COVID-19 vaccination and attend to the publics’ emotions underlying those discourses. Methods We collect tweets related to COVID-19 vaccines from March 2020 to March 2021. In total, 304,292 tweets from 134,015 users are collected. We conduct a Latent Dirichlet Allocation (LDA) modeling analysis and a sentiment analysis to analyze the discourse themes and sentiments. Results This study identifies seven themes of COVID-19 vaccine-related discourses. Vaccine advocacy (24.82%) is the most widely discussed topic about COVID-19 vaccines, followed by vaccine hesitancy (22.29%), vaccine rollout (12.99%), vaccine facts (12.61%), recognition for healthcare workers (12.47%), vaccine side effects (10.07%), and vaccine policies (4.75%). Trust is the most salient emotion associated with COVID-19 vaccine discourses, followed by anticipation, fear, joy, sadness, anger, surprise, and disgust. Among the seven topics, vaccine advocacy tweets are most likely to receive likes and comments, and vaccine fact tweets are most likely to receive retweets. Conclusions When talking about vaccines, publics’ emotions are dominated by trust and anticipation, yet mixed with fear and sadness. Although tweets about vaccine hesitancy are prevalent on Twitter, those messages receive fewer likes and comments than vaccine advocacy messages. Over time, tweets about vaccine advocacy and vaccine facts become more dominant whereas tweets about vaccine hesitancy become less dominant among COVID-19 vaccine discourses, suggesting that publics become more confident about COVID-19 vaccines as they obtain more information.

Using Behavioral Science to Address COVID-19 Vaccine Hesitancy Among Cancer Survivors: Communication Strategies and Research Opportunities.

Due to cancer survivors’ increased vulnerability to complications from COVID-19, addressing vaccine hesitancy and improving vaccine uptake among this population is a public health priority. However, several factors may complicate efforts to increase vaccine confidence in this population, including the underrepresentation of cancer patients in COVID-19 vaccine trials and distinct recommendations for vaccine administration and timing for certain subgroups of survivors. Evidence suggests vaccine communication efforts targeting survivors could benefit from strategies that consider factors such as social norms, risk perceptions, and trust. However, additional behavioral research is needed to help the clinical and public health community better understand, and more effectively respond to, drivers of vaccine hesitancy among survivors and ensure optimal protection against COVID-19 for this at-risk population. Knowledge generated by this research could also have an impact beyond the current COVID-19 pandemic by informing future vaccination efforts and communication with cancer survivors more broadly.

Trends in COVID-19 Vaccination Intent, Determinants and Reasons for Vaccine Hesitancy: Results from Repeated Cross-Sectional Surveys in the Adult General Population of Greece during November 2020-June 2021.

Vaccine hesitancy is a major barrier to achieving large-scale COVID-19 vaccination. We report trends in vaccination intention and associated determinants from surveys in the adult general population in Greece. Four cross-sectional phone surveys were conducted in November 2020 and February, April and May 2021 on nationally representative samples of adults in Greece. Multinomial logistic regression was used on the combined data of the surveys to evaluate independent predictors of vaccination unwillingness/uncertainty. Vaccination intention increased from 67.6% in November 2020 to 84.8% in May 2021. Individuals aged 65 years or older were more willing to be vaccinated (May 2021: 92.9% vs. 79.5% in 18–39 years, p < 0.001) but between age-groups differences decreased over time. Vaccination intention increased substantially in both men and women, though earlier among men, and was higher in individuals with prograduate education (May 2021: 91.3% vs. 84.0% up to junior high). From multivariable analysis, unwillingness and/or uncertainty to be vaccinated was associated with younger age, female gender (in particular in the April 2021 survey), lower educational level and living with a child ≤12 years old. Among those with vaccine hesitancy, concerns about vaccine effectiveness declined over time (21.6% in November 2020 vs. 9.6% in May 2021, p = 0.014) and were reported more often by men; safety concerns remained stable over time (66.3% in November 2020 vs. 62.1% in May 2021, p = 0.658) and were reported more often by women. In conclusion, vaccination intention increased substantially over time. Tailored communication is needed to address vaccine hesitancy and concerns regarding vaccine safety.

Burden of the Beast

Burden of the Beast

Pandemics: Historical Perspective and Vulnerabilities Among Minority Elderly

While infectious organisms surround us, critical circumstances need to occur for a pandemic to develop, such as that of the novel coronavirus disease 2019 (COVID-19), declared by the World Health Organization in March 2020. Prior pandemics had many feautres in common with COVID-19. Pandemics can expose weaknesses in public health response systems, as well as vulnerabilities in the populations who are most susceptible to adverse outcomes, and can lead to scapegoating of specific groups and attempts to conceal the disease. COVID-19 has disproportionately impacted the mental and physical health of minority seniors, and caused significant economic hardships. Long-standing social determinants of mental and physical health have led to health disparities highlighted by COVID-19, and demonstrate the complex intersection of health, medical comorbidities, and barriers to access to culturally competent physical and mental healthcare. The pandemic has caused significant mental health problems even among those who were spared the infection, primarily manifested as social isolation, depression, anxiety and opioid use disorders. Public health measures, including screening, vaccinations, and access to quality healthcare can all mitigate adverse outcomes. Similarly, best practices that include collaborations between social service agencies and faith-based groups are effective strategies to bring these mitigating strategies nearer to the minority seniors who are most in need. Addressing vaccine hesitancy is a critical component of ending this pandemic. Future research should bring together practitioners, public health agencies, and community-based organizations for the collaborative design and implementation of effective, culturally competent interventions to address the medical, psychosocial, and behavioral health needs of ethnic/racial minority older adult communities in the face of COVID-19 and other chronic health conditions. Using the Social Determinants Of Health framework as a guide, clinicians and researchers can work to address structural and systemic racism and poverty and create targeted interventions to COVID-19 and to prevent future pandemics.

COVID-19 Pandemic: Addressing Vaccine Hesitancy Based on Gender

COVID-19 Pandemic: Addressing Vaccine Hesitancy Based on Gender

The differential effects of a governmental debunking campaign concerning COVID-19 vaccination misinformation

ABSTRACT Background Throughout the ongoing COVID-19 pandemic debunking misinformation has been one of the most employed strategies used to address vaccine hesitancy. We investigated whether – and for whom – debunking is effective or even counterproductive in decreasing misinformation belief and vaccination hesitancy. Method We conducted a randomized controlled trial (N = 588) utilizing a real-world debunking campaign from the German Ministry of Health. We considered the condition (debunking vs. control) as between-subjects factor, assessed misinformation belief (pretest vs. posttest) as a repeated-measures factor and vaccination intention as a dependent variable. Preregistered subgroup analyses were conducted for different levels of a priori misinformation belief and general vaccination confidence. Results The analyses revealed differential effects on misinformation belief and vaccination intention in participants with low, medium, and high a priori belief: A debunking effect on misinformation belief (dRM = –0.80) was only found in participants with a medium a priori belief and did not extend to these participants’ vaccination intentions. Among participants with a high a priori misinformation belief, explorative analysis revealed a small unintended backfiring effect on vaccination intentions (ηp 2 = 0.03). Conclusions Our findings suggest that debunking is an effective communication strategy to address moderate levels of misinformation beliefs, but it does not constitute a one-fits-all strategy to reduce vaccination hesitancy among the general public. Although countering misinformation should certainly be an integral part of public health communication, additional initiatives, which address individual concerns with targeted and authentic communication, should be taken to enhance the impact on hesitant populations and avoid backfiring effects.

COVID-19 Vaccination in those with mental health difficulties: A guide to assist decision-making in England, Scotland, and Wales.

There is currently no specific guidance addressing vaccine hesitancy in those with mental health difficulties in the United Kingdom. This is particularly problematic when one considers that individuals with serious mental illnesses are at greater risk of infection and have poorer health outcomes for a range of reasons. There are also many individual and system level barriers to vaccination in this group. When an affected adult lacks the capacity to make a decision for themselves, it often falls to healthcare professionals to make a decision on that person's behalf and in their best interests. This article explores this matter with regard to the law in practice in the English and Welsh, and Scottish, jurisdictions and consider this with relevance to the safest approach that doctors and other healthcare professionals should take in working with patients for whom mental disorder may impact on decision-making capacity. The article focuses on psychiatric inpatients, including those who are detained involuntarily, to consider whether, and in what circumstances, COVID-19 vaccination should be given to individuals who cannot or do not consent.

Impact of COVID-19 health information sources on student vaccine hesitancy

BackgroundThe purpose of this study was to determine how health care professional and undergraduate students stay informed on COVID-19 and which characteristics influence the decision to receive or recommend a vaccine to focus efforts on addressing misinformation and vaccine hesitancy. MethodsA 13-item survey was administered to currently enrolled undergraduate and health care students (including nursing, dental, medical, and pharmacy) within the same university. Students were asked to rate their utilization and trust of COVID-19 resources and were asked about the importance and challenges of staying current with COVID-19 information. Student willingness to receive the vaccine was also assessed. ResultsThe school of pharmacy had the highest percentage of students (88.3%, n = 159) who would receive the vaccine. Only 73.6% (n = 323) of undergraduate students reported they would be willing. Students who were willing to receive the vaccine had higher average scores of trust for scientific journals, school curriculum/coursework, and school communication and utilized these sources for COVID-19 information more than those who would not receive the vaccine and were unsure about receiving the vaccine. ConclusionsThis study confirms that students who were most trusting of their COVID-19 information sources were more likely to receive the vaccine. Pharmacy students relied heavily on information provided by the school curriculum/coursework, indicating the need for pharmacy faculty to include methods of addressing vaccine hesitancy such as simulation modules and the Pharmacists' Patient Care Process to help students combat vaccine hesitancy and misinformation when communicating with patients.

Parental coronavirus disease vaccine hesitancy for children in Bangladesh: a cross-sectional study.

Background: Coronavirus disease 2019 (COVID-19) requires mass immunization to control the severity of symptoms and global spread. Data from developed countries have shown a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in low- and middle-income countries are scarce. This study aimed to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy in parents in Bangladesh. Methods: A cross-sectional study was conducted on the parents of children aged <18 years from October 10, 2021 to October 31, 2021. Parents participated in face-to-face interviews in randomly selected locations in Bangladesh using a vaccine hesitancy questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified using binary logistic regression analysis. Results: Data from 2,633 eligible parents were analyzed. Overall, 42.8% reported COVID-19 vaccine hesitancy for their youngest child. The final model suggested the following factors were associated with hesitancy: children's age; parent's age, religion, occupation, monthly household income, permanent address, living location, status of tobacco use, adherence with regular government vaccination programs (other than COVID-19), perceptions ofCOVID-19 vaccine efficacy among Bangladeshi children, self-vaccination intentions, reported family members' illness or death from COVID-19, and perceived threat of COVID-19 were the independent predictors of parental COVID-19 vaccine hesitancy. Conversely, participants who were not tobacco users, parents who were very likely to believe that their children or family members could be infected with COVID-19 in the following year and who were very concerned about their children or a family member contracting COVID-19 in the next year had significantly lower odds of COVID-19 vaccine hesitancy. Conclusions: Our study suggested that vaccine hesitation varied based on sociodemographic characteristics, religion, behavior, and perceived COVID-19 threat. Therefore, interventions focused on addressing vaccine hesitancy among specific subgroups are warranted.

YouTube as a source of misinformation on COVID-19 vaccination: a systematic analysis

IntroductionVaccines for SARS-CoV-2 have been accessible to the public since December 2020. However, only 58.3% of Americans are fully vaccinated as of 5 November 2021. Numerous studies have supported YouTube...

Motivational Interviewing Strategies for Addressing COVID-19 Vaccine Hesitancy.

Severe acute respiratory syndrome coronavirus 2, or coronavirus disease 2019 (COVID-19), vaccine hesitancy, defined as a behavioral phenomenon whereby individuals neither fully accept nor fully reject the COVID-19 vaccine, presents a major health threat in the midst of the current pandemic. Traditional approaches for addressing vaccine hesitancy in health care lack empirical support and, in some instances, have actually increased vaccine hesitancy. Thus, there is an urgent need for approaches that effectively address COVID-19 vaccine hesitancy, especially in health care settings. The current article highlights the need for and importance of motivational interviewing (MI), which emphasizes collaborative communication between physicians and patients, in addressing vaccine hesitancy. We describe a 3-step process for addressing COVID-19 vaccine hesitancy that includes using a guiding style, using the MI toolbox, and responding mindfully and skillfully to the individual's degree of hesitancy. The discussion concludes with a consideration of possible challenges in implementing these steps when addressing and resolving COVID-19 vaccine hesitancy.

Parental coronavirus disease vaccine hesitancy for children in Bangladesh: a cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) requires mass immunization to control the severity of symptoms and global spread. Data from developed countries have shown a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in low- and middle-income countries are scarce. This study aimed to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy in parents in Bangladesh. Methods: A cross-sectional study was conducted on the parents of children aged <18 years from October 10, 2021 to October 31, 2021. Parents participated in face-to-face interviews in randomly selected locations in Bangladesh using a vaccine hesitancy questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified using binary logistic regression analysis. Results: Data from 2,633 eligible parents were analyzed. Overall, 42.8% reported COVID-19 vaccine hesitancy for their youngest child. The final model suggested the following factors were associated with hesitancy: children's age; parent's age, religion, occupation, monthly household income, permanent address, living location, status of tobacco use, adherence with regular government vaccination programs (other than COVID-19), perceptions of COVID-19 vaccine efficacy among Bangladeshi children, self-vaccination intentions, reported family members' illness or death from COVID-19, and perceived threat of COVID-19 were the independent predictors of parental COVID-19 vaccine hesitancy. Conversely, participants who were not tobacco users, parents who were very likely to believe that their children or family members could be infected with COVID-19 in the following year and who were very concerned about their children or a family member contracting COVID-19 in the next year had significantly lower odds of COVID-19 vaccine hesitancy. Conclusions: Our study suggested that vaccine hesitation varied based on sociodemographic characteristics, religion, behavior, and perceived COVID-19 threat. Therefore, interventions focused on addressing vaccine hesitancy among specific subgroups are warranted.

Modelling the impact of vaccine hesitancy in prolonging the need for Non-Pharmaceutical Interventions to control the COVID-19 pandemic

BackgroundVaccine hesitancy – a delay in acceptance or refusal of vaccines despite availability – has the potential to threaten the successful roll-out of SARS-CoV-2 vaccines globally. In this study, we aim to understand the likely impact of vaccine hesitancy on the control of the COVID-19 pandemic.MethodsWe modelled the potential impact of vaccine hesitancy on the control of the pandemic and the relaxation of non-pharmaceutical interventions (NPIs) by combining an epidemiological model of SARS-CoV-2 transmission with data on vaccine hesitancy from population surveys.ResultsOur simulations suggest that the mortality over a 2-year period could be up to 7.6 times higher in countries with high vaccine hesitancy compared to an ideal vaccination uptake if NPIs are relaxed. Alternatively, high vaccine hesitancy could prolong the need for NPIs to remain in place.ConclusionsWhile vaccination is an individual choice, vaccine-hesitant individuals have a substantial impact on the pandemic trajectory, which may challenge current efforts to control COVID-19. In order to prevent such outcomes, addressing vaccine hesitancy with behavioural interventions is an important priority in the control of the COVID-19 pandemic.

Message - Francisco T. Duque III

The outbreak of COVID-19 has placed extraordinary burdens upon the Philippines, especially in our healthcare system. In response to the crisis, the country implemented a whole-of-government, whole-of-society, and whole-of-system approach, with emphasis on quick response, resource management, and strategic communications through Prevent, Detect, Isolate, Treat, and Re-integrate (PDITR) Strategies. The Department of Health (DOH) remains committed to providing science- and evidence-based responses to ensure the resiliency of our healthcare system, optimize the use of resources, and balance the health and economic needs of the country. The theme of this year’s scientific meeting is very timely, as it reminds us that we should continue to build upon the learnings, experiences, and strategies from pandemics past and present, in order to prepare our systems and augment our capacity for the next. We know that demand for quality health service will only grow; hence, we are called to relentlessly advance the state of medicine and science in the country. This year, we welcomed the development of COVID-19 vaccines as our latest weapon to combat this pandemic. While the DOH continues to assure the public that science guarantees the safety and effectiveness of our COVID-19 vaccines, we are still tackling the realities of vaccine hesitancy in the country head on. We invite everyone to take part in addressing vaccine hesitancy and communicating the value of vaccines in cutting transmission, protecting our health system, and saving lives. Most of all, allow me to extend my sincerest gratitude to all the health professionals and healthcare workers, researchers, scientists, and individuals who continue to respond selflessly and whole-heartedly to the call of service even during the trying times. The DOH underscores that everyone has a role during the public health crisis. By dutifully and honestly fulfilling these roles, I am confident that we will endure, overcome, and heal as one. Let us all continue moving in one accord for the future of the Philippine public health, for an improved tomorrow of the Filipino nation. Thank you very much.

The Landscape of COVID-19 Vaccination in Zimbabwe: A Narrative Review and Analysis of the Strengths, Weaknesses, Opportunities and Threats of the Programme.

The ongoing COVID-19 pandemic brought unprecedented challenges for the population. The advent of national COVID-19 vaccination programmes was therefore welcome as a key control strategy for the COVID-19 pandemic, as evidence has shown that vaccination is the best strategy to reduce the adverse individual and population level adverse outcomes associated with infectious diseases such as COVID-19. Zimbabwe rolled out its vaccination programme in February 2021 with an ambitious target to vaccinate at least 60% of its eligible population by December 2021. However, by that time, the country was still to reach that target. To move the vaccination programme towards achieving this target, it is crucial to understand the strengths, weaknesses, opportunities and threats to the programme. We, therefore, with this narrative review, discuss some of the strengths, weaknesses, opportunities and threats to the programme since its rollout in February 2021. Though the programme has several strengths and opportunities to leverage on, we argue that among other challenges, the emergence of new variants of concern poses one of the biggest threats to local, regional and international vaccination programmes and requires concerted multistakeholder efforts to deal with. Additionally, addressing vaccine hesitancy remains as important as availing the vaccines to the population, to obtain the most benefits out of the programme.

Training to address vaccine hesitancy in first-year students

Aim: This study's aim was to determine if an additional educational component on pharmacy students can increase their knowledge and skill level to address vaccine hesitancy and/or refusal related to a future Covid 19 vaccine. Methods: First-year pharmacy students were given additional education beyond what they received in their Accreditation Council for Pharmaceutical Education (ACPE) module, on motivational interviewing (MI). They were given a pre-and post-survey assessing their knowledge and confidence in addressing vaccine hesitancy and the application of MI. This study was approved by the Institutional Review Board (IRB). Results: This study showed that additional motivational interviewing education had a significant impact on the student's knowledge, self-assessment of skills in talking to patients, and understanding how the skills impacted patients regarding vaccines both general and Covid-19 vaccines. Conclusion: The study’s findings indicate that additional training that focuses on motivational methods to engage patients is needed for students to be able to address vaccine hesitancy, especially when a new vaccine using different science is on the market.

Unpacking the Implications of SARS-CoV-2 Breakthrough Infections on COVID-19 Vaccination Programs.

Despite an array of preventive global public health interventions, SARS-CoV-2 has continued to spread significantly, infecting millions of people across the globe weekly. Newer variants of interest and concern have continued to emerge, placing the need for policymakers to rethink prevention strategies to end the pandemic. The approval of SARS-CoV-2 vaccines for public health use in December 2020 was seen as a significant development towards pandemic control and possibly ending the pandemic. However, breakthrough infections have continued to be observed among the ‘fully vaccinated’, and the duration and sustainability of vaccine-induced immunity has remained a topical public health discourse. In the absence of accurate public health communication, the breakthrough infections and waning immunity concepts have potential to further compound vaccine hesitancy. With this viewpoint, we discuss breakthrough SARS-CoV-2 infections, waning immunity, the need for COVID-19 booster shots, vaccine inequities, and the need to address vaccine hesitancy adequately to propel global vaccination programs forward.

Offline: Complacency threatens progress against COVID-19

Hans Kluge, WHO's Regional Director for Europe, has been reported as saying that European nations could soon be entering a “long period of tranquillity” as the pandemic abates. Pointing out that mortality from COVID-19 seemed to be plateauing, he suggested the continent was approaching a “plausible endgame” and an “enduring peace”. As WHO's chief spokesperson for the 53 countries that make up his regional responsibility, Kluge was no doubt seeking to strike an optimistic and encouraging note. But it is disappointing that he took such a narrow geographical perspective about a global pandemic. His words promote a false reassurance that could breed complacency, even conceit. Omicron has spread across Europe from west to east, with countries on the eastern reaches of the continent still experiencing increased transmission. The Institute for Health Metrics and Evaluation (IHME) predicts that half the population of Europe will have been infected by March 1. Infections are estimated to be a staggering 10 million per day. R is greater than 1 in at least 24 countries in the region. Hospitalisations and deaths are still increasing in some areas. With over 5000 deaths each day, COVID-19 remains the second largest killer after ischaemic heart disease. Health systems will experience particular pressure in the next few weeks, not least because of shortages of health workers. Daily hospitalisations will peak at 1·1 million in early February. In the coming weeks, IHME predicts that 45 countries will endure high or extreme stress on their intensive care facilities. 174 000 additional deaths from COVID-19 are predicted between Jan 31 and June 1. This period cannot be defined as tranquil. Although the aftermath of the omicron wave will most likely usher in a relatively quiet spring and summer, IHME predicts that “COVID-19 will return”. Waning immunity and an approaching winter will create conditions for a further surge of infections later in 2022. There is no immediate endgame in sight. The available data point to a much more uncertain future. Indeed, the vaccination status of Kluge's member states reveals a sharply divided continent. Western European nations have achieved relatively high levels of vaccination. 22 countries have double vaccinated over two-thirds of their populations. But as one looks eastwards, the picture is far more bleak. 19 countries have vaccinated fewer than half of their citizens. Rather than celebrating an “enduring peace”, Kluge should be urging countries to be vigilant for new (and old) SARS-CoV-2 variants, build stronger surveillance capacities, address vaccine hesitancy, expand access to antivirals, maintain clear public health messaging about protecting those most vulnerable to the virus, and be wary of animal reservoirs that could reseed human populations with the virus. Europe is not an island. The continent exists amid an evolving global pandemic. R is greater than 1 in 71 countries. Estimated infections still stand at more than 40 million per day. Hospitalisations are around 1·9 million per day. Deaths have increased to over 17 000 per day. COVID-19 is the third largest cause of death worldwide, after heart disease and stroke. IHME predicts that 754 000 deaths from COVID-19 are expected between Jan 31 and June 1. And a huge question mark hangs over China, where the omicron surge has yet to hit. Amid these daunting statistics, new evidence is accruing about the lessons we can learn from this pandemic—lessons that should be embraced more assiduously by global health leaders. Perhaps the most striking finding came recently from the COVID-19 National Preparedness Collaborators. They found that the measures of pandemic preparedness we have relied on in the past do not explain variations in infection fatality between countries. What has been missing from understanding why some countries performed better than others was political context. Countries with low levels of trust in government suffered more. It is this political context that WHO's leaders shrink from underlining. It is far easier to point to technical weaknesses in national and global responses. But WHO should also be more vocal in holding political leaders accountable for the fractured trust their regimes have fostered. A lack of honesty in the assessments of pandemic responses by global health leaders indicates that these lessons have not been learned. And while WHO continues to avoid these inconvenient truths, the world's peoples remain at risk from political ineptitude and dysfunctional governance.

Parental thoughts after the Codroipo case: the other side of the story.

To address vaccine hesitancy and to build public trust, many factors need to be considered in the process of planning consistent public health interventions. After uncertain vaccinations of the Codroipo case, hesitant parents were surveyed about own beliefs and trusted sources of information. A semi-structured phone survey was conducted between December 2017 and February 2018, collecting also age and educational level of respondents. The most trusted sources of information of the 258 surveyed parents were pediatricians (27.2%), general practitioners (25.4%) and institutional channels (12.1%). Highly educated parents trusted self-study of the scientific literature and expressed doubts about vaccine effectiveness more than others (p=0.0018). Despite the underlying improper vaccination issue undermined public trust, healthcare professionals and institutional channels maintained their role as trusted sources of information. Educational patterns emerged among doubtful parents should be considered by public health policies to effectively tackle vaccine hesitancy.