Address Vaccine Hesitancy Research Articles

Interventions employed to address vaccine hesitancy among Black populations outside of African and Caribbean countries: a scoping review

Abstract Background Black people are disproportionately affected by structural and social determinants of health, resulting in greater risks of exposure to and deaths from COVID-19. Structural and social determinants of health feed vaccine hesitancy and worsen health disparities. Objective This scoping review explored interventions that have been employed to address vaccine hesitancy among Black population outside of African and Caribbean countries. This review provides several strategies for addressing this deep-rooted public health problem. Methods The scoping review followed the five-step framework outlined by Arksey and O’Malley. It complies with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Research studies that examined interventions utilized to promote vaccine confidence within Black populations living outside of African and Caribbean countries were reviewed. Findings A total of 20 articles met the inclusion criteria for this study: 17 were quantitative studies and three were mixed-method studies. This scoping review highlighted six themes: educational advancement, messaging, multi-component approaches, outreach efforts, enhancing healthcare access, and healthcare provider leadership. Conclusion The review identified effective interventions for addressing vaccine hesitancy among Black populations outside Africa and the Caribbean, emphasizing education, multidimensional approaches, and healthcare provider recommendations. It calls for more qualitative research and interventions in countries like Canada and the UK to enhance vaccine confidence and reduce mistrust.

Overview of CHIC symposia series: Summary of Africa and South Asia symposia

This article presents an overview of the main challenges and lessons learned that were presented during the symposia organized by the Coalition to Strengthen the HPV Immunization Community (CHIC) in Africa and South Asia in 2022. Discussions at these meetings revolved around introduction, planning, implementation, and sustainability of HPV prevention and control programmes, with a particular focus in HPV immunisation, as well as cervical cancer screening in South Asian countries. This article also discusses the recently endorsed off-label single-dose HPV vaccination schedule and its potential impact on programme delivery and access. Furthermore, it highlights the importance of intersectional collaboration, effective communication and advocacy strategies, and the need for robust health information systems. Some of the critical factors identified for reducing the burden of cervical cancer in low- and middle-income countries (LMICs) included strategies for increasing access and coverage, addressing vaccine hesitancy, and building capacity among health care providers. The symposia emphasized the importance of face-to-face interactions for collaboration and decision making, with live translation services enabling full participation by stakeholders from diverse backgrounds. The paper concludes with a call for continued collaboration to make progress in reducing the burden of cervical cancer in LMICs.

Evaluating vaccination timing, hesitancy and effectiveness to prevent future outbreaks: insights from COVID-19 modelling and transmission dynamics

The COVID-19 vaccine has been available in India since January 2021, although many individuals have refused to take the vaccine for various reasons. Vaccination plays a crucial role in disease control by preventing a substantial number of cases and associated disabilities. However, vaccine hesitancy poses a barrier that hinders these efforts. Our article presents a novel approach by proposing a mathematical model for COVID-19 that incorporates vaccine hesitancy, vaccine efficacy and behaviour compensation post-vaccination. The model is calibrated with COVID-19 incidence data for India from 13 February 2021 to 12 January 2022, using the Markov chain Monte Carlo method. The analysis examines the effects of hesitancy and social interventions through a series of practical simulations. The simulation results show that while COVID-19-infected individuals may have natural immunity, vaccination post-recovery is crucial to reduce cases by up to 64.1%. Social interventions, such as face masks and distancing, remain essential to prevent a rise in cases and ensure effective disease control. The model demonstrates that vaccination, combined with continued social interventions, is crucial for effectively reducing COVID-19 cases and preventing future outbreaks. Addressing vaccine hesitancy and maintaining preventive measures are key to successfully controlling the pandemic.

“There's a lot of factors”: Researcher reflections on using I-Poetry to empathetically understand vaccine hesitant individuals

Background: Despite higher vaccination rates compared to other age groups, many US older adults remain under-vaccinated against preventable diseases leading to increased risk of serious illness, hospitalization, or death posed from disease. This study investigates the underlying reasons for older adults not getting vaccinated. Methods: From a larger interview study conducted in North Dakota, eight older adults (Mean Age = 73) were identified as being vaccine hesitant. Participants were asked, “How do you decide about whether or not to get a specific vaccine?” Then, participants' responses were analyzed using the I-poetry qualitative methodology, which involves creating a poem from interview transcripts to capture the essence of participants' experiences. Results: Poetic findings clarify interacting sources of immunization unease and highlight potential intervention avenues for medical professionals. Specifically, the poetic analysis revealed themes of mistrust in the healthcare system, preference for natural immunity, and concerns about vaccine side effects. The study suggests that healthcare professionals should consider using empathetic communication strategies to address vaccine hesitancy in older adults. Conclusions: Understanding vaccine hesitancy as a tapestry instead of individual factors may be more useful for older adults who culminate their hesitant beliefs from prior life experiences. Additionally, to improve trust in healthcare providers, it is suggested that more first-person narratives of older adult experiences are used and solicited by healthcare providers. Possible interventions are discussed.

COVID-19 vaccine or booster uptake and hesitancy for children aged 6 months–5 years in the United States: A national descriptive study using the household pulse survey between March and May 2023

The Centers for Disease Control and Prevention recommends that children aged 6 months–5 years (children under 5) receive multiple doses of COVID-19 vaccine, including updated (bivalent) COVID-19 vaccine. However, since the updated vaccines became available for children under 5, there has been limited knowledge regarding hesitancy toward the original vaccine or boosters in vaccinating children. To address this gap, this study utilized data from the Household Pulse Survey conducted from March 1, 2023 to May 8, 2023 (Phase 3.8). The purpose of the study was to examine the proportion of children under 5 who had received at least one dose of COVID-19 vaccine and to assess the likelihood of vaccination, categorized as willingness to vaccinate, moderate hesitancy, and strong hesitancy. Additionally, we identified sociodemographic factors that may influence the level of vaccine hesitancy for children. Overall, 24.5 % (95 % CI: 22.2–26.8) of children under 5 had received at least one dose of the COVID-19 vaccine, with the highest percentage among non-Hispanic Asians (42.1 %, 95 % CI: 36.4–47.8). Respondents who had not received the vaccine showed a statistically significant decrease in their inclination to vaccinate children. There was a higher level of vaccine hesitancy among females compared to males regarding vaccinating children under 5. As household income and educational attainment decreased, there was an observed increase in the proportion of individuals showing strong vaccine hesitancy. Households without health insurance had significantly lower vaccine uptake and higher rates of strong vaccine hesitancy compared to those with health insurance. Parents, guardians, and healthcare providers play essential roles in vaccinating children under 5. Targeted interventions are needed to address vaccine hesitancy and promote the importance of booster doses in the vaccination of children.

Designing persuasive communication models for vaccine acceptance in isolated communities: A mass communication approach

This study introduces the Persuasive Communication Model as a novel approach to address vaccine hesitancy in isolated U.S. communities, where infectious diseases such as measles and influenza continue to pose significant public health threats. By integrating mass communication theories like the Elaboration Likelihood Model (ELM) and Social Cognitive Theory (SCT), with AI-driven message personalization, the model effectively tailors health communication strategies to the cultural, cognitive, and socio-economic contexts of vaccine-hesitant populations. In a randomized controlled trial, the model increased vaccination uptake by over 20% compared to traditional methods, while also enhancing trust in healthcare systems. The model’s adaptive communication, utilizing both digital platforms and community leaders, was instrumental in overcoming barriers related to geographic isolation, religious beliefs, and cultural resistance. These findings are particularly relevant for enhancing national public health security and reducing the economic burden of vaccine-preventable diseases. The study highlights the model's superiority over static communication frameworks, offering scalable applications for broader public health interventions.

Herd immunity and sustainable development goals: role of nurses in strengthening primary health care

Herd immunity has proven as a highly valuable public health concept for dealing with reinfection. It is the immunity developed in a population to an infectious disease through vaccination or previous infection which is contributed by the virulence of the organism, susceptibility of an individual to infection, extent of immunity developed towards the pathogen, occurrence of clinical and subclinical infection in the herd and herd structure. Herd immunity assessment is imperative for continuously monitoring the risk of epidemics. The minimum proportion of the population that needs to be immune to herd effect is called herd immunity threshold which can be achieved through adequate immunization coverage. Immunization contributes to 14 out of its 17 sustainable development goals (SDGs) and is important in reaching SDGs. Nurses play a vital role in strengthening primary health care through vaccination campaigns, addressing vaccine hesitancy, community outreach programs, monitoring and surveillance of diseases, advocacy, and policy development. Nurse practitioners and nurse-led vaccination programs help in reaching underserved communities or groups with vaccine hesitancy and lead to an upsurge in vaccination rates, patient satisfaction, and attainment of community immunity. Thus, vaccination is a powerful, cost-effective public health tool to achieve the eradication of diseases through proper coverage and development of population immunity.

The Scourge of measles

Abstract Once considered a disease of the past, the resurgence of measles in England has garnered significant attention in recent weeks and months. The uptake of routine childhood vaccines including the measles, mumps and rubella (MMR) vaccine is the lowest it has been in a decade and is well below the 95% uptake needed to protect the population and prevent outbreaks. This is giving this serious disease a chance to get a foothold in our communities. From having never seen a case of measles in their life time doctors in England are now notifying cases of measles based on clinical suspicion. Since October, we have seen a rapid increase in both measles cases and outbreaks of measles across England (the total number of cases confirmed since October 2023 to date is 1109) and it has been declared a national incident. The abstract highlights the consequences of vaccine hesitancy, illustrated by case studies of outbreaks of measles among susceptible populations such as schools and prisons and the steps being taken to control the spread. Social media misinformation, distrust in healthcare authorities, and concerns over vaccine safety are some of the factors shaping parental attitudes towards MMR vaccination. In response to these challenges, the abstract underscores the importance of targeted interventions aimed at addressing vaccine hesitancy, such as community engagement initiatives, tailored communication strategies, and healthcare provider training. By emphasizing the critical role of MMR vaccination in preventing measles resurgence, this abstract advocates for a collaborative approach involving healthcare stakeholders, policymakers, and the public to combat to combat this preventable yet persistent threat to public health.

2.I. Scientific session: Addressing vaccine hesitancy: from understanding determinants to implementing targeted strategies

Abstract Supported by NextGenerationEU (no. PE00000007) and EU4Health (VAXaction), the workshop will present a pan-European perspective on vaccine hesitancy and the effectiveness of counteracting interventions, especially when facing potentially pandemic infectious threats. Analysing human responses to epidemics is crucial to improve mathematical disease modelling and develop strategies to monitor behaviours during outbreaks, including assessing levels of vaccine hesitancy. This session will explore the multifaceted issue of vaccine hesitancy, which remains a significant barrier to achieving optimal vaccination coverage and is identified as one of the top threats to global health. By integrating theoretical frameworks with practical applications, the workshop aims to present a comprehensive overview of strategies employed to mitigate hesitancy across various demographics and regions. The first presentation will cover a thorough overview of the strategies employed to counteract vaccine hesitancy, leveraging existing infrastructure, health promotion policies, and educational initiatives. It will also explore the role of digital health tools and regulatory measures, such as health passes and nudging techniques, in enhancing vaccination uptake. Furthermore, the session will cover a systematic review of immunisation information systems (IISs) and the proposal of an innovative unvaccinated registry. This part of the workshop will delve into technological advancements and the integration of behavioural insights, which are essential for enhancing vaccine coverage and informing public health strategies. Another significant aspect of the discussion will be the evolution of vaccine mandates, from their historical roots to their contemporary applications. This discussion will reflect on policy shifts necessitated by emerging public health challenges and the need for adaptable strategies that can respond effectively to fluctuating vaccine coverage and acceptance rates. Panel discussions will feature notable experts such as Prof. Carlo Signorelli, President of the Italian NITAG, and Prof. Maria Ganczak, Vice President of the EUPHA Infectious Diseases Control section. These discussions will provide a comparative analysis of vaccination policies across different European countries, highlighting diverse approaches to mandates and the implementation of public health interventions aimed at combating vaccine hesitancy. By providing a unified approach to understanding and combating vaccine hesitancy, we aim to facilitate a critical exchange of ideas and strategies among experts in the field. It will serve as a dynamic platform for discussing evidence-based interventions tailored to specific population needs, enhancing public health outcomes across Europe. This engaging session promises to offer valuable insights into the complexities of vaccine hesitancy and the collaborative efforts required to address this global health challenge effectively. Key messages • Enhanced data collection and analysis are essential to combat vaccine hesitancy, allowing for tailored interventions that address specific community needs and barriers to vaccination. • Effective strategies against vaccine hesitancy require historical understanding and flexibility to adapt to new challenges, ensuring public health policies are responsive and culturally sensitive.

Leveraging Social Marketing to Increase Vaccination Rates: A Systematic Review

Abstract Introduction Vaccinations are crucial for protecting individuals from preventable diseases, serving as a cornerstone of public health, safeguarding entire populations. Low vaccination rates can have devastating consequences, leading to outbreaks of preventable diseases. Social marketing has had an increasing role to play in public health. This systematic review seeks to investigate social marketing effectiveness in boosting vaccination adherence. Methods A literature search was conducted in PubMed, Scopus and Cochrane Library, using keywords “social marketing”, ‘campaigns”, “vaccination”, “vaccination uptake”. The search was limited to English-language studies, including studies discussing social marketing campaigns and its impact on vaccination uptake. Prior to inclusion, the studies were evaluated for relevance and applicability to the research question. Included studies were analysed for methodology, sample size, data collection methods, and key findings. Results Of 198 articles identified, 26 studies met inclusion criteria. All studies reported demonstrable improvement in vaccination adherence and hence higher vaccination rates with the use of social marketing campaigns. Targeted messaging on social media allows communication to be tailored to specific demographics and address their unique concerns. Community engagement combats vaccine hesitancy by dismantling misinformation and rebuilding trust. Additionally, these campaigns leverage social influence and mobilise communities to cultivate pro-vaccine attitudes. By addressing personal choice, knowledge gaps, and hesitancy, social marketing paves the way for greater vaccination uptake. Conclusions Social marketing has been proven to be an effective tool in promoting vaccination adherence in public health. As vaccination remains a critical aspect of public health, the continued use of social marketing interventions is essential for improving vaccination rates and ultimately enhancing overall population health. Key messages • Social marketing campaigns lead to higher vaccination rates across various populations. • By addressing vaccine hesitancy, social marketing paves the way for increased vaccination uptake.

Advancing immunisation information systems: a proposal for the “unvaccinated registry”

Abstract Through a systematic review of 253 studies, we identified significant advancements in IIS functionalities including real-time data access, interoperability, and life-course vaccination records, crucial for robust public health responses. Our review reveals that vaccinations are vital for public health and societal welfare; however, vaccine hesitancy is a significant barrier, driven by complex factors. Most IIS implementations predominantly utilise web-based platforms focused on children’s vaccinations with features that enhance data interoperability and public health surveillance. Despite these advancements, gaps in vaccine coverage and hesitancy mapping persist due to suboptimal data integration and system interoperability. Parallelly, we propose a comprehensive registry that includes unvaccinated individuals, aiming to address vaccine hesitancy by integrating demographic and socio-economic data. This initiative promises to enhance health equity by providing actionable insights into vaccination gaps and facilitating targeted interventions. Ethical considerations, particularly data privacy, are paramount, as well as adhering to regulations such as GDPR to ensure the protection of personal health information. The integration of IIS with a registry that includes unvaccinated populations represents a transformative approach to public health, potentially increasing vaccine coverage and effectively informing policy decisions. This dual strategy leverages not only technological advancements but also incorporates essential behavioural insights, offering a path forward in the ongoing battle against vaccine-preventable diseases. This model aligns with the Italian National Vaccination Prevention Plan and underscores proactive, evidence-based strategies to enhance vaccination uptake, serving as a cornerstone for broader application in other national contexts.

The EU project VAXaction: tacking effectively vaccine hesitancy in Europe

Abstract The main objective of VAX-ACTION is to support EU Member States and relevant stakeholders to implement the results of tailored, evidence-based interventions aimed to reduce vaccine hesitancy. Based on the evaluation of effectiveness of these interventions, which will be conducted in selected target regions in EU member states, recommendations will be drawn through diverse dissemination strategies to allow scaling up good practices to other member States, but also to the USA and Canada, where gaps in implementation strategies also have prevented effective, evidence-based interventions aimed to better deal with vaccine hesitancy. The first phase of the research involved some relevant systematic reviews with the aim of: 1. to map public health evidence and research results on large-scale vaccination programs in Europe and north America; 2. to map interventions aimed to address vaccine hesitancy regarding new and well-stablished vaccines and vaccination programs (Covid-19, mpox, national immunizations programs for children) in Europe and north America; 3. to identify successful and unsuccessful interventions designs aimed to address vaccine hesitancy, including challenges in the implementation, evaluation designs, and the feasibility of scaling-up solutions that are context-sensitive; 4. to identify significant similarities or dissimilarities in the designs and outcomes of interventions aimed to address vaccine hesitancy in northern countries where political and academic concern towards this phenomenon is growing; 5. to identify the extent to which ‘grounding’ (bottom-up) experiences aimed to address vaccine hesitancy are evidence-based, build on current international knowledge and guidelines, and whether they are internationally reported; 6. to systematize the mapping of interventions aimed to address vaccine hesitancy in the northern hemisphere in a way that can be shared and used by third parties. This contribution will illustrate the results of the first phase of the project.

Comparing role of religion in perception of the COVID-19 vaccines in Africa and Asia Pacific

BackgroundIn the midst of the global COVID-19 vaccine distribution challenge, religion stands out as a key determinant of vaccine hesitancy and health choices. Notably, the multifaceted religious environments of Africa and the Asia Pacific remain under-researched in this context.MethodsUtilizing data from two survey waves conducted between 2021 and 2022, this cross-sectional study investigated the effects of religious beliefs on perceptions of compatibility between religion and vaccines and COVID-19 vaccine acceptance in Africa and Asia Pacific. Logistic regression models were employed, with interaction terms between socio-economic factors incorporated to account for variations among diverse subpopulations.ResultsAmong the eight religious groups identified, Atheists and Buddhists in the Asia Pacific exhibit the lowest agreement, with fewer than 60% acknowledging the religious compatibility of vaccines. Willingness to accept vaccines, however, is consistently higher in Asia Pacific by at least four percentage points compared to Africa, with the disparity widening further in the second wave. Impacts of education on vaccine perceptions vary across religious groups, while acknowledging vaccine compatibility with religion positively contributed to vaccine acceptance. Dynamics between region, religion, and other socio-demographic factors have changed substantially over time. All but Atheists and Muslims exhibit a higher propensity to endorse vaccines during Survey Wave 2.ConclusionsOur study reveals complex, context-dependent connections between vaccine attitudes and religion and the heterogeneous effects of time and education among different religious affiliations. Understanding the underlying drivers of these temporal variations helps inform tailored approaches aimed at addressing vaccine hesitancy, promoting vaccine uptake, and improving the well-being of each religious group.

COVID-19 vaccination intention among people who use drugs in France in 2021: results from the international community-based research program EPIC

BackgroundCOVID-19 vaccination is crucial to reduce the incidence of severe forms of the disease in the population. However, people who use drugs (PWUD) face structural and individual barriers to vaccination, and little is known about vaccination intention and factors associated with that intention among PWUD. This study aimed to estimate vaccination intention in PWUD and associated factors in the early stage of vaccination campaigns.MethodsWe conducted cross-sectional study in France among PWUD, as part of the international EPIC program, a community-based research study coordinated by Coalition PLUS. It included 166 unvaccinated PWUD attending harm reduction centers. A questionnaire collected data on sociodemographic characteristics, COVID-19 related difficulties, and mental health, among other things. Multivariate logistic regression was used to identify factors associated with low vaccination intention.ResultsOnly 19% of participants reported strong intention to get vaccinated against COVID-19. Factors independently associated with low vaccination intention were younger age (aOR = 0.90, 95%CI = 0.85–0.95), lower education level (aOR = 2.67, 95% CI = 0.95–7.55), and unstable housing (aOR = 6.44, 95% CI = 1.59–40.34). The most-cited reasons for low intention were mistrust in COVID-19 vaccines (66.1%), fear of side effects (48.7%), and non-belief in vaccinations in general (25.2%).ConclusionsThis study highlights the need for targeted COVID-19 information and interventions to increase vaccine uptake in PWUD, especially those living in precarity. Community-based interventions and targeted government assistance could play a crucial role in addressing vaccine hesitancy in this population, not only for COVID-19 but for future epidemics.

Vaccine hesitancy and the challenge of successful scientific communication

Vaccine hesitancy and the challenge of successful scientific communication Drawing on personal experiences and public discourse, Dr. Klaus Eyer, an Associate Professor at Aarhus University, explores the challenges of communicating about vaccine science to address vaccine hesitancy. Various hurdles need to be overcome by a vaccine to protect against a disease. It needs to be proven safe and effective in clinical studies. It also needs to be widely accepted and used by the public. This article examines the difficulties of communicating about vaccine science based on personal experiences and public discussions. My background is rooted in continental Europe, and my perspective may differ from those with other cultural or personal backgrounds. I have been actively involved in public outreach to promote vaccination, driven by my conviction in scientific evidence that shows current vaccines offer a net benefit to both individuals and communities, despite the challenges they present in terms of safety and efficacy in very rare cases, as I discussed in the previous article for this publication.(1) To offer a broader view, I’ve included insights from colleagues gathered through discussions in recent years, but we will still only be able to scratch the surface.

Developing a Public Health Course to Train Undergraduate Student Health Messengers to Address Vaccine Hesitancy in an American Indian Community.

The purpose of the Diné Teachings and Public Health Students Informing Peers and Relatives about Vaccine Education (RAVE) project was to develop strategies for health communication that addressed COVID-19 vaccine safety for residents of the Navajo Nation. The RAVE project developed a 16-week course using the Diné Educational Philosophy as a framework to train Diné College (DC) public health undergraduate students (n = 16) as health messengers to share COVID-19 vaccine safety information with unvaccinated peers and relatives. An online community survey (n = 50) was used to assess DC community vaccination perceptions to guide course development. The two primary reasons survey participants got vaccinated were to protect the health of others [82% (n = 41)] and to protect their own health [76% (n = 38)]. A pretest/post-test and a retrospective pretest (n = 13) were implemented to determine course effectiveness. A finding approaching significance was related to student confidence in being health messengers (9.1% increase). RAVE offers the first example in the published literature of successfully training American Indian undergraduate students in the context of a public health course to contribute to the response workforce during a public health crisis.

From obligation to action: unraveling the roles of social responsibility and prosocial tendency in shaping Chinese doctors' vaccine hesitancy.

The hesitation of healthcare professionals towards vaccines is becoming increasingly concerning, potentially undermining public confidence in vaccination programs. This study aimed to investigate the relationship between social responsibility, Prosocial tendency, and vaccine hesitancy among Chinese doctors, and to identify demographic factors associated with vaccine hesitancy. A cross-sectional survey was conducted among 976 Chinese doctors. Participants completed a questionnaire to assess their sense of social responsibility, Prosocial tendency, and vaccine hesitancy. Demographic information, including age, gender, and marital status, was also collected. Correlation and mediation analyses were conducted to examine the relationships between the main variables. Social responsibility was negatively correlated with vaccine hesitancy (r=-0.564, P<0.01) and positively correlated with Prosocial tendency (r=0.519, P<0.01). Prosocial tendency was negatively correlated with vaccine hesitancy (r=-0.505, P<0.01) and partially mediated the relationship between social responsibility and vaccine hesitancy. Younger age, female gender, and unmarried status were associated with higher levels of vaccine hesitancy. This study emphasized the important role of social responsibility and Prosocial tendency in reducing vaccine hesitancy among Chinese doctors. The findings suggest that interventions aimed at fostering a strong sense of social responsibility and promoting Prosocial tendency may effectively address vaccine hesitancy in this population. Additionally, targeted interventions focusing on young, female, and unmarried doctors may be necessary.

Drivers of COVID-19 Vaccination among Eligible Adults in Abuja, Nigeria: A Mixed-Methods Study Using the WHO Behavioral and Social Drivers of Vaccination Framework.

Despite the availability of COVID-19 vaccines, Nigeria still faces significant COVID-19 vaccine hesitancy, with only 60.7% of the eligible population fully vaccinated as of 20 March 2023. Our study, part of a community-based effort to improve knowledge and uptake of the COVID-19 vaccine in the Gwagwalada Area Council of Abuja, the Federal Capital Territory (FCT) of Nigeria, utilized the WHO's Behavioral and Social Drivers (BeSDs)-of-vaccination framework to examine the drivers of COVID-19 vaccination among eligible adults. This was a mixed-method study with focus group discussions (FGDs) and in-depth interviews (IDIs) involving 40 purposively sampled participants. We triangulate qualitative findings with data from a household survey of 1512 eligible adults identified using a two-stage systematic cluster sampling approach. All data were collected from the 1-18 November 2022. The household survey showed 46% COVID-19 vaccine uptake, with Pearson chi-square and Fisher's exact test showing significant associations between vaccine uptake and gender, religion, and education. Multivariate logistic regression showed that confidence in vaccine safety, knowing vaccination sites and family/friends' endorsement of COVID-19 vaccination were the strongest items associated with vaccine uptake in the thinking-and-feeling, practical-issue, and social-process domains, respectively. Multiple items measuring these domains aligned with BeSD priority question, demonstrating the robustness of the pared-down framework. Qualitative data corroborated these findings. To address vaccine hesitancy and increase uptake, community-driven approaches to improve trust in vaccine safety and benefits and promote positive vaccination norms are needed. In addition, service delivery strategies to make vaccination services easily accessible and identifiable should be developed and tailored to community needs.

Service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with BRIDGE IPC Skill tool

ABSTRACT Background: For COVID-19 pandemic and associated factors, around 25 million children missed routine immunization in 2021. NFHS-5 for Assam reported 67% coverage with routine immunization in 2019–21 which is below national average (77%) and lowest among Indian States/UTs. Lack of knowledge and skill among provider can reduce coverage. To address vaccine hesitancy and demand generation for routine immunization, BRIDGE IPC Skills (Boosting Routine Immunization Demand Generation) training in routine immunization for frontline workers considered an effective tool. Objectives: To estimate the service delivery in postpandemic period for routine childhood immunization in Assam following capacity building with a BRIDGE IPC Skill tool. Materials and Methods: This cross-sectional comparative study was conducted among immunization service providers from April 2022 to March 2023, where training coverage of service providers on BRIDGE IPC Skill was assessed. Comparison was made between functionalities of trained services by service providers with untrained ones. Results: A total of 2312 session sites were visited, of which 67.7% of frontline workers were trained, while 32.3% were not trained. Alternate vaccine delivery was present in 58.5%. Updated due list was present in 64.1% vs 29.8% in trained and untrained sites. Significant association was found between delivery of key message and status of frontline worker on BRIDGE IPC Skill training. Conclusion: Capacity building of frontline workers on BRIDGE IPC Skill can boost efficiency of frontline workers and may facilitate in addressing gaps that EXIST between health care system and community.

Religious belongings and Covid-19 vaccination

IntroductionVaccine hesitancy poses a complex global challenge. Our study investigates correlations between COVID-19 vaccination rates, religious demographics, and educational performance.Materials and methodsUsing cross-sectional analysis, data from reputable sources were analyzed for correlations using Pearson’s correlation and linear regression.ResultsWe found statistically significant positive correlations between COVID-19 vaccination rates and PISA scores, Catholic populations, non-religious, and atheist populations. Conversely, negative correlations were observed with Muslim and Eastern Orthodox populations. Our findings suggest potential influences of religious beliefs and educational attainment on vaccination rates.ConclusionThe data reveals a positive correlation between COVID-19 vaccination rates and the percentages of Catholic, Non-Religious, and Atheist populations, while indicating a negative correlation between COVID-19 vaccination rates and the percentages of Muslim and Eastern Orthodox populations. These findings underscore the potential significance of engaging religious leaders in promoting vaccinations as a strategy to address vaccine hesitancy.