Fear Of Adverse Effects Research Articles

Coverage evaluation of Iron folic acid and vitamin A supplementation among children in rural Puducherry-A Mixed method study.

Despite many measures taken by the government, still the problem of Vitamin A deficiency and anaemia exists among children. This study focuses on coverage of iron and folic acid and Vitamin A supplementation among children aged between 9 months and 5 years and to find out the barriers in administrating these supplements to children. An explanatory sequential mixed methodology was conducted in the field practice area of Thirubuvanai primary health centre. In the quantitative survey, a cross-sectional cluster sampling survey was conducted to find the coverage of IFA and Vitamin A supplementation among children (n = 215), followed by a qualitative interview (n = 14) to find out the barriers in administrating these supplements to children was conducted among the mothers. Our study found that Vitamin A supplementation coverage was taken only by 42% of the children in the last 6 months preceding the survey. IFA supplementation was taken by 31.2% of the children in the last 7 days preceding the survey. Lack of awareness, myths and misbeliefs, fear of adverse effects and lack of family support were found as barriers in administering the supplement to the children. The study findings have highlighted the need for community health education to improve the coverage of supplement administration.

A study of knowledge, attitude and behavior of patients towards their illness and their relation to sociodemographic factors

Background: This study was conducted to assess basic knowledge, attitudes, and practices of patients to their illness and find its correlation with various socio-demographic factors. Method: This was a cross-sectional questionnaire-based analytical study. All patients over 18 years of age who attended the OPD or were admitted to the medical ward and who agreed to participate in the study were included. A questionnaire regarding the demographic characteristics of the study participants as well as the patient’s knowledge, attitudes, and practices regarding their disease was administered regularly by experienced physicians dealing with OPD and IPD both type of patients. Results: Out of total 100, only 38% patients came for regular follow up and only 57% brought old records. 36% were not taking medications regularly for various reasons (trying alternative medicine (22.2%), advice from others (11.1%), found medicines ineffective and stopped without reconsulting (8.3%), fear of adverse effects (8.3%), couldn’t afford (8.3%), worsening of symptoms (5.6%) etc. 19.4% had no reasons. 67% patients got medicines prescribed from a qualified clinician while other sources were pharmacist (9%), relatives/friends (5%) and self-medication (6%). Significantly more females, educated and employed were aware about their medical condition and medications. Significantly more educated and employed brought old records and came for regular follow up (p-0.0187), Significantly more educated seeked qualified doctor’s advice as compared to uneducated. (p=0.0002). Conclusion: There is a need to educate patients about the importance of medication awareness, adherence, regular follow up, disadvantages of unscientific and unreliable information to improve compliance to treatment.

Over Three Decades of Growth Hormone Treatment in Children With Chronic Kidney Disease-Associated Growth Failure Before and After Kidney Transplantation.

Growth retardation and short final height is a common complication of chronic kidney disease (CKD) beginning in childhood, with profound deleterious effects on quality of life, mental health, and social achievement. Despite optimal treatments of causative factors for growth retardation in children with CKD, more than 50% of patients reach end-stage renal failure with a height >2 SD below the mean, and most do not demonstrate "catch-up" growth after receiving a kidney transplant. Four decades ago, recombinant human growth hormone (rhGH) treatment was introduced after studies showed increased growth velocity and improved height SDS in uremic subjects. Since then, an abundance of published data showed significant improvements in health-related quality of life, and most studies revealed no significant adverse effects. Clinical practice guidelines recommended rhGH treatment in CKD Stages 3-5D and after transplantation. Despite these guidelines, this therapy remained underutilized. Most commonly cited barriers to the implementation of rhGH treatment were the need for daily injections, financial challenges, physicians' unfamiliarity with guidelines, and fear of adverse events. rhGH has been shown to improve growth and final height in short children with CKD, with minimal adverse effects. Despite data of its successful use generated over 3 decades, this treatment is underutilized. More judicious utilization of the treatment should emphasize educating patients, their care givers, and members of the multidisciplinary treating team. Additional studies are needed to assess the longer-term rhGH treatment in larger cohorts of patients, leading to additional supportive data and clearer recommendations.

Attitudes, weight stigma and misperceptions of weight loss strategies among patients living with obesity in the Lazio Region, Italy.

Patient engagement is essential to achieve long-term goals in obesity management. It is crucial to identify patients' perspectives, misperceptions and unmet educational needs on obesity etiology and treatments, to establish a correct therapeutic alliance between healthcare providers and patients. Objective: This study, promoted by the regional section of the Italian Obesity Society (SIO Lazio), explores attitudes towards obesity, self-awareness, misperceptions of weight loss strategies, experiences of weight stigma and educational needs of patients living with overweight or obesity. Design and subject: We conducted an anonymous survey among patients who accessed an Obesity Management Centers across the Lazio region of Italy for the first time, from October 2023 to April 2024. Approach: The survey consisted of 27 closed-ended questions grouped into 4 sections: (1) sociodemographic factors and self-reported anthropometric measures; (2) self-awareness and attitudes towards obesity and weight loss strategies; (3) experiences of obesity-related stigma; (4) knowledge and perceptions of obesity treatment options. A total of 300 patients (67.9% women, aged 49.1 ± 14.4 years) returned completed surveys. Despite the self-reported BMI 35.3 ± 7.0 kg/m2 with three out of four (75.3%) of participants having a BMI ≥ 30 kg/m2, only 49% correctly identified themselves as affected by obesity. Almost one-third of the patients believed that obesity does not imply a genetic predisposition (31.9%) and that it is always secondary to psychological or behavioral disorders (29.7%). Interestingly, 66.7% of the patients declared themselves as completely responsible for their own condition and 39.4% considered obesity always treatable by means of lifestyle interventions. Stigma and weight discrimination in healthcare settings were reported by a substantial portion of patients (31.9%). A perception of inadequate support from the National Healthcare System emerged in most of the interviews (61.9%). Most patients (72.1%) felt they were not sufficiently informed about anti-obesity medications and a relevant part of their knowledge was derived from healthcare providers (57.7%) and social networks (19.1%). Weight loss medications were considered useful (63.2%) or necessary (18.4%) by the majority of patients, but only 60.1% would accept without any hesitation a pharmacologic treatment. The main reasons for refusal of pharmacological treatments were the belief that lifestyle intervention is a sufficient treatment (46.9%), the fear of adverse effects (28.1%) and feeling defeated (12.5%). Similarly, for most of participants bariatric surgery is useful (73.3%) or necessary (13.6%). Despite advancements in obesity research, this study underscores the need to improve patient education and public awareness to optimize the management and treatment of obesity. Addressing misconceptions, stigma, and gaps in knowledge are critical steps towards improving patient outcomes and fostering a supportive healthcare environment.

Vaccine hesitancy during the COVID-19 pandemic among young people with an ethnic background in east Oslo – a qualitative study

Few studies have been conducted on young people's attitudes to the COVID-19 vaccine during the pandemic. We wished to examine how young people with an ethnic minority background decided whether to have the COVID-19 vaccine, based on the concept of vaccine hesitancy. Vaccine hesitancy involves uncertainty with regard to vaccination, irrespective of the decision taken. Fourteen qualitative in-depth interviews with young people aged 16-25 years with an ethnic minority background and from the east side of Oslo were analysed and categorised into main themes. The participants also had links to the Middle East, South Asia and Africa. Several of the study participants were hesitant to be vaccinated. Their hesitation was linked to the impression that the vaccine had been developed rapidly, false rumours, long travel times to vaccination centres and fear of adverse effects. A number called for better information. Vaccination through the school was described as a facilitating factor. Family and friends were less crucial in their assessment of whether to have the COVID-19 vaccine. The majority had trust in the authorities. Insufficient knowledge about the vaccine and fear of adverse effects, as well as practical barriers associated with undergoing vaccination, appears to contribute to vaccine scepticism among young people with an ethnic minority background. The authorities and healthcare personnel should provide young people with better vaccine information. Information should be provided by personnel they already trust, such as the school nurse.

COVID-19 vaccination rate in patients admitted to the Immunology and Allergy Outpatient Clinic

Aim
 Misinformation, lack of awareness, and beliefs about vaccines can cause hesitations about vaccines and affect the rate of vaccination. We aimed to reveal the vaccination rates against coronavirus disease-19 (COVID-19) (vaccine types and dose), and the reasons for not being vaccinated in patients admitted to the immunology and allergy outpatient clinic. In addition, we aimed to find out whether allergic reactions were observed in vaccinated patients.
 Methods
 The history of COVID-19 and vaccination of patients admitted to the Immunology and Allergy Outpatient Clinic between December 2021 and February 2022 were evaluated retrospectively.
 Results
 In our study, which included 451 patients, the median age of the patients was 35 (range 18-82), and 61.2% were women. 16.9% of the patients admitted to the immunology and allergy outpatient clinic were never vaccinated, while the rate of those who did not receive two doses of vaccine was 26.6%. The top three reasons for not being vaccinated were fear of allergies, fear of adverse effects, and distrust of the vaccine, respectively. Unvaccinated patients were younger, which is statistically significant. Vaccination rate was found to be lower in drug allergy and immunodeficiencies compared to other disease groups. 
 Conclusion
 Understanding the causes of vaccine hesitations and increasing the vaccination rate by organizing public health campaigns is an important point in the control of the pandemic. Despite being rare, allergic reactions can be observed with COVID-19 vaccines. Therefore, immunologists and allergists play an important role in the COVID-19 vaccine program.

"The targets…are driving the agenda and that probably needs to change": stakeholder perspectives on HIV partner notification in sub-Saharan Africa.

Voluntary assisted partner notification (VAPN) in HIV contact tracing is a globally recommended strategy to identify persons who have been exposed to HIV and link them to HIV testing and follow-up. However, there is little understanding about how VAPN is experienced by stakeholders in sub-Saharan African (SSA) contexts. We conducted a multi-level and multi-national qualitative analysis evaluating stakeholder perspectives surrounding VAPN implementation to inform the development of future VAPN policies. We conducted in-depth interviews (IDIs) with VAPN stakeholders at global (n = 5), national (n = 6), and community level (n = 4) across a total of seven SSA countries. Eligible participants were ≥ 18years old and had experience developing, implementing, or overseeing VAPN policies in SSA. We sought to understand stakeholder's perspectives on policy development, implementation, and perceived outcomes (barriers and facilitators). Interviews were audio recorded, transcribed, and analyzed thematically using a combination of inductive and deductive approaches. Between December 2019 and October 2020 we conducted 15 IDIs. While participants agreed that VAPN resulted in a high yield of people newly diagnosed with HIV; they noted numerous barriers surrounding VAPN implementation across global, national, and community levels, the majority of which were identified at community level. Barriers at global and national level included high target setting, contradictory laws, and limited independent research disenfranchising the experiences of implementing partners. The barriers identified at community level included client-level challenges (e.g., access to healthcare facilities and fear of adverse events); healthcare worker challenges (e.g., high workloads); limited data infrastructure; and cultural/gender norms that hindered women from engaging in HIV testing and VAPN services. In response to these barriers, participants shared implementation facilitators to sustain ethical implementation of VAPN services (e.g., contact tracing methods) and increase its yield (e.g., HIV self-testingintegrated with VAPN services). Overall, stakeholders perceived VAPN implementation to encounter barriers across all implementation levels (global to community). Future VAPN policies should be designed around the barriers and facilitators identified by SSA stakeholders to maximize the implementation of (ethical) HIV VAPN services and increase its impact in sub-Saharan African settings.

Health beliefs and attitudes toward Influenza and COVID-19 vaccination in Portugal: a study using a mixed-method approach.

Vaccination is one of the most effective population strategies to prevent infectious diseases and mitigate pandemics, and it is important to understand vaccine uptake determinants since vaccine hesitancy has been increasing for the past few decades. The Health Belief Model (HBM) has been widely used for understanding vaccination behavior. The current study aimed to assess influenza vaccine (IV) non-uptake and attitudes toward COVID-19 vaccination, two important respiratory diseases with similar symptoms, and routes of transmission in the Portuguese population. We conducted a cross-sectional study using a panel sample of randomly chosen Portuguese households. A total of 1,050 individuals aged 18 years and over responded to a telephone or online questionnaire. Through a mixed-method approach, we employed thematic content analysis to describe reasons for not taking the IV, considering the HBM dimensions, and quantitative statistical analysis to estimate IV and COVID-19 vaccine coverage. The IV uptake for the overall population was 30.7% (CI 95%: 26.5, 35.2). Susceptibility was found to be a main factor for IV non-uptake, followed by barriers, such as stock availability and fear of adverse effects. The uptake of the COVID-19 vaccine was very high in the study population (83.1%, CI 95%: 13.6%-20.9%). There was a high perception of COVID-19-associated severity and fear of the consequences. Individuals who reported IV uptake seemed to perceive a higher severity of COVID-19 and a higher benefit of taking the COVID-19 vaccine for severe complications. Thus, the population does not seem to consider influenza to be a health risk, as opposed to COVID-19, which is considered to be a possibly severe disease. The association between IV uptake and COVID-19 perceptions highlights that an overall attitude toward vaccination in general may be an important individual determinant.

A Holistic Strategy of Mother and Child Health Care to Improve the Coverage of Routine and Polio Immunization in Pakistan: Results from a Demonstration Project.

The eradication of poliovirus and improving routine immunization (RI) coverage rates present significant challenges in Pakistan. There is a need for interventions that focus on strengthening community engagement to improve routine immunization coverage. Our primary objective is to assess the impact of an integrated strategy designed to enhance community engagement and maternal and child health immunization campaigns on immunization coverage in Pakistan's high-risk union councils of polio-endemic districts. We implemented an integrated approach for routine immunization and maternal and child health in the polio-endemic district of Pakistan. This approach involved setting up health camps and actively engaging and mobilizing the local community. An independent team conducted surveys at three key points: baseline, midline, and endline, to evaluate immunization coverage among children under the age of five. The primary outcome measures for the study were coverage of OPV, IPV, and changes in the proportion of unvaccinated and fully vaccinated children. To select clusters and eligible households in each cluster, we utilized a 30 × 15 cluster sampling technique. Multivariable associations between socio-demographic factors and changes in the proportion of fully vaccinated children at the UC level were assessed using hierarchical linear regression models. A total of 256,946 children under the age of five (122,950 at baseline and 133,996 at endline) were enrolled in the study. By the endline, full immunization coverage had increased to 60% or more in all three study areas compared to the baseline. Additionally, there was a significant increase in the coverage of both OPV and IPV across all three provinces at the endline. The full immunization rates were assessed on three levels of the framework: the distal, intermediate (access and environment), and proximal level (camp attendance and effectiveness). At the distal level, on multivariate analysis, family size was found to be a significant predictor of change in immunity within the families (β = 0.68; p ≤ 0.0001). At the intermediate level, the likelihood of full immunization decreased with the decrease in knowledge about vaccination (β = -0.38; p = 0.002), knowledge about polio vaccine (β = -0.25; p = 0.011), and knowledge about IPV (β = -0.06; p = 0.546). Perceived obstacles to vaccination were fear of adverse events (β = -0.4; p ≤ 0.0001) and lack of education (β = 0.23; p = 0.031), which were found to be significant in bivariate and multivariate analyses. At the proximal level, community mobilization (β = 0.26; p = 0.008) and attendance at health camp (β = 0.21; p ≤ 0.0001) were found to enhance full immunization coverage. On the other hand, the most prominent reason for not attending health camp included no need to attend the health camp as the child was not ill (β = -0.13; p = 0.008). This study found that community mobilization and attendance at health camps significantly enhanced full immunization coverage. The findings highlight the importance of community engagement and targeted interventions in improving immunization coverage and addressing barriers to healthcare seeking.

Refusal and hesitation regarding vaccination against COVID-19 in Douala, Cameroon

vaccination is one of the strategies the World Health Organization recommends to reduce the burden of COVID-19. However, many African countries like Cameroon have low COVID-19 vaccination coverage. The purpose of this study was to investigate the reasons for the refusal of the population of the city of Douala to be vaccinated against COVID-19. we conducted a cross-sectional and analytical study in Douala from February 10 to May 31, 2022. Participants, aged at least 21 years and residing in the city of Douala, were interviewed. Associations between the variables of interest were measured using Chi-square and Fisher tests, with a 95% confidence interval. a total of 1555 people were included in the study. Only 168 (11%) had been vaccinated. The proportion of vaccine refusal was high, with 711 (45.7%) refusing, 640 participants (41.1%) hesitating, and 204 people (13.2%) being in favor of COVID-19 vaccination. The main reasons for refusing anti-COVID-19 vaccination were fear of adverse effects (406; 44.8%), lack of information about vaccines (331; 36.5%), and lack of confidence (302; 33.3%). Factors associated with vaccine refusal were religion (p=0.026) and level of education (p=0.002). this study revealed low COVID-19 vaccination coverage in Douala, with a significant proportion of refusal and hesitation towards vaccination. Communication strategies should take into account the reasons and factors associated with refusal.

Perceptions of childhood immunization in São Paulo: quantitative-qualitative cross-sectional study.

Vaccination hesitation spans from historical diseases such as smallpox to the current challenges with the coronavirus disease (COVID-19). In Brazil, vaccination faces obstacles related to trust and convenience. Despite the National Immunization Program, fear of adverse effects as well as misinformation challenge confidence in vaccines, and anti-vaccine movements have gained momentum. This study investigated childhood vaccine refusal, including COVID-19 vaccines, by comparing the reasons for and sociodemographic differences between vaccinated individuals and those who hesitated or refused immunization. A cross-sectional study was conducted in São Paulo, Brazil, using questionnaires administered during pediatric consultations between January and April 2023. This study investigated vaccine hesitancy and the attitudes of parents and caregivers of children (0-12 years) towards vaccines. The questionnaire was administered during routine pediatric consultations at three different locations, each with 50 participants for a total of 150 participants, to avoid selection bias. Marked differences were evident among caregivers in terms of sex, race, income, education, and religion, which influenced their attitudes toward vaccination. There was an increase in the refusal of seasonal vaccinations and a significant distrust of the efficacy of the COVID-19 vaccine (52%), with concerns about its side effects. Although most patients did not stop vaccination, significant delays occurred, especially in the clinical setting (58%). This study emphasizes the importance of childhood health decisions, indicating the need to build trust in vaccines, tailor health policies, and investigate the causes of distrust to promote childhood immunizations.

Evaluating the knowledge, attitude, perception, and readiness of caregivers of under 5-year-old children to accept malaria vaccine in Nigeria.

The global burden of disease and mortality is greatly influenced by malaria, particularly in children. Nigeria alone accounts for about 25% of global malaria cases and fatalities. Despite efforts to control and eliminate malaria, conventional treatments have limitations, prompting the need for a vaccine. However, while efforts have focused on researching and developing malaria vaccines, less attention has been given to public acceptance and preparedness for vaccination. The study employed a cross-sectional approach to assess the knowledge, perceptions, and readiness of caregivers towards the malaria vaccine. Data were collected through a physical and online survey among a representative sample of caregivers across the six geopolitical regions of Nigeria. The data was analyzed using principal component analysis and percentages. Out of 347 respondents, 180 (51%) men, 165 (46.6%) women, 2 (0.5%) transgender, 156 (45%) rural settlers, and 191 (55%) urban settlers were identified in this study. The study reported an overall acceptance rate of 78.4% and 21.6% resistance rate. The age group between 21-30 years recorded the highest 207 (59.6%). A significant number of participants, 252 (59.6%), held at least a higher or post-secondary certificate, out of which 193 (55.6%) demonstrated strong readiness to accept the malaria vaccine. The study showed that fear of adverse effects was the main reason for malaria vaccine resistance among caregivers. This study's findings offer valuable insights into caregivers' knowledge about the malaria vaccine, highlighting the factors that impact the acceptance of the malaria vaccine.

Factors associated with parental Human Papillomavirus (HPV) vaccination intention of daughter: A national survey in Finland

BackgroundHuman papillomavirus (HPV) vaccines are offered free of charge in Finland to 10–12-year-old children. Nationally about 80% of girls are vaccinated, with regional differences in first dose coverage varying from 62% to 82% in girls born in 2011. This study examined the factors associated with HPV vaccination intention. Furthermore, we assessed the realisation of HPV vaccination among the daughters of the participating parents. MethodsA web-based survey was conducted for randomly selected parents of girls (N = 6 465) aged 10 to 14 years of age. Data was collected in February and March 2022 in five Finnish high and low coverage municipalities. The national vaccination register was employed to assess realisation of vaccination. ResultsParticipation rate was 13.7% (n = 883 parents). Almost all parents were aware of the association between HPV and cervical cancer, but only one fifth was aware of other diseases associated with HPV. Adherence to the national vaccination programme, parents’ mother tongue, and trusting in official information were associated with positive vaccination intention. The most often reported reason for non-vaccination was fear of adverse effects (22%). Overall, parental attitudes towards HPV vaccination were positive, with 83% of parents indicating their daughter had received or will receive the vaccination. Vaccination realisation was subsequently examined and 88% of the daughters were vaccinated. ConclusionsDespite low knowledge of HPV-related diseases overall, majority of parents held a positive intention to vaccinate their daughter. Realisation of intention was high in our study, higher than the national uptake. Foreign-origin parents had lower intention to vaccinate their daughters. As information on HPV and its vaccine is available in 11 languages, there is a need to re-think accessibility. In-depth interviews are needed to better explore the reasons behind non-vaccination.

Covid-19 vaccine uptake and its associated factors among adult population in Dangila district, Awi Zone, Northwest Ethiopia: A mixed method study.

Vaccination is the most cost-effective approach that significantly reduces morbidity and mortality related to Coronavirus disease -19 (COVID-19). Nevertheless, there is a lack of information on the COVID-19 vaccine uptake and related factors in Ethiopia including the research area. To assess COVID-19 vaccine uptake and its associated factors among adult population in Dangila District, Awi Zone, Northwest Ethiopia, 2023. A community-based mixed-type study design was conducted from Oct, 15-Nov 15/2022. The study population was chosen using the multistage stratified random sampling technique for the quantitative study and the purposive sampling method for the qualitative inquiry. The collected data were managed and analyzed using SPSS version 25. Bivariable and multivariable logistic regressions were employed to identify factors associated with vaccine uptakes. In the qualitative part of the study, key informant interview was applied. After the interview was listened, the transcripts were coded and categorized into themes, and analyzed using Atlas.ti 7 software. Finally, the finding was triangulated with the quantitative results. The vaccine uptake among the adult population was found to be 47% (95% CL: 42.7%, 51.0%). History of having test for COVID-19 (AOR: 1.70, 95% CI: 1.02, 2.84), good knowledge about COVID-19 vaccine (AOR; 3.12, 95% CI; 2.11, 4.59), no formal education (AOR: 1.78, 95%: 1.26, 2.58), good attitude (AOR: 3.21, 95% CI: 2.13, 4.89), being in poor Income category (AOR: 1.83, 95% CI: 1.08, 3.06), being female (AOR: 1.75, 95% CI: 1.2, 2.58) and living in rural area (AOR: 3.1, 95% CI: 1.87, 5.12) were significantly associated with vaccine uptake rate. The study also identified that misperceptions about the vaccine efficacy and safety, availability of vaccine, lack of knowledge about the vaccine, mistrust of the corona virus vaccine, fear of adverse effects, social media influence and religious beliefs were found to be barriers of COVID -19 vaccine uptake. In the Dangila district, adult population vaccination uptake for COVID-19 was comparatively low. To raise the rate of vaccination uptake, interventions must focus on the identified modifiable factors.

Changes in Local and Systemic Adverse Effects following Primary and Booster Immunisation against COVID-19 in an Observational Cohort of Dutch Healthcare Workers Vaccinated with BNT162b2 (Comirnaty®).

In healthcare workers (HCWs) and in the general population, fear of adverse effects is among the main reasons behind COVID-19 vaccine hesitancy. We present data on self-reported adverse effects from a large cohort of HCWs who underwent primary (N = 470) and booster (N = 990) mRNA vaccination against SARS-CoV-2. We described general patterns in, and predictors of self-reported adverse effect profiles. Adverse effects following immunisation (AEFI) were reported more often after the second dose of primary immunisation than after the first dose, but there was no further increase in adverse effects following the booster round. Self-reported severity of systemic adverse effects was less following booster immunisation. Prior infection with SARS-CoV-2 was found to be a significant predictor of AEFI following primary immunisation, but was no longer a predictor after booster vaccination. Compared to other studies reporting specifically on adverse effects of SARS-CoV-2 vaccination in healthcare workers, we have a relatively large cohort size, and are the first to compare adverse effects between different rounds of vaccination. Compared to studies in the general population, we have a considerably homogenous population. Insights in AEFI following primary and booster vaccinations may help in addressing vaccine hesitancy, both in HCWs and in the general population.

Factors Influencing Adherence to New Vaccine Recommendations - The Experience of Covid-19

Abstract The COVID-19 pandemic has highlighted the critical role of medical doctors in vaccine recommendation adherence. This study aimed to explore the factors influencing adherence to COVID-19 vaccine recommendations among Romanian medical doctors, one year into the vaccination campaign. We conducted a cross-sectional voluntary survey, and data from 94 physician respondents were analysed. We found that specialty, fear of adverse effects, and inflexible thinking were significant factors influencing vaccine recommendation adherence. General practitioners have higher adherence, while surgical specialists are more reluctant. Political and religious views don't associate with adherence to vaccine recommendations. These findings emphasize the importance of educational interventions to improve adherence and mitigate fear among medical doctors.

Public perception on childhood cancers from a population-based study in South India: Lessons to learn to avoid stigma

BackgroundThe probability of survival for childhood cancer in several low- and middle-income countries (LMIC) is less than 30%. Myths and misconceptions among the general public concerning childhood cancers have detrimental effects on early detection and treatment. Materials and methodsThis study aimed to assess public perceptions of childhood cancer among the public. We conducted a cross-sectional survey with 310 respondents by using an interview schedule. ResultsMost (n = 244, 79.7%) participants were aware of the occurrence of childhood cancer in the community and the curability of cancer in children. The respondents’ knowledge was mainly derived from online media (television, cinema, or social media). Most (n = 189, 61.8%) respondents knew that blood cancer was the most common malignancy among children. Among the causative factors, the infectious nature, environmental factors, and curse of god were perceived as reasons by 19.6%, 29%, and 33% of the subjects, respectively. Half of the cohort felt that the child would never return to normal life after treatment completion. The reasons for hesitancy to treat even after knowing the curability of the disease were fear of treatment expenses, wrong beliefs, wrong/lack of information, fear of adverse effects, and lack of family support. ConclusionDespite the advances in the diagnosis and treatment of childhood cancers, cancer remains a stigma in our community, interfering with the reintegration process of children into society, which is a significant barrier to improving survival.

Drivers of vaccine hesitancy among vulnerable populations in India: a cross-sectional multi-state study.

India's Covid-19 vaccination campaign engaged frontline workers (FLWs) to encourage vaccination among vulnerable segments of society. The FLWs report encountering a variety of barriers to vaccination and are often unsuccessful despite multiple visits to the same person. This cross-sectional study aims to pinpoint which of these barriers drive vaccine hesitancy among these segments, to help streamline vaccine communication, including FLW training, to better safeguard the population. Trained field enumerators contacted 893 individuals from five states across India and collected self-reported assessments of fifteen vaccination barriers (identified through discussions with FLWs), current vaccination status and future vaccination intentions, and covariates (demographics/comorbidities). Factor analysis of the fifteen barriers yielded two factors, one relating to fear of vaccine adverse effects and a second focused on peripheral concerns regarding the vaccine. The covariates significantly associated with current vaccination status were combined under a latent class regime to yield three cluster types (health access, financial strength, and demographics). The primary analysis examined the effect of the two barrier factors, the covariate clusters, and comorbidity, on current vaccination status and future vaccine intentions. Fear of vaccine adverse effects was the primary driver of vaccine hesitancy; peripheral concerns frequently mentioned by the FLWs had no impact. Although cluster membership and the presence of comorbidities predicted vaccine uptake, neither of them materially altered the effect of fear of vaccine adverse effects with the following exception: fear of adverse effects was not associated with vaccination status among young Muslim men. Subject to limitations, these results indicate that interventions to decrease vaccine hesitancy should focus primarily on fear associated with vaccines rather than spend resources trying to address peripheral concerns.

Acceptability of COVID-19 Vaccination by Doctors: Cross-Sectional Survey from Mohammed VI University Hospital in Marrakech

Covid-19 has rapidly became a major public health crisis. Several public health and containment measures were deployed to contain this epidemy; however, a return to a normal life could only be expected after the generalization of anti-Covid 19 vaccination, allowing a global collective immunity. The success of this campaign depends essentially on the acceptance of the new Covid-19 vaccines. We conducted a descriptive and analytical observational cross-sectional study to evaluate the acceptability of Covid-19 vaccines, among resident and intern doctors at the Mohammed VI University Hospital in Marrakech, to determine the factors associated with vaccine acceptance, and the reasons for hesitation or nonacceptance of vaccination. Out of 145 participants (59.1% female, mean age 26.6 years), 89.7% received the vaccine at least partially. 49% of our population did not delay their vaccination and intended to complete it, so we considered them accepting. However, 40.7% were considered hesitant because of delayed or abandoned Covid-19 vaccination. People living alone and resident physicians in medical or biological specialties were the most likely to accept vaccination. Factors influencing refusal or hesitation included: speed of vaccine development, fear of adverse effects, lack of information on vaccine efficacy, acquisition of natural immunity following previous infection with Covid-19, lack of confidence in the pharmaceutical industry. Doctors' general attitudes towards COVID-19 vaccination, in our study, are positive, but specific concerns about the COVID-19 vaccine are widespread. Addressing barriers to vaccination in these groups will be essential to avoid exacerbating the health inequalities highlighted by this pandemic.

Hemodiyaliz hastalarında aşılanma oranları ve farkındalığı

Aims: Vaccination is main risk reducing strategy for vaccine-preventable infections in chronic kidney disease (CKD) patients, but vaccination rates in hemodialysis patients are not at the desired level. In this study, we aimed to search the rates of influenza, pneumococcal, hepatitis B and coronavirus disease-2019 (COVID-19) vaccination, the vaccination awareness and the reasons for not taking vaccination in hemodialysis patients.
 Methods: In this cross-sectional study, 232 CKD patients undergoing hemodialysis in two centers for at least six months were included. The patients completed the questionnaire about vaccination. The data about patients’ history of vaccination regarding influenza, pneumococcal, hepatitis B and COVID-19 vaccines; patients’ attitudes and knowledge about vaccination; the source of information about vaccination were collected via this questionnaire.
 Results: The rates of pneumococcal, influenza, hepatitis B and COVID-19 vaccination were 9.9%, 56.6%, 38.8% and 87.1%, respectively. In patients with missing vaccination, the main reasons for not taking vaccination were lack of knowledge about vaccination (48.7%), the thought that the vaccine is not beneficial (12.5%) and fear of adverse effects (3.4%). The main sources of information about vaccination were healthcare workers (90.5%), radio/televison (1.7%) and internet (1.7%). 
 Conclusion: Our findings showed that the rates of influenza, pneumococcal and hepatitis B vaccination were below the targeted levels and the main reason was the lack of information about vaccination and the main source of information about vaccination was health personnel. Strategies should be developed to increase the awareness and rate of vaccination for vaccine-preventable infections in CKD patients.