Parental Hesitancy Research Articles

Attitudes, healthcare interactions, and communication preferences for HPV vaccines among hesitant Hispanic/Latinx parents: how does this compare with influenza and COVID-19 vaccines?

ABSTRACT Objective We explored HPV vaccine concerns and healthcare provider communication among Hispanic/Latinx hesitant parents during the COVID-19 pandemic, and how those concerns and provider communications compared for influenza and COVID-19 vaccines. As a secondary aim, we explored communication needs and strategies for these recommended vaccines. Design We applied a concurrent, multi-method study design (survey and interview) with 23 Hispanic/Latinx American parents of adolescents aged 11–18 years. An inductive deductive thematic approach was used to interpret interview data. Descriptives were used to analyze survey data. Results Overall, most parents (77%) perceived that their child was receiving too many vaccines. Regarding hesitancy for the HPV vaccine, major parental concerns related to vaccine effectiveness (83%), vaccine necessity (83%), and vaccine safety (80%). For the COVID vaccine, major concerns were the newness of vaccine (83%), vaccine safety (77%), low perceived effectiveness (77%), and low perceived need (77%). For influenza vaccines, major parental concerns were vaccine safety (73%), low perceived need (73%), and preference for natural over vaccine-induced immunity (73%). Parents had overall positive views towards vaccination. Some parents prioritized school-required vaccines, and others ranked the recommended vaccines- HPV, COVID-19, and influenza vaccines- for their children. They saw the benefits of recommended vaccines; however, there were concerns. The majority received a provider’s recommendation for HPV vaccination for their child, while over half had not received a recommendation for COVID-19 and influenza vaccines. Recommended communication strategies were diverse with parents highlighting the need for providers to capitalize on waiting and clinic rooms to provide education. Conclusion Healthcare providers should take advantage of missed opportunities, improve healthcare interactions with a strong recommendation and persistent communication, and offer diverse communication strategies and messaging for vaccines. Future work should further explore multi-vaccine concerns and how addressing these concerns through healthcare-provider communication could improve HPV vaccination along with COVID-19 and influenza vaccination.

The association of vaccine hesitancy with other public health practices in well child care: a cross-sectional study

Vaccination is one of the most successful public health initiatives in human history. Despite all the benefits of vaccination, it is noteworthy that the number of vaccine hesitant parents has increased in recent years. Individuals with vaccine hesitancy are known to have similar attitudes towards other scientific initiatives. In this study, we investigated the relationship between the attitudes of vaccine hesitant parents and other practices and interventions in well child care. The “Parental Attitudes Towards Childhood Vaccinations (PACV) scale was applied to parents of children aged 2-6 without chronic diseases. A PACV score of 50 or above was considered as vaccine hesitancy. Sociodemographic characteristics, economic status and practices in well child care were questioned. Parents' vaccine hesitancy and their approaches to other practices in well child follow-up were compared. A total of 329 parents were included in the study. The rate of parents with vaccine hesitancy was 22.8% (n=75). In both groups, most participants had an undergraduate/graduate level of education. Those with vaccine hesitancy were less likely to have received vitamin K at birth (81.3% vs. 97.6%, p<0.01), and use of prophylactic vitamin D (72% vs. 88.2%, p<0.01) and iron supplements in the first year of life (66.7% vs 78.3%, p=0.038) were lower. No difference was found for developmental hip dysplasia and hearing screening. The current attitudes of vaccine hesitant parents are not limited to vaccination, but also affect other health initiatives. In our study, we have shown that vaccine hesitant individuals are also opposed and/or reluctant to child health initiatives. Taking this into account when developing strategies to overcome vaccine hesitancy may lead to more effective results.

Message framing's limited efficacy in counteracting parental hesitancy towards human papillomavirus vaccination for female adolescents: Insights from a randomized trial.

Parental acceptance of HPV vaccination remains low. This study investigates the influence of different message framing on Chinese parental intentions to vaccinate their daughters against HPV. A 2 (appeal framing: gain vs. loss) × 2 (cultural value: individualism vs. collectivism) × 2 (evidence type: narrative vs. non-narrative) factorial design was used in an online experiment. Parents of unvaccinated junior high school girls were recruited and included in the experiment. The primary outcome assessed was the reduction in HPV vaccine hesitancy (VH). The analysis of variance tests (ANOVAs) and hierarchical regression analyses were conducted to test the hypotheses. Of 4012 participants, the majority were women with low VH. Only loss-framing exerted a direct effect on advocacy (p = .036). Initial VH negatively moderated this effect (p = .027). Except for narrative evidence (p = .068), message framings showed significant small effects in low-hesitant participants (p = .032). An incentive policy negatively moderated the initial VH's effect on advocacy (p = .042). Persuasion was evident only among low-hesitant participants not receiving incentives (p = .002). In contrast, for highly hesitant individuals without incentive policies, loss-framing (p = .024) and collectivism perspective (p = .033) produced counterintuitive effects. Message framing is effective among low-hesitant parents of female adolescents in improving HPV vaccination decisions without economic incentives. Non-narrative evidence and loss-framing messages should be prioritized over narrative evidence and gain-framing messages. Nonetheless, caution is warranted when engaging with highly hesitant parents.

Parental Attitudes Towards Palliative Care in Pediatric Oncology: Insights from Bereaved Families

Palliative care (PC) has shown significant growth in the US and is associated with improved patient and caregiver experiences. Nevertheless, there are concerns that PC is underutilized in pediatric oncology. Understanding parental attitudes towards PC is crucial to improving PC utilization. This study aimed to explore bereaved parent attitudes towards PC in pediatric oncology. This study used data from Alex's Lemonade Stand: My Childhood Cancer Bereavement Survey. The survey included questions regarding bereaved parents' attitudes towards PC. The survey included 72 bereaved families. Parents completed the survey a median of 11 years after their child's death. PC was involved in 71% of cases. These families were more likely to have do not resuscitate (DNR) orders, an advanced care plan, hospice care, a planned death location, and for their child to die outside the hospital. Although most parents (86%) agreed that it is a doctor's obligation to inform all patients with cancer about PC. PC referrals appeared to happen later than parents preferred. Lack of PC involvement was primarily due to PC not being offered or sudden death of the child. Parental hesitancy should not be viewed as a barrier to PC involvement. Although parents held mixed attitudes about PC, families accepted PC, desired earlier referrals, and believed it was a doctor's obligation to offer PC. These findings highlight the need for timely PC referrals, improved education, and increased awareness of PC services to enhance the integration of PC in pediatric oncology.

Parental Hesitancy toward Seasonal Influenza Vaccination for Children under the Age of 18 Years and Its Determinants in the Post-Pandemic Era: A Cross-Sectional Survey among 1175 Parents in China.

Children's susceptibility to influenza increased after COVID-19 control measures were lifted. This study investigated parental hesitancy toward seasonal influenza vaccination (SIV) for children and its determinants in the post-pandemic era. An online survey of full-time adult factory workers was conducted in Shenzhen, China in December 2023. This analysis was based on 1175 parents who had at least one child under the age of 18 years. Among all parents, 37.1% were hesitant to have their index child receive SIV. Mothers exhibited lower parental hesitancy toward SIV compared to fathers (31.9% versus 41.3%, p < 0.001). After adjusting for significant background characteristics, mothers and fathers who were more satisfied with the SIV health promotion materials, perceived more severe consequences of seasonal influenza for their children, and perceived more benefits, cues to action, and self-efficacy related to their children's SIV were less likely to exhibit hesitancy toward SIV. Higher frequency of exposure to information about the increasing number of patients or severe cases due to seasonal influenza and other upper respiratory infections on social media was associated with lower parental hesitancy toward SIV among fathers but not mothers. There is a strong need to address parental hesitancy toward SIV for children in the post-pandemic era.

What happens at two? Immunisation stakeholders’ perspectives on factors influencing sub-optimal childhood vaccine uptake for toddlers in regional and remote Western Australia

BackgroundIn Western Australia (WA), children aged 24 months living regionally or remotely (non-urban) have suboptimal vaccine uptake. As there has not yet been a systematic approach to understanding the facilitators and barriers to childhood vaccination in regional and remote WA, this study aimed to understand the views of key immunisation stakeholders regarding barriers and solutions.MethodsDrawing on the World Health Organization’s “Tailoring Immunization Programmes” approach, we undertook a qualitative study with three forms of data collection: (1) semi-structured interviews with immunisation experts within Australia’s immunisation system, (2) a semi-structured focus group with immunisation coordinators and health workers working in regional or remote WA, and (3) member checking with senior staff from WA Health. Data from the interviews and focus group was deductively analysed using the Capability-Opportunity-Motivation-Behaviour (COM-B) model on NVivo 20.ResultsThere was no clear consensus on the typical under-vaccinated child in country WA. A range of barriers were identified: lack of awareness of the vaccine schedule, difficult access to vaccination services, a shortage in a workforce able to have meaningful conversations with vaccine hesitant parents, ineffective reminder systems, and the rapid spread of misinformation. Participants described previous efforts used to improve vaccine uptake, and felt the following would improve uptake: better access to vaccine clinics, building capacity of Aboriginal Health Workers, and vaccine reminders.ConclusionThis is the first time the facilitators and barriers to routine childhood vaccine uptake in country WA has been explored. Addressing some of these barriers may see an increase in uptake.

Determinants of Parental Vaccine Hesitancy During the COVID-19 Era in Saudi Arabia: A Cross-Sectional Survey.

Background Despite the success of childhood vaccination in reducing vaccine-preventable diseases (VPDs), vaccine hesitancy remains a significant challenge in several countries, such as Saudi Arabia, both during and beyond the COVID-19 era. Furthermore, the pandemic may have impacted vaccine hesitancy trends, potentially affecting parents' intentions to adhere to scheduled childhood vaccination programs. Aim This article aims to assess the extent of parents' hesitancy towardchildhood vaccination, determine if it increased or decreased due to the COVID-19 pandemic, highlight the factors and determinants that influenced this hesitancy, whether positively or negatively, during the COVID-19 era, andestimate the acceptance of COVID-19 vaccination in relation to the acceptance of scheduled childhood vaccination. Methods A cross-sectional study was conducted in Saudi Arabia through a snowball sampling technique. Data were collected between September 2022 and October 2022 using an online survey using Google Forms. The inclusion criteria were parents or guardians in Saudi Arabia with a child up to 18 years of age.Responses were analyzed using SPSS V25 (IBM Corp., Armonk, NY, US), with chi-square tests and logistic regression performed to compare hesitancy and vaccination status. Results Among the 1,209 parents and care providers who participated, the prevalence of parents' vaccine hesitancy was 374 (30.9%). The educational level of the parents was not significantly associated with hesitancy status (p 0.490). The most refused vaccine was Mpox (345; 28.5%), whereas the one that caused the most hesitancy was the COVID-19 vaccine (352; 29.1%). Regarding the parents' concerns, the main reason for their hesitancy was the influence of their negative perceptions from social media content, including false or misleading information and negative allegations about vaccines, reported by 449 (18.98%) of the participants. Logistic regression analysis indicated that negative social media perceptions significantly increased the likelihood of vaccine hesitancy (OR = 2.15, 95% CI = 1.78-2.60, p < 0.001). Conclusion Our study highlights the prevalence of parental vaccine hesitancy during the COVID-19 era; the most significant hesitancy was observed towardthe COVID-19 vaccine, and the mpox vaccine was the most rejected. Negative social media was the main reason for parental hesitancy; public health efforts should focus on providing accurate and easily accessible information through educational campaigns on social media and other platforms.

Contemporary provider perspectives on how to address HPV vaccine hesitancy in the US: A qualitative study

IntroductionDespite over 15 years of real-world data that supports the safety and efficacy of the human papillomavirus (HPV) vaccine, in the United States vaccine hesitancy persists. Many studies have focused on vaccine-hesitant parents, but fewer have examined provider perspectives on how to address HPV vaccine hesitancy. MethodsBetween July 2021-April 2022, we recruited providers in Maryland and the broader Mid-Atlantic region who practiced pediatrics, primary care, family medicine, or adolescent medicine and who provided outpatient care for children ages 10–17. Semi-structured virtual interviews focused on provider-reported strategies to address HPV vaccine-hesitant parents, as well as perceived barriers to successful vaccination and provider perspectives on specific interventions to address parental hesitancy. Audio recordings were transcribed and analyzed via a combination of deductive and inductive coding.Higher-level themes within the domains of strategies, barriers, and perspectives on specific proposed interventions were identified. Results and discussionA total of sixteen providers completed an interview. Within the domain of provider-reported strategies, the following themes emerged: 1) leveraging continuity of care and established parental trust, 2) supporting parental autonomy, 3) tailoring the approach to specific concerns of vaccine-hesitant parents, 4) normalizing the HPV vaccine, and 5) focusing on health prevention and cancer prevention. Barriers providers identified were: 1) limited time, 2) lack of common ground with parents, 3) parent–child decision discordance, 4) availability of misinformation, and 5) parental concerns such as safety and necessity. In the domain for proposed interventions, providers favored interventions that saved time or were not resource-intense, that did not single out the HPV vaccine as different, were patient friendly, and leveraged efficiency through the electronic medical record. The insights from this study can help inform the development of provider-acceptable and feasible tools and interventions to address parental HPV vaccine hesitancy.

Examining Current Vaccination Practices for Neonates, Including Healthcare Provider and Parental Attitudes and the Challenges of Implementing Vaccination Schedules: A Clinical Study.

Vaccination of neonates is crucial for preventing infectious diseases and ensuring public health. However, understanding the attitudes of healthcare providers and parents towards neonatal vaccination and the challenges in implementing vaccination schedules is essential for optimizing vaccination strategies. A clinical study was conducted involving healthcare providers and parents of neonates. Surveys were administered to assess attitudes towards neonatal vaccination, perceived barriers, and adherence to vaccination schedules. Data analysis was performed using statistical methods to identify trends and associations. Among healthcare providers (n = 200), 85% expressed strong support for neonatal vaccination, citing its importance in disease prevention. However, concerns regarding vaccine safety (62%) and parental hesitancy (48%) were identified as significant barriers. Among parents (n = 500), 78% reported willingness to vaccinate their neonates, with 60% adhering strictly to vaccination schedules. Common reasons for non-adherence included fear of adverse reactions (42%) and misinformation (28%). Challenges in vaccine administration, such as access issues (20%) and vaccine shortages (15%), were also reported. Healthcare providers generally endorse neonatal vaccination, recognizing its benefits in preventing infectious diseases. However, addressing concerns about vaccine safety and parental hesitancy is crucial for improving vaccination rates. Strategies aimed at enhancing education, promoting vaccine confidence, and addressing logistical challenges are essential for the successful implementation of neonatal vaccination schedules.

Healthcare Professionals' Discursive Constructions of Parental Vaccine Hesitancy: A Tale of Multiple Moralities.

Healthcare professionals play a crucial role in addressing the concerns of vaccine-hesitant parents since they form a trusted source for vaccine-related information. An increasing body of evidence suggests that healthcare professionals are faced with complexities when navigating the sensitive topic of parental vaccine hesitancy, as they balance their own vaccine- and context-specific concerns with institutional and societal pressures to vaccinate. Furthermore, health choices, such as parental choices for childhood vaccination, are often linked to moralisation. Given the emphasis on effective communication with vaccine-hesitant parents in the patient-centred care literature, it is important to consider healthcare professionals' interpretations of parental vaccine hesitancy. Hence, a deeper understanding of how healthcare professionals make sense of, and moralise, childhood vaccination can help us understand how moralisation might appear in their communication with hesitant parents (in)directly. Drawing on a critical social-psychological framework for discourse analysis, this study analyses 39 semi-structured interviews with healthcare professionals in Flanders, Belgium, and presents the discursive patterns articulated by healthcare professionals on parental vaccine hesitancy. The findings elucidate how healthcare professionals perpetuate, or resist, moral discourse in their accounts of vaccine hesitancy by constructing five different interpretative repertoires, that is, a "good" or "bad" parenting repertoire, a freedom of choice repertoire, an individual risk-benefit repertoire, a public health repertoire, and an accessibility repertoire. Our study highlights the complexities healthcare professionals experience in negotiating vaccine hesitancy, as their understandings of vaccine hesitancy are affected by, and contribute to, existing moral dilemmas and dominant discourses surrounding health and parenting.

Determinants of influenza non-vaccination among Canadian children: insights from a nationwide survey.

To identify determinants influencing Canadian parents' decision not to vaccinate their children aged 6 months to 17 years against seasonal influenza. Data from the 2022 Childhood COVID-19 Immunization Coverage Survey, a national survey of approximately 10,500 Canadian parents/guardians and their children, was analyzed. The survey examined influenza vaccine coverage, parental perspectives on vaccines, reasons for hesitancy, and factors influencing immunization. Socio-demographic characteristics, including ethnicity, household income, working sector, educational attainment, and prevalence of chronic medical conditions among children were considered. Historical vaccine uptake and the impact of the COVID-19 pandemic on immunization decisions were also reviewed. Key determinants of non-vaccination in the 2021-2022 influenza season were analyzed using multivariable logistic regression, with a statistical significance level set at p-value <0·05. 70% of children aged 6 months to 17 years did not receive the seasonal influenza vaccine. Key predictors for non-vaccination included: residing in rural settings (aOR 1·35, 95% CI 1·13-1·60), parental education attainment of less than high school (aOR 2·48, 95% CI 1·24-4·97), and the absence of chronic medical conditions in children (aOR 1.60, 95% CI 1.34-1.91)· Other strong predictors included lower household income; deterrence due to the COVID-19 pandemic; and parental hesitancy stemming from concerns about the vaccine's safety, effectiveness, and by beliefs that their child was not at risk of contracting the influenza or severe consequences from the infection. This research underscores pivotal determinants of parental decisions not to vaccinate their children against seasonal influenza and sheds light on the impact of the COVID-19 pandemic. The results highlight the importance of addressing safety concerns and providing clear information to alleviate hesitancy.

Factors Affecting Parental Intent to Vaccinate Against COVID-19 in the United States.

The topic of childhood vaccinations has become increasingly contentious, sparking debate, and creating challenging decisions for parents. This study aimed to explore the factors influencing COVID-19 vaccination decisions for parents of unvaccinated children and identify the most common reasons for not vaccinating children against COVID-19 in the U.S. Authors analyzed data from Phase 3.7, Week 53 of the United States Census Bureau's Household Pulse Survey (N = 68,504), collected from January 4 to January 16, 2023. Standard descriptive statistics and adjusted odds ratio (aOR) were used to analyze the data. The top three reasons for vaccine hesitancy were concerns about side effects, lack of trust in the vaccine, and the perception that children in the household were not part of a high-risk group. Among respondents, nearly 87% (n = 59,363) reported receiving a COVID- 19 vaccination, and these individuals were more inclined to vaccinate their children across all age groups studied. Additionally, participants with higher levels of education (bachelor's degree or higher) were more likely to vaccinate their children against COVID-19 (aOR = 5.79; 95% CI, 5.43-6.17; p <0.001). Findings from the study suggest that some parents are still concerned about the COVID-19 vaccine and are hesitant to vaccinate their children against the disease. Information and insights from this study allow for a greater understanding of how parents are making this decision nearly three years after the pandemic officially began. Further studies are needed to determine how other factors, such as geographical location, also may affect parental COVID-19 vaccination hesitancy.

Prevalence and Determinants of Routine Childhood Vaccination Hesitancy in Makkah, Saudi Arabia.

Vaccines are among the most important inventions of the last century; they contribute significantly to preventing infectious diseases. In 2019, the World Health Organization (WHO) recognized vaccine hesitancy as one of the top ten threats. This study aimed to estimate the prevalence and determinants of routine childhood vaccine hesitancy among parents in Makkah City in 2023 using the Parent Attitude about Childhood Vaccine (PACV) survey. A cross-sectional study was conducted from October to December 2023 among parents of children aged six years or younger who attended primary healthcare centers (PHCC) in Makkah City using a stratified sampling technique. Data were collected using an electronic self-administered questionnaire, and the Arabic PACV Cronbach's alpha was 0.79. A total of 246 parents participated in the study. Over half of the participants were males (56.5%), and the mean age was 36 ± 7.2. Parents who scored 50% or more were considered hesitant. The study identified approximately 3% of parents as hesitant. The only significant association toward hesitancy status was age; younger parents were less hesitant than older parents, P-value < 0.006. The other variables, such as gender, educational level, marital status, employment status, household income, number of children, and having a child with chronic disease, were not significantly associated with vaccine hesitation. Though the overall parental hesitation rate is low, several questions received more hesitant responses than non-hesitant responses. Therefore, we recommend raising awareness through healthcare providers focusing on educating parents and correcting misconceptions about the safety and efficacy of vaccines.

Parental hesitancy toward children vaccination: a multi-country psychometric and predictive study

AimUnderstanding vaccine hesitancy, as a critical concern for public health, cannot occur without the use of validated measures applicable and relevant to the samples they are assessing. The current study aimed to validate the Vaccine Hesitancy Scale (VHS) and to investigate the predictors of children’s vaccine hesitancy among parents from Australia, China, Iran, and Turkey. To ensure the high quality of the present observational study the STROBE checklist was utilized.DesignA cross-sectional study.MethodIn total, 6,073 parent participants completed the web-based survey between 8 August 2021 and 1 October 2021. The content and construct validity of the Vaccine Hesitancy Scale was assessed. Cronbach’s alpha and McDonald’s omega were used to assess the scale’s internal consistency, composite reliability (C.R.) and maximal reliability (MaxR) were used to assess the construct reliability. Multiple linear regression was used to predict parental vaccine hesitancy from gender, social media activity, and perceived financial well-being.ResultsThe results found that the VHS had a two-factor structure (i.e., lack of confidence and risk) and a total of 9 items. The measure showed metric invariance across four very different countries/cultures, showed evidence of good reliability, and showed evidence of validity. As expected, analyses indicated that parental vaccine hesitancy was higher in people who identify as female, more affluent, and more active on social media.ConclusionsThe present research marks one of the first studies to evaluate vaccine hesitancy in multiple countries that demonstrated VHS validity and reliability. Findings from this study have implications for future research examining vaccine hesitancy and vaccine-preventable diseases and community health nurses.

Parental Factors Associated with COVID-19 Vaccine Uptake for Children over 5 Years of Age in Texas.

The COVID-19 vaccine is safe and effective for children, yet parental hesitancy towards vaccinating children against the virus persists. We conducted a telephone-administered weighted survey in Texas to examine parents' sociodemographic factors and medical conditions associated with COVID-19 vaccination intention for parents with unvaccinated children ages 5-17 years. We collected responses from 19,502 participants, of which 4879 were parents of children ages 5-17 years. We conducted multiple logistic regression with Lasso-selected variables to identify factors associated with children's vaccination status and parents' intention to vaccinate their children. From the unweighted sample, less than half of the parents (46.8%) had at least one unvaccinated child. These parents were more likely to be White, English-speaking, not concerned about illness, privately insured, and unvaccinated for COVID-19 themselves (p < 0.001). In the adjusted regression model, parents who were unvaccinated (vs. having COVID-19 booster, aOR = 28.6) and financially insecure (aOR = 1.46) had higher odds of having unvaccinated children. Parents who were Asian (aOR = 0.50), Black (aOR = 0.69), Spanish-speaking (aOR = 0.57), concerned about illness (aOR = 0.63), had heart disease (aOR = 0.41), and diabetes (aOR = 0.61) had lower odds of having unvaccinated children. Parents who were Asian, Black, Hispanic, Spanish-speaking, concerned about illness for others, and vaccine-boosted were more likely to have vaccination intention for their children (p < 0.001). Children's vaccination is essential to reduce COVID-19 transmission. It is important to raise awareness about the value of pediatric COVID-19 vaccination while considering parents' sociodemographic and medical circumstances.

Benefits, challenges, and strategies related to using presumptive recommendations for HPV vaccination: A qualitative study with rural and non-rural-serving primary care professionals

ABSTRACT HPV vaccination coverage remains far below the national target of 80% among US adolescents, particularly in rural areas, which have vaccine uptake rates that are 10% points lower than non-rural areas on average. Primary care professionals (PCPs) can increase coverage by using presumptive recommendations to introduce HPV vaccination in a way that assumes parents want to vaccinate. Through semi-structured interviews, we explored PCPs’ experiences and perceptions of using presumptive recommendations in rural- and non-rural-serving primary care clinics in North Carolina. Thematic analysis revealed that most PCPs in rural and non-rural contexts used presumptive recommendations and felt the strategy was an effective and concise way to introduce the topic of HPV vaccination to parents. At the same time, some PCPs raised concerns about presumptive recommendations potentially straining relationships with certain parents, including those who had previously declined HPV vaccine or who distrust medical authority due to their past experiences with the healthcare system. PCPs dealt with these challenges by using a more open-ended approach when introducing HPV vaccination to parents. In conclusion, our findings suggest that PCPs in both rural and non-rural settings see value in using presumptive recommendations to introduce HPV vaccination, but to adequately address concerns and ensure increased HPV vaccine uptake, PCPs can use simple and culturally sensitive language to ensure fully informed consent and to maintain parental trust. And to further strengthen HPV vaccine discussions, PCPs can utilize other effective HPV communication techniques, like the Announcement Approach, in discussing HPV vaccinations with hesitant parents.

Sociodemographic Trends and Correlation between Parental Hesitancy towards Pediatric COVID-19 Vaccines and Routine Childhood Immunizations in the United States: 2021-2022 National Immunization Survey-Child COVID Module.

Multiple factors may influence parental vaccine hesitancy towards pediatric COVID-19 vaccines and routine childhood immunizations (RCIs). Using the United States National Immunization Survey-Child COVID Module data collected from parents/guardians of children aged 5-11 years, this cross-sectional study (1) identified the trends and prevalence estimates of parental hesitancy towards pediatric COVID-19 vaccines and RCIs, (2) examined the relationship between hesitancy towards pediatric COVID-19 vaccines and RCIs, and (3) assessed trends in parental hesitancy towards RCIs by sociodemographic characteristics and behavioral and social drivers of COVID-19 vaccination. From November 2021 to July 2022, 54,329 parents or guardians were interviewed. During this 9-month period, the proportion of parents hesitant about pediatric COVID-19 vaccines increased by 15.8 percentage points (24.8% to 40.6%). Additionally, the proportion of parents who reported RCIs hesitancy increased by 4.7 percentage points from November 2021 to May 2022 but returned to baseline by July 2022. Over nine months, parents' concerns about pediatric COVID-19 infections declined; however, parents were increasingly worried about pediatric COVID-19 vaccine safety and overall importance. Furthermore, pediatric COVID-19 vaccine hesitancy was more prevalent among parents of children who were White (43.2%) versus Black (29.3%) or Hispanic (26.9%) and those residing in rural (51.3%) compared to urban (28.9%) areas. In contrast, RCIs hesitancy was higher among parents of children who were Black (32.0%) versus Hispanic (24.5%) or White (23.6%). Pediatric COVID-19 vaccine hesitancy was 2-6 times as prevalent among parents who were RCIs hesitant compared to those who were RCIs non-hesitant. This positive correlation between parental hesitancy towards pediatric COVID-19 vaccines and RCIs was observed for all demographic and psychosocial factors for unadjusted and adjusted prevalence ratios. Parent-provider interactions should increase vaccine confidence, shape social norms, and facilitate behavior change to promote pediatric vaccination rates.

Increasing Confidence in the HPV Vaccine

HPV causes approximately 26,600 new cancer cases every year in the United States. HPV vaccination initiatives have helped lower HPV infection rates. However, vaccination rates still remain incredibly low. Less than 40% of adolescents that qualify for vaccination have completed a full series. Community engagement through focus groups, interviews, pre and post online surveys of parents have been shown to improve attitudes toward vaccinations. This is a qualitative cross-sectional survey using both quantitative and non-numerical data collected through interviews in order to further understand the reasoning of HPV vaccine hesitant parents who decide to either opt out of vaccination or fail to complete the vaccine series. The study seeks to implement educational strategies such as the testing of a website that works to close the information gap, the amount of available knowledge regarding HPV vaccination compared to the level of knowledge parents actually have. These strategies are implemented with the goal of addressing the concerns of vaccine hesitant parents and assessing their level of hesitancy before and after providing the requisite information regarding HPV vaccination through the interview process. The goal of this study is to both educate and aid in parents decision making when deciding to vaccinate their children for HPV. There is limited community based research available on HPV vaccination hesitancy amongst parents. The approach of using educational materials along with a webpage is new in addressing vaccine hesitancy with regards to HPV. This research could help increase HPV vaccination rates in order to lower HPV related cancers in the future. We found that knowledge played a critical role in improving attitudes toward the HPV vaccine and that improving the knowledge quality of vaccine participants may improve vaccination rates. This work was supported by the American Cancer Society. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Communication strategies for healthcare providers to enhance vaccine discussions with vaccine-hesitant patients

This study examines vaccine hesitancy as an emerging public health concern that undermines the efficacy of vaccination initiatives. Healthcare providers play a crucial role in addressing vaccine hesitancy; however, many lack effective communication strategies. This study developed evidence-based communication guidelines to assist healthcare providers in discussing vaccines with hesitant patients. Drawing on Bourdieu's theoretical framework, semi-structured interviews were conducted with ten vaccine-hesitant parents and ten paediatricians in Nigeria. Through reflexive thematic analysis of the interview transcripts, this study uncovers power dynamics, legitimacy struggles, and cultural capital's significance in vaccine conversations. The findings reveal that hesitant parents question the legitimacy of vaccine recommendations, feeling marginalised yet constrained by societal norms of responsible parenthood. Similarly, healthcare providers' reliance on biomedical expertise often proves insufficient without rapport building, cultural competency, and addressing patients' unique knowledge assets. The findings of this study contribute to communication theory, medical education, and clinical practice by advocating for power-conscious, dialogue-based strategies to promote vaccination amidst uncertainty and scepticism.

Willingness and hesitancy towards the governmental free human papillomavirus vaccination among parents of eligible adolescent girls in Shenzhen, Southern China

BackgroundSince 2020, China has actively promoted HPV vaccination for eligible adolescent girls through various pilot programmes. This study investigated parental willingness and hesitancy towards the government-sponsored, free human papillomavirus (HPV) vaccination for eligible adolescent girls in Shenzhen, Southern China.MethodsFrom June to August 2022, a cross-sectional survey was conducted with parents of girls entering Grade 7, employing an adapted Vaccine Hesitancy Scale to assess vaccine hesitancy and logistic regression to identify factors influencing willingness to accept the free domestic vaccines.ResultsAlthough only 3.4% of the 2856 respondents had their daughters vaccinated against HPV prior to the survey, 91.7% were willing to utilise the governmental vaccination services. Parents with children in public schools (χ2 = 20.08, p < 0.001), those with more secure medical insurance (χ2 = 4.97, p = 0.026), and parents who had received an HPV vaccine themselves (χ2 = 28.829, p < 0.001) showed more reluctance towards the free vaccines. Vaccine hesitancy was presented in a mere 2.1% but was a significant predictor of vaccine refusal, even after adjusting for multiple factors (adjusted OR = 15.98, 95% CI: 9.06, 28.20). Notably, about four-fifths of parents of unvaccinated daughters harboured concerns about the safety and efficacy of the domestic vaccine.ConclusionsAlthough parents show a strong inclination to utilise the government vaccination services, their vaccine hesitancy, driven by safety concerns and a preference for imported vaccines, remains a significant barrier for rolling out vaccination coverage. This study highlights the need for multifaceted intervention strategies that address these issues to enhance HPV vaccine uptake effectively.