Safety Of Childhood Vaccinations Research Articles

The impact of the COVID-19 pandemic on parental vaccine hesitancy: A cross-sectional survey

BackgroundIt is unclear how hesitancy towards pediatric vaccines has changed quantitatively since the onset of the COVID-19 pandemic, and if changes are more readily apparent in clusters of low COVID-19 vaccination. In this study, we assess how clusters of low COVID-19 vaccination correlate with changing parental beliefs about childhood vaccines. MethodsA cross-sectional, opt-in, internet-based survey of parents resident in the U.S. was conducted during August-September 2022. Our survey measured changes in beliefs about childhood vaccine safety, importance, and effectiveness since the start of COVID-19. We also measured parents’ perceived vaccination rates in the community, assessing its relationship with changing vaccination perceptions using Rao-Scott chi-square tests, and multinomial logistic regression models. ResultsAmong 310 parents of children 0–17 years old, 11 % (95 % CI: 7 %, 15 %) believed that childhood vaccines are less safe, 12 % (95 % CI: 8 %, 17 %) less important, and 13 % (95 % CI: 9 %, 18 %) less effective since the start of the COVID-19 pandemic. About 9 % (95 % CI: 5 %, 12 %) stated COVID-19 vaccination coverage was low in their community. Among those who stated COVID-19 vaccination coverage was low, 38 % reported believing childhood vaccines were less effective (vs 12 % of those who stated vaccination coverage was high). This corresponds to 4.34 times greater odds of believing childhood vaccines were less effective since the start of the pandemic (95 % CI: 1.38, 13.73) in those who believe COVID-19 vaccination coverage to be low in their community vs high. ConclusionOur study demonstrates that parental perceptions about childhood vaccines have been affected by the COVID-19 pandemic through geographic and social clustering of non-vaccination. Beliefs about the COVID-19 vaccine have spillover with beliefs about childhood vaccines, and more negative beliefs may be clustering in areas with low vaccination coverage, which could predispose the area to outbreaks of vaccine-preventable disease.

Spillover effects of the COVID-19 pandemic on attitudes to influenza and childhood vaccines

The current study sought to determine whether public perceptions of other vaccines and diseases than COVID-19 have been impacted by the COVID-19 pandemic. We longitudinally examined whether there had been a change from before the COVID-19 pandemic to during the pandemic in: (a) influenza vaccination behaviour and intentions; (b) the perceived benefit of childhood vaccines and influenza vaccines; (c) the perceived safety of childhood vaccines and influenza vaccines; (d) the perceived severity of measles and influenza; and (e) trust in healthcare professionals in two samples of Finnish adults (N = 205 in Study 1 and N = 197 in Study 2). The findings showed that during the pandemic, more people than before had received or wanted to receive the influenza vaccine. The respondents also believed that influenza was more dangerous during the pandemic and that vaccinations were safer and more beneficial. On the other hand, for childhood vaccines only perceived safety increased. Finally, in one of the studies, people had more confidence in medical professionals during the pandemic than they had before. Together, these findings imply a spillover of the COVID-19 pandemic on how people view other vaccines and illnesses.

Overconfident, resentful, and misinformed: How racial animus motivates confidence in false beliefs

AbstractObjectiveWe examine the role of racial resentment in motivating Americans to express confidence in misinformed beliefs on racialized scientific issues.MethodsWe study survey data from the 2020 American National Election Study. We examine respondents’ endorsement of misinformation on different scientific issues and their reported confidence in these views.ResultsWe find that racial resentment plays a strong role in leading Americans to hold confidently misinformed views about highly racialized policy issues (e.g., the occurrence of anthropogenic climate change or the origins of the COVID‐19 pandemic), but not on less racialized issues (e.g., childhood vaccine safety).ConclusionsOur work underscores the often‐overlooked importance of intergroup attitudes in shaping overconfidence and helps resolve theoretical tensions in the study of misinformation acceptance.

Factors influencing intent to receive COVID-19 vaccination among Black and White adults in the southeastern United States, October – December 2020

ABSTRACT Vaccination intent is foundational for effective COVID-19 vaccine campaigns. To understand factors and attitudes influencing COVID-19 vaccination intent in Black and White adults in the US south, we conducted a mixed-methods cross-sectional survey of 4512 adults enrolled in the Southern Community Cohort Study (SCCS), an ongoing study of racial and economic health disparities. Vaccination intent was measured as “If a vaccine to prevent COVID-19 became available to you, how likely are you to choose to get the COVID-19 vaccination?” with options of “very unlikely,” “somewhat unlikely,” “neither unlikely nor likely,” “somewhat likely,” and “very likely.” Reasons for intent, socio-demographic factors, preventive behaviors, and other factors were collected. 46% of participants had uncertain or low intent. Lower intent was associated with female gender, younger age, Black race, more spiritual/religious, lower perceived COVID-19 susceptibility, living in a greater deprivation area, lower reading ability, and lack of confidence in childhood vaccine safety or COVID-19 vaccine effectiveness or safety (p < .05 for all). Most factors were present in all racial/gender groups. Contextual influences, vaccine/vaccination specific issues, and personal/group influences were identified as reasons for low intent. Reasons for higher intent included preventing serious illness, life returning to normal, and recommendation of trusted messengers. Hesitancy was complex, suggesting tailored interventions may be required to address low intent.

Quantifying the effect of Wakefield et al. (1998) on skepticism about MMR vaccine safety in the U.S.

Efforts to trace the rise of childhood vaccine safety concerns in the US often suggest Andrew Wakefield and colleagues' retracted 1998 Lancet study (AW98)-which alleged that the MMR vaccine can cause children to develop autism-as a primary cause of US vaccine skepticism. However, a lack of public opinion data on MMR safety collected before/after AW98's publication obscures whether anecdotal accounts are indicative of a potentially-causal effect. We address this problem using a regression discontinuity framework to study change in monthly MMR injury claims (N = 74,850; from 1990-2019) from the Vaccine Adverse Events Reporting System (VAERS) to proxy concern about vaccine safety. Additionally, we suggest a potential mechanism for the effect of AW98 on vaccine skepticism, via automated sentiment analyses of MMR-related news stories (N = 674; from 1996-2000) in major television and newspaper outlets. AW98 led to an immediate increase of about 70 MMR injury claims cases per month, averaging across six estimation strategies (meta-analytic effect = 70.44 [52.19, 88.75], p < 0.01). Preliminary evidence suggests that the volume of negative media attention to MMR increased in the weeks following AW98's publication, across four estimation strategies (meta-analytic effect = 9.59% [3.66, 15.51], p < 0.01). Vaccine skepticism increased following the publication of AW98, which was potentially made possible by increased negative media coverage of MMR. Childhood vaccine skepticism presents an important challenge to widespread vaccine uptake, and undermines support for pro-vaccine health policies. In addition to advancing our understanding of the previously-obscured origins of US vaccine skepticism, our work cautions that high-profile media attention to inaccurate scientific studies can undermine public confidence in vaccines. We conclude by offering several recommendations that researchers and health communicators might consider to detect and address future threats to vaccine confidence.

Maternal and paternal confidence in vaccine safety: Whose attitudes are predictive of children’s vaccination?

Relatively little is known about the differential impact of maternal and paternal perceptions of vaccine safety on children’s vaccination status in New Zealand. Using a sample of 68 couples from the New Zealand Attitudes and Values Study (NZAVS), the present study investigated the distinct influence of mothers’ and fathers’ confidence in the safety of childhood vaccinations following the national immunisation schedule on their reports of children’s vaccination status. Actor-Partner Interdependence Modelling revealed that mothers’, but not fathers’, vaccine confidence predicted children’s vaccination status, regardless of who reported their children’s vaccination status. Higher maternal vaccine confidence increased the likelihood of child full vaccination status, but paternal vaccine confidence showed no unique significant effects. As women tend to express lower vaccine confidence than men, it is imperative to further investigate the key drivers of their low confidence and develop target interventions accordingly. Encouraging fathers’ involvement in the vaccination decision-making process may also be beneficial in increasing the likelihood of childhood vaccination uptake.

Attitudes toward vaccinations are becoming more polarized in New Zealand: Findings from a longitudinal survey.

BackgroundDespite continuing vaccine controversies, little is known about the trajectory of change in vaccine confidence over time. The current study examined whether there are subpopulations among the New Zealand public with diverging trajectories of confidence in the safety of childhood vaccinations from 2013 to 2017.MethodsUsing longitudinal survey data from the New Zealand Attitudes and Values Study, latent class growth models identified subpopulations with distinct rates and directions of change in vaccine confidence from 2013 to 2017 (N= 12,423; 11,912; 12,009; 10,254). The demographic profiles of these subpopulations were examined.FindingsMost New Zealanders’ (60%) maintained strong vaccine confidence throughout the years (i.e. vaccine believers), but 30% expressed decreasing confidence over time (i.e. vaccine skeptics). Around 10% were former skeptics who had low vaccine confidence in 2013 but showed increasing confidence thereafter. Men, Europeans/Others, those more educated and living in more affluent regions were more likely to be vaccine believers. Relative to former skeptics, women, older individuals and those with lower education were more likely to be vaccine skeptics.InterpretationAttitudes toward the safety of childhood vaccinations are becoming increasingly polarized in New Zealand. Roughly 30% of the population are becoming more concerned about vaccine safety over time, 10% are becoming more confident, whereas 60% show consistent high vaccine confidence. It is vital to further investigate the key contributors to decreasing confidence among vaccine skeptics and implement target interventions.FundingTempleton Religion Trust Grant (TRT0196) for data collection; Corresponding author supported by University of Auckland Doctoral Scholarship.

Standards for the provision of antenatal care for patients with inflammatory bowel disease: guidance endorsed by the British Society of Gastroenterology and the British Maternal and Fetal Medicine Society

BackgroundPregnant women with inflammatory bowel disease (IBD) are at increased risk of adverse pregnancy outcomes. Comprehensive guidelines on medical management have been published; yet, there is limited guidance on service...

Personality and demographic correlates of New Zealanders' confidence in the safety of childhood vaccinations.

Despite extensive scientific evidence on the safety of standard vaccinations, some parents express skeptical attitudes towards the safety of childhood immunisations. This paper uses data from the 2013/14 New Zealand Attitudes and Values Study (NZAVS) survey (N=16,642) to explore the distribution, and demographic and personality correlates of New Zealanders' attitudes towards the safety of childhood vaccinations. Around two thirds (68.5%) of New Zealanders strongly agreed/were confident that "it is safe to vaccinate children following the standard New Zealand immunisation schedule," 26% were skeptical and 5.5% were strongly opposed. Multiple regression analysis indicated that people lower on Conscientiousness and Agreeableness but higher on Openness to Experience expressed lower confidence about vaccine safety. Having higher subjective health satisfaction, living rurally, being Māori, single, employed and not a parent were all associated with lower confidence, while a higher income and educational attainment were associated with greater confidence. Our findings suggest that the majority of New Zealand adults trust in the safety of scheduled childhood vaccinations, but about one third do express some degree of concern. This finding highlights the importance of improving public education about the safety and necessity of vaccinations.

Poison or Prevention? Understanding the Linkages between Vaccine-Negative Individuals’ Knowledge Deficiency, Motivations, and Active Communication Behaviors

ABSTRACTThe last few decades have seen growing concerns among parents regarding the safety of childhood vaccines, arguably leading to the rise of the anti-vaccine movement. This study is an effort to understand situational and cross-situational factors that influence individuals’ negative attitudes toward vaccines, referred to as vaccine negativity. In doing so, this study elucidated how situational and cross-situational factors influence vaccine negativity. Specifically, this study tested how knowledge deficiency, or acceptance of scientifically inaccurate data about vaccines, and institutional trust influenced negative attitudes toward vaccines. Using the situational theory of problem solving as the theoretical framework, this study also identified and tested a knowledge–attitude–motivation–behavior framework of vaccine negative individuals’ cognitions and behaviors about the issue.

Continuous active surveillance of adverse events following immunisation using SMS technology

IntroductionOn-going post-licensure surveillance of adverse events following immunisation (AEFI) is critical to detecting and responding to potentially serious adverse events in a timely manner. SmartVax is a vaccine safety monitoring tool that uses automated data extraction from existing practice management software and short message service (SMS) technology to follow-up vaccinees in real-time. We report on childhood vaccine safety surveillance using SmartVax at a medical practice in Perth, Western Australia. MethodsParents of all children under age five years who were vaccinated according to the Australian National Immunisation Schedule between November 2011 and June 2015 were sent an SMS three days post administration to enquire whether the child had experienced a suspected vaccine reaction. Affirmative replies triggered a follow-up SMS requesting details of the reaction(s) via a link to a survey that could be completed using a smartphone or the web. Rates of reported AEFI including fever, headache, fatigue, rash, vomiting, diarrhoea, rigours, seizures, and local reactions were calculated by vaccination time point. ResultsOverall, 239 (8.2%; 95% CI 7.2–9.2%) possible vaccine reactions were reported for 2897 vaccination visits over the 44 month time period. The proportion of children experiencing a possible AEFI, mostly local reactions, was significantly greater following administration of diphtheria–tetanus–pertussis–poliomyelitis vaccine at 4 years of age (77/441; 17.5%; 95% CI 13.9–21.0%) compared to the vaccinations given at 2–18 months (p<0.001). Across all time points, local reactions and fatigue were the most frequently reported AEFI. ConclusionAutomated SMS-based reporting can facilitate sustainable, real-time, monitoring of adverse reactions and contribute to early identification of potential vaccine safety issues.

Highlighting consensus among medical scientists increases public support for vaccines: evidence from a randomized experiment.

BackgroundA substantial minority of American adults continue to hold influential misperceptions about childhood vaccine safety. Growing public concern and refusal to vaccinate poses a serious public health risk. Evaluations of recent pro-vaccine health communication interventions have revealed mixed results (at best). This study investigated whether highlighting consensus among medical scientists about childhood vaccine safety can lower public concern, reduce key misperceptions about the discredited autism-vaccine link and promote overall support for vaccines.MethodsAmerican adults (N = 206) were invited participate in an online survey experiment. Participants were randomly assigned to either a control group or to one of three treatment interventions. The treatment messages were based on expert-consensus estimates and either normatively described or prescribed the extant medical consensus: “90 % of medical scientists agree that vaccines are safe and that all parents should be required to vaccinate their children”.ResultsCompared to the control group, the consensus-messages significantly reduced vaccine concern (M = 3.51 vs. M = 2.93, p < 0.01) and belief in the vaccine-autism-link (M = 3.07 vs M = 2.15, p < 0.01) while increasing perceived consensus about vaccine safety (M = 83.93 vs M = 89.80, p < 0.01) and public support for vaccines (M = 5.66 vs M = 6.22, p < 0.01). Mediation analysis further revealed that the public’s understanding of the level of scientific agreement acts as an important “gateway” belief by promoting public attitudes and policy support for vaccines directly as well as indirectly by reducing endorsement of the discredited autism-vaccine link.ConclusionThese findings suggest that emphasizing the medical consensus about (childhood) vaccine safety is likely to be an effective pro-vaccine message that could help prevent current immunization rates from declining. We recommend that clinicians and public health officials highlight and communicate the high degree of medical consensus on (childhood) vaccine safety when possible.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2541-4) contains supplementary material, which is available to authorized users.

Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment

This Report presents empirical evidence relevant to assessing the claim — reported widely in the media and other sources — that the public is growing increasingly anxious about the safety of childhood vaccinations. Based on survey and experimental methods (N = 2,316), the Report presents two principal findings: first, that vaccine risks are neither a matter of concern for the vast majority of the public nor an issue of contention among recognizable demographic, political, or cultural subgroups; and second, that ad hoc forms of risk communication that assert there is mounting resistance to childhood immunizations themselves pose a risk of creating misimpressions and arousing sensibilities that could culturally polarize the public and diminish motivation to cooperate with universal vaccination programs. Based on these findings the Report recommends that government agencies, public health professionals, and other constituents of the public health establishment (1) promote the use of valid and appropriately focused empirical methods for investigating vaccine-risk perceptions and formulating responsive risk communication strategies; (2) discourage ad hoc risk communication based on impressionistic or psychometrically invalid alternatives to these methods; (3) publicize the persistently high rates of childhood vaccination and high levels of public support for universal immunization in the U.S.; and (4) correct ad hoc communicators who misrepresent U.S. vaccination coverage and its relationship to the incidence of childhood diseases.

Subjectivity of Parents in Refusal of Childhood Vaccination: A Q-methodology Approach.

PURPOSE: Despite the well-known public health benefits of vaccination, increasing public concern about the safety of childhood vaccinations has led some parents to refuse or hesitate having their children immunized. The purpose of this study was to identify the subjectivity of parents toward refusal of childhood vaccination.METHODS: Q-methodology, in which subjective viewpoints are explored and analyzed using a combination of quantitative and qualitative techniques, was used. Thirty-five participants were asked to rank 42 statements on diverse issues of childhood vaccination according to a continuous 9-point scale ranging from -4 for strongly disagree to +4 for strongly agree. Collected data was analyzed using the PC-QUANAL program.RESULTS: The results revealed three discrete groups of parents in the refusal of children's immunization: type I, distrust; type II, concern about side effects, and type III, belief that vaccinations are unnecessary.CONCLUSION: Special nurse counselors who can provide correct information about vaccination based on the three types should be part of the government policy. Customized education programs to shift viewpoints should be also redeveloped according to the results in this study.

A randomised controlled trial to compare opt-in and opt-out parental consent for childhood vaccine safety surveillance using data linkage

IntroductionNo consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent.MethodsA...

Danish 2011 update on childhood vaccine safety

Danish 2011 update on childhood vaccine safety

P2-111 Improving the health of Japanese women: acceptance of HPV vaccination in mothers of adolescent girls

IntroductionCervical Cancer (CC) caused by oncogenic Human Papillomavirus (HPV) is the most common cancer in young Japanese women. Vaccination against HPV offers a primary prevention strategy. This study investigates knowledge...

A randomised controlled trial to compare opt-in and opt-out parental consent for childhood vaccine safety surveillance using data linkage: study protocol

BackgroundThe Vaccine Assessment using Linked Data (VALiD) trial compared opt-in and opt-out parental consent for a population-based childhood vaccine safety surveillance program using data linkage. A subsequent telephone interview of all households enrolled in the trial elicited parental intent regarding the return or non-return of reply forms for opt-in and opt-out consent. This paper describes the rationale for the trial and provides an overview of the design and methods.Methods/DesignSingle-centre, single-blind, randomised controlled trial (RCT) stratified by firstborn status. Mothers who gave birth at one tertiary South Australian hospital were randomised at six weeks post-partum to receive an opt-in or opt-out reply form, along with information explaining data linkage. The primary outcome at 10 weeks post-partum was parental participation in each arm, as indicated by the respective return or non-return of a reply form (or via telephone or email response). A subsequent telephone interview at 10 weeks post-partum elicited parental intent regarding the return or non-return of the reply form, and attitudes and knowledge about data linkage, vaccine safety, consent preferences and vaccination practices. Enrolment began in July 2009 and 1,129 households were recruited in a three-month period. Analysis has not yet been undertaken. The participation rate and selection bias for each method of consent will be compared when the data are analysed.DiscussionThe VALiD RCT represents the first trial of opt-in versus opt-out consent for a data linkage study that assesses consent preferences and intent compared with actual opting in or opting out behaviour, and socioeconomic factors. The limitations to generalisability are discussed.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12610000332022

Evidence-Based Practice and Social Work: An Illustration of the Steps Involved

The current focus of the health care system involves a commitment to the process of considering evidence when making decisions (Donald, 2002). The principles of an emerging paradigm referred to as evidence-based (EBP) are ideally suited to fulfill this commitment. Evidence-based is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of clients (Gibbs & Gambrill, 2002, p. 452). Theoretically, EBP works by converting information from thousands of studies into risk estimates and thereby provides a framework for addressing questions asking is the chance certain things harm or benefit people, according to a fair and scientifically rigorous process (Donald). EBP offers social work practitioners and administrators a philosophy of that is compatible with obligations described in the profession's code of ethics and educational accreditation policies and standards (for example, informed consent, to draw on practice--and policy-related research findings) (Gambrill, 2003). Unfortunately, however, Gambrill noted that the philosophy and technology of EBP described in health care are typically not described in the social work literature. If social workers do not take the time to comprehend the systemic, client-oriented vision of EBP, then we risk losing critical opportunities to decrease gaps between professional, ethical obligations and accreditation standards and what is done in everyday practice (Gambrill, p. 18). Thus, in an era in which social workers must defend their domain from encroaching disciplines, adding the role of evidence-based practitioner to the plethora of other social work roles is fundamental. Using the vaccine safety dilemma as an example, we present the five steps involved in EBP and demonstrate their utility to social work practice. EVIDENCE-BASED PRACTICE Step 1: Converting Client Needs into Answerable Questions The first step of EBP involves converting client information needs into answerable questions (Sackett, Richardson, Rosenberg, & Haynes, 1997; Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). Questions that lend themselves to searching for the best evidence must be specific enough to generate an answer in an electronic search, by designating the patient population or problem, identifying the intervention or area of interest, identifying a comparison intervention or status if applicable, and designating measurable outcomes (Gibbs, 2003; Melnyk & Fineout-Overholt, 2002). Features of a well-built question include the client type or problem, the intervention or what you (the social worker) might do, an alternate course of action, and what you (the social worker) would like to accomplish (Gibbs). Example Social workers working in a health care domain are confronted with an array of client concerns and needs. One example of a client concern stems from the current health care debate about the safety of childhood vaccines. An increase in the number of vaccinations that children receive has yielded an increase in adverse events following vaccinations and thereby an increase in parental concern about the safety of vaccines (Centers for Disease Control and Prevention [CDC], 2002; Gellin, Maibach, & Marcuse, 2000). Using this as an example, the client type is children, the problem is adverse reactions to vaccines, the intervention is vaccines, an alternate course of action is no vaccines, and what you (the social worker) would like to establish is the probability of vaccine adverse reactions based on data from empirical studies. Incorporating these features to form an answerable question would result in the following: If a child receives a mandatory childhood vaccine, what is the probability of the child's developing an adverse reaction to the vaccine? Step 2: Locating the Best External Evidence to Answer the Question The second step of EBP involves searching for, with maximum efficiency, the best evidence with which to answer the question. …

Parent Attitudes Toward Immunizations and Healthcare Providers: The Role of Information

Lack of information has been associated with patient anxiety or concern in a number of healthcare areas. (1) Identify the proportion of parents who agreed, were neutral, and disagreed that they had access to enough information to make a decision about immunizing their child; (2) examine how parents who agreed and disagreed differed with respect to sociodemographic characteristics, and their attitudes about immunizations, their child's healthcare provider, immunization requirements/exemptions, and immunization policymakers; and (3) identify if differences exist in specific immunization concerns. A sample of parents with at least one child aged < or =6 years (n=642) was analyzed using data from the HealthStyles survey conducted during July and August 2003. Odds ratios and the Mantel-Haenszel chi-square test were used for analysis. Response rate for HealthStyles was 69% (4035/5845). The largest proportion of parents agreed they had access to enough information (67%) compared to parents who were neutral (20%) or who disagreed (13%). Compared to parents who agreed, parents who disagreed were more likely to be less confident in the safety of childhood vaccines (odds ratio [OR]=5.4, 95% confidence interval [CI]=3.3-8.9), and to disagree that their child's main healthcare provider is easy to talk to (OR=10.3, 95% CI=3.7-28.1). There was a significant linear trend in the percentage of parents expressing immunization concerns among those who agreed, were neutral, and who disagreed they had access to enough information (p<0.05; df=1). While most parents agreed that they had access to enough immunization information, approximately a third did not. Perceived lack of information was associated with negative attitudes about immunizations and toward healthcare providers. Basic information about the benefits and risks of vaccines presented by a trusted provider could go a long way toward maintaining and/or improving confidence in the immunization process.