Vaccine Uptake Research Articles

Parental Perspectives on Human Papillomavirus (HPV) Vaccination in Gulf Cooperation Council Countries: A systematic review.

This systematic review aims to synthesize existing research on parental knowledge, attitudes, and barriers to human papillomavirus (HPV) vaccination in the Gulf Cooperation Council (GCC) countries. Following PRISMA guidelines, this systematic review analyzed parental knowledge, attitudes, and barriers to HPV vaccination in 6 GCC countries. A comprehensive search across multiple electronic databases (Embase, Cumulative Index of Nursing and Allied Health Literature, Scopus, Ovid MEDLINE, Web of Science, and PubMed) was conducted, focusing on studies published between January 2010 and December 2023. Inclusion criteria targeted studies in English or Arabic involving parents in GCC countries, excluding non-research publications and those not using survey techniques. The review included 7 studies from Saudi Arabia, the United Arab Emirates, and Qatar. No study was found in Oman, Bahrain, and Kuwait. The findings highlighted low knowledge and awareness of HPV and the vaccine, with significant variation across studies. According to our review findings, the level of awareness in the 7 studies was found to be low to high. These studies collectively illustrate a range of awareness levels, from as low as 11% awareness of the HPV-cervical cancer link to as high as 68% general awareness of HPV. Attitudes towards vaccination were poor in Saudi Arabia but more positive in the United Arab Emirates and Qatar. Major barriers included safety concerns, lack of information, and cultural beliefs. Despite moderate awareness in some GCC countries, substantial knowledge gaps and vaccine hesitancy persist. Targeted educational campaigns, effective communication strategies, and involvement of community leaders are essential to improve HPV vaccination uptake.

A behaviourally informed chatbot increases vaccination rates in Argentina more than a one-way reminder.

Maintaining COVID-19 vaccine demand was key to ending the global health emergency. To help do this, many governments used chatbots that provided personalized information guiding people on where, when and how to get vaccinated. We designed and tested a WhatsApp chatbot to understand whether two-way interactive messaging incorporating behaviourally informed functionalities could perform better than one-way message reminders. We ran a large-scale preregistered randomized controlled trial with 249,705 participants in Argentina, measuring vaccinations using Ministry of Health records. The behaviourally informed chatbot more than tripled COVID-19 vaccine uptake compared with the control group (a 1.6 percentage point increase (95% confidence interval, (1.36 pp, 1.77 pp)) and nearly doubled uptake compared with the one-way message reminder (a 1 percentage point increase (95% confidence interval, (0.83 pp, 1.17 pp)). Communications tools designed with behaviourally informed functionalities that simplify the vaccine user journey can increase vaccination more than traditional message reminders and may have applications to other health behaviours.

Drivers of COVID-19 vaccine uptake among rural populations in Madagascar: a cross-sectional study

BackgroundThe WHO set the global immunisation threshold for COVID-19 at 70% to achieve worldwide protection against the disease. To date, global COVID-19 vaccine coverage is still below this threshold, in particular in several sub-Saharan African (SSA) countries, such as Madagascar. While factors influencing COVID-19 vaccine hesitancy have been widely explored in the past few years, research on drivers of COVID-19 vaccine uptake remains scarce. This study aimed at investigating drivers associated with COVID-19 vaccine uptake in the Boeny region of Madagascar.MethodsThe study used a cross-sectional survey design to collect data on drivers of vaccine uptake from a sample of adults recruited from 12 healthcare facilities between November 2022 and February 2023. Relative and absolute frequencies were used to summarize participants’ characteristics. Prevalence ratios were estimated by Poisson regression to identify and compare sociodemographic and motivational drivers of vaccine uptake among those who were willing to get vaccinated against COVID-19 with those who had already been vaccinated.ResultsA total of 928 participants aged between 18 and 76 years were included in the study. Among those recruited, 44.9% (n = 417) had already been vaccinated and 55.1% (n = 511) were willing to receive their first dose of COVID-19 vaccine on the day of the interview. The proportions of those respondents who live in urban areas (56.5% vs. 43.8%) and who have high school or university education (46.6% vs. 35.8%) were higher for the uptake group, whereas the proportion of employed respondents (66.3% vs. 56.5%) was higher among those willing to get vaccinated. Vaccine being free of charge (aPR = 1.77 [CI 95%: 1.45–2.17]) and being able to travel again (aPR = 1.61 [CI 95%: 1.30–1.98]) were the drivers most strongly associated with higher vaccine uptake after adjustment for sociodemographic factors.ConclusionsThis study shows that actual COVID-19 vaccine uptake is influenced by a different set of factors than willingness to get vaccinated. Taking this difference in drivers into account can inform more tailored vaccination strategies to increase worldwide coverage.

Effectiveness and efficiency of immunisation strategies to prevent RSV among infants and older adults in Germany: a modelling study

BackgroundRecently, several novel RSV immunisation products that protect infants and older adults against RSV disease have been licensed in Europe. We estimated the effectiveness and efficiency of introducing these RSV immunisation strategies in Germany.MethodsWe used a Bayesian framework to fit a deterministic age-structured dynamic transmission model of RSV to sentinel surveillance and RSV-specific hospitalisation data in Germany from 2015 to 2019. The calibrated model was used to evaluate different RSV intervention strategies over 5 years: long-acting, single-dose monoclonal antibodies (mAbs) in high-risk infants aged 1–5 months; long-acting mAbs in all infants aged 1–5 months; seasonal vaccination of pregnant women and one-time seasonal vaccination of older adults (75 + /65 + /55 + years). We performed sensitivity analysis on vaccine uptake, seasonal vs. year-round maternal vaccination, and the effect of under-ascertainment for older adults.ResultsThe model was able to match the various RSV datasets. Replacing the current short-acting mAB for high-risk infants with long-acting mAbs prevented 1.1% of RSV-specific hospitalisations in infants per year at the same uptake. Expanding the long-acting mAB programme to all infants prevented 39.3% of infant hospitalisations per year. Maternal vaccination required a larger number to be immunised to prevent one additional hospitalisation than a long-acting mAB for the same uptake. Vaccination of adults older than 75 years at an uptake of 40% in addition to Nirsevimab in all infants prevented an additional 4.5% of all RSV hospitalisations over 5 years, with substantial uncertainty in the correction for under-ascertainment of the RSV burden.ConclusionsImmunisation has the potential to reduce the RSV disease burden in Germany.

Human PapillomaVirus Vaccine Uptake: Attitudes and Practices Among Moroccan Physicians.

In Morocco, cervical cancer is a serious public health problem with an estimated number of 2165 new cases and 1199 deaths in 2020. The human papillomavirus (HPV) vaccine has been available in Morocco since 2008. Few data are available on physicians' practices and attitudes toward HPV vaccine. Hence, this study aims to evaluate physicians' awareness and practice towards HPV vaccine and to highlight the main factors affecting physicians' recommendation of this vaccine in Morocco. We have carried out a structured interviewer-administered questionnaire with 500 physicians in different Moroccan regions between March 2019 and March 2020. This study showed an insufficient level of awareness of the two most common types of HPV associated with cervical cancer (36.6%). The rate of HPV vaccine recommendation did not exceed 16.6%. However, more than 63% of participants who were aware of HPV vaccine were willing to recommend it for their future eligible patients. Age (p value < 0.01), sector of activity (p value < 0.01), awareness of the two most common types of HPV associated with genital warts (p value = 0.02), of the vaccine schedules (p value = 0.03), and of the commercial name of this vaccine (p value < 0.01), were significant factors influencing physicians' recommendation of HPV vaccine. Our results showed that, older age (above 51years old) was associated with negative attitude towards the recommendation of this vaccine (OR: 0.17, 0.06-0.46 CI 95%). Practice in public sector was positively associated with recommendation of HPV vaccine (OR: 7.54, 3.38-16.80 CI 95%). Who were aware of the two most common types of HPV associated with genital warts were more likely to recommend HPV vaccine (OR: 3.36, 1.31-8.65 CI 95%). In the same line, participants, who were also more likely to recommend the vaccine, were those who were aware of HPV vaccine schedules (OR: 6.07, 3.51-10.50 IC 95%); participants who were aware of the commercial name of the HPV vaccine were more likely to recommend the vaccine (OR: 10.04, 5.02-20.09 IC 95%). Indeed, raising physicians' awareness is urgently needed to improve HPV vaccine coverage within Moroccan population.

Institutional trust, conspiracy beliefs and Covid-19 vaccine uptake and hesitancy among adults in Ghana.

Vaccine hesitancy is considered one of the ten threats to global health. In the context of the COVID-19 pandemic, vaccine hesitancy may undermine efforts toward controlling or preventing the disease. Nevertheless, limited research has examined vaccine hesitance, particularly in low- and middle-income countries (LMICs). It is thus imperative to examine how institutional trust and conspiracy belief in tandem influence the uptake of COVID-19 vaccines. Using data (n = 2059) from a cross-sectional study in Ghana, this study examines the association between institutional trust, conspiracy beliefs, and vaccine uptake among adults in Ghana using logistics regression. The regression model (model 3) adjusted for variables such as marital status, age, gender, employment, income, and political affiliations. The results show that individuals were significantly less likely to be vaccinated if they did not trust institutions (OR = .421, CI = .232-.531). Similarly, we found that individuals who believed in conspiracy theories surrounding the COVID-19 vaccine were less likely to be vaccinated (OR = .734, CI = .436-.867). We also found that not having a COVID-19-related symptom is associated with vaccine refusal (OR = .069, CI = .008-.618). Similarly, compared to those with a vaccine history, those without a vaccine history are less likely to accept the COVID-19 vaccine (OR = .286, CI = .108-.756). In conclusion, our results demonstrate the need for enhanced education to tackle conspiracy beliefs about the disease and enhance vaccine uptake. Given the role of trust in effecting attitudinal change, building trust and credibility among the institutions responsible for vaccinations ought to be prioritized.

The Saudi thoracic society guidelines for vaccinations in adult patients with chronic respiratory diseases

Abstract: Adult patients with chronic respiratory diseases (CRDs) are considered high risk group who are more likely to experience worse clinical outcomes if they acquire viral or bacterial infections. Vaccination is the best preventive tool to reduce the risk of infection and disease occurrence and to reduce the level of severity of complications associated with the various vaccine-preventable infections. These guidelines were developed by the Saudi Thoracic Society task force to emphasize the critical importance of improving the vaccine coverage rates in adult patients with CRD. They are intended to serve as a reference for healthcare practitioners managing CRD patients. The guidelines aimed to review the current knowledge related to vaccination efficacy in adult patients with CRD, based on the recent evidence and recommendations. Integrating the administration of the recommended vaccines in routine healthcare, such as during outpatient visits or before hospital discharge, is crucial for improving the vaccination rates in high-risk patients. The key strategies to address this public health priority include simplifying vaccination guidelines to enhance their accessibility and implementation by healthcare providers, increasing awareness in both the patients and healthcare providers that vaccines are not only intended for children. Additional strategies include maintaining continuous surveillance and advance research to discover novel vaccines. This approach aims to expand the range of preventable diseases and improve overall health and well-being. Vaccine hesitancy remains a significant challenge that necessitates a clear understanding of the community concerns. Providing appropriate education and communication, as well as addressing these concerns, are the crucial steps toward improving vaccine acceptance and uptake. By implementing these guidelines and multifaceted strategies, healthcare systems can optimize vaccine coverage and protection for patients with CRD, reduce the burden of vaccine-preventable complications, and improve the clinical outcomes in this vulnerable population.

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

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

COVID-19 vaccine effectiveness and uptake in a national cohort of English children and young people with life-limiting neurodisability

ObjectiveTo investigate SARS-CoV-2 vaccine uptake and effectiveness in children and young people (CYP) with life-limiting neurodisability.DesignWe undertook a retrospective cohort study using national hospital data in England from 21 December...

Differences in COVID-19 Vaccination and Experiences among Patients with Hypertension in Colombia and Jamaica during the COVID-19 Pandemic.

During the COVID-19 pandemic, hypertensive patients had increased infection and healthcare disruption in many low- and middle-income countries (LMICs) with limited vaccine access. The objective of this report is to describe COVID-19 experiences and vaccination uptake among hypertensive patients in Colombia and Jamaica. A cross-sectional study of patients with hypertension was conducted in primary care clinics in both countries between 2021 and 2022. Trained interviewers used a telephone-administered questionnaire to assess COVID-19 experiences (infection, vaccination, and healthcare access). A total of 576 patients (68.5% female, mean age: 67.5 years) participated. Health service disruption affecting access to care was low (<10%). Compared to Jamaica, more participants from Colombia reported testing positive for COVID-19, having family members or friends testing positive, losing family members or friends due to COVID-19, and being vaccinated. In logistic regression models, adjusted for age, sex, education, and rural/urban clinic status, fear of COVID-19 (OR 2.7, 95% CI: 1.2-6.1) and residence in Colombia (OR 5.9, 95% CI: 2.4-14.6) were associated with higher vaccination uptake. Disparities in access to COVID-19 testing and diagnosis may have influenced these country differences including fear of COVID-19 and vaccine uptake. Other factors need to be better understood to prepare for future pandemic responses.

Human Papillomavirus (HPV) Vaccination Rates Among U.S. Military Veteran Females and Males and Non-Veterans in the National Health Interview Survey.

Human papillomavirus (HPV) infection is a major risk factor for the development of multiple cancers. Active duty service members have higher rates of HPV infection than civilians, while Veterans are diagnosed with a disproportionately high burden of HPV-associated cancers compared to civilians without prior service. While a highly effective HPV vaccine has been available for over a decade, vaccination rates in the United States remain suboptimal. The objective of this study was to investigate HPV vaccination rates among male and female Veterans compared with their non-Veteran counterparts. We performed a secondary analysis of cross-sectional National Health Interview Survey (NHIS) data pooled from 2015 to 2018 to analyze HPV vaccination rates for respondents aged 18-45 years. We used multivariable logistic regression to compare HPV vaccination rates between Veterans and non-Veterans stratified by sex while controlling for sociodemographic factors, including age, race/ethnicity, education level, income, insurance coverage, and VA coverage. All analyses used NHIS survey weights to produce national estimates. Among 45,493 respondents aged 18 to 45 years, vaccination rates were low across all groups: 9.6% of male Veterans and 8.4% of male non-Veterans (P = .21) had received at least one HPV immunization, whereas 32.0% of female Veterans and 25.1% of female non-Veterans (P = .02) were immunized. After controlling for sociodemographics, both male Veterans (AOR 1.79; 95%CI 1.31, 2.44) and female Veterans (AOR 1.56; 95%CI 1.1, 2.21) exhibited higher odds of HPV vaccination compared to their non-Veteran counterparts. VA coverage was also independently associated with higher odds of HPV vaccination among female Veterans (AOR 2.39; 95%CI 1.10, 5.21). Veterans of both sexes are more likely to be vaccinated than their non-Veteran civilian counterparts. However, vaccination rates overall remain low. To our knowledge, ours is the first study of its kind to establish HPV vaccination rates among female Veterans. These findings underscore the important role of DoD and VA health care systems in improving HPV vaccine uptake and mitigating HPV-associated cancer risk among Veterans.

Factors associated with COVID-19 vaccine hesitancy and uptake among populations in the West department of Haiti.

The COVID-19 pandemic in Haiti led to increased challenges for a population concurrently dealing with natural and social disasters, poor quality health care, lack of clean running water, and inadequate housing. In 2022, the population of Haiti was 11.4 million. While half a million vaccines for COVID-19 were donated by the United States to the government of Haiti, less than 5% of the population agreed to be vaccinated. This resulted in thousands of unused doses that were diverted to other countries. The purpose of this study was to evaluate population characteristics related to vaccine uptake in order to inform future interventions to improve COVID-19 vaccine uptake as well as inform strategies to safeguard against future global health security threats. This was a mixed-methods, cross-sectional study conducted in the West Department of Haiti within peri-urban communes. Participants consisted of adults in this setting responding to a survey from June 15 to July 18, 2022. The survey assessed demographic information, household characteristics, religious beliefs, past vaccine use, and current COVID-19 vaccine status. Multivariate regression modeling was conducted to assess predictors of vaccine hesitancy. Qualitative focus group discussion participants were recruited and focus group discussions were conducted between August-September 2022 among community groups, religious leaders and health professionals to provide additional, community-level context on perceptions of the COVID-19 pandemic and vaccines. A total of 1,923 respondents completed the survey; of which a majority were male (52.7%), between the age of 18-35 (58.5%), had a medical visit within the last year (63.0%) and received the COVID-19 vaccine (46.1%). Compared to those who had been COVID-19 vaccinated, participants who had not been vaccinated were more likely to be male (57.7% vs 46.8%, p < .0001), have completed secondary education (30.5% vs 16.6%, p < .001), unemployed (20.3% vs 7.3%, p < .0001) and had a medical visit 3 or more years ago (30.2% vs 11.2%, p < .0001). Unvaccinated COVID-19 participants were also more likely to have never received any other vaccine (36.1% vs22.5%, p < .0001), have a religious leader speak out against the vaccine (20.0% vs 13.1%, p < .0001), not believe in the effectiveness of the vaccine (51.2% vs 9.1%, p < .0001) and did not trust the healthcare worker administering the vaccine (35.2% vs 3.8%, p<0.0001). These results show that targeted interventions to religious leaders and health care workers on how to engage with the community and share clearer messages around the COVID-19 vaccination may result in increased vaccine uptake. Results also shed light on how activities surrounding vaccinations can be tailored to meet client needs addressing the misinformation encountered to achieve greater health impact thereby safeguarding the population against future global health security threats.

To vaccinate or not to vaccinate? Experiences of COVID-19 vaccine uptake among people living with non-communicable diseases in Ghana: A qualitative study.

Following the development of a vaccine for COVID-19, the expectation was instantaneous widespread distribution and uptake to halt further spread, severe illness and deaths from the virus. However, studies show very low uptake, especially in resource-poor settings, and little is documented about the drivers of vaccine uptake in populations classified as high-risk. In this study, we explored access and uptake of COVID-19 vaccines among people living with non-communicable diseases (PLWNCDs) in Ghana. A qualitative study using in-depth interviews and focus group discussions was conducted among adults (>18 years) PLWNCDs stratified by sex, age, and type of non-communicable diseases (NCDs) at the community level (non-users of the health service) and health facility levels. Purposive sampling was used to select eligible participants. Topic guides were used to facilitate the face-to-face in-depth interviews and focus group discussions. The interviews and discussions were all digitally audio recorded. All transcripts and field notes were thematically analysed. Overall, 62 participants were recruited for this study. Family members, friends/peers, health workers and media were identified as the main sources of information for COVID-19 vaccines. Several barriers that mediated access to the COVID-19 vaccines in Ghana were reported including mistrust of vaccine efficacy and fears of vaccine side-effects, long distance to and waiting hours at vaccination centres, shortages of vaccines at vaccination centres and non-prioritization of NCD patients for the vaccine. To improve uptake, intensified education and sensitization, house-to-house vaccination, expansion of vaccination centers and increased supply of vaccines were recommended by participants. Compared to studies elsewhere, misinformation and disinformation were not major causes of vaccine hesitancy. If policymakers can improve community-based vaccine delivery, reduce queues and waiting times, prioritize PLWNCDs and other vulnerable groups, and improve sensitization and communication-our findings suggest there will be major improvements in COVID-19 vaccine coverage in Ghana.

Knowledge, Attitudes, and Practices towards Influenza Vaccine among Guangzhou Residents: A Cross-Sectional Study.

Influenza vaccination is an important prevention strategy for flu illness. However, the vaccination rate is still low in Guangzhou, China. This study aimed to understand the status of knowledge, the attitude towards the vaccines' reliability and safety, and other aspects associated with the willingness and practice of influenza vaccines in the pediatric and adult populations of Guangzhou city. This study was performed in eleven districts in Guangzhou between November 2020 and December 2020, including the Yuexiu, Liwan, Haizhu, Tianhe, Baiyun, Panyu, Huadu, Nansha, Huangpu, Zengcheng, and Conghua districts. The parents of children and teenagers under the age of eighteen in Guangzhou were surveyed using self-administered questionnaires in four domains: demographic information, the knowledge status and perception of influenza vaccination, the willingness and attitude towards influenza vaccination, and previous vaccine uptake. A multivariable logistic regression was employed to assess the possible determinants of willingness and practice to receive influenza vaccination, calculating the odds ratios (ORs) and 95% confidence interval (CI). A two-sided p-value < 0.05 was deemed statistically significant. A total of 13,213 valid questionnaires were collected (validity rate 98.8%). Out of these participants, 42.62% (5631 participants) expressed a willingness to receive the influenza vaccine, while 55.40% (7320 participants) reported that their children and teenagers had been vaccinated against the flu. Furthermore, 40.44% of the respondents (5343 participants) or other family members had received the influenza vaccine. Logistic regression indicated that factors such as being female (OR = 1.395, 95% CI: 1.278-1.522), being involved in the work of COVID-19 prevention and control (1.551, 1.396-1.724), affirming the preventive effects of vaccination (2.474, 2.106-2.906), knowing about annual influenza vaccination (2.756, 2.540-2.992), and understanding prioritized influenza vaccination populations (1.464, 1.343-1.596) were all positively associated with vaccination willingness. Conversely, middle-aged persons (aged 40-49 years old) (0.726, 0.617-0.853), higher educational levels (undergraduate versus middle school) (0.858, 0.768-0.959), heightened concerns about vaccine safety (considering side effects are obvious versus considering it is safe and basically no side effects) (0.284, 0.188-0.429) and lower knowledge scores (0.813, 0.701-0.942) were adversely linked with vaccination willingness. These findings provide essential insights for altering the perception of influence and influenza vaccination, as well as enhancing health communication strategies to improve influenza vaccine uptake among Guangzhou residents.

Reconsidering inequalities in COVID-19 vaccine uptake in Germany: a spatiotemporal analysis combining individual educational level and area-level socioeconomic deprivation

Combining the frameworks of fundamental causes theory and diffusion of innovation, scholars had anticipated a delayed COVID-19 vaccination uptake for people in lower socioeconomic position depending on the socioeconomic context. We qualify these propositions and analyze educational differences in COVID-19 vaccination status over the first ten months of Germany’s vaccination campaign in 2021. Data from the study “Corona Monitoring Nationwide” (RKI-SOEP-2), collected between November 2021 and February 2022, is linked with district-level data of the German Index of Socioeconomic Deprivation (GISD). We estimated the proportion of people with at least one vaccination dose stratified by educational groups and within different settings of regional socioeconomic deprivation at three time points. Logistic multilevel regression models were applied to adjust for multiple covariates and to test cross-level-interactions between educational levels and levels of area-level socioeconomic deprivation. Vaccination rates were lower among respondents with lower education. With increasing area-level socioeconomic deprivation, educational differences were larger due to particularly low vaccination rates in groups with low education levels. The analysis of vaccination timing reveals that educational gaps and gaps by area-level socioeconomic deprivation had appeared early in the vaccination campaign and did not close completely before the 4th wave of COVID-19 infections

Comparison of Predictive Factors of Flu Vaccine Uptake Pre- and Post-COVID-19 Using the NIS-Teen Survey

Background: Seasonal influenza vaccination rates are very low among teenagers. Objectives: We used publicly available data from the NIS-Teen annual national immunization survey to explore factors that influence the likelihood of a teen receiving their seasonal flu shot. Methods: Traditional stepwise multivariable regression was used in tandem with machine learning to determine the predictive factors in teen vaccine uptake. Results and Conclusions: Age was the largest predictor, with older teens being much less likely to be vaccinated than younger teens (97.48% compared to 41.71%, p &lt; 0.0001). Provider participation in government programs such as Vaccines for Children and the state vaccine registry positively impacts vaccine uptake (p &lt; 0.0001). Identifying as non-Hispanic Black was a small, negative predictor of teen vaccine uptake (78.18% unvaccinated compared to 73.78% of White teens, p &lt; 0.0001). The state quartile for COVID-19 vaccine uptake also strongly predicted flu vaccine uptake, with the upper quartile of state COVID-19 vaccine uptake being significantly more likely to also get vaccinated for influenza (76.96%, 74.94%, 74.55%, and 72.97%, p &lt; 0.0001). Other significant factors are the number of providers, education of the mother, poverty status, and having a mixed provider facility type. Additionally, the multivariable regression analysis revealed little difference in the predictive factors of vaccine uptake between pre- and post-pandemic datasets.

Exploring differences in perceived barriers and facilitators to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino communities in Southwest Florida

ABSTRACT Background: Identifying factors impacting vaccination and testing for COVID-19 is crucial to reduce health disparities, especially for rural/agricultural, low access and high poverty Latino communities disproportionately affected by the pandemic. This study examined differences in perceived barriers and facilitators (such as values, beliefs, and concerns) to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino community members in Southwest Florida. Methods: Rural Latino community members (N = 493) completed a cross-sectional survey in Spanish (86.0%) or English (14.0%) on perceived COVID-19 vaccine/testing barriers and facilitators, as well as demographics, mental health, medical history, health perceptions, and health literacy. Results: At the time of the survey, approximately 43% of participants were unvaccinated and 46.4% were testing hesitant. Significantly more vaccinated participants acknowledged keeping their family (d = .25), community (d = .27), and themselves (d = .22) safe as facilitators to vaccination (ps < .001). Among the unvaccinated participants, the most common concerns for getting vaccinated were side effects (d = −.53) and lack of knowledge about how the vaccine works (d = −.35, ps < .001). Testing hesitant participants reported concerns including not knowing where to get tested (d = −.25, p = 0.01) and less confidence in a positive test result (d = −.40, p < 0.001). Doctors and faith leaders were ranked as the most trusted information sources across groups. In logistic regression models, vaccination was linked to age, gender, education, and protecting others, while concerns about needles and side effects reduced odds; testing was driven by education, anxiety, hope, and safety concerns. Conclusion: Promoting family and community safety may be effective facilitators influencing vaccine and testing intention in rural Latino communities. Enhanced education by trusted information sources, such as doctors and faith leaders may alleviate associated concerns. Our findings may inform actions for future pandemics. Further studies should determine the generalizability of our findings across other rural migrant communities and other vaccines.

Uptake and correlates of influenza vaccine among older adults residing in rural regions of south China: a cross-sectional study.

Seasonal influenza continues to pose a substantial public health challenge for older adults residing in rural areas worldwide. Vaccination remains the most efficacious means of preventing influenza. This study aimed to investigate the extent of influenza vaccine coverage and identify the factors influencing vaccine uptake among older adults in rural regions of south China. A cross-sectional study utilizing convenience sampling was conducted in two rural sites in Guangdong Province. Individuals needed to meet specific inclusion criteria: (1) attainment of 60 years of age or older; (2) originating from rural households; (3) demonstrating a voluntary desire to partake in the survey, either through written or verbal informed consent. Data encompassed variables such as socio-demographic information, influenza infection and vaccination history, knowledge and attitudes toward influenza vaccination, and perceived beliefs regarding the influenza vaccine. Univariate and multivariable logistic regression analyses were employed to ascertain the factors associated with influenza vaccine utilization. In the multivariable model, adjustments were made for gender, age, legal marital status, highest educational attainment, and monthly income. A total of 423 participants were ultimately included in this study, with the majority falling within the age range of 60-75 years (81.3%). Only one-third of the participants had received an influenza vaccine in the past year (30.0%). Notably, nearly half of the older adults exhibited hesitancy toward influenza vaccination (45.1%). The multivariable analysis revealed that rural older people with a robust understanding of influenza vaccines and a positive attitude toward them (adjusted odds ratio [aOR] = 2.60, 95% confidence interval [CI]: 1.41-4.81), along with a high level of trust in vaccination service providers (aOR = 2.58, 95% CI: 1.01-6.63), were positively associated with receiving influenza vaccination in the past year. This study reveals a low rate of influenza vaccine uptake among older adults residing in rural areas of south China. Given the limited adoption of influenza vaccination and the significant threat it poses, there is an urgent imperative to devise precise interventions aimed at enhancing the effectiveness of influenza vaccination programs.

Assessing changes in COVID-19 vaccine uptake and intentions among the Brigada Digital Latino social media audience: a repeated cross-sectional study

BackgroundU.S. Latinos experienced disproportionate COVID-19 impacts in terms of morbidity and mortality. Vaccination against COVID-19 is an important strategy for mitigating health impacts, and yet, vaccine uptake was slower among U.S. Latino adults compared to other racial/ethnic groups. Vaccine hesitancy has been a significant barrier within Latino communities, and exposure to misinformation has been associated with negative attitudes toward vaccination. While some COVID-19 mitigation efforts have included community-based outreach, few studies have explored the impact of community-based digital messaging in Spanish to counter COVID-19 misinformation, build trust, and promote vaccination. To address this gap, we conducted a one-year repeated cross-sectional study to assess changes in COVID-19 vaccine uptake, intentions, and perceived norms, as well as barriers to accessing reliable information and levels of trust in COVID-19 information sources among Latino adults exposed to Brigada Digital de Salud social media content. This culturally-tailored content disseminated on Facebook, Instagram, and X platforms was amplified by community health workers and partners, and focused on COVID-19 risk and prevention, vaccine safety and efficacy, and correcting related misinformation.ResultsStatistically significant increases in COVID-19 vaccination and intentions to vaccinate children were observed from May 2022 (wave 1) to April 2023 (wave 2). Among perceived difficulties accessing information, respondents indicated the most difficulty in judging the reliability of COVID-19 information in the media; however, a statistically significant decrease in perceived difficulty was observed between waves. With regard to trust in COVID-19 information sources, levels of trust were highest for healthcare providers in both waves, and there were statistically significant increases in trust in the FDA to ensure COVID-19 vaccine safety and trust in the federal government to ensure child COVID-19 vaccine safety at wave 2.ConclusionsSocial media messaging by trusted community-based sources shows promise as a strategy for combating health misinformation and ameliorating information access gaps for language minority populations. This digital approach represents an important tool for deploying critical information to underserved populations in public health emergency and crisis contexts, and for supporting changes in attitudes, trust, and behaviors to improve health outcomes.

Overcoming Barriers to Childhood and Adolescent Vaccination: Opportunities in Precision Health Promotion

Abstract Background Vaccination remains one of the greatest success stories in public health as cost-effective interventions to reduce morbidity and mortality from infectious diseases at the population level. However, the COVID-19 pandemic created unprecedented challenges to the immunization sector. Uptake of routine childhood and adolescent vaccinations was forestalled by challenges related to pandemic lockdowns/quarantine, reduced patient-provider interactions, parental reluctance to seek preventative services, poor access to health services, and loss of income and/or health insurance. Compared to pre-pandemic estimations, the pandemic era brought a consequential decline in coverage of all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). This study sought to address suboptimal adolescent vaccine delivery systems and bolster uptake in the post-pandemic era with the introduction of precision health promotion strategies centered around the use of Personal Health Libraries (PHL). Methods Leveraging artificial intelligence (AI), and semantic web technologies to integrate contextual knowledge (i.e., clinical, biomedical, and SDoH data) with patient preferences, proposed PHL platforms could aid in generating personalized evidence-based recommendations useful to both care provider promotion of vaccination and mitigating patient and caregiver hesitancy. The proposed application stands to provide customized digital health interventions by 1) facilitating remote knowledge acquisition, exchange, and visualization of the benefits of on-time vaccination, 2) improving health information-seeking behaviors to reduce hesitancy, 3) bolstering patient reminder and recall systems for follow-up and series completion, and 4) learning usage patterns to incorporate end-user preferences to empower patients, promote best practices, and enable them to make informed health decisions. Results The proposed PHL would serve as an ecosystem to manage and deliver tailored vaccine-related information to inform health decision-making regarding ACIP-recommended immunizations. Such a resource could administer health education and promotion that addresses common misconceptions regarding vaccination, alleviate safety, efficacy, and side effect concerns, and deliver evidence-based support of vaccines as primary protective measures (i.e., cancer prevention). Conclusion The use of PHL would enable rapid and real-time collection and interpretation of patient data beyond the traditional clinical setting, supplying care providers with tools for optimal vaccination recommendation to bolster uptake in the post-pandemic era. Moreover, the application would enable patients and caregivers to readily access vital health information and play a crucial role in addressing the obstacles encountered when seeking accurate and dependable vaccine-related information.