Vaccine Refusal Research Articles

Unvaccinated, Just Like Everybody Else. Vaccine Hesitancy in a Romanian Religious Community

Abstract Vaccine hesitancy was a widespread phenomenon during the COVID-19 pandemic. It held back large-scale immunization in countries where vaccines were available and it aggravated the pandemic. The way we understand vaccine hesitancy in postmodern societies emphasizes individual risks, reflexivity, and patients making informed decisions. But how is vaccine hesitancy experienced in traditional communities? We explored answers to this question through ethnographic interviews conducted in the least vaccinated village in Romania. In this Pentecostal community, vaccination decisions were made at the community level, where an informal norm of vaccine refusal was dominant. This norm emerged through two types of interactions – local and mediated interactions – as collective discussions were centred on religious interpretations of Biblical fragments and on information from TV shows and social media about the adverse effects of vaccines. People formed symbolic alliances with influential actors in their community who were unvaccinated, such as the mayor and the pastor, and with citizens from Western European countries who also refused COVID-19 vaccination. Mainstream fears of vaccination were expressed during the interviews, concerning paralysis and death resulting from vaccination and mistrust in official authorities. Vaccination accentuated pre-existing differences in status, demarcating people with a high level of education working at the village hall, who were vaccinated, from those with a lower socio-economic status, who were not vaccinated.

VACCINE HESITANCY IN BRAZIL: CAUSES AND CONSEQUENCES

Vaccine refusal or delay is an old and increasingly prevalent phenomenon. The effectiveness of vaccines has been proven, for example, by eliminating human smallpox. However, some of the population questions this resource. Vaccine hesitancy can be caused by personal beliefs, the spread of fake news, political positioning, and growth of anti-vaccine movements. Despite personal freedom, public health needs to be prioritized. Instead, it ends up suffering consequences. Among these, low vaccine coverage and economic impact.

The societal cost of vaccine refusal: A modelling study using measles vaccination as a case study

BackgroundIncreasing vaccine hesitancy and refusal poses a challenge to public health as even small reductions in vaccine uptake can result in large outbreaks of infectious diseases. Here we estimate the societal costs of vaccine refusal using measles as a case study. MethodsWe developed a compartmental metapopulation model of measles transmission to explore how the changes in the size and level of social mixing between populations that are “pro-vaccination”, and “anti-vaccination” impacts the burden of measles. Using the projected cases and deaths, we calculated the health, healthcare, direct medical costs, and productivity loss associated with vaccine refusal. Using measles in England as a case study, we quantified the societal costs that each vaccine refusal imposes on society. FindingsWhen there is a high level of mixing between the pro- and anti-vaccination populations, those that refuse to be vaccinated benefit from the herd immunity afforded by the pro-vaccination population. At the same time, their refusal to be vaccinated increases the burden in those that are vaccinated due to imperfect vaccines, and in those that are not able to be vaccinated due to other underlying health conditions. Using England as a case study, we estimate that this translates to a societal loss of GBP 292 million and disease burden of 17 630 quality-adjusted-life-years (sensitivity range 10 594–50 379) over a 20-year time horizon. Of these costs, 26 % are attributable to healthcare costs and 74 % to productivity losses for patients and their carers. This translates to a societal loss per vaccine refusal of GBP 162.21 and 0.01 (0.006–0.03) quality-adjusted-life-years. InterpretationOur findings demonstrate that even low levels of vaccine refusal can have a substantial and measurable societal burden on the population. These estimates can support the value of investment in interventions that address vaccine hesitancy and vaccine refusal, providing not only improved public health but also potential economic benefits to society.

Reasons for parental hesitancy or refusal of childhood vaccination in Türkiye.

Although vaccines play a critical role in the control of infectious diseases and disease outbreaks, vaccination rates have been declining in recent years because of vaccine hesitancy or refusal. We aimed to determine the rates and reasons for parental hesitancy or refusal of vaccination for their children in Türkiye. A total of 1100 participants selected from 26 regions of Türkiye were involved in this cross-sectional study conducted between July 2020 and April 2021. Using a questionnaire, we collected data on the sociodemographic characteristics of parents, the status of vaccine hesitancy or refusal for their children, and reasons for the hesitancy or refusal. Using Excel and SPSS version 22.0, we analysed the data with chi-square test, Fisher's exact test and binomial logistic regression. Only 9.4% of the participants were male and 29.5% were aged 33-37 years. Just over 11% said they were worried about childhood vaccination, mainly because of the chemicals used in manufacturing the vaccines. The level of concern was greater among those who got information about vaccines from the internet, family members, friends, TV, radio, and newspapers. Those who used complementary health services were considerably more hesitant about vaccination than those who used mainstream services. Parents in Türkiye have several reasons for hesitating or refusing to vaccinate their children, key among which are concerns about the chemical composition of the vaccines and their ability to trigger negative health conditions such as autism. This study used a large sample size across Türkiye, although there were differences by region, the findings would be useful in designing interventions to counter vaccine hesitancy or refusal in the country.

Acceptability of COVID-19 vaccination among healthcare workers in Sudan.

Several studies have investigated COVID-19 vaccine acceptability and hesitancy, especially among healthcare workers (HCWs). However, acceptability of the vaccine by HCWs in Sudan remains unclear. We investigated acceptability of the COVID-19 vaccine and its determinants among HCWs in Sudan. Using a semi-structured questionnaire, we conducted a web-based cross-sectional study of COVID-19 vaccine hesitancy and its associated determinants among healthcare workers in Sudan during March-April 2021. A total of 576 HCWs responded to the survey. Mean age was 35 years. Females (53.3%), medical doctors (55.4%) and being located in Khartoum State (76.0%) each accounted for more than half of the participants. Absolute refusal of the COVID-19 vaccine was expressed by 16.0% of the respondents. Males were more than twice as likely to accept the vaccine as females. Lower acceptability was statistically significantly associated with the nurses (OR = 0.35, 95% CI: 0.15-0.82, P < 0.001), increased perceived harm from the vaccine (OR = 0.11, 95% CI: 0.05-0.23, P < 0.001), lack of confidence in the source of the vaccine (OR = 0.16, 95% CI: 0.08-0.31, P < 0.001) and lack of confidence in organizations or government sectors supervising the vaccination process (OR = 0.31, 95% CI: 0.17-0.58, P < 0.001). This study highlights a moderate level of COVID-19 vaccine acceptability among HCWs in Sudan. Special consideration should be given to addressing vaccine hesitancy among female HCWs and nurses.

A Cross-Sectional Study to Identify Factors for Vaccination Uptake Amongst University Staff and Students in Northern Ireland

With the increased uptake of the COVID-19 vaccination in 2021, universities resumed face-to-face classes and clinical placements. However, even with incentives, some individuals chose not to receive a vaccination due to personal beliefs and other reasons. Understanding motivations for vaccination uptake or vaccine hesitancy is important to help develop future public health strategies. Therefore, a cross-sectional online survey was carried out among students and staff in a UK university to assess the level of vaccination and explore their views on the acceptability of incentives that may encourage uptake. Almost three quarters (74.4%) of the sample had received at least one dose of a COVID-19 vaccine with a higher proportion of staff receiving a vaccine compared to students (80.0% vs. 70.6%, p &lt; 0.001). Vaccine hesitancy or refusal was due to the perceived lack of research and knowledge of the potential long-term effects at the time of vaccination, religious, personal and ethical beliefs and feeling like vaccinations should not be used to restrict social events, travel and medical challenges. This study shows that university staff and students had a relatively high uptake of the COVID-19 vaccination. However, the findings indicate that nearly 20 percent were unsure or unwilling to take the vaccination, therefore suggesting that clearer information and motivational strategies are needed to support the roll out of new vaccines.

PARENTAL INTENTION TO VACCINATE THEIR CHILDREN ABOUT COVID-19 VISITING A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN

The SARS-CoV-2 virus is the source of the extremely contagious illness known as COVID-19. One of the most important ways to control the pandemic now is vaccination. However, vaccine reluctance exists in various communities due to false information and myths. This study evaluated parental readiness to vaccinate their children following the establishment of pediatric immunization recommendations. Parents who visited the National Institute of Child Health outpatient clinics in Karachi, Pakistan, were the subjects of a cross-sectional survey. Data on demographics, parental attitudes toward the COVID-19 vaccine, and parental readiness to administer it to their children were gathered by trained data collectors. A total of 341 parents participated in the study; the majority (47.2%) were female and between the ages of 31 and 40. Regarding the acceptability of immunizing their kids against COVID-19, 47.2% of parents said they would be willing to do so, while 27% said they would be reluctant. Lack of knowledge (95.5%) and a lack of supporting proof were the most often cited objections among those who declined (92.6 percent ). Parental age, notably between the ages of 31 and 40, and the age of their children, particularly between the ages of 4 and 12, were strongly linked with lower vaccine reluctance. The impacts of gender, marital status, or educational attainment were not statistically significant. A big part of stopping the spread of COVID-19 is vaccination. According to our research, the majority of parents are probably going to vaccinate their kids. The age of the kid and certain parent age groups (31–40 years old) were strongly linked to reduced vaccine reluctance. To increase vaccine acceptance rates among parents, addressing the lack of knowledge and evidence, which are the main causes of vaccine refusal, is critical.

Perceptions and Intentions around Uptake of the COVID-19 Vaccination among Older People: A Mixed-Methods Study in Phuket Province, Thailand.

A 70% vaccination rate against COVID-19 in the general population was required for re-opening Phuket tourist industry. However, prior to this research, 39.61% of older people remained unvaccinated. This study aimed to examine perceptions and intentions around COVID-19 vaccination amongst older people and to explore the reasons and factors influencing their decisions to receive or refuse vaccination. This was a mixed-methods approach with a sequential explanatory design. We conducted an online survey and semi-structured qualitative interview with a subsample. Multinomial logistic regression was applied and thematic content analysis was conducted. 92.4% of participants reported intention to receive the vaccine. Multinomial regression analysis revealed that perceived barriers (AdjOR = 0.032; 95% CI: 0.17-0.59), perceived benefit (AdjOR = 2.65; 95% CI: 1.49-4.71), good health (AdjOR = 3.51; 95% CI: 1.01-12.12) and health not good (AdjOR = 0.10; 95% CI: 0.02-0.49) were predictors of vaccine uptake. In the qualitative interviews, four key influences on up-take for the 28 vaccinated participants were: prevention and protection, convenience, fear of death from COVID-19, and trust in the vaccine. Four key influences on refusal of vaccination in the eight unvaccinated participants were: rarely leaving the house, fear of vaccine side-effects, fear of death after getting the vaccine, and not enough information for decision-making. Intervention and campaigns addressing COVID-19 vaccination should employ strategies, including the widespread use of social and other popular media to increase older people's perceived benefit of vaccination on their current and future health status, while decreasing perceived barriers to receiving the vaccine.

Factors Encouraging A Change of Health Care Worker’s Attitudes Who Are Hesitant or Opposed to Receiving A Vaccine Against the COVID 19 Virus and Increasing Vaccination Rate

Background: Although vaccines were found to be effective in preventing and reducing morbidity, the last two decades saw a steep increase in anti-vaccination and vaccine hesitancy [1]. In March 2020, the World Health Organization (WHO) declared the ongoing COVID-19 outbreak as pandemic with global economic, political, vocational, and social ramifications. COVID-19 vaccines are considered safe and effective in reducing morbidity rates. Nevertheless, according to the ministry of health only 59% of the Israeli population is vaccinated against COVID-19 [2]. In 2016 the WHO defined vaccine hesitancy as the “reluctance or refusal to vaccinate despite the availability of vaccines”. Vaccine hesitancy curtails the ability of health services to safely and effectively prevent morbidity and to preserve public health [11]. Results from surveys show that there is little variation in the factors affecting vaccine hesitancy in healthcare workers (HCWs) across countries [7]. From December 2020 to March 2021 hospital workers were given the opportunity to vaccinate in the workplace instead of vaccinating through their HMOs (Health Maintenance Organizations). To date, most workers had already vaccinated and only 150 remained unvaccinated. 93 (1.6%) of them refuse to vaccinate although they have no medical conditions that preclude vaccination. 190 (3.2%) out of the vaccinated group have done so from April to July 2021 and we shall refer to them as “vaccine hesitants”. The aim of this survey was to determine the underlying causes of vaccine hesitancy and refusal in hospital personnel, in order to better plan interventions. The data was collected by performing a cross-sectional study using anonymous online surveys. After processing and analyzing the data, we are planned future intervention. Methods: The data had been collected using a cross-sectional study by administering an online anonymous questionnaire. After evaluation of the data, an intervention is planned to be developed. Results: The survey was answered by 42 staff members. From them, 22 (52.4%) were late to receive the vaccine, while 20 (47.6%) refused it. No differences were found between the two groups in background variables. There were no significant differences between the two groups in positions regarding the coronavirus. The question with the highest average was related to the belief that “COVID is like a normal flu. There were no significant differences in COVID-19 knowledge sources between the hesitant group and the anti-vaccinationist group. The most prominent knowledge sources were the government and the ministry of health, doctors, information from the press or the hospital, and information from social media. Significant differences were found between the two groups in the feeling that they have sufficient information in selected topics concerning the coronavirus The response averages were higher among the hesitant group than among the anti-vaccinationist group in relation to knowledge about the severity of the disease and side effects of the vaccine.There were no significant differences between the two groups in the motivations for their refusal to vaccinate. The most common motive in both groups was that “I don’t need the vaccine” or that “I am not at risk from the disease”. There were no significant differences between the two groups in the motives for their eventual vaccination. The most common reason for vaccination in both groups was “pressures from my superiors at work”. Conclusion: The findings of the present study show that HCWs who are directly involved in treating COVID patients are more likely to vaccinate. We therefore opine that more emphasis should be placed on other sectors of HCWs, such as administration, para-medical professions, and more. It is imperative to understand what are the motivations and characteristics of each sector, and perform appropriate adaptations in propaganda materials according to the sector’s specific needs. We predict that the continuation of experiments showing the effectiveness of the vaccine will increase vaccination rates. A combination of different strategies, such as educational campaigns, the publication of studies, and relevant instruction will increase vaccination rates in hesitants.

Adaptation and Validation of a French Version of the Vaccination Attitudes Examination (VAX) Scale.

Over the past decades, vaccination has proven to be largely beneficial to global health. Despite vaccine efficacy, the French population has been recently affected by more anti-vaccination attitudes and vaccine refusal, and it is therefore necessary to validate tools to study this health issue. The Vaccination Attitudes Examination scale (VAX) is a 12-item questionnaire targeting adults that assesses general attitudes towards vaccination. The aims of the study were to translate and adapt the original English version of the scale into French and to test the psychometric properties of the scale in a French-population-based sample of adults. We included 450 French speaking adults that completed the French VAX and other questionnaires to assess convergent and divergent validities. Exploratory and confirmatory factor analyses showed that the French version of the VAX replicated the factorial structure of the original scale. Moreover, it demonstrated high internal consistency, good convergent and divergent validities, and excellent temporal stability. Furthermore, scores on the scale differentiated vaccinees from non-vaccinee respondents. Results on the scale provide us with insight into factors involved in vaccine hesitancy in France, therefore allowing French authorities and policy makers to address these specific concerns and improve vaccine acceptance rates in this country.

Crisis Communication during Covid–19

Early in 2020, the Covid–19 epidemic started, posing many challenges for civilisation. The pandemic caused a paradigm change in many ways, unavoidably increasing people’s uncertainty and worry about a new global order. Along with stopping the virus, governments aiming to contain the pandemic had to deal appropriately with the infodemic scenario, which supported several pseudo-scientific opinions among substantial numbers of people. The spread of more and more nonsense fake news has eroded the trust in the institutions, which has led to a prolonged phase of the epidemic’s end. It is yet unknown how long the coronavirus epidemic will have an impact on daily life as of the time of writing, in the summer of 2022, more outbreaks have been brought on by mask use and vaccination refusal. Because of this, controlling the crisis and reducing the harm the infodemic creates depends on effective government crisis communication. This essay attempts to illustrate effective crisis communication strategies based on international literature.

Future COVID-19 Booster Vaccine Refusal in Healthcare Workers after a Massive Breakthrough Infection Wave, a Nationwide Survey-Based Study.

Background: An unprecedented coronavirus disease 2019 (COVID-19) wave occurred in China between December 2022 and January 2023, challenging the efficacy of the primary series of COVID-19 vaccines. The attitudes toward future COVID-19 booster vaccines (CBV) after the massive breakthrough infection among healthcare workers remain unknown. This study aimed to explore the prevalence and determinants of future CBV refusal after the unprecedented COVID-19 wave among healthcare workers. Methods: Between 9 and 19 February 2023, a cross-sectional nationwide online survey was conducted using a self-administered questionnaire vaccine among healthcare workers in China. Sociodemographics, profession, presence of chronic medical conditions, previous COVID-19 infection, attitudes towards future CBV, and reasons for future CBV refusal were collected. We estimated odds ratio [OR] with 95% confidence interval [CI] using a multivariable logistic regression model to explore the factors associated with future CBV refusal. Results: Among the 1618 participants who completed the survey, 1511 respondents with two or more doses of COVID-19 vaccines were analyzed. A total of 648 (41.8%) of respondents were unwilling to receive a future CBV. Multivariable logistic regression analysis revealed the association of CBV refusal with profession (vs. other staff, physician-adjusted OR 1.17, 95%CI 0.79-1.72, nurse-adjusted OR 1.88, 95%CI 1.24-2.85, p = 0.008), history of allergy (adjusted OR 1.72, 95%CI 1.05-2.83, p = 0.032), a lower self-perceived risk of future COVID-19 infection (p < 0.001), and a lower belief in CBV effectiveness (p = 0.014), safety (p < 0.001), and necessities for healthcare workers and the public (p < 0.001, respectively). Conclusions: Our findings highlight that a considerable proportion of healthcare workers were against a future booster dose after an unprecedented COVID-19 wave. Self-perception of future COVID-19 risk, and potential harm or doubtful efficacy of vaccines are the main determinants. Our findings may help public health authorities to establish future COVID-19 vaccination programs.

Determinants of Covid vaccine uptake and perinatal outcome in pregnant women at a tertiary care center.

To determine the factors for hesitancy and uptake of coronavirus disease-2019 vaccine, and to compare perinatal outcomes in vaccinated and nonvaccinated pregnant women. The cross-sectional study was conducted from November 2021 to February 2022 at the Ruth Pfau Civil Hospital, Karachi, and the Holy Family Hospital, Karachi, and comprised pregnant women admitted in delivery suite for operative or vaginal delivery. Data was collected using a self-designed questionnaire which also explored knowledge about vaccine, contextual factors and reasons for and against vaccination. Perinatal outcomes included stillbirth, preterm delivery, low birth weight and Appearance-Pulse-Grimace-Activity-Respiration score. Also, 3cc blood was collected from the umbilical cord at the time of delivery, and enzyme-linked immunosorbent assay technique was used for antibodies titre. Data was analysed using SPSS 24. Of the 186 women, 114(61.3%) with mean age 27.9±4.1 years were vaccinated, and 72(38.7%) with mean age 27.5±5.2 years were not vaccinated. Physician's advise 104 (91.2%), vaccine safety and its effect on foetus 52(72.2%) were main determinants for vaccine uptake and refusal, repectively. Family and peer pressure was also responsible in 19(26.4%) cases for vaccine refusal. Body mass index, parity, level of education, socioeconomic status, history of coronavirus disease-2019 infection, booking status and presence of gestational diabetes mellitus were significantly different between the vaccinated and unvaccinated groups (p<0.05). Antibody titers and Appearance-Pulse-Grimace-Activity-Respiration score at 1 minute were significantly higher in the group of vaccinated women (p<0.05). Vaccine uptake was found to be low. Safety concern against vaccine, and doctor's advice were the main determinants for hesitancy and uptake. Antibody titers in newborns were higher in the group of vaccinated women.

Perceptions and Rumors About the Ebola Virus Disease Vaccine in the Ituri and Kivu Provinces of the Democratic Republic of Congo.

Perceptions and rumors about vaccinations can contribute to vaccine hesitancy. This study aimed to examine perceptions and rumors about the Ebola vaccine during the 10th Ebola Virus Disease outbreak in the Ituri and North Kivu provinces of the Democratic Republic of Congo. Eight hundred randomly selected respondents were surveyed with a uniform structured questionnaire. Further, we collected qualitative data through focus group discussions and using in-depth interview guides. Results revealed several misperceptions and rumors about the vaccine, which led to some level of vaccine hesitancy and refusal among the people. The acceptance rate of the vaccine was 67.3% (below the 80% threshold needed to create herd immunity in the population). More of the urban population (31.3%) than the rural population (10.4%) accepted the vaccine. Refusals were largely due to fear that the vaccine could activate other diseases in the body and could even kill. Some feared that it was a conspiracy of the government to reduce the population in the study area through forced fertility control and death, among other such concerns. In conclusion, these rumors increased mistrust, which challenged the efforts of the government and its partners to safeguard the health of the people.

Seasonal Influenza Vaccination Among Saudi Children: Parental Barriers and Willingness to Vaccinate Their Children in the Makkah Region.

The influenza virus produces everything from seasonal epidemics to unexpected pandemics, making its prevention and management a worldwide public health challenge. The main method to prevent and control seasonal influenza is vaccination. Children responded quite successfully to influenza vaccinations, particularly live vaccines. Despite the strong recommendations and effectiveness of seasonal influenza vaccinations in children, some parents still hesitate and refuse to give their children the shot. This study, given the importance of knowing the factors that contribute to parents' refusal of influenza vaccine, also aims to assess parental barriers and willingness to vaccinate their children in the Makkah region of Saudi Arabia. This is a descriptive cross-sectional study conducted among Saudi parents in the Makkah region. For data collection, an online survey was conducted between December 1, 2022, and February 11, 2023. In total, 334 of the parents participated in our study. The result shows that there is a significant association between parents' gender and receiving the flu vaccine, with significantly more females (52.4%). Regarding the willingness to get the vaccine, the majority of the parents reported that they will get the vaccine and vaccinate their children, and the most common barrier that prevents parents from vaccinating their children is that they do not need it because they are healthy (21.48%). Furthermore, there is a strong relationship between educational level and knowledge about seasonal influenza vaccination; the majority of parents at each level of education have poor knowledge regarding influenza vaccines. In addition, nearly all of our participants (96.7%) believed the information provided by the Saudi Ministry of Health as well as the advice of their physicians. This study highlights the need to increase awareness, educate the parents in the Makkah region about the importance of the influenza vaccine, and encourage them to vaccinate their children.

Vaccine hesitancy: current status, associated factors, measurement, and approach

Definition and present status Vaccine hesitancy, defined as "delay in acceptance or refusal of vaccination despite availability of vaccination services," is a global public health concern. Specifically, COVID-19 and human papillomavirus (HPV) vaccine hesitancy remains a major social challenge in Japan, and effective preventive strategies are urgently required. In this review, we discuss previous studies that have described vaccine hesitancy.Associated factors Vaccine hesitancy is affected by several factors, primarily psychological variables (referred to as the "3Cs" comprising confidence, complacency, and convenience regarding individuals' perceptions of vaccination) and sociodemographic variables (age, sex, socioeconomic status, race, and social capital). "Behavioral and Social Drivers of Vaccination Framework", developed recently by the World Health Organization, has focused on vaccination-specific beliefs and reports that programs may affect and are likely to have wide applicability in the development of effective interventions.Measurement Identification of psychological factors associated with vaccination hesitancy is important to establish strategies to increase vaccine uptake. Many scales are available to measure vaccine hesitancy and psychological factors that affect vaccine hesitancy. These scales include different evaluation items, validity, reliability, and availability of validated Japanese versions. Therefore, careful selection of scales based on their intended purpose and the target population in whom the desired intervention is intended are important. A representative 7C scale is widely used globally. It has been translated into more than 10 languages, including Japanese.Approach Several studies and articles, mainly developed for the European and American populations provide guidelines for selection of evidence-based strategies and interventions to increase vaccine uptake. Evidence-based strategies may be broadly classified into the following categories: (1) Strengthening the healthcare system through implementation of the principles of behavioral science. (2) Development of tailored approaches using systematic listening activities. (3) Provision of evidence-based resources to support healthcare personnel. (4) Utilization of media. Based on findings described by previous studies discussed in this report, it may be important to plan strategies to improve the uptake of each vaccine in Japan, such as those for COVID-19, HPV, and also childhood vaccines.

Effectiveness Analysis of a Compromise Approach to Solving the Problem of Refusal of Influenza Vaccination

Relevance. The ineffectiveness of current methods of engaging the population in vaccine prophylaxis leads to the need to develop new means of solving the problem of vaccination abandonment.Aims is to show the effect of applying the theory of compromise solutions to the analysis of the problem of refusal of influenza vaccination.Materials and methods. Data on number of vaccinated and morbidity among vaccinated and unvaccinated; the research method is based on the compilation of criteria reflecting the interests of the administration and the population, followed by finding a compromise solution and evaluating it using an indicator of tensions.Results. Based on data on morbidity among vaccinated and unvaccinated, the existence of an optimal percentage of vaccinated for the adult population and for each of the three risk groups is shown: medical staff, service employees and persons over 60 years of age; on the example of the group «persons over 60 years of age», the possibility of reducing tension in the case of replacing a single vaccination with a complex one is shown.Conclusion. The effectiveness of the application of the theory of compromise solutions to the assessment of tensions between the sanitary and epidemiological inspection service and the population in terms of vaccination is presented; the possibility of reducing tension by switching to complex immunoprophylaxis is presented.

Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study.

Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovirus circulation. A matched case-control study was conducted from April to July 2017 in eight super high-risk Union Councils of five towns in Karachi, Pakistan. A total of 3 groups, each with 250 cases, including refusals for the Oral Polio Vaccine (OPV) in campaigns (national immunization days and supplementary immunization activities), RI, and both, were matched with 500 controls and identified using surveillance records. Sociodemographic characteristics, household information, and immunization history were assessed. Study outcomes included social-behavioral and cultural barriers and reasons for vaccine refusal. Data were analyzed in STATA using conditional logistic regression. RI refusal was associated with illiteracy and fear of the vaccine's adverse effects, while OPV refusals were linked to the mother's decision authority and the assumption that the OPV caused infertility. Conversely, higher socioeconomic status (SES) and knowledge of and willingness to vaccinate with Inactivated Polio Vaccine (IPV) were inversely associated with RI; and lower SES, walking to the vaccination point, knowledge of IPV, and an understanding of contracting polio were inversely associated with OPV refusals, with the latter two also inversely associated with complete vaccine refusal. Education, knowledge and understanding of vaccines, and socioeconomic determinants influenced OPV and RI refusals among children. Effective interventions are needed to address knowledge gaps and misconceptions among parents.

Belief in COVID-19 Conspiracy Theories, Level of Trust in Government Information, and Willingness to Take COVID-19 Vaccines Among Health Care Workers in Nigeria: Survey Study.

The World Health Organization recently declared vaccine hesitancy or refusal as a threat to global health. COVID-19 vaccines have been proven efficacious and are central to combatting the pandemic. However, many-including skilled health care workers (HCWs)-have been hesitant in taking the vaccines. Conspiracy theories spread on social media may play a central role in fueling vaccine hesitancy. The objective of this study was to investigate HCWs' belief in COVID-19 vaccine conspiracy theories (ie, that the vaccines can alter one's DNA or genetic information and that the vaccines contain microchips) and trust in government information on COVID-19 vaccines. Health care workers in Ondo State, Nigeria, representing different health care professions were asked to participate anonymously in an online survey. The participants were asked about their beliefs in 2 viral conspiracy theories and their trust in government information on COVID-19 vaccines. We used multivariable logistic regressions to investigate the relationships between trust in government information on COVID-19 vaccines and (1) belief in DNA alteration, (2) belief in microchip implantation through the vaccine, and (3) willingness to accept the vaccine. A total of 557 HCWs (n=156, 28% men and n=395, 70.9% women) were included in the study. A total of 26.4% (n=147) of the sampled HCWs believed COVID-19 vaccines contained digital microchips, while 30% (n=167) believed the vaccines could alter one's DNA or genetic information. The beliefs varied according to professional group, with 45.8% (55/120) and 50% (5/10) of nurses and pharmacists, respectively, believing in the DNA alteration theory and 33.3% (40/120) and 37.5% (6/16) of the nurses and laboratory scientists, respectively, believing in the microchip theory. Social media was an important source of COVID-19 information for 45.4% (253/557) of HCWs. A total of 76.2% (419/550) of the participants expressed a willingness to take the vaccine. The odds of HCWs believing that COVID-19 vaccines contained digital microchips increased significantly with decreasing level of trust in government information on COVID-19 vaccines (odds ratio [OR] 4.6, 95% CI 2.6-8.0). We made a similar finding in those who believed COVID-19 vaccines could alter DNA and genetic information (OR 5.2, 95% CI 3.1-8.8). Misinformation regarding COVID-19 vaccines reaches and influences HCWs. A high proportion of the sampled HCWs believed that COVID-19 vaccines contained microchips or that the vaccines could alter recipients' DNA and genetic information. This might have negative consequences in terms of the HCWs' own COVID-19 vaccination and their influence on other people. Lack of trust in government and its institutions might explain the belief in both conspiracy theories and vaccine hesitancy. There is a need for health care stakeholders in Nigeria and around the world to actively counteract misinformation, especially on social media, and give HCWs necessary scientifically sound information.

Spatial distribution and determinants of childhood vaccination refusal in the United States.

Parental refusal and delay of childhood vaccination has increased in recent years in the United States. This phenomenon challenges maintenance of herd immunity and increases the risk of outbreaks of vaccine-preventable diseases. We examine US county-level vaccine refusal for patients under five years of age collected during the period 2012-2015 from an administrative healthcare dataset. We model these data with a Bayesian zero-inflated negative binomial regression model to capture social and political processes that are associated with vaccine refusal, as well as factors that affect our measurement of vaccine refusal. Our work highlights fine-scale socio-demographic characteristics associated with vaccine refusal nationally, finds that spatial clustering in refusal can be explained by such factors, and has the potential to aid in the development of targeted public health strategies for optimizing vaccine uptake.