Vaccine Refusal Research Articles

Examining Factors Affecting Acceptance of Childhood Vaccines: Vaccine Refusal

Amaç: Bu çalışmada çocukluk çağı aşılanması ile aşı reddine karşı ailelerin genel tutum ve görüşlerinin saptanması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya Karabük’te yaşayan ve çocuklarını Karabük eğitim araştırma hastanesi çocuk polikliniğine kontrole getiren 0-12 yaş çocuğu olan 198 anne dahil edildi. Literatür doğrultusunda hazırlanan sosyo-demografik özellikler, güncel aşı takvimini ve çocukluk çağı aşıları ile ilgili bilgileri içeren 33 sorudan oluşan veri toplama formu kullanıldı. Bulgular: Annelerin aşı reddi oranı %6,6 olarak saptanmıştır. Aşı reddinde olan annelerin aşılama takvimi boyunca çocuklarını en bir kez aşıladığı saptanmıştır. Aşı ile ilgili edinilen bilginin %70,2 oranında sosyal medya olduğu saptanmıştır. Annelerin aşı reddi nedenleri Binary lojistik regresyon incelendi. Modelde anne yaşının aşı reddi üzerinde 0,19 kat, çocuklarında aşı yan etkisi yaşamanın da 4,22 kat etkili olduğu saptandı. Sonuç: Çalışma annelerin aşılama programına güvendiği ve aşılara karşı görüşlerinin olumsuz olmadığı görüldü. Aşı güvenliği de dahil olmak üzere aşılar hakkında çevrimiçi ve aşı randevularında bilgi, aşıya olan güveni korumak için önemli olduğu görüldü. Aşı reddi konusunda en güvenli bilginin sağlık çalışanlarından alınması ve şekilde de aşı reddi oranının düşeceği düşülmektedir.

Free Consumer Web Resources on Immunization and Vaccination

Great advances in immunization have resulted in the eradication of multiple deadly diseases. Nevertheless, current sources of misinformation, such as social media, have led to growing vaccination hesitancy and refusal to vaccinate. It is the role of medical and information professionals to educate the general public about the importance of evaluating online information on immunization and to provide access to the most accurate, comprehensive, and high-quality online health-care resources. Numerous free, reputable websites created by government and health-care institutions should be recommended to patients to address questions about the safety of vaccines, importance of immunization, and vaccination schedules.

COVID-19 vaccination refusal trends in Kenya over 2021

BackgroundVaccination refusal exacerbates global COVID-19 vaccination inequities. No studies in East Africa have examined temporal trends in vaccination refusal, precluding addressing refusal. We assessed vaccine refusal over time in Kenya, and characterized factors associated with changes in vaccination refusal. MethodsWe analyzed data from the Kenya Rapid Response Phone Survey (RRPS), a household cohort survey representative of the Kenyan population including refugees. Vaccination refusal (defined as the respondent stating they would not receive the vaccine if offered to them at no cost) was measured in February and October 2021. Proportions of vaccination refusal were plotted over time. We analyzed factors in vaccination refusal using a weighted multivariable logistic regression including interactions for time. FindingsAmong 11,569 households, vaccination refusal in Kenya decreased from 24 % in February 2021 to 9 % in October 2021. Vaccination refusal was associated with having education beyond the primary level (−4.1[−0.7,−8.9] percentage point difference (ppd)); living with somebody who had symptoms of COVID-19 in the past 14 days (−13.72[−8.9,−18.6]ppd); having symptoms of COVID-19 in the past 14 days (11.0[5.1,16.9]ppd); and distrusting the government in responding to COVID-19 (14.7[7.1,22.4]ppd). There were significant interactions with time and: refugee status and geography, living with somebody with symptoms of COVID-19, having symptoms of COVID-19, and believing in misinformation. InterpretationThe temporal reduction in vaccination refusal in Kenya likely represents substantial strides by the Kenyan vaccination program and possible learnt lessons which require examination. Going forward, there are still several groups which need specific targeting to decrease vaccination refusal and improve vaccination equity, including those with lower levels of education, those with recent COVID-19 symptoms, those who do not practice personal COVID-19 mitigation measures, refugees in urban settings, and those who do not trust the government. Policy and program should focus on decreasing vaccination refusal in these populations, and research focus on understanding barriers and motivators for vaccination.

Vaccine refusal risk factors among parents of children with autism spectrum disorders.

Vaccine refusal is a global trend and was announced as one of the top ten health threats in recent years. The rate of vaccine refusal (VR) among children with autism spectrum disorders (ASD) has also increased in parallel with the global trend but their vaccination behavior may differ from that of the normal population. This study aims to determine the VR rates among parents of children with ASD, to define the risk factors for developing VR, and to evaluate the parental concerns for childhood vaccinations in this susceptible population. We conducted a 4-part survey questionnaire among parents of children with ASD, evaluating the vaccination status for both the child with ASD and their younger sibling. The vaccination uptake of the first child was accepted as the `baseline` behavior, while the following sibling`s uptake was suggested as the `current` behavior. The risk factors of VR were determined with logistic regression analysis. The study group included 110 parents of children with ASD (M/F:76/34) and their younger siblings (M/F:57/53). The rate of `baseline VR` was 12.7 % whereas the `current VR` was 40% (p=0.001). High socioeconomic status (relative risk [RR]: 4.4; 95% confidence interval [CI]: 1.01-16.6; p=0.04), using social media as the main source of information (RR: 7; 95% CI: 1.5-32; p= 0.01) and lack of regular well-child visits of the sibling (RR: 25; 95% CI 4.1-166; p=0.001) were determined as risk factors for VR. The vaccination behavior of parents changed after having a child with ASD, and thus, the younger siblings may constitute a risk group for VR. In clinical practice, pediatricians should be aware of this risk and evaluate the vaccination uptake of the younger siblings of children with ASD more carefully. Regular well-child visits and improving media literacy may be the key points to prevent VR in this susceptible population.

Analysis Of Factors Associated With Covid-19 Vaccination Refusal In The Second Grade Of Nino Conis Santana High School In Lautem Municipality East Timor

Corona Virus is a virus with the Coronaviridae Subfamily family, one way of prevention with Covid-19 vaccination. However, the program received various responses in the form of rejection of vaccination by some people in Timor Leste. This study aims to determine the factors associated with the refusal of Covid-19 vaccination in Grade II students of Nino Conis Santana High School. This type of research is an observational analytical study with a crossectional approach. The study respondents amounted to 80 people according to the specified criteria selected by the simple random sampling method. Data collection was done by questionnaires and in-depth interviews. Data analysis was performed using chi square and multiple logistic regression. Factors related to refusal of Covid-19 vaccination were knowledge (p = 0.000), family support (p = 0.011), and support of health workers (0.002) while those who were not related were age (p = 0.100), distance to facilities (p = 0.063), comorbid disease (p = 0.941), sex (p = 0.392) and perception (0.086). The most dominant variable is the support of health workers. In grade II students of Nino Conis Santana High School, with the support of poor health workers, they have the opportunity to refuse Covid-19 vaccination 9,538 times. Health workers should use strategies by adjusting the characteristics of each individual in approaching students who refuse Covid-19 vaccination to be willing to do Covid-19 vaccination.

An Optimal Vaccine Allocation Model Considering Vaccine Hesitancy and Efficacy Rates Among Populations

Vaccines need to be urgently allocated in pandemics like the ongoing COVID-19 pandemic. In the literature, vaccines are optimally allocated using various mathematical models, including the extensively used Susceptible-Infected-Recovered epidemic model. However, these models do not account for the time duration concerning multi-dose vaccines, time duration from infection to recovery or death, the vaccine hesitancy (i.e., delay in acceptance or refusal of vaccination), and vaccine efficacy (i.e., the time-varying protection capability of the vaccine). To make the vaccine allocation model more applicable to reality, this paper presents an optimal model considering the above mentioned time duration concerning multi-dose vaccination, time duration from infection to recovery or death, hesitancy rates, efficacy levels, and also breakthrough rates—the rates at which individuals get infected after vaccination. This vaccine allocation model is constructed using a revised Susceptible-Infected-Recovered model. The concept of people*week infections is introduced to measure the number of infected people within a certain time duration, and in this paper, the amount of people*week infections is minimized by the proposed vaccine allocation model. Our case study of the New York State 2021 population of 19,840,000 shows that this optimal allocation method can avoid 0.05%~2.75% people*week infections than the baseline allocation method when 2 to 11 million vaccines are optimally allocated. In conclusion, the obtained optimal allocation method can effectively reduce people*week infections and avoid vaccine waste when more vaccines are available.

Perception regarding routine childhood vaccinations: a cross-sectional study in Al-Qassim married population

Background: Vaccines are the most effective and risk-free health intervention available. Vaccination-related hesitancy is increasing in all countries, despite its global success. The current study aimed to assess the perception of the Qassim married population towards childhood vaccines and determine the factors affecting their decision regarding routine vaccination. Methods: This cross-sectional study was carried out using an online questionnaire (the SAGE group's vaccine hesitancy scale). The questionnaire was distributed using Twitter and WhatsApp. To study the association between categorical variables, chi-sqaure test was used. Unpaired t-test was employed to compare the average and overall score for the Vaccine Attitude Scale between groups. Results: The questionnaires were completed by 416 respondents. Regarding vaccine hesitancy, 16.6% of the included parents were hesitant to get a vaccination for their children, and 7.93% refused vaccination with an 18.5% overall hesitancy/refusal. Responses showed an overall positive attitude towards childhood vaccinations. It was discovered that vaccine hesitancy and children's vaccination status were significantly related, with 10% of the hesitant parents reporting that their children were never vaccinated compared to 0.86% of non-hesitant parents (p < 0.001). The overall attitude score was significantly higher in non-hesitant than hesitant respondents (42.2 ± 4.74 vs. 30.5 ± 7.28, p < 0.001). The most common reasons for vaccine hesitancy/ refusal were safety concerns (61%), lack of need (42.9%), and negative media information (41.6%). Vaccine hesitancy/refusal was less prevalent in males (36.6%) than females (63.4%), with a significantly higher overall score in males than females (41 ± 5.89 vs. 38.9 ± 8.05, p = 0.005). Conclusion: Findings from the current study showed moderate hesitancy and low refusal towards routine childhood vaccination in the married population in the Al-Qassim region and suggested a sound attitude towards routine vaccination. Awareness campaigns should be directed towards raising the knowledge regarding the importance of vaccination from an individual and community perspective to reduce hesitancy or refusal of vaccination.

Validación del cuestionario sobre vacunas y reticencia a vacunarse en la Sociedad Española de Epidemiología

ObjectiveTo develop and validate a survey aimed at epidemiologists to measure factors associated with vaccine reluctance. MethodVaccination hesitancy refers to delayed acceptance or refusal of vaccination despite the availability of vaccination services. WHO included vaccination hesitancy among the 10 global health threats in 2019. Within this conceptual framework proposed by WHO, a committee of six experts from the Spanish Society of Epidemiology (SEE) designed a self-administered questionnaire to study factors associated with vaccination hesitancy in epidemiologists. This questionnaire was approved by the SEE Board, and was sent online to all members in 2019. Based on the responses obtained, the following characteristics were validated: face validity, internal validity, construct validity, criterion validity, reliability, as well as the characteristic curves of each item and the information function per item and overall. ResultsThe final questionnaire showed two well-defined components, perception of vaccines and confidence in the transparency of vaccine data with high degrees of fit in all aspects of validation. Both components have shown that the higher the reluctance to vaccinate the better the questionnaire reports on these aspects. ConclusionsThe study has allowed the development of a validated instrument in Spanish to measure the factors associated with vaccine reluctance among epidemiologists.

МАРКЕТИНГОВІ АСПЕКТИ МЕДИЧНИХ ПОСЛУГ З ВАКЦИНАЦІЇ В УМОВАХ ІНФОРМАЦІЙНО-КОМУНІКАЦІЙНОЇ ПІДТРИМКИ ДЕРЖАВИ

The article analyzes the marketing aspects of the population's attitude to vaccination medical services based on a nationwide survey of respondents. The article analyzes the dynamics of the Ukrainian population's attitude to vaccination based on surveys of respondents in 2016-2020. It was revealed that during this period the share of the population expressing a positive attitude towards vaccination increased. At the same time, there is a positive trend of a decrease in the share of the population that expressed a negative attitude to vaccination, as well as some growth in the category of the population that had a neutral attitude to vaccination. In the process of the research, it was established that an important positive shift in the issue of vaccination of the adult population and children is a decrease among respondents who oppose vaccination in Ukraine, where their share in 2020 decreased to 8.2 percent compared to previous periods. A marketing analysis of respondents who have children in the household and an assessment of their attitude to vaccination in the regions of Ukraine in 2020 was carried out. The percentage of respondents who had the experience of refusing vaccinations for a child was characterized and divided by region (among those who had children under 18 years of age in the household and information about their health status) in 2020. The authors investigated the main reasons for respondents' refusal to receive vaccinations for children in 2018–2020. It was found that one of the main reasons for refusing vaccination was that parents were afraid of complications from the vaccine and that the child was sick during the period when it was necessary to vaccinate children. It is summarized that the implementation of communication and information policy is an important component of immunoprophylaxis for both the adult population and children, which will prevent the outbreak of many types of infectious diseases in the future. Key words: marketing, medical services, population's attitude to vaccination, refusal of vaccinations, communication and information policy of the state, attitudes of respondents.

How do the characteristics of juvenile idiopathic arthritis affect the continuation or refusal of vaccination against diphtheria? A cross-sectional study data

How do the characteristics of juvenile idiopathic arthritis affect the continuation or refusal of vaccination against diphtheria? A cross-sectional study data

COVID-19 vaccination hesitancy and psychological health among general population in Saudi Arabia

Background: In 2019, World Health Organization considered COVID-19 vaccination a global health threat. Vaccine hesitancy is a behavior with delay in acceptance or refusal of vaccines despite available services. The psychological well-being of the individuals, such as anxiety or depression, could also affect their acceptability of the new vaccine. The present study aimed at evaluating COVID-19 vaccination hesitancy and psychological health among the general population in Saudi Arabia. Methods: A cross-sectional study using a self-administered online, close-ended questionnaire was conducted among the general adult population from all regions of Saudi Arabia. The questionnaire included sociodemographic data, the 5C tool to measure vaccination hesitancy, patient health questionnaire (PHQ-9), and Generalized Anxiety Disorder (GAD-7). Data were collected, tabulated, and analyzed using the Statistical Package of Social Science program, version 26. Results: In this study, we collected data from 2,543 adults in Saudi Arabia, where 53% were males. According to PHQ-9, we found that 68.7% of the participants reported a degree of depression, and GAD-5 showed that 27.2% had mild anxiety, 19.5% had moderate anxiety, and 6.8% had severe anxiety symptoms. The mean confidence constraints, complacency, calculation, and responsibility scores among the participants were 4.91, 3.07, 3.34, 509, and 5.14. Conclusion: The results of this study showed moderate to good acceptance of the COVID-19 vaccination among individuals in Saudi Arabia. Moreover, this study reported a significant relationship between depression/anxiety and vaccination hesitancy.

Abstract A125: Vaccine hesitancy: Can we convince the unvaccinated to vaccinate?

Abstract Background: Vaccine hesitancy is defined as “delay in acceptance or refusal of vaccination despite the availability of vaccination services”. When individuals choose not to get vaccinated, efforts to control the spread of the disease are hindered. Despite scientific evidence that COVID-19 vaccines are safe and effective, one in four adults in the United States is not fully vaccinated. However, some individuals, despite being previously vaccine-hesitant got the COVID-19 vaccine and vice versa, leading to an intention-behavior gap. In this study, we ask an important question: What socio-demographic, psychological, ideological, and communication-related factors can contribute to the vaccination-related intention-behavior gap? An understanding of these factors can also help create communication strategies to encourage the vaccine-hesitant to get vaccinated, especially in populations where there are greater vaccine disparities. Methods: This longitudinal study uses two nationally representative surveys of Americans from 2020 and 2021 to determine the factors that contribute to COVID-19 vaccination-related intention-behavior gap and overcome vaccine hesitancy, using multivariable logistic regression. Results: The results indicated that 51% of previously vaccine-hesitant individuals were vaccinated against COVID-19, and only 14% of previously pro-vaccine individuals remained unvaccinated. Some factors associated with a higher likelihood of vaccine-hesitant individuals getting vaccinated were high perceptions of risk, high vaccine acceptance, being informed about the vaccines, endorsing less COVID-19 misinformation, having confidence in scientists, being over 60 years old, and being female. Alternatively, some factors associated with a lower likelihood of pro-vaccine individuals not getting vaccinated were high perceptions of risk, high vaccine acceptance, being informed about the vaccines, identifying as a Republican, having confidence in scientists, having access to healthcare, and having higher education. Conclusions: The study indicates that it is possible to convince the vaccine-hesitant individuals to get vaccinated as well as prevent the pro-vaccine individuals from realizing their vaccination intentions. Developing evidence-based persuasive and targeted communication strategies can help convince the unvaccinated and increase the uptake of COVID-19 vaccines. Targeted communication strategies can also help reduce disparities among populations that have lower vaccination rates. Moreover, such strategies may also be useful to increase the uptake of other vaccines such as human papillomavirus (HPV) vaccines to lower the rates of HPV-attributable cancers in the United States. Citation Format: Dhriti Dhawan, Mesfin Awoke Bekalu, Ramya Pinnamaneni, Rachel McCloud, Kasisomayajula Viswanath. Vaccine hesitancy: Can we convince the unvaccinated to vaccinate? [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A125.

АНАЛИЗ ЭПИЗООТИЧЕСКОЙ СИТУАЦИИ ПО ЯЩУРУ В РОССИИ С 1991 ПО 2023 ГОДЫ

The spread of foot-and-mouth disease (FMD) in the world has led to the development of a system of regionalisation and the assignment of a status to each country depending on safety and vaccination. FMDfree without vaccination countries export their products around the world. Therefore, it is necessary to strive for the status. To see the true picture of the FMD epizootic situation, the authors analysed the archival materials of Rosselkhoznadzor (the Federal Service for veterinary and Phytosanitary Surveillance) for the period from 1991 to 2023. The research aimed to conduct a retrospective analysis of the FMD epizootic situation in the Russian Federation and determine the prospects for obtaining the status of a “FMD-free without vaccination” country. The study established 96 unsafe points in eleven Russian regions for the analysed period. FMD was most often found in regions that have a land border with China, Mongolia and Kazakhstan. Trans-Baikal Territory is the most FMD affected region, where foot and mouth disease has been recorded eight times over the past thirty years. Primorsky Territory has recorded five FMD outbreaks; four records of FMD were found in Amur Region. A sporadic FMD occurred in Moscow, Vladimir, Orenburg, Khabarovsk and Krasnodar regions, and in the republics of Bashkortostan, Karachay-Cherkessia and Kabardino-Balkaria. The most common FMD serotype is serotype O, which accounts for about 70 % of all outbreaks since 2010. Serotype A was only found in five regions in 2013–2014. The Asia 1 serotype was found once in Vladimir region. Despite the focused effort to obtain the status of “FMD-free without vaccination”, Russia is at high risk of introducing pathogens from border areas. Vaccine refusal may negatively affect the epizootic situation, which has been stable for the past two years. Given the length of the land border, the high risk for FMD in Kazakhstan and the unstable political and economic situation, keeping the country free from FMD is a priority for the Russian Federation.

Attitudes of parents with children aged 12-18 to COVID-19 vaccines for themselves and their children.

The incidence of vaccine hesitancy is increasing in many countries. This study aims to determine parents` attitudes and related factors regarding COVID-19 vaccine acceptance for themselves and their children aged 12-18. A cross-sectional survey was conducted on parents between 16th November and 31st December 2021, after COVID-19 vaccines were initiated for children in Türkiye. In the survey, the sociodemographic characteristics of the parents, whether they and their children were vaccinated against COVID-19, and if not, the reasons for this were asked. Multivariate binary logistic regression analysis was used to evaluate the factors affecting parents` refusal to vaccinate their children for COVID-19. Three hundred and ninety-six mothers and fathers were included in the final analysis. Overall, 41.7% of parents reported vaccine refusal for their children. COVID-19 vaccine refusal was higher in mothers younger than 35 (β = 6.5, p = 0.002, 95% CI: 2.0-23.1), children aged 15 and younger (β = 2.3, p = 0.001, 95% CI: 1.4-3.7). Concerns about the side effects of the COVID-19 vaccine (29.7%) and their children not wanting to be vaccinated (29.0%) were the most common causes of COVID-19 vaccine refusal. In the present study, the rate of children not vaccinated due to COVID-19 vaccine refusal was relatively high. Parents` concerns about vaccine side effects, as well as their children`s unwillingness to be vaccinated, suggest that both parents and adolescents should be informed about the importance of COVID-19 vaccines.

Vaccine Hesitancy and Factors Related to Vaccine Hesitancy in COVID-19 Vaccination among a Tribal Community of Meghalaya: A Mixed Methods Study.

Vaccine hesitancy should be dealt as an important issue as it carries both individual- and community-level risks; however, it lacks proper assessment in particular among the indigenous tribal population. A community-based sequential explanatory mixed methods study was conducted among 238 eligible individuals in Ri-Bhoi district, Meghalaya. The quantitative part involved a cross-sectional study to determine the proportion of vaccine hesitancy and the qualitative part comprised in-depth interviews among the eligible residents and key informant interviews among the health workers providing the vaccination services, to explore the facilitators and barriers of vaccine uptake. A total of 113 [47.5% (95% confidence interval [CI]: 41.0%-54.0%)] participants were found to be hesitant to vaccination, among which 16.8% (95% CI: 12.4%-22.3%) were initially hesitant and 30.7% (95% CI: 24.9%-37.0%) had vaccine refusal. The themes generated through qualitative interviews were individual-related, disease-related, vaccine-related, healthcare system and provider related and socio-cultural and religious. The main barriers for the likelihood of action were perceived susceptibility and perceived severity under the individual perception along with ambiguity aversion, scepticism about the efficacy, mistrust, concerns on side effects, rumors, and socio-cultural and religious misbeliefs. Vaccine hesitancy is found to be considerably higher and it depends on complacency toward the vaccine, confidence in its safety, perceived susceptibility to the disease and perceived severity to the disease coupled with modifying factors for cues for action. Healthcare workers should better communicate to improve the uptake of vaccines by reducing the barriers to the vaccine acceptance.

Social Worldviews Predict the General Factor of Paranormal and Generic Conspiracist Beliefs.

Even though wide access to any warranted information in the modern age, the problem of unfounded belief is still relevant, since these beliefs often lead to negative consequences (e.g., vaccination refusal, homeopathic treatment, etc.). The aim of this study was testing the relationship of social worldviews with paranormal beliefs and conspiracy beliefs. We assumed dimensionality hypothesis based on functional standpoint that there should be a general factor (underlying all the domains of paranormal beliefs and generic conspiracist beliefs), which has associations with the social worldviews as well. Derived our analysis from the survey of 228 participants (Mage = 30.6, SD = 11.7), we found that (a) the structure of paranormal and generic conspiracist beliefs can be described by a bifactor model; (b) the general factor of paranormal and generic conspiracist beliefs in the bifactor model was positively associated with global belief in just world and dangerous worldview; (c) paranormal beliefs were positively associated with global belief in just world and negatively associated with competitive worldview; (d) generic conspiracist beliefs were positively associated with dangerous worldview, competitive worldview, and zero-sum game belief; (e) contrary to our hypotheses, there was no evidence for any negative association of paranormal beliefs with dangerous worldview or zero-sum game belief and for any negative association of generic conspiracist beliefs with global belief in just world. We claim that the unfounded beliefs can be of some functional nature, demonstrating a connection with social worldviews, which opens up new perspectives for considering this problem within the framework of social psychology.

Autonomia do paciente ante a vacinação contra covid-19

Abstract Amidst the serious public health crises caused by the COVID-19 pandemic, vaccination became a key measure to combat the disease; however, vaccination refusal or hesitancy hinders the efforts to reach collective immunity. Such refusal is a right arising from patient autonomy and can be influenced by political factors, trust in governments, skepticism towards the pharmaceutical industry, and media exposure. Thus, knowledge of these aspects added to public health efforts is paramount to mitigate refusal and promote vaccination acceptance.

HESITAÇÃO VACINAL DE PAIS E FAMILIARES DE CRIANÇAS E O CONTROLE DAS DOENÇAS IMUNOPREVENÍVEIS

ABSTRACT Objective: to analyze, in scientific productions, the reasons that lead parents and family members of children to vaccine hesitancy in the context of control of immunopreventable diseases. Method: integrative review using the following informational resources: Scientific Electronic Library Online, Latin American and Caribbean Literature on Health Sciences, Nursing Database, Índice Bibliográfico Español en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online, and Cumulative Index to Nursing and Allied Health Literature. A time cut-off from 2016 to 2021 was used. Results: Twenty-four articles comprised the final sample, and two categories emerged: Un(knowledge) about vaccines; and In(decision) and lifestyle. Conclusion: this study contributes to professional practice, encouraging health units’ managements to establish strategies for interventions with the hesitant. Vaccine refusal or delay in vaccination should be considered by these professionals a window of opportunity to approach parents and family members.

The issue of vaccine refusal: study of risky behaviour.

The aim of this study is to identify the influence of factors that determine the refusal of influenza vaccine among three subjects groups. A survey was conducted amongst three high‑risk groups in years 2018-2019 (Moscow, Russia). The survey involved 1,620 parents and pregnant women (group 1), 324 doctors (group 2) and 433 students (group 3). The analysis revealed a poor vaccine uptake among respondents of all three groups. According to the survey results, only 22.2 % of children and 13.8 % of adults were vaccinated against influenza. The group 2 showed higher rates for vaccinated adults and children, namely 36.7 % and 58.7 % , respectively. The lowest adherence to annual vaccinations was recorded in group 3 (only 17.3 %). There is also a negative correlation between adherence to vaccination and smoking -0.66), unhealthy diet -0.73), poor oral hygiene -0.61) as well as insufficient awareness of the need of influenza vaccine -0.81). The general lack of vaccination awareness has a fundamental role in forming a negative attitude toward influenza vaccine. It is necessary to conduct research to promote vaccination against influenza to improve vaccine uptake among high‑risk groups, particularly in students (Tab. 1, Fig. 1, Ref. 32).

What impact does the attitude toward COVID-19 vaccination have on physicians as vaccine providers? A cross sectional study from the German outpatient sector.

COVID-19 vaccination is recognized as a key component in addressing the COVID-19 pandemic. Physicians' attitudes toward vaccination are known to play a defining role in the management and dissemination of medical advice to patients. In Germany, outpatient practitioners are predominantly responsible for the dissemination of vaccines. Using a cross-sectional online survey, 932 outpatient general practitioners, gynecologists, and pediatricians in Germany were asked in fall, 2021, about their attitude toward COVID-19 vaccination and - among others - their communication in vaccine discussions, their assessment of vaccine safety, and reporting of suspected adverse events. Physicians were divided into two groups along their attitudes toward COVID-19 vaccination. In addition, multivariate linear regression models were constructed to assess differences in communication strategies. 92% of physicians had a positive or very positive attitude toward COVID-19 vaccination. Own vaccination status, practice-based vaccination delivery, and estimated vaccination coverage among patients were significantly associated with the attitude toward vaccination. Confidence in vaccine safety was significantly lower among physicians with negative attitudes. There were no differences between the two groups in self-assessment of the ability to detect suspected adverse events, but there were differences in the observing and reporting of adverse events. For the linear regression models, we found that a more negative attitude toward COVID-19 vaccination was significantly associated with increased acceptance of patient refusal of COVID-19 vaccination and empathic behavior for patient concerns. In contrast, willingness to engage in a detailed persuasion consultation was significantly lower. Pediatricians showed significantly higher empathy for patient-side concerns compared to general practitioners, whereas gynecologists showed less empathy than general practitioners. The physician's attitude toward COVID-19 vaccination influences the physician's practices as a vaccine provider. However, when providing medical advice and healthcare, the physician should focus on the actual needs of the patient.