The role of citizenship in the acceptance and completion of COVID-19 vaccine cycle in the resident population with foreign citizenship registered with the Umbrian Health Care System - An analysis of regional data.

Introduction: Non-italian citizens experienced less access to anti-COVID-19 vaccination, compared to the native population. Literature has found differences in adherence to anti-COVID-19 vaccination among these groups; however, there are apparently no studies that investigated the role of citizenship. Our objective was to investigate the role of citizenship in vaccine hesitancy toward anti-COVID-19 vaccination and the completion of vaccine cycle, in the non-Italian citizens resident in the Umbria Region. Study design: This is a population study, performed on resident population in Umbria. Methods: Population data were obtained thanks to a record linkage between the Regional Health Information System and the regional DBCOVID Umbria database. On this dataset, a descriptive and logistic regression analyses were performed. Results: The 19.2% of non-Italian citizens did not take even one dose, 2.1% did not complete it and 40.6% did not take the additional dose. The range of values of which these results are an average, however, is very wide, suggesting important differences in COVID-19 vaccine up taking, among different citizenships. The logistic regression shows that citizenships with the highest probability of non-adherence to vaccination, compared to Philippine, was Romanian (OR=7.8), followed by Macedonian (OR=7.3) and Polish (OR=5.9). Conclusions: The study provides evidence of differences among citizenships that pinpoint the importance of understanding the reasons behind these behaviours, to support decisions around health policies tailored to each citizenship.

Vaccine Literacy and Hesitancy on routine and travelers' vaccines: a preliminary online survey.

Background: The vast amount of conflicting information during the COVID-19 pandemic might have had a detrimental effect on people's opinions about vaccinations, including groups like travelers. This study aimed at assessing Vaccine Literacy in a sample of the general Italian population, together with antecedents of Vaccine Hesitancy, such as confidence, complacency, and convenience, the so-called "3Cs", and their effects on accepting routine and travelers' vaccines. Study Design: A specifically designed anonymous questionnaire was created by using Google forms and validated through a face validity process. Subsequently, it was employed in an online cross-sectional survey. Methods: The assessment Vaccine Literacy scale used in this survey was similar to that employed in earlier surveys. In addition to demographic data and information sources used by participants, the questionnaire was composed, in total, of nine multiple choice questions on Vaccine Literacy, and six questions on the 3Cs. Considered outcomes were self-reported participants' beliefs, attitudes, behaviors and intentions toward recommended routinary adulthoods vaccines and arboviral vaccines for travelers. A section of the questionnaire focused on chikungunya awareness, taken as an example of arboviral disease that has caused outbreaks in Italy, but not yet vaccine-preventable at the time of the investigation. Results: After cleaning the database, 357 responses were suitable for analysis. Vaccine Literacy mean functional score was 2.81 ± 0.74 (lower than in an earlier survey, p = 0.012), while the interactive-critical (score 3.41 ± 0.50) was higher (p<0.001). Vaccine literacy was confirmed to be associated with attitudes and behaviors towards vaccination, with the 3Cs often acting as a mediator. However, interactive Vaccine Literacy was misaligned with respect to functional and critical ones, as if looking for information sources or discussing about vaccination was less relevant than amidst the pandemic. Also, there was an increase in Vaccine Hesitancy, particularly with regard to travel vaccinations, with 10-17% of individuals refusing to be vaccinated if travelling in areas at risk. The main limitation of the study was the unbalance in demographic variables, in particular the education level. Conclusions: The study highlights the risks associated with current travel, including those related to climate change and the spread of vector-borne infections. It underscores the importance of raising awareness about arboviral diseases and the vaccines available to prevent them. As with all online surveys that employ convenience sampling, this study might not have provided a comprehensive representation of the entire population. Nevertheless, a dedicated analysis has been conducted to reduce biases and make data interpretation easier. Despite the need for further research, the findings indicate potential new approaches for assessing Vaccine Literacy and Vaccine Hesitancy, to ease the development of new communication strategies to enhance routine and travel vaccinations.

Propiedades psicométricas de la Escala Dispvac: evidencia de la validez de contenido interna, externa y fiabilidad / Psychometric properties of Dispvac Scale: evidence of its content, internal validity, external validity, and reliability

Resumen Introducción: una de las barreras al acceso a la vacunación contra las enfermedades infecciosas es la reticencia a la vacunación, la cual suele medirse o asociarse a una poca disposición para vacunarse, actitudes antivacunas o la probabilidad reportada de obtener una vacuna. Sin embargo, no existe un consenso en la forma en la cual este constructo es medido. Objetivo: el propósito de este artículo es identificar las propiedades psicométricas y la estructura factorial de la nueva Escala Dispvac en una muestra colombiana. Método: se realizó un diseño psicométrico para identificar las propiedades psicométricas de la escala con una muestra de 1131 participantes (masculino: 37.30%, femenino 61.90%, otro: 0.79%; media edad: 25.84, SD edad: 10.19), a través de un muestreo por conveniencia. Se realizó un análisis factorial exploratorio, un análisis factorial confirmatorio, un análisis de fiabilidad y la validez convergente. Resultados: se sugieren dos factores: actitudes cognitivas hacia la vacunación y legitimidad percibida de las autoridades al requerir la vacunación que comprende la prueba. La prueba Dispvac se correlaciona de manera negativa con la Escala VAX. Conclusiones: los dos factores que comprenden la Escala Dispvac sugieren que la intención a vacunarse implica también creencias sobre la autoridad/instituciones en vacunación.

Abstract Introduction: One of the main barriers to access to vaccination against infectious diseases is vaccine hesitancy, which is usually measured or associated to a low disposition to receive vaccination, anti-vaccine attitudes or the reported probability to receive a vaccine. However, there is no consensus in the way this construct is measured. Objective: The objective of this study it to identify the psychometric properties and the factorial structure of the Scale Dispvac in a Colombian sample. Method: To this goal, a psychometric design was made to identify the psychometric properties of the new scale making use of 1131 participants (male: 37.30%, female: 61.90%, other: 0.79%; age mean: 25.84, age SD: 10.19), through a convenience sampling. We conducted an exploratory factorial analysis, a confirmatory factorial analysis, a reliability analysis, and the convergent validity. Results: Two factors are suggested: Cognitive attitudes towards vaccination and perceived legitimacy of authorities to require vaccination. The Dispvac Scale is negatively correlated with the VAX Scale. Conclusions: The mentioned factors suggest that intention to vaccinate also implies beliefs on the authority in vaccination.

Assessment of childhood vaccination hesitancy among syrian parents under temporary protection.

BACKGROUND AND AIM: Vaccination programs become increasingly crucial during migratory movements driven by conflict and other disruptions. This study aims to determine the prevalence of childhood vaccination hesitancy among Syrian parents under temporary protection and identify areas for targeted interventions. METHOD: A total of 227 Syrian parents attending three Immigrant Health Centers in Sultangazi were assessed using the Arabic version of the Parent Attitude about Childhood Vaccines (PACV) survey, conducted between October and December 2023. RESULTS: The prevalence of vaccine hesitancy among these parents was found to be 10.6%. An inverse correlation was observed between maternal education level and vaccine hesitancy, indicating that higher education levels were associated with lower levels of hesitancy. CONCLUSION: The observed rate of vaccine hesitancy among Syrian parents under temporary protection underscores the urgent need for targeted interventions. Tailored vaccination strategies for immigrant populations are essential to improve immunization rates and ensure the health and well-being of these communities.

Determinants of pneumococcal vaccination among older adults: A scoping review.

OBJECTIVES: To identify the range of factors that impact health behaviours pertaining to the uptake of pneumococcal vaccination (PV) among older persons. STUDY DESIGN: Scoping review. METHODS: This review followed Arksey and O'Malley's framework. Five databases: PubMed, CINAHL, PsycINFO, Scopus and Embase were searched for relevant studies on PV uptake among outpatient older adults ≥65 years published between January 2013 and October 2023. Data were extracted and verified using a standardised template, and synthesised using inductive content analysis. Findings were classified according to Andersen's behavioural model of health services use (BMHSU). RESULTS: Twenty-seven papers were included in the final analysis. Reception of PV was influenced by predisposing factors such as (i) awareness and risk perception, (ii) demographic characteristics, and (iii) cultural beliefs towards preventive medicine; enabling factors including (i) disease and vaccine literacy, (ii) past experience with preventive health services, and (iii) access to relevant resources; as well as reinforcing factors namely, (i) vaccine efficacy and safety, (ii) social influence, (iii) support from healthcare professionals, and (iv) vaccine administration environment. CONCLUSIONS: Older adults' health behaviours, particularly their attitudes towards vaccination are often complex and this attests to the need for multidimensional, cross-sector barrier-specific strategies to raise PV coverage. Key issues identified in this review highlight the focus areas that healthcare providers, policy makers and other stakeholders should collaborate on to resolve underutilisation of preventive medicine and promote health among this population.

Understanding the oscillations of an epidemic due to vaccine hesitancy.

Vaccine hesitancy threatens to reverse the progress in tackling vaccine-preventable diseases. We used an $ SIS $ model with a game theory model for vaccination and parameters from the COVID-19 pandemic to study how vaccine hesitancy impacts epidemic dynamics. The system showed three asymptotic behaviors: total rejection of vaccinations, complete acceptance, and oscillations. With increasing fear of infection, stable endemic states become periodic oscillations. Our results suggest that managing fear of infection relative to vaccination is vital to successful mass vaccinations.

Vaccine Hesitancy and COVID-19 Risk Behaviors Associated with Social Media Use in Japan.

We examined the associations between the use of different types of media and COVID-19 vaccine hesitancy, as well as risk behaviors of COVID-19 infection, in Japan in late 2021. Cross-sectional surveys were conducted using rapid online surveys of residents in Iwate Prefecture from February 5 to 7, 2021, and from October 1 to 3, 2021. Each individual's risk of acquiring SARS-CoV-2 infection was calculated using a quantitative assessment tool (the microCOVID). Intention to get vaccinated for COVID-19 was assessed by self-report. Usage of five types of media for obtaining COVID-related information was assessed: (1) newspapers, (2) television or radio, (3) internet or news apps, (4) social network services (SNS) (excluding LINE, a popular messaging app), and (5) other. Reliance on SNS did not show significant associations with either intention to get vaccinated or engaging in risky behavior for acquiring COVID-19. Although users of the internet or news apps were marginally significantly less likely to engage in high-risk behavior, significant associations between vaccine hesitancy and the usage of the internet or news apps were found in the middle age and elderly groups (OR [95% confidence interval (CI)] in middle age: 1.55 [1.07-2.23]; in elderly; 9.24 [3.28-26.02]). The differential associations between different types of media use and COVID-19 prevention behaviors may assist in preparing for future pandemic outbreaks. One implication for public health risk communication is audience segmentation, such as emphasizing vaccine safety and effectiveness for older audiences.

Vaccine hesitancy and routine revaccination among adult HCT survivors in the United States: A convergent mixed methods analysis.

Revaccination to restore immunity to vaccine-preventable diseases (VPDs) is essential risk mitigation in the prevention of infectious morbidity and mortality after hematopoietic cell transplantation (HCT). However, revaccination rates have been shown to be insufficient and to what extent vaccine hesitancy contributes to survivors not becoming fully revaccinated is unknown. We performed a cross-sectional, mixed methods survey-based study to explore how vaccine hesitancy influences revaccination among US adult HCT survivors who were 2 to 8 years after transplant. Participants were asked to complete the Vaccination Confidence Scale (VCS) and open-ended survey items regarding vaccine confidence. The survey response rate was 30 %; among 332 respondents, vaccine confidence was high in 69 %, medium in 20 %, and low in 11 %. On multivariable analysis, four factors associated with high vaccine confidence were: predominantly Democrat zip codes (per 2020 election results), ability to pay for revaccination out of pocket, receipt of pre-HCT adult vaccines, and receipt of COVID-19 vaccines. From 189 participants who also answered open-ended items, 14 themes associated with vaccine confidence were identified and collapsed into 4 categories based on the VCS: Benefits, Harms, Trust, and Other. Merged analysis showed congruence between VCS scores and open-ended survey responses and created a narrative about the relative importance of the constructs when approaching revaccination by vaccine confidence level. These findings significantly expand our knowledge of how vaccine hesitancy influences revaccination uptake among US adult HCT survivors. Population-specific interventions to approach vaccine-hesitant survivors should be developed and tested.

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

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

Attitudes of healthcare professionals regarding vaccines and influencing factors: A cross-sectional study.

AIMS: This study aims to examine the attitudes of healthcare professionals toward vaccines and identify factors influencing these attitudes. METHODS: The study, which employed a descriptive and cross-sectional methodology, included doctors, nurses, and midwives employed at a public hospital between March 2022 and February 2023. Data were collected through face-to-face interviews using structured questionnaires, including the "Attitudes Towards Vaccination Scale." RESULTS: Healthcare workers generally had positive attitudes toward vaccination, with nearly all receiving the COVID-19 vaccine. Participants with children reported high childhood vaccination rates, and factors such as gender and occupation significantly influenced vaccination attitudes (p < 0.001). While 87.1 % of the participants expressed concerns about the potential adverse effects of vaccines, those who believed vaccines had no side effects exhibited more favorable attitudes toward vaccination. Furthermore, the study revealed a considerable degree of endorsement for mandatory childhood vaccinations, with 75.1 % of participants expressing support for implementing legal obligations. CONCLUSION: The findings of this study show healthcare workers' generally positive attitudes and confidence toward vaccines. However, more research should be conducted on the reasons for hesitancy toward COVID-19 vaccination. Increasing education and information activities is essential to overcome hesitations against new vaccines. Since the attitudes of healthcare workers toward vaccines can affect society's general vaccine acceptance and vaccination rates, studies in this field are of great importance. IMPLICATIONS TO PRACTICE: The study underscores the crucial role of healthcare professionals as advocates for vaccination, emphasizing the need for tailored communication strategies to effectively address vaccine hesitancy, particularly regarding safety concerns.

Association of the belief in conspiracy narratives with vaccination status and recommendation behaviours of German physicians.

Vaccine hesitancy has been identified as one of the top ten threats to global health by the World Health Organization (WHO). The belief in conspiracy narratives is repeatedly discussed as a major driver of vaccine hesitancy among the general population. However, there is a lack of research investigating the role of the belief in conspiracy narratives in vaccination decisions and recommendation behaviours of physicians. This is particularly relevant as physicians are one of the major and trusted sources of information for patients' vaccination decisions. This study therefore investigated the association between believing in COVID-19-related conspiracy narratives and physicians' own COVID-19 vaccination status and their recommendation behavior for COVID-19 and other vaccines (e.g., HPV or flu). In a cross-sectional survey among German physicians (N = 602, April 2022) two conspiracy narratives were assessed, stating that the coronavirus is a hoax or that it is human-made. Additional control variables included trust in health institutions, the rejection of complementary and alternative medicine (CAM), the 5C psychological antecedents of vaccination (confidence, complacency, constraints, calculation, and collective responsibility) and demographic variables. Hierarchical regressions indicated that greater belief in the conspiracy narrative claiming that the coronavirus is a hoax was associated with lower COVID-19 vaccination uptake and fewer COVID-19 vaccination recommendations among physicians. The results for recommendation behavior remain robust even when controlling for other variables. Contrary to our assumption, believing that the coronavirus is human-made was not related to vaccination status nor vaccine recommendation behavior. In conclusion, believing in conspiracy narratives that question the existence and thus also the danger of the virus is an important independent predictor of vaccine hesitancy among physicians that should be addressed in future public health interventions.

Unwelcome return: analyzing the recent rise of measles cases in the United States.

Measles is a highly contagious viral illness mainly affecting the younger population worldwide despite the availability of a safe and effective vaccine. The disease is caused by measles virus, a member of the Paramyxoviridea family, which is transmitted through aerosols and respiratory droplets. Widespread vaccination has led to a significant decline in morbidity and mortality worldwide; however, recent years have witnessed a resurgence of outbreaks in the United States, highlighting barriers in achieving and sustaining elimination goals. The measles and rubella elimination initiative, under Immunization Agenda 2030, required at least 5 World Health Organization regions to achieve measles elimination by 2020, but none of the regions met these goals. Vaccine hesitancy, virus importation via international travel, and waning immunity are considered contributing factors to the recent surge of measles outbreaks. This review highlights the challenges in the pursuit of measles eradication and the importance of a multidimensional approach involving public health interventions.

Trust in Health Institutions Across Racial Groups: Implications for Dual Flu-Coronavirus Vaccine Adoption.

This study investigates the factors that influence individuals' willingness to accept a combined COVID-19 and flu vaccine. The primary focus is on examining the impact of trust in health institutions, frequency of flu vaccine uptake, and COVID-19 vaccine uptake. The analysis further delves into racial differences to better understand variations among different racial groups. METHODS: This study employs t-tests to compare the means of trust in health institutions, frequency of flu vaccine uptake, and COVID-19 vaccine uptake between individuals who are willing and unwilling to accept the combined vaccine. Additionally, a weighted logistic regression analysis is conducted to predict the likelihood of individuals to receive the combined vaccine, considering key independent and control variables. RESULTS: The t-test results reveal that individuals who are willing to accept the combined vaccine exhibit higher levels of trust in health institutions, more frequent flu vaccine uptake, and higher COVID-19 vaccine uptake. This pattern holds true across all racial groups. The logistic regression analysis demonstrates that trust in health institutions, frequency of flu vaccine uptake, and COVID-19 vaccine uptake significantly predict individuals' willingness to accept the combined vaccine. Partisanship and demographic characteristics also exert influence on vaccine acceptance. CONCLUSION: Trust in health institutions plays a pivotal role in vaccine acceptance among individuals from all racial groups. Encouraging routine vaccination practices and leveraging existing vaccination campaigns can facilitate the adoption of combined vaccines. It is imperative to address racial disparities and tailor communication strategies to specific demographic groups to enhance vaccine uptake.

Vaccine skepticism and vaccine development stages; inoculation from "cowpox" lesion to the current mRNA vaccine of COVID-19: review.

Global pandemics can be tackled by two means: lockdowns and vaccinations. As vaccination has a low impact on economic outcomes and better acceptance by people, it is the preferred method by most governments as a medium- to long-term solution. Vaccines have played a significant role in reducing the global burden of infectious diseases. They are designed to teach the immune system how to fight a particular infection before it causes a disease in subsequent exposures by creating a memory. Although vaccines effectiveness is well known, anti-vaccination movements pose significant challenges, even in high-income settings, leading to outbreaks of life-threatening infectious diseases. Hesitancy to take vaccines is not new and began with the first vaccination of smallpox. At that time, the problem was solved by a regulatory obligation to take vaccines, declared in England and Wales in 1853, which eventually led to its eradication in 1980. Different studies show that there is a decline in awareness of vaccines, hesitancy to take them, and concerns and trust issues regarding healthcare professionals. These problems have been rising over the past few decades for several reasons, notably, because of misinformation spread by social media. Therefore, the objective of this review is to provide a brief overview about vaccine hesitancy and attributable factors, illustrate the different types of vaccines, show the major challenges of vaccine development, and illustrate the pros and cons of each type.

Hesitancy to take vaccines and stages of vaccine development starting from the first vaccine; inoculation from "cowpox" wound to the current mRNA vaccine of COVID-19: Review Global pandemics can be tackled by two means: lockdowns and vaccinations. As vaccination has a low impact on economic outcomes, it is the preferred method by most governments as a medium- to long-term solution. Vaccines play a significant role in reducing the global burden of infectious diseases. They are designed to teach our body defense mechanism how to fight a particular infection before it causes a disease in subsequent infections by creating a memory. Although its effectiveness is well known, anti-vaccination movements pose many challenges, even in high-income settings, leading to outbreaks of life-threatening infectious diseases. Vaccine hesitancy is not new and began with the first vaccination of smallpox. At that time, the problem was solved by a regulatory obligation to take vaccines, declared in England and Wales in 1853, which eventually led to its eradication in 1980. Different studies show that there is a decline in awareness of vaccines, hesitancy to take them, and concerns and trust issues regarding healthcare professionals. These problems have been rising over the past decades for a number of reasons. Therefore, the objective of this review is to provide a brief overview of the different types of vaccines, show the major challenges of vaccine development, and illustrate the pros and cons of each type.

Vaccine Refusal and Hesitancy among Iranians Participated in the National COVID-19 Vaccine Hesitancy Survey: A Qualitative Study.

Background: Success in COVID-19 vaccination depends on understanding why people refuse or hesitate to take the vaccine. This study aims to explore vaccine refusal and hesitancy among Iranians who participated in the national COVID-19 vaccine hesitancy survey. Methods: A qualitative content analysis approach was used. Twenty-six participants were selected by purposive sampling. In-depth, semi-structured telephone interviews were conducted during the year 2022. A directed content analysis approach was used for analyzing the data by extracting the codes, subcategories, and categories. Results: Four major categories and their respective subcategories related to refusal and/ or hesitancy against COVID-19 vaccination emerged: "lack of confidence" (distrust in policymakers and pharmaceutical companies, distrust in national media, belief in conspiracy theory, and lack of confidence in the vaccine's safety and effectiveness), "complacency" (Fatalism and philosophical beliefs, low perceived risk, and belief in the adequacy of the precautionary principles), "constrains" (personal and psychological barriers), and "coercion" (coercion by relatives and unsteady imposed mandatory vaccination by the government). Conclusion: Distrust, fatalism, low perceived risk, and overconfidence in traditional Persian medicine were important barriers to COVID-19 vaccine acceptability needing a variety of measures for improving COVID-19 vaccine uptake, including enhancing public trust in government and policymakers, clarifying vaccine safety and effectiveness, dealing with religious fatalism, and regulating anti-science messages on social media.

Attitudes and beliefs of healthcare providers toward vaccination in the United States: A cross-sectional online survey.

BACKGROUND: Healthcare providers' (HCPs') beliefs and practices regarding vaccination influence vaccine acceptance in patients. OBJECTIVE: To describe HCPs' beliefs and practices regarding vaccines and perceptions of patient perspectives related to vaccine hesitancy. METHODS: This was a non-interventional, cross-sectional, online survey administered to 1213 HCPs based in the United States from December 2021 through January 2022. HCPs provided responses regarding their demographic and professional characteristics, beliefs about vaccine safety and effectiveness, vaccination practices, and their views regarding patients' willingness to receive vaccination. RESULTS: Study participants included doctors (55.4 %); physician assistants (11.2 %); pharmacists (11.7 %); nurse practitioners (11.1 %); and registered nurses (10.6 %) from across the United States (West, 35.6 %; Midwest, 27.0 %; South, 25.6 %; Northeast, 11.9 %). HCPs belonged to group practices or clinics (34.5 %), private practices (31.9 %), hospital-based practices (21.9 %), or pharmacies (11.7 %). Most HCPs strongly believed it was their duty to promote vaccination (78.1 %) and used in-person conversations to educate patients about vaccines (85.0 %); 95.1 % had been vaccinated against COVID-19. HCPs reported that 54.9 % of patients accept all vaccines without hesitation, 21.0 % accept all vaccines but hesitate, 16.8 % accept only select vaccines, and 7.2 % reject all vaccines. Reasons commonly cited by patients for being hesitant to accept vaccines or refusal included negative media (hesitancy: 64.6 %; refusal: 73.2 %), the influence of friends or family (hesitancy: 60.5 %; refusal: 68.7 %), distrust of the government (hesitancy: 45.8 %; refusal: 68.4 %), concerns over long-term side effects (hesitancy: 56.1 %; refusal: 68.3 %), and worries about vaccine-related autism or infertility (hesitancy: 49.7 %; refusal: 71.9 %). HCPs reported that the largest contributors to vaccine misinformation among patients were social media (91.0 %), celebrities/TV personalities (63.5 %), and mass media (61.1 %). CONCLUSIONS: Despite most HCPs being active proponents of vaccination, misconceptions about vaccination and vaccine hesitancy persists. Consideration should be given to HCP training to support their efforts to promote vaccine acceptance.

Pediatric COVID-19 vaccine hesitancy among pregnant and post-partum women: A mixed-method study.

BACKGROUND: This study aims to understand factors contributing to pediatric COVID-19 vaccine hesitancy among pregnant and postpartum adults. METHOD: The study used targeted intercept advertising on Facebook, Twitter, and Instagram to recruit a panel of 3600 pregnant and postpartum US adults. Data were collected between December 2021 and April 2022 (i.e., before the introduction of pediatric COVID-19 vaccines in the U.S.). We used logistic regression to understand factors associated with pregnant and postpartum women's hesitancy towards getting children <5 vaccinated against COVID-19. Poststratification weights were applied to analyses to promote the representativeness of the sample. We also conducted a qualitative thematic analysis to determine the reasons for pediatric vaccine hesitancy. RESULTS: Nearly half (45.6 %) of pregnant or postpartum women were hesitant to vaccinate their child against COVID-19. Vaccine hesitancy was lower among those who had a high perceived susceptibility to COVID-19, had increased perceived severity of COVID-19, and increased perceived benefits of the COVID-19 vaccine. Perceived barriers related to long-term side effects of vaccines were positively associated with hesitancy to vaccinate children. Older women, women in urban areas, and those born outside the US were less likely to be hesitant to vaccinate children <5 against COVID-19. Compared to respondents with a high school education or less, the odds of pediatric vaccine hesitancy were higher among respondents with some college. Pregnant and postpartum women who were hesitant about getting children <5 vaccinated cited the following reasons for hesitancy: concerns about the vaccine, lack of evidence on vaccine safety, and the COVID-19 vaccine is not necessary for children. CONCLUSION: Our findings suggest that public health messages to promote the COVID-19 vaccine for young children should focus on the risks and consequences of the disease and share data on the effectiveness of the vaccine in preventing severe COVID-19-related outcomes.

Effects of Simulation on Nursing students' Knowledge and Learning Related to Measles Vaccine and Vaccine Hesitancy: A Mixed Method Study.

Vaccine hesitancy is a persistent, global public health concern that community health nurses are well-positioned to manage. Simulations involving standardized patients are effective experiential learning on managing vaccine hesitancy for other allied health disciplines. A pretest-posttest design, with a mixed-methods, one-group, quasi-experimental approach, was used to examine the effectiveness of a simulation on nursing students' knowledge of measles, mumps, and rubella vaccine hesitancy, as well as their attitudes toward the intervention. The study was completed with 61 participants. After participation in the simulation, pretest/posttest data showed a mean increase in participants' knowledge of the measles, mumps, and rubella vaccine. There was a significant improvement in the test scores from 62.62 ± 14.82 to 69.50 ± 15.75; z = -3, 897 (1-17 days) (p = 0.001). A postintervention questionnaire revealed participants most appreciated the direct interaction with a live person, the opportunity to observe classmates' performance and share feedback, multistage structure, and safety. Drawbacks included stress from being observed by peers, time constraints, and the necessity of sharing the nursing role with a partner during the scenario. Another drawback is the simulation's inability to effectively prepare participants for hesitancy in clinical settings as they needed to assess natural clinical settings. Simulations incorporating vaccine hesitancy education and standardized patients can effectively prepare nursing students for situations related to vaccine hesitancy in community clinical settings.

Factors Associated With Repeat Pediatric Influenza Vaccination Among Inconsistent Vaccinators.

Promoting consistent vaccination practices may help improve suboptimal influenza vaccination rates. This study evaluated the prevalence and correlates of repeat influenza (flu) vaccination among children who had previously received the vaccine inconsistently. An online survey study was conducted in 2022 among parents of commercially insured children ages 3 to 19 years who were previously inconsistently vaccinated. Of 317 respondents, 85% reported that their child received a flu vaccine in the 2021 to 2022 flu season. Among these parents, 61% reported concern that their child would get sick from flu as the most important reason for vaccinating. Repeat vaccination was less likely among parents who reported that school/daycare requirements were a reason for vaccinating in the prior season (odd ratio [OR] = 0.17, 95% confidence interval [CI] = 0.05-0.55). Our findings suggest that school policies may improve vaccination rates among inconsistent vaccinators.