Unmasking vaccine hesitancy and refusal: a deep dive into Anti-vaxxer perspectives on COVID-19 in Spain.

BACKGROUND: At the time of the emergence of COVID-19, denialist and anti-vaccine groups have also emerged and are shaking public confidence in vaccination. METHODS: A qualitative study was conducted using online focus groups. Participants had not received any doses of vaccination against the disease. A total of five focus group sessions were conducted with 28 participants. They were recruited by snowball sampling and by convenience sampling. RESULTS: The two major topics mentioned by the participants were adverse effects and information. The adverse effects described were severe and included sudden death. In the case of information, participants reported: (1) consultation of websites on which scientists posted anti-vaccination content; and (2) distrust. CONCLUSIONS: At a time when anti-vaccine groups pose a major challenge to public health in general, and to COVID-19 vaccination campaigns in particular, this study is a first step towards gaining deeper insight into the factors that lead to COVID-19 vaccine refusal.

Acceptance of vaccination against pertussis, COVID-19 and influenza during pregnancy: a cross-sectional study.

BACKGROUND: This study aims to assess the uptake of maternal pertussis and COVID-19 vaccination and the intention towards accepting the maternal influenza vaccination. Insights into different socio-demographic factors related to maternal vaccination coverage might help to address vaccine acceptance and improve maternal vaccine uptake in the future. METHODS: We conducted a cross-sectional survey among pregnant women and recent mothers, up to 6 months post-partum. The primary outcome measures of this study were behaviour for maternal pertussis and COVID-19 vaccination, and maternal influenza vaccination intention. Associations between socio-demographic factors and maternal pertussis vaccination and maternal COVID-19 vaccination behaviour; and socio-demographic factors and maternal influenza vaccination intention were assessed using binary logistic regression analyses. RESULTS: In total 1361 respondents filled out the questionnaire. Almost all women (95%) were vaccinated against pertussis during pregnancy, while almost two-third were vaccinated against COVID-19 during pregnancy (58%) and almost one-third (28%) had a positive intention towards receiving the maternal influenza vaccination. Results show that young maternal age and low education level were associated with lower maternal vaccination acceptance. CONCLUSION: Vaccination campaigns focusing on the severity of diseases that are prevented, are needed to increase maternal vaccine acceptance in younger and low-educated pregnant women. We expect that differences in vaccination coverage between the three maternal vaccinations might partly be explained by existing recommendations, campaigns and whether the vaccination is part of the national immunisation program.

COVID-19 vaccine hesitancy in a developing country: prevalence, explanatory factors and implications for the future.

OBJECTIVES: Vaccine hesitancy is a public health challenge highlighted during the COVID-19 pandemic. This study sought to determine the prevalence and explanatory factors leading to COVID-19 vaccine hesitancy in the Jamaican population to inform vaccination strategies. STUDY DESIGN: This was an exploratory cross-sectional study. METHODS: An exploratory survey was distributed electronically between September and October 2021 to gather information on COVID-19 vaccination behaviour and beliefs among the Jamaican population. Data were expressed as frequencies and analysed using Chi-squared followed by multivariate logistic regressions. Significant analyses were determined at P < 0.05. RESULTS: Of the 678 eligible responses, most were females (71.5%, n = 485), between ages 18-45 years (68.2%, n = 462), had tertiary education (83.4%, n = 564) and were employed (73.4%, n = 498), with 10.6% (n = 44) being healthcare workers. COVID-19 vaccine hesitancy was present in 29.8% (n = 202) of the survey population, mainly because of safety and efficacy concerns and a general lack of reliable information about the vaccines. The likelihood of hesitancy increased amongst respondents under 36 years (odds ratio [OR] 6.8, 95% confidence interval [CI] 3.6, 12.9), those who delayed initial acceptance of vaccines (OR 2.7, 95% CI 2.3, 3.1); parents for their children and with long waits at vaccination centres. Likelihood of hesitancy decreased for respondents over 36 years (OR 3.7, 95% CI 1.8, 7.8) and with vaccine support from pastors/religious leaders (OR 1.6, 95% CI 1.1, 2.4). CONCLUSIONS: Vaccine hesitancy was more prevalent in younger respondents who were never exposed to the effects of vaccine-preventable diseases. Religious leaders had more influence than healthcare workers to increase vaccine uptake.

Psychological and Social Aspects of Vaccination Hesitancy-Implications for Travel Medicine in the Aftermath of the COVID-19 Crisis: A Narrative Review.

Vaccines are an important tool of preventive medicine. Although organized vaccination programs have saved large populations from serious infectious diseases, there is a considerable part of the population who oppose vaccinations. In particular, anti-vaccination perceptions, among travelers to countries with endemic diseases, are a major public health concern. Although hesitancy towards vaccinations is not a novel phenomenon, it came back to the forefront during the fight against the COVID-19 pandemic. This review explores the etiology of anti-vaccination beliefs among travelers and draws conclusions about their impact on public health and society in general. For this purpose, a purposeful search for data on the causative factors of vaccine hesitancy and their impact on people's health was conducted. A descriptive analysis of the findings and conclusions regarding possible implications in health policy and clinical practice are presented. A fear of side effects, lack of credence in the necessity of vaccines, and mistrust of medical authorities are important causative factors. Their interplay shapes hesitancy towards vaccines. However, anti-vaccination beliefs can also be an aspect of a more general unconventional stance of life. Health care professionals and organizations must be ready to tackle vaccine hesitancy by making the necessary interventions. Correcting misconceptions about vaccinations is a prerequisite for ensuring personal and public health, especially in the context of a pandemic or epidemic. Moreover, ensuring the efficacy and safety of vaccines, especially in cases of modern technology applications, is a fundamental factor in addressing people's concerns about vaccines. For this purpose, medical authorities and organizations must provide accurate and clear information on vaccines so as to eliminate misinformation. Furthermore, clinicians should cultivate their communication skills in order to convey the appropriate messages to prospective recipients of vaccinations.

A study of health literacy and social media use of the students on vaccine preferences during COVID-19 pandemic in Turkey.

Background: It is unknown if health-care literacy and social media use of the students affect vaccine preferences during the COVID-19 pandemic. Objectives: The aim of the present research was to detect whether health-care literacy and social media use of the students affect vaccine preferences during the COVID-19 pandemic. Materials and Methods: The universe of the sample consisted of the students of a university in Mus Alparslan University. The sample of the research included students whose last digit of the school number is an odd number. Four hundred and twenty students participated into the study. The data of the study were collected through the "Sociodemographic Characteristics Questionnaire," "Health Literacy Scale (HLS)," and "Social Media Usage Scale (SMUS)." Results: The total score average of the students on the "HLS" was 42.74 ± 13.85 and the "SMUS" was 21.30 ± 7.38. It was determined that those who have preferred the "Sinovac" vaccine had higher score averages on the "Information Understanding Subdimension" and "HLS" than those who have preferred the Türkovac vaccine. Furthermore, it was determined that the score average of "Continuity Subdimension," "Competency Subdimension" and "Social Media Use Scale" were higher, and these differences were statistically significant. Conclusion: It was detected that the health literacy (HL) levels of the students were lower and they do not use social media competently. On the other hand, it was determined that social media use and HL affect the vaccine preferences.

The shift in COVID-19 vaccination policy for pregnant women, from restricted to required, and the confusion that ensued.

Introduction: The aim was to investigate the response of pregnant women when the COVID-19 vaccination policy shifted from restricted to required, and the confusion that ensued during pregnancy, bearing in mind that women undergo unique physiological and immunological changes during pregnancy, making them at risk of developing a more severe course of COVID-19 infection compared to their non-pregnant peers. Material and methods: A cross-sectional study was carried out at the outpatient clinics at Jordan University Hospital for all pregnant women during the period of the survey from 1st October 2021 to 31st December 2021, focusing on the source of information about the vaccine, receiving the vaccine, and the reasons for rejecting the vaccine, especially during pregnancy. Results: In total, 468 pregnant women were interviewed. The single primary source of information about the COVID-19 vaccine was the traditional media, audio-visual and print media being the most important as reported by 191 women (40.81%), while possible harm to the fetus was the single main reason for refusal of vaccination during pregnancy as reported by 111 women (23.72%). Conclusions: Reluctance toward vaccination is primarily driven by the fierce media campaign that portrayed its initially ambiguous effects on the pregnancy and fetus in a negative light, in conjunction with the open media platforms that enabled semi-experts to issue medically inaccurate statements and information and further complicated the matter by planting the seed of fear and mistrust of the public in the health care system and providers. More public healthcare awareness regarding the safety of the COVID-19 vaccine is needed.

Why do parents refuse childhood vaccination? Reasons reported in Finland.

AIMS: This article examines the reasons for partial and complete refusal of childhood vaccination as reported by parents in Finland. It analyzes perceptions and experiences central in vaccination decisions. METHODS: The analysis is based on 38 in-depth interviews with Finnish parents who have refused all or several vaccines for their children. The interviews were analyzed using qualitative content analysis. RESULTS: Three categories of reasons were identified in the analysis: 1) risks and effects of vaccination - concern about and/or experiences of possible side-effects was the most important reason for avoiding vaccines; 2) distrust - participants did not trust vaccination recommendations made by health officials and medical professionals due to perceived bias in medical research, ties between health officials and the pharmaceutical industry, and personal experiences of (suspected) adverse effects and the way these concerns were received in healthcare institutions; 3) health perceptions and practices - parents supported their vaccination choices with complementary and alternative medicine treatments and alternative health understandings. Many stated that contracting vaccine-preventable illnesses would provide longer lasting and more 'natural' immunity than vaccination, and possibly other health benefits. CONCLUSIONS: A loss of trust in medical and public health actors was central to the process in which parents came to question, contest, and eventually refuse childhood vaccination. The adverse effects of the Pandemrix vaccine in 2009-2010 have been important in leading to distrust and contestation. Distrust may relate to personal experiences of (suspected) adverse effects or to broader concerns over the neutrality of health authorities and the trustworthiness of medical research.

Influenza Vaccination During COVID-19 in a Rural Community: A Cross-sectional Survey.

Vaccination behavior is an informative metric for assessing flu seasons and is especially important to understand for the 2020-2021 flu season, which coincided with the COVID-19 pandemic. This study aimed to estimate flu vaccine behavior and assess vaccine perceptions during the pandemic season. Using a cross-sectional descriptive study design, we conducted an online survey to assess vaccination behavior and perceptions of both COVID-19 and the flu. Patients were identified as recently seen by providers in an academic internal medicine practice (n = 827) and surveys were distributed as messages in the Epic electronic medical record system. We found that 88.3% of respondents (188/206) had received their flu vaccination for the season at the time of their survey response in December 2020-February 2021. Of those that had not yet received the flu vaccine, only 13.6% indicated they planned on getting one. 12.5% of respondents said they had changed their flu vaccine plans due to the COVID-19 pandemic. Looking at differences from past season's behavior, more individuals switched to getting the flu vaccine than those that switched to not getting the vaccine this season. The most frequently cited reasons for not receiving the flu vaccination were concerns about side effects and not being in a priority group. Changes in flu vaccination behavior from previous seasons represent a net positive in the direction of vaccine acceptance. Barriers to vaccination were identified and results from this study provide more information on vaccine perceptions, beliefs, and behavior, which can benefit future vaccination programs.

A meta-analysis of COVID-19 vaccine attitudes and demographic characteristics in the United States.

OBJECTIVES: Despite the potential for COVID-19 vaccination to prevent severe disease and death, vaccine hesitancy is common in the United States, with more than a quarter of eligible Americans yet to receive the first dose. We draw on existing published studies on COVID-19 vaccine attitudes to estimate the overall prevalence of vaccine hesitancy and assess how it varies across demographic groups. STUDY DESIGN: A systematic literature search was conducted to identify and meta-analyze relevant studies, which examined vaccine acceptance and hesitancy in the context of the COVID-19 vaccine. METHODS: We meta-analyzed the prevalence rate of vaccine acceptance across all participants as well as for specific demographic subgroups. To assess time effects, we coded each study for the month during which data were collected and subjected the meta-analytic data to a regression analysis. To assess the magnitude of differences between demographic subgroups, we conducted a separate meta-analysis of odds ratios. RESULTS: Across the 46 samples, an average of 61% of participants indicated they were willing to receive the COVID-19 vaccine. The biggest demographic differences were found for race and political affiliation, with Black respondents and Republicans reporting significantly higher vaccine hesitancy than White respondents and Democrats. CONCLUSIONS: These results inform current vaccination efforts by identifying the groups that are least likely to get vaccinated and supporting the need for tailored vaccine strategies to alleviate the concerns specific to those populations. Comparing intentions to vaccinate with actual vaccination rates, vaccine hesitancy appears to have declined considerably among women and Black Americans.

[Public Resistance to Vaccination During Epidemics: The Example of COVID-19Resistência da população à vacinação em tempos de epidemias: sobre a COVID-19]. / Resistencia de la población hacia la vacunación en época de epidemias: a propósito de la COVID-19.

Objective: This article presents the findings of a review of the literature on public resistance to vaccines and the main factors that have influenced their decisions about immunoprevention, with a focus on the COVID-19 pandemic. Methods: We searched the literature using the terms DeCs/MeSH, anti-vaccination movement, vaccination refusal, epidemics, COVID-19, and impacts on health, using the Boolean operators OR and AND in Google Scholar, Medline, Lilacs, and Ibecs. Documents from official sources were also considered. Results: Throughout history, since vaccination began, people have had controversial perceptions of the procedure: some accept what the health authorities recommend, and others allege hidden intentions behind immunization. The COVID-19 vaccine against SARS-CoV-2 has been no exception. Conclusions: Vaccination has been one of the greatest scientific achievements in public health. However, despite its benefits, it has raised fear, uncertainty, and suspicion in the population. For this reason, it is important to increase health education actions in the population-with clear, concise, understandable information that is based on reliable and truthful sources-in order to reduce resistance to vaccination and address preventable diseases.

Objetivo: Este artigo busca apresentar os achados de uma revisão da literatura sobre a resistência da população às vacinas e os principais motivos que influenciaram suas decisões em relação à imunoprevenção, com foco na pandemia de COVID-19. Métodos: Foi realizada uma busca na literatura utilizando os termos DeCs/MeSH anti-vaccination movement, vaccination refusal, epidemics, COVID-19 e impacts on health, relacionados entre si pelos operadores booleanos OR e AND, no Google Scholar, MEDLINE, LILACS e IBECS. Documentos de fontes oficiais também foram levados em consideração. Resultados: Ao longo da história, desde o início da vacinação, a percepção das pessoas em relação a esse procedimento foi controversa. Há quem aceite o que as autoridades de saúde recomendam e quem alegue intenções ocultas por trás da imunização. A vacina contra o SARS-CoV-2, que causa a COVID-19, não foi exceção. Conclusões: A vacinação tem sido uma das maiores conquistas científicas em termos de saúde pública ­ um avanço que, apesar de seus benefícios, tem causado medo, incerteza e desconfiança na população. Por isso, é importante aumentar as ações de educação em saúde para a população, com informações claras, concisas e compreensíveis, baseadas em fontes confiáveis e verídicas, a fim de diminuir a resistência à vacinação e evitar doenças preveníveis.

Vaccination for COVID-19 in children: Denialism or misinformation?

In the current pandemic scenario, vaccines for children have been scientifically approved; however, there is a challenge faced globally: parents' hesitation about vaccinating their children for COVID-19, which can hamper adherence to vaccine campaigns. This issue is due to the lack of information or access to fake news that affects the parents' power of judgment. The experience of the vaccine process with Pfizer's immunizer in several countries successfully reduced the number of hospitalized and prevented hundreds of child deaths from COVID-19. All health professionals must encourage the vaccination of children from the age of 5, sharing reliable scientific data, thus reducing the spread of fake news.

Factors associated with influenza vaccination acceptance in Mexican healthcare workers: A multicenter cross-sectional study.

Adherence of healthcare workers (HCWs) to influenza vaccination is far from optimal despite its being the most effective intervention for preventing influenza. In order to evaluate factors associated with influenza vaccination acceptance among Mexican HCWs during the 2017-2018 influenza season, a multicenter cross-sectional study spanning public and private hospitals was conducted. Participants were consecutively invited to answer a self-administered questionnaire. A total of 1513 out of 1553 questionnaires were evaluated. The median age of the participants was 32 (26-44) years and 65.8% were women. Nurses and physicians comprised 53.0% of the surveyed population. Total self-reported adherence to influenza vaccination among HCWs during the 2017-2018 season was 63.5% and varied across participating hospitals (P < 0.001). Factors positively associated with influenza vaccination were incremental doses of influenza vaccine received within the last 5 years (aOR = 1.94, 95% CI = 1.78-2.10), City 3 (aOR = 1.62, 95% CI = 1.19-2.20) and City 1 (aOR = 1.39, 95% CI = 1.02-1.91), whereas factors negatively associated were lack of a previous dose of influenza vaccine (aOR = 0.03, 95% CI = 0.01-0.08) and unawareness of the vaccination campaign (aOR = 0.57, 95% CI = 0.44-0.72). Lack of information and poor communication were barriers identified by both vaccinated and unvaccinated personnel. This study concluded that adherence to influenza vaccination in Mexican HCWs is suboptimal and that the factors associated with receipt of influenza vaccine are similar to those reported in other studies.

COVID-19 vaccine hesitancy in people with migratory backgrounds: a cross-sectional study among Turkish- and German-speaking citizens in Munich.

BACKGROUND: This study aimed to investigate the knowledge, attitudes, behaviors, and COVID-19 vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich. METHODS: Primary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false items). Other variables included demographics, attitudes to COVID-19 and vaccination (7 items), and behaviors regarding COVID-19 (7 items). The attitude and behavior questions had 5-point Likert scales. Of the 10 Turkish-speaking family physicians in Munich, six agreed to administer Turkish or German questionnaires to consecutive patients in February 2021. Furthermore, participants with either citizenship, country of origin, native language, or place of birth being non-German were categorized as "Having a migratory background." Data from 420 respondents were analyzed. RESULTS: Women constituted 41.4% (n = 174), the mean age was 42.2 ± 15.5 years, 245 (58.3%) preferred the Turkish questionnaire, 348 (82.9%) had a migratory background, and 197 (47.9%) intended to be vaccinated. The mean knowledge, attitude, and behavioral scores were 21.5 ± 3.2 (max = 25), 3.7 ± 0.8 (max = 5), and 4.0 ± 0.5 (max = 5). While 42.3% (n = 145) of the participants with a migratory background considered getting vaccinated, this proportion was 76.5% (n = 52) for non-immigrant Germans (Chi-square = 26.818, p < 0.001). Non-migratory background (odds ratio (OR): 3.082), high attitude scores (OR: 2.877), male sex (OR: 2.185), years of schooling (OR: 1.064), and age (OR: 1.022) were positively associated with vaccination intention. CONCLUSIONS: We suggest initiating or supporting projects run by persons or groups with immigrant backgrounds to attempt to elaborate and change their vaccination attitudes.

Influenza vaccination during the coronavirus pandemic: intention to vaccinate among the at-risk population in the Central Catalonia Health Region (VAGCOVID).

BACKGROUND: Influenza is a major public health issue, with the primary preventive measure being an annual influenza vaccination. Nevertheless, vaccination coverage among the at-risk population is low. Our understanding of the behaviour of the influenza virus during the SARS-CoV-2 coronavirus pandemic is limited, meaning influenza vaccination is still recommended for individuals at risk for severe complications due to influenza infection. The aim of the study is to determine the intention to vaccinate against seasonal influenza among the at-risk population in the 2020-21 campaign during the SARS-CoV-2 pandemic and to analyse the factors which influence such intention. METHODS: Cross-sectional telephone survey of adults (aged over 18) with risk factors in central Catalonia where the need for the Seasonal Influenza Vaccine (SIV) was recommended. RESULTS: A total of 434 participants responded to the survey, 43.3% of whom intended to be vaccinated against influenza for the 2020-2021 influenza season, 40.8% had no intention to be vaccinated and 15.9% were uncertain or did not express their opinion. The intention to get vaccinated against influenza is associated with having dependents, the individual's perception of the risk of being infected with influenza and the perceived risk of transmission to dependents. It is also associated with age, whether the individual had received influenza vaccine the previous season or any other season before. The best predictors of the intention to vaccinate are the individual's perception of the risk of catching influenza and whether the individual had been vaccinated in the previous season. CONCLUSIONS: Intention to vaccinate can be a good predictor of individual behaviour in relation to vaccination. During the current SARS-CoV-2 pandemic many individuals are hesitant to influenza vaccination. In order to improve influenza vaccination coverage in people included in risk groups, it is necessary to promote educational actions, especially among those who express doubts.

Characteristics of Antivaccine Messages on Social Media: Systematic Review.

BACKGROUND: Supporters of the antivaccination movement can easily spread information that is not scientifically proven on social media. Therefore, learning more about their posts and activities is instrumental in effectively reacting and responding to the false information they publish, which is aimed at discouraging people from taking vaccines. OBJECTIVE: This study aims to gather, assess, and synthesize evidence related to the current state of knowledge about antivaccine social media users' web-based activities. METHODS: We systematically reviewed English-language papers from 3 databases (Scopus, Web of Science, and PubMed). A data extraction form was established, which included authors, year of publication, specific objectives, study design, comparison, and outcomes of significance. We performed an aggregative narrative synthesis of the included studies. RESULTS: The search strategy retrieved 731 records in total. After screening for duplicates and eligibility, 18 articles were included in the qualitative synthesis. Although most of the authors analyzed text messages, some of them studied images or videos. In addition, although most of the studies examined vaccines in general, 5 focused specifically on human papillomavirus vaccines, 2 on measles vaccines, and 1 on influenza vaccines. The synthesized studies dealt with the popularity of provaccination and antivaccination content, the style and manner in which messages about vaccines were formulated for the users, a range of topics concerning vaccines (harmful action, limited freedom of choice, and conspiracy theories), and the role and activity of bots in the dissemination of these messages in social media. CONCLUSIONS: Proponents of the antivaccine movement use a limited number of arguments in their messages; therefore, it is possible to prepare publications clarifying doubts and debunking the most common lies. Public health authorities should continuously monitor social media to quickly find new antivaccine arguments and then create information campaigns for both health professionals and other users.

Pediatric and Parents' Attitudes Towards COVID-19 Vaccines and Intention to Vaccinate for Children.

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination is necessary to reach herd immunity and essential for mitigating the spread of the pandemic. In May 2021, the US FDA and the EU have expanded the emergency use authorization for a COVID-19 vaccine to children aged 12 to 15. The aim of this study was to investigate parental acceptability of COVID-19 vaccination for their children, factors affecting their acceptability, and children's perceptions of COVID-19 vaccines in Republic of Korea. METHODS: We conducted a questionnaire survey at two tertiary hospitals from May 25, 2021 to June 3, 2021. Subjects were parents having children under 18 years and children aged 10-18 years. RESULTS: Two hundred twenty-six parents and 117 children aged 10-18 years were included in the final analysis. Overall, 76.5% and 64.2% of parents intended to get vaccinated against COVID-19 and intended to have their children vaccinated, respectively. However, only 49.6% of children responded that they would get COVID-19 vaccination. In the multivariate analysis, high confidence in the safety of COVID-19 vaccines (adjusted odds ratio [AOR], 4.87; 95% confidence interval [CI], 1.32-24.12), parents' willingness to vaccinate themselves (AOR, 19.42; 95% CI, 6.85-64.00), and awareness of the need to vaccinate children against COVID-19 (AOR, 13.15; 95% CI, 4.77-41.27) were associated with positive factors intention to vaccinate their children. CONCLUSION: This study provides insight into how parents think about the COVID-19 vaccine for their children in South Korea. Our findings could be referenced in establishing a policy for childhood COVID-19 vaccination in the future.

Altered Influenza Vaccination Coverage and Related Factors in Pregnant Women in Korea from 2007 to 2019.

BACKGROUND: Pregnant women are at a high-risk of influenza infection. We have previously reported a low influenza vaccination coverage rate (4.0%) in Korea during the 2006-2007 influenza season. We conducted follow-up studies in 2011-2012 and 2018-2019 to observe changes in influenza vaccination coverage. METHODS: Women who delivered at Inha University Hospital (Incheon, Korea) in 2011-2012 and 2018-2019 were enrolled in the study. We surveyed the rate of influenza vaccination, perception scores, and related factors through telephonic interviews and compared the results from 2011-2012 and 2018-2019 with those from 2006-2007. RESULTS: The number of survey respondents was 227 in 2006-2007, 152 in 2011-2012, and 171 in 2018-2019. The rate of vaccination coverage increased from 4.0% in 2006-2007 to 42.0% in 2011-2012 and 59.3% in 2018-2019. Perception scores also increased progressively from 3.8 in 2006-2007 to 4.2 in 2011-2012 and 5.1 in 2018-2019. Physician recommendations for influenza vaccination also increased from 4.8% in 2006-2007 to 36.8% in 2011-2012 and 49.7% in 2018-2019. The most common reason for not getting vaccinated was the lack of awareness of influenza vaccination during pregnancy (36.9%). The perception scores and physician recommendation rates were significantly lower for unvaccinated women (3.87 and 8.4%, respectively) than for vaccinated women (5.14 and 69.1%, respectively). CONCLUSION: The influenza vaccination coverage rate in pregnant women has increased significantly since our study in 2006-2007. However, further improvement in the coverage rate is needed. There is a need for active and comprehensive publicity and education regarding this issue among physicians and pregnant women.

COVID-19 vaccine hesitancy and acceptance in Mexico: a web-based nationwide survey.

OBJECTIVE: To identify factors associated with COVID-19 vaccine hesitancy and acceptance among the Mexican population. METHODS: In a web-based nationwide survey in early December 2020, respondents were inquired about their sociodemographic characteristics and their willingness to accept a hypothetical COVID-19 vaccine given a 50% or 90% effectiveness. A logistic regression model was used to identify the factors associated with hesitancy and acceptance. RESULTS: A total 3 768 responses were analyzed. A 90% effective vaccine was accepted by 85% of respondents, while only 46% would accept being vaccinated with a 50% effective vaccine. In univariate analysis, each age group (40-49, 50-59, and ≥60) was strongly associated with vaccine hesitancy for a 90% effective vaccine (OR 0.48, 95% CI 0.38, 0.63; OR 0.33, 95 CI 0.26, 0.41; and OR 0.28, 95 CI 0.21, 0.38, respectively) compared to the 18-39 age group. After multivariable adjustment, similar magnitudes of association were observed. Being female and higher socioeconomic status were also associated with higher vaccine hesitancy. CONCLUSIONS: Vaccine hesitancy represents a major public health problem in Mexico and is driven by multiple factors. Our study provides relevant insights for the development of effective policies and strategies to ensure widespread vaccination in Mexico.

[How to improve vaccination coverage in France? Qualitative study among health care workers]. / Comment améliorer la couverture vaccinale en France ? Étude qualitative auprès de professionnels de santé.

BACKGROUND: The risk benefit ratio has been clearly proven for a long time to be in favor of vaccination. However, the vaccine distrust is still increasing in the French population and vaccination coverage could be improved. There is a real need to increase confidence in vaccination. In this study, we interviewed heath care workers to collect their opinion concerning vaccination hesitancy amongst their patients. METHODS: A qualitative study, using semi structured interviews, was performed. All the Pharmacists and doctors were interviewed by the same person using an interview guide prepared by a multidisciplinary team. Interviews were recorded and transcribed verbatim, then used as a basis for analysis and synthesis of the areas where improvement seems possible for the health care workers interviewed. RESULTS: Data saturation was obtained after 10 interviews. Analysis of the verbatim allowed the classification of the leads proposed by health care workers in three main themes: improvement of transparency and restoration of the trust for vaccine policy, improved initial and further training of health care workers, and a better communication towards the population. CONCLUSION: Results provide helpful insights into practical avenues to improve the vaccination confidence. If some of them need an in-depth reflection, others could be easily implemented in order to increase the adhesion of the population to vaccination, and consequently the vaccination coverage.

Vaccine distrust: Investigation of the views and attitudes of parents in regard to vaccination of their children.

BACKGROUND: In France, many parents have lost confidence in vaccinations, which has a direct impact on immunization coverage. Pharmacists, like other health professionals, often encounter parents exhibiting vaccine distrust. METHODS: Using a survey distributed in a school and in a number of volunteering pharmacies, the objective of this study was to gain a better understanding of the views and the attitude of parents in regard to vaccination of their children. RESULTS: Our results show that the main concerns were in regard to vaccine adjuvants, the risk of short- and long-term adverse effects, and the risk of developing a disease or a disability as a result of vaccination. The parents, although they tended to express a degree of reluctance and apprehension, in general, they were not opposed to vaccination, and they sought objective scientific information and full transparency regarding all aspects of vaccine composition, adverse effects, and effectiveness. Cooperation of all the parties involved in the health system on this subject is essential for a seamless chain of care and to improve vaccination coverage. CONCLUSION: The information collected, combined with a review of the international literature, allow avenues for dialogue adapted to parents' opinions to be established and thus assist health professionals to communicate effectively regarding vaccines, which is a bona fide public health issue.