Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Research protocol for bridging research, accurate information and dialogue (BRAID)-clinical trials: a mixed-methods study of a community-based intervention to improve trust and diversify participation in clinical trials.

Cultural beliefs, personal experiences, and historic abuses within the healthcare system-rooted in structural racism-all contribute to community distrust in science and medicine. This lack of trust, particularly within underserved communities, contributes to decreased participation in clinical trials and a lack of representation in the data. Open dialogue about community concerns and experiences related to research participation and medical care processes can help build trust and change attitudes and behaviors that affect community health. This protocol outlines an approach to increase trust in science and clinical trials among communities in the Bronx, New York that are typically underrepresented in research data. Bridging Research, Accurate Information and Dialogue (BRAID) is a two-phased, evidence-based community engagement model that creates safe spaces for bilateral dialogues between trusted community messengers, and clinicians and scientists. The team will conduct a series of BRAID Conversation Circles on the topic of clinical trials with local trusted community messengers. Participants will be members of the community who are perceived as "trusted messengers" and can represent the community's voice because they have insight into "what matters" locally. Conversation Circles will be audiotaped, transcribed, and analyzed to identify emergent challenges and opportunities surrounding clinical trial participation. These key themes will subsequently inform the codesign and co-creation of tailored messages and outreach efforts that community participants can disseminate downstream to their social networks. Surveys will be administered to all participants before and after each Conversation Circle to understand participants experience and evaluate changes in knowledge and attitudes about clinical trials, including protections for research participants the advantages of having diverse representation. Changes in motivation and readiness to share accurate clinical trial information downstream will also be assessed. Lastly, we will measure participants dissemination of codesigned science messages through their social networks by tracking participant specific resource URLs of materials and videos posted on a BRAID website. This protocol will assess the effectiveness and adoptability of an innovative CBPR model that can be applied to a wide range of public health issues and has the potential to navigate the ever-changing needs of the communities that surround health systems.

Parental Attitudes and Hesitancy About COVID-19 Vaccination Versus Routine Childhood Vaccination in a Selected Hospital in the United Arab Emirates: A Cross-Sectional Study.

Background: A complex interplay of social and political influences, cultural and religious beliefs, the availability and interpretation of health and scientific information, individual and population experiences with health systems, and government policies contributes to the anxiety about vaccines and their programs that results in vaccine hesitancy. Vaccine hesitancy is becoming a serious threat to vaccination programs; in 2019, the World Health Organization (WHO) listed it as one of the top ten global health threats. The negative impacts of antivaccination movements are blamed for the major portion of the global resistance to vaccination. Objective: To evaluate and compare parental attitudes and reluctance regarding routine childhood vaccinations versus COVID-19 vaccines among children in the United Arab Emirates (UAE). Methods: A study of 102 parents with children admitted to SAQR Hospital in Ras Al Khaimah, UAE, was conducted using a convenience sample approach in a descriptive cross-sectional study. One-on-one interviews were conducted to gather data using the standardized Vaccine Hesitancy Scale (VHS) questionnaire developed by the WHO. Statistical Package for Social Sciences version 25 was used for data analysis. Results: Vaccine-hesitant respondents are also highly resistant to the required proof of vaccination. A statistically significant difference (P = .000) was observed between parental reluctance to receive the COVID-19 vaccination and routine childhood vaccination. Parental knowledge of the COVID-19 vaccine hesitancy (P = .001) and confidence (P = .000) showed a statistically significant correlation. No significant correlation was observed with sociodemographic factors. Conclusion: The impact of vaccine hesitancy on herd immunity, social, psychological, and public health strategies to combat vaccine hesitancy was observed in this study with various challenges to overcome in COVID-19 vaccination campaigns. Expanding access to and acceptance of vaccines among parents in low- and middle-income nations, as well as raising vaccination rates among those who express a lack of confidence in vaccines.

COVID-19 vaccine hesitancy among unvaccinated individuals in a primary care setting, Pretoria.

BACKGROUND:  South Africa faced challenges while implementing coronavirus disease 2019 (COVID-19) measures such as mass vaccination. Some people rejected or were hesitant to receive government-recommended vaccines. This study explored COVID-19 vaccination hesitancy among unvaccinated individuals in a primary care setting in Pretoria, South Africa. METHODS:  This was an exploratory phenomenological study that included one-on-one interviews with 12 individuals at Temba Community Health Centre in Pretoria, South Africa. RESULTS:  The research revealed five themes: perceptions of COVID-19 disease, perceptions of COVID-19 vaccine, factors related to non-vaccination, information sources about the COVID-19 vaccine, and long-term vaccination decisions. There were seven linked sub-themes. CONCLUSION:  Overall, participants had a good understanding of COVID-19 disease, but limited knowledge about the vaccine, causing hesitancy to get vaccinated. Reasons for not getting vaccinated included health-related concerns, safety concerns, personal experiences, and social and political factors. Safety and health-related concerns were prevalent, with adverse vaccine outcomes being the most common concern. Most participants had experienced a historic encounter with a vaccine-related death or illness.Contribution: Vaccine hesitancy should be viewed as a powerful concern from the community, and a key source of worry for the health authorities over any vaccine-related doubt.

Assessing vaccine hesitancy among healthcare providers in Brazil: the influence of vaccine status and professional experience.

OBJECTIVE: Assess the occurrence of vaccine hesitancy among pediatricians and their patients and identify potential predictors to mitigate hesitancy among them. METHODS: The study is a cross-sectional survey using an online questionnaire sent to pediatricians affiliated with the Brazilian Society of Pediatrics. The data was analyzed using statistical methods such as exploratory factor analysis, principal component analysis, correspondence analysis, and generalized linear mixed models. RESULTS: A total of 982 respondents, with a majority being females (77.4%), participated in the research. Among them, the proportion of pediatricians with complete vaccine status was 41.14%, while 90.6% had undergone medical residency. Furthermore, 9.3% worked in public healthcare settings, 30.4% in private settings, and 60.3% in mixed healthcare settings. The analysis revealed a significant association between vaccine status and pediatricians' misconceptions about COVID-19 vaccines, with those having complete vaccine status showing lower misconceptions (mean difference of -0.15, p = 0.010). Moreover, pediatricians with medical residency experience exhibited fewer misconceptions about COVID-19 vaccines (mean difference of -0.33, p = 0.002). Additionally, correspondence analysis unveiled the presence of two distinct profiles among pediatricians, showcasing variations in vaccine education, professional experience, and vaccine confidence perceptions. CONCLUSION: The study highlights the influence of vaccine status and medical residency experience on pediatricians' attitudes and misconceptions about vaccines, emphasizing the need for targeted educational interventions to promote vaccine confidence and combat hesitancy within the healthcare provider community.

Evidence brief on facilitators, barriers and hesitancy of COVID-19 booster doses in Canada.

Background: Understanding the facilitators, barriers and hesitancy to accepting COVID-19 booster doses is important for encouraging recommended vaccination. This evidence brief summarizes literature on the intention to accept or reject COVID-19 vaccine booster doses and the factors associated with intention/uptake among individuals in Canada. Methods: A database of COVID-19 literature established at the Public Health Agency of Canada was searched for articles referencing vaccination and knowledge, attitudes and behaviours towards COVID-19 boosters. A grey literature search of Canadian governmental and academic institutions was also conducted. Primary research conducted in Canada (n=21) and relevant systematic reviews of the global literature (n=8) were included in this evidence brief. Results: Intentions to get a booster dose in the general population have decreased between 2021-2023, with intentions varying across subpopulations. In Canada and within the global systematic reviews, facilitators, barriers and hesitancy were similar. Older age was the most common factor positively associated with intention/uptake of a booster, and the most common motivators were government/healthcare provider recommendations and helping to protect others. The main reasons for hesitancy were concerns about vaccine side effects and a lack of belief in the vaccine's efficacy. Conclusion: Intentions to get a booster dose have decreased in Canada. Understanding the reasons for vaccine hesitancy and motivators for obtaining a booster can help guide future public health COVID-19 booster vaccination programs.

Moral values and vaccination behavior in Russia during the COVID-19 pandemic.

OBJECTIVE: Effective persuasive communication necessitates message matching; the conveyed message should resonate with the recipient's characteristics, including individual moral values. While studies examining the relationship between moral values and vaccination behavior have been conducted in a limited number of countries, this study seeks to provide evidence on this relationship beyond Western democracies. METHODS: A cross-sectional online survey was conducted from November 4 to December 17, 2021, in Russia. Participants reported their COVID-19 vaccination behavior and completed the Moral Foundations Questionnaire, designed to measure the endorsement of moral values (n = 415). Regression analysis was employed to assess the association between each moral foundation and COVID-19 vaccination behavior. RESULTS: Our findings indicate that the moral foundations of Care, Loyalty, Fairness, and Sanctity significantly influence vaccination behavior. Individuals who strongly endorse Fairness (AME = -0.019; 95 % CI = -0.033, -0.005) and Sanctity (AME = -0.016; 95 % CI = -0.031, -0.002) were less likely to be vaccinated. Conversely, individuals endorsing Care (AME = -0.018; 95 % CI = -0.031, -0.005) and Loyalty (AME = -0.015; 95 % CI = -0.028, -0.001) were less likely to report refusal of vaccination. These results remain robust after adjusting for sociodemographic variables related to vaccination barriers. CONCLUSION: Our findings carry public health implications; an understanding of the moral psychology underlying vaccination behavior can facilitate more targeted and effective health communication. Employing skillfully crafted moral appeals may mitigate negative attitudes toward vaccination and enhance vaccination rates.

'Is It Safe? Is it not?' A Youth-Led Photovoice Study of Youth Perspectives of COVID-19 Vaccine Confidence.

BACKGROUND: Youth have been uniquely affected by the COVID-19 pandemic. Despite high rates of COVID-19 infection, youth had one of the lowest vaccine uptake rates. Certain characteristics can affect vaccine uptake, such as mental health and substance use, but it is important to understand uptake for an effective response to pandemics. OBJECTIVE: This study examined the perspectives of youth with mental health or substance use concerns on COVID-19 vaccine confidence, hesitancy and overall COVID-19 vaccine perspectives. METHODS: Using photovoice, a community-based participatory research method, a sample of 27 youth aged 14-24 years participated in a series of photography workshops and focus groups. Participants submitted final photographs for discussion. Focus groups were recorded, transcribed and thematically analysed. RESULTS: Four themes were generated: (1) Youth deciphered the vaccine discourse in a changing information landscape; (2) mixed perspectives of families, friends and loved ones influenced the vaccine journey; (3) complex societal influences affected views and decisions around the COVID-19 vaccine; and (4) youth navigated their vaccine journeys through first- and second-hand experiences. The four themes and subthemes highlight the evolution of youth's journeys with the COVID-19 vaccine over the course of the pandemic and into the late-pandemic period. CONCLUSIONS: Youth with mental health or substance use challenges navigated a complex environment during the COVID-19 pandemic. The wide variety of factors influencing vaccine perspectives should be taken into account in public health messaging and future research on youth vaccine uptake. Youth-led and youth-engaged research can help solicit rich and meaningful perspectives of young people on important public health issues. PATIENT OR PUBLIC CONTRIBUTION: This was a youth-led study. A youth research analyst conducted the study activities together with the support of a youth advisory group, an adult photographer with lived experience, and a scientific team.

Predicting herd immunity achievement: a time-series analysis of vaccination and fatality rates using 1,075 days of COVID-19 data.

Introduction: The COVID-19 pandemic, driven by SARS-CoV-2, has made vaccination a critical strategy for global control. However, vaccine hesitancy, particularly among certain age groups, remains a significant barrier to achieving herd immunity. Methods: This study uses Poisson regression and ARIMA time-series modeling to identify factors contributing to vaccine hesitancy, understand age-specific vaccination preferences, and assess the impact of bivalent vaccines on reducing hesitancy and fatality rates. It also predicts the time required to achieve herd immunity by analyzing factors such as vaccine dosing intervals, age-specific preferences, and changes in fatality rates. Results: The study finds that individuals recovering from COVID-19 often delay vaccination due to perceived immunity. There is a preference for combining BNT162b2 and CoronaVac vaccines. The BNT162b2 bivalent vaccine has significantly reduced vaccine hesitancy and is linked with lower fatality rates, particularly in those aged 80 and above. However, it tends to induce more severe side effects compared to Sinovac. Vaccine hesitancy is most prevalent among the youngest (0-11) and oldest (80+) age groups, posing a challenge to reaching 90% vaccination coverage. Conclusion: Vaccine hesitancy is a major obstacle to herd immunity. Effective strategies include creating urgency, offering incentives, and prioritizing vulnerable age groups. Despite these challenges, the government should have continued to encourage vaccinations while gradually lifting COVID-19 control measures, balancing public health safety with the return to normal life, as was observed in the transition period during the latter stages of the pandemic.

Assessing vaccinated persons' intention to take the COVID-19 boosters using a combined theoretical framework: an online survey in Egypt.

Vaccines, like the Corona Virus Disease-2019 (COVID-19) vaccines, can control diseases, but vaccine hesitancy reduces their use. It is important to assess the intention to use COVID-19 vaccines boosters and the determinants of this intention to help in developing programs to promote the uptake of boosters. An online survey collected data from adults in Egypt between March and June 2022 using a questionnaire that assessed demographic characteristics, and constructs of the Theory of Planned Behaviour (TPB) and the Health Belief Model (HBM). The survey was uploaded to SurveyMonkey and the links were posted on social media platforms. Binary regression analysis was used and the dependent variable was intention to use boosters of COVID-19 vaccines. The independent variables were indicators of the HBM including perceived susceptibility to COVID-19 infection (medical history) and possibility of disease prevention (awareness of the availability of types of COVID-19 vaccines); and indicators of the TPB including attitude toward COVID-19 vaccines (that they are harmful, that they may lead to death and confidence in locally and foreign manufactured vaccines), perceived norms (the percentage of vaccinated persons in one's circle) and perceived control over booster uptake (presence of government mandates for COVID-19 vaccination). The confounders were sociodemographic factors (age, sex, education, and place of residence). Complete responses were available from 1113 out of 1401 participants (79.4%), with mean (SD) age = 25 (9.5) years, of whom, 66.7% (n = 742) were females and 68.6% (n = 764) were university students. About 39.4% and 31.2% indicated that they would get or would definitely get the booster dose of the COVID-19 vaccines. In multiple regression, intention to use a booster dose was significantly related to not agreeing (AOR = 4.87, P < 0.001) or not agreeing at all (AOR = 8.46, P = 0.001) that vaccines are harmful and to having no confidence (AOR = 0.21, P < 0.001) or no confidence at all (AOR = 0.14, P < 0.001) in foreign-manufactured vaccines. Most university-educated Egyptians in the study intended to take the COVID-19 vaccine booster dose and this intention was associated with attitude toward the harm of the vaccine and confidence in foreign-manufactured vaccines. Awareness campaigns are needed to counteract misinformation and promote booster dose uptake.

Drivers and barriers of seasonal influenza vaccination 2015/16 & 2019/20 to 2022/23 - a survey on why most Norwegians don't get the flu vaccine.

BACKGROUND: This study aimed to explore the reasons adults in the general population, influenza risk groups (RGs) and health care workers (HCWs) in Norway give for their vaccination choices and whether these reasons vary between groups or over time in order to further improve influenza vaccination coverage. METHODS: Respondents of a nationally representative telephone survey conducted by Statistics Norway were asked "What was the most important reason why you did/did not get vaccinated?". The question on influenza non-vaccination was included in 2016 and in 2020 to 2023 and the question on influenza vaccination in 2021 to 2023. RESULTS: The study included 9 705 individuals aged 18-79 years. Influenza vaccination coverage in the RGs increased from 20.6% in 2016 to 63.1% in 2022, before a reduction to 58.3% in 2023. Common reasons for non-vaccination were similar in all groups. The most cited reasons were "no need" for the vaccine and "no specific reason", followed by "not recommended/offered the vaccine", "worry about side effects" and "vaccine refusal". The most frequent reasons for vaccination among the general population and RGs were protection against influenza and belonging to a RG, while the most frequent responses among HCWs were being offered the vaccine at work/work in health care, followed by a desire for protection against influenza. Receiving a vaccine recommendation from a health professional was mentioned in all groups. We also observed that the proportion reporting "no need" for the vaccine decreased over time, especially among HCWs, and that the proportions reporting vaccine refusal and worry about side effects as reasons for non-vaccination were temporarily reduced during the COVID-19 pandemic. CONCLUSIONS: The general population and RGs cite protection against influenza as their primary incentive for vaccination, while HCWs mainly refer to their professional role or workplace vaccination. For non-vaccination we see a similar pattern in all groups, with "no need" and "no specific reason" as the main reasons. Of note, worry about side effects and vaccine refusal is as frequent among HCWs as in other groups. Continued efforts to maintain and increase vaccine confidence are needed.

Factors that shape COVID-19 pediatric vaccine decision-making in rural agricultural communities: A qualitative study.

While COVID-19 immunizations can improve outcomes from SARS-CoV-2, vaccine rates in the United States have been lowest among children under age 11 and among rural agricultural communities. This study examined factors influencing pediatric COVID-19 vaccine uptake among rural agricultural and predominantly Hispanic communities in Washington State. We conducted in-depth interviews with school district employees and students and held English and Spanish focus group discussions with parents, all of which were audio-recorded and transcribed. We used inductive coding with constant comparison approach to capture emergent themes. We identified five factors that influenced pediatric COVID-19 vaccine uptake in a rural community, including: 1) concerns and misinformation surrounding the new vaccine; 2) witnessing others' vaccine and pandemic experiences; 3) participation in social activities; 4) politicization of and political climate surrounding the vaccine; and 5) health education surrounding the vaccines. To increase pediatric COVID-19 vaccine uptake in rural communities, school districts, students, and parents should receive accurate information and reassurance to dispel health concerns and misinformation, without politicization of the vaccine and fears surrounding vaccine regulations. Social networks can be leveraged to encourage vaccine uptake by sharing positive vaccination vignettes. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04859699https://clinicaltrials.gov/ct2/show/NCT04859699.

Factors Associated with Parents' COVID-19 Vaccination Decisions for Their Children in an Economically Marginalized, Diverse Community.

COVID-19 vaccine hesitancy is a significant public health concern, particularly among parents who serve as gatekeepers for their child(ren)'s vaccination status. This study adds to the literature by examining COVID-19 vaccine decisions among parents living in a mid-size, lower-income, racially/ethnically diverse, community. Parents of children, < 18 years and enrolled in the public schools system, were invited to complete a questionnaire offered in English, Spanish, and Portuguese. The questionnaire included questions about their child(ren)'s vaccination status, as well as factors which, based on the literature, might impact parents' vaccination decisions. Parents (n = 277) were mostly Hispanic/Latinx, females, with a high school degree/GED as their highest level of education achieved, a mean age of 40 years, and an average of two children < 18 years. Four-fifths (78.6%) of parents reported being vaccinated against COVID-19, but only 40.8% reported having all of their children vaccinated; 14.8% had some of their children get the COVID-19 vaccine, and 44.4% had none of their children get the COVID-19 vaccine. In bivariate associations, parents' vaccination status, parents age, the CDC website as a COVID-19 information source, awareness of age eligibility for the COVID-19 vaccine, parents reporting knowing someone who does not want to vaccinate their child, and parents' perceived social norm score were associated with children's vaccination status. However, when multivariate analyses were conducted, only parents' age and perceived social norms increased parents' odds of choosing to vaccinate their child. These findings have implications for those promoting COVID-19 vaccination among parents in lower-income, diverse communities.

Do social media epistemological beliefs and health perception impact parents' vaccine hesitancy? A mediation analysis.

In recent years, there has been a notable increase in vaccine hesitancy among individuals. It is crucial to identify the factors contributing to vaccine hesitancy to effectively address this issue. This study aims to investigate the impact of social media-specific epistemological beliefs on vaccine hesitancy and the mediating role of health perception in this impact. This study is a cross-sectional study conducted with 444 parents. Data were collected using the Personal Information Form, the Social Media-Specific Epistemological Beliefs Scale, the Perception of Health Scale, and the Vaccine Hesitancy Scale. When there is no mediator variable, the total effect of social media-specific epistemological beliefs on vaccine hesitancy is statistically significant (ß = -0.219, p < 0.001). However, it was found that health perception did not mediate the relationship between social media-specific epistemological beliefs and vaccine hesitancy (ß = 0.0038, 95% confidence interval (-0.0090, 0.0205)). Furthermore, it was determined that social media-specific epistemological beliefs positively predicted health perception (ß = 0.136, p < 0.01). Health perception was found to have no significant effect on vaccine hesitancy (ß = 0.028, p > 0.05). It can be concluded that social media-specific epistemological beliefs negatively predict vaccine hesitancy, and this effect is independent of health perception. Primary healthcare professionals should consider incorporating interventions aimed at enhancing individuals' social media-specific epistemological beliefs into their health education programs related to vaccines.

Vaccination hesitancy: agreement between WHO and ChatGPT-4.0 or Gemini Advanced.

Background: An increasing number of individuals use online Artificial Intelligence (AI) - based chatbots to retrieve information on health-related topics. This study aims to evaluate the accuracy in answering vaccine-related answers of the currently most commonly used, advanced chatbots - ChatGPT-4.0 and Google Gemini Advanced. Methods: We compared the answers provided by the World Health Organization (WHO) to 38 open questions on vaccination myths and misconception, with the answers created by ChatGPT-4.0 and Gemini Advanced. Responses were considered as "appropriate", if the information provided was coherent and not in contrast to current WHO recommendations or to drug regulatory indications. Results and Conclusions: The rate of agreement between WHO answers and Chat-GPT-4.0 or Gemini Advanced was very high, as both provided 36 (94.7%) appropriate responses. The few discrepancies between WHO and AI-chatbots answers could not be considered "harmful", and both chatbots often invited the user to check reliable sources, such as CDC or the WHO websites, or to contact a local healthcare professional. In their current versions, both AI-chatbots may already be powerful instrument to support the traditional communication tools in primary prevention, with the potential to improve health literacy, medication adherence, and vaccine hesitancy and concerns. Given the rapid evolution of AI-based systems, further studies are strongly needed to monitor their accuracy and reliability over time.

The Impact of Video-Based Educational Intervention on Parents' Decision to Uptake the Measles-Rubella (MR) Vaccine in Jordan.

BACKGROUND: Interventions are needed to decrease measles and rubella (MR) vaccine hesitancy/refusal among Jordanian parents during the implementation campaign in Jordan by 2023. This study developed an educational video for parents with hesitancy or refusal to enhance their attitudes and decisions toward the MR vaccine. OBJECTIVE: This study aimed to assess the impact of video-based educational intervention on the attitudes of parents toward the MR vaccine and the decision to accept the MR vaccine. METHOD: One group pretest-posttest experimental design was used. A 5-min MR vaccine education video was shown to parents. Parents' decisions on the MR vaccine and the parent attitudes about childhood vaccines (PACV) scale were collected before, immediately, and 2 weeks after the video, the differences in the scores were also measured. RESULTS: The initial PACV scale score averaged 24 ± 1.5. After watching the MR education video, the PACV scores immediately and after 2 weeks were 21 ± 1.6 and 21.8 ± 1.4, respectively, with a statistically significant difference (p value < 0.05). The parents' likelihood of refusing the MR vaccine decreased immediately and 2 weeks after watching the video (68% and 70.5%; respectively), and this decrease was sustained after 2 weeks (p value = 0.617). CONCLUSION: An educational video intervention was associated with improved PACV and improved parents' attitudes toward the MR vaccine, potentially altering the decisions of hesitant or refusing parents to accept the vaccine during the 2023 MR vaccine campaign in Jordan. These positive effects appeared to persist even 2 weeks after the intervention.

Association between parental vaccine hesitancy and geographical coverage for childhood vaccination: A cross-sectional study.

BACKGROUND: The aim of this study was to explore the relationship between parental vaccine hesitancy and vaccine coverage for all recommended vaccines for children under five years residing in Statistical Areas Level 3 (SA3). SA3 groupings represent clustering groups of smaller areas, such as regional towns and cities or clusters of related suburbs, which share similar regional characteristics, administrative boundaries or labour markets, and generally have populations between 30,000 and 130,000 persons. METHODS: We used parental vaccine hesitancy data from the VBAT (Vaccine Barrier Assessment Tool) study and vaccine coverage by postcode data from the Australian Immunisation Coverage Report 2020/21. Binary logistic regression analysis explored the association. RESULTS: There were complete data for 1110 participants. We found lower vaccine concerns in parents residing in medium coverage (adjusted odds ratio (aOR) 0.36, 95 % confidence interval (CI): 0.22 to 0.59) and high coverage (aOR 0.37, 95 % CI: 0.22 to 0.60) SA3 areas compared to low coverage geographical areas. CONCLUSIONS: Developing effective policies to vaccinate children under five in low coverage areas will help reduce vaccine inequity in Australia. Future strategies to improve vaccine coverage should consider ways to address both access and acceptance barriers.

The intention of Egyptian healthcare workers to take the monkeypox vaccine: is urgent action required?

BACKGROUND: In light of the ongoing monkeypox (MPOX) epidemic, healthcare workers (HCWs) have been in contact with various diseases. Therefore, they should take appropriate preventive and control measures to maintain their health. This study assessed Egyptian HCWs' intentions to take MPOX vaccines. METHODS: A cross-sectional survey was conducted using social media platforms between September 27 and November 4, 2022. An anonymous online survey using the 5C scale was conducted using convenience and snowball sampling methods to assess the five psychological antecedents of vaccination (i.e., confidence, constraints, complacency, calculation, and collective responsibility). RESULTS: A total of 399 HCWs with a mean age of 32.6 ± 5.7 participated in this study. Of them, 89.7% were female. The five C psychological antecedents of vaccination were as follows: 55.9% were confident about vaccination, 50.6% were complacent, 56.6% experienced constraints, 60.7% calculated the risk and benefit, and 58.4% had collective responsibility. Multivariate analysis showed that high income level and having information about MPOX were significant predictors of confidence in the MPOX vaccines (adjusted odds ratio ((AOR) = 4.19, 95% CI (1.12- 15.59), P = 0.032). Participants aged 31-45 years and 19-30 years showed significant association (AOR = 2.46, 95% CI (0.85-7.15), P = 0.096) and (AOR = 4.19, 95% CI (1.39-12.64), P = 0.011), respectively. Having an idea about the MPOX vaccines significantly predicted the complacency domain (AOR = 3.77, 95%CI (1.47-9.65, P = 0.006). Moreover, precollege/undergraduate education and having an idea about MPOX vaccination were significant predictors of the constraint domain (AOR = 1.81.95% CI (1.09-2.99, P = 0.020), (AOR = 2.70, 95% CI (1.05-6.95, P = 0.038), respectively). Female sex, having a diploma, postgraduate studies, and having an idea about MPOX vaccine significantly predicted calculation domain (AOR = 2.06, 95% CI (1.05-4.04, P = 0.035), (AOR = 3.98,95% CI (1.33-11.87, P = 0.013), (AOR = 2.02, 95% CI (1.25-3.26, P = 0.004) & (AOR = 2.75. 95% CI (1.05-7.18, P = 0.039), respectively. The only significant predictor of collective responsibility was having a diploma and postgraduate studies (AOR = 3.44, 95% CI (1.21-9.78, P = 0.020), (AOR = 1.90,95% CI (1.17-3.09, P = 0.009). CONCLUSIONS: Efforts to control MPOX should focus on promoting protective measures such as the vaccination of HCWs as well as raising their awareness about the updated information regarding the virus and the approved vaccines.

Understanding COVID-19 vaccine hesitancy of different regions in the post-epidemic era: A causality deep learning approach.

Objective: This paper aims to understand vaccine hesitancy in the post-epidemic era by analyzing texts related to vaccine reviews and public attitudes toward three prominent vaccine brands: Sinovac, AstraZeneca, and Pfizer, and exploring the relationship of vaccine hesitancy with the prevalence of epidemics in different regions. Methods: We collected 165629 Twitter user comments associated with the vaccine brands. The comments were labeled based on willingness and attitude toward vaccination. We utilize a causality deep learning model, the Bert multi-channel convolutional neural network (BertMCNN), to predict users' willingness and attitude mutually. Results: When applied to the provided dataset, the proposed BertMCNN model demonstrated superior performance to traditional machine learning algorithms and other deep learning models. It is worth noting that after March 2022, the public was more hesitant about the Sinovac vaccines. Conclusions: This study reveals a connection between vaccine hesitancy and the prevalence of the epidemic in different regions. The analytical results obtained from this method can assist governmental health departments in making informed decisions regarding vaccination strategies.

Interventions to Reduce COVID-19 Vaccine Hesitancy among Black and African American Individuals in the United States: A Systematic Literature Review.

COVID-19 vaccine hesitancy had major implications for racial health equity at the beginning of the vaccination campaign in the U.S. Interventions to reduce vaccine hesitancy among Black and African American individuals partially helped to reduce vaccine hesitancy in specific communities. This article describes findings on interventions to reduce COVID-19 vaccine hesitancy among Black and African American individuals from a literature review we conducted. We found 12 studies that described communication, partnerships, and distribution interventions. Regarding communication, examples include a webinar hosted by an academic-community partnership team, information sessions, social media campaigns, educational materials, and virtual town halls. Effective partnerships identified through this literature review were a statewide alliance and one between an academic institution and faith and community leaders. Distribution interventions identified through the literature review were the deployment of multiple tactics to increase COVID-19 vaccine uptake (virtual town halls, a confidential employee hotline, department huddles, written educational material, and accessible vaccination stations) and offering to administer the COVID-19 vaccine during medical appointments. The results of this review show that implementing interventions directed at specific minority groups improves COVID-19 vaccine acceptance without undermining overall vaccine distribution or uptake.