Medical and dental student knowledge about COVID-19 and influenza vaccines impact opinions about vaccine advocacy and future practice.

Introduction: The World Health Organization has identified vaccine hesitancy as a global public health challenge. Healthcare providers are among the most influential and trusted figures for vaccine counseling. This article focuses on COVID-19 and influenza personal immunization behaviors, vaccine knowledge and opinions, and vaccine counseling confidence among future healthcare providers - dental and medical students. Methods: A cross-sectional anonymous online survey was conducted at four dental schools and one allopathic medical school in the United States. Items included personal vaccination status for the COVID-19 and influenza vaccines and vaccine-specific items developed based on past research to assess knowledge, opinions, and behaviors. Results: Two hundred and thirty-two medical and 221 dental students completed the survey. 68 and 55% scored average/above-average knowledge on COVID-19 and influenza vaccine items, respectively. There were significant differences between those with average/above-average and below-average knowledge scores regarding learning about, recommending, and advocating for vaccines and counseling vaccine-hesitant patients for both vaccines (p < 0.0001). Although higher-knowledge students had higher vaccination rates (p < 0.0001), many had insufficient knowledge about vaccines. Discussion: Healthcare providers play a crucial role in vaccine advocacy. The identified knowledge gaps are significant as they impact quality of patient care. And opinions about future vaccination practice such as recommending, providing, and counseling about vaccines. Equipping students with knowledge and communication skills will enable them to be strong vaccine advocates to improve overall public health.

Oral healthcare providers play a vital role in vaccination efforts: Patient perspectives.

OBJECTIVES: Human papillomavirus (HPV) is associated with 70% of oropharyngeal squamous cell carcinomas. Coronavirus disease 2019 (COVID-19) is the infectious cause of a global pandemic that killed millions worldwide. Effective vaccinations exist against both diseases, but patient acceptance remains a challenge. The objective of this study was to assess patients' attitudes toward oral healthcare providers' (OHCPs) roles in HPV and COVID-19 vaccinations. METHODS: A cross-sectional survey of young adult patients was distributed in Philadelphia, PA, between April and June 2021. The survey assessed knowledge and attitudes around OHCPs serving various roles in COVID-19 and HPV vaccination. RESULTS: Nearly 70% of 163 respondents would accept the recommendation for a COVID-19 vaccine from an OHCP, while 56% would for HPV. Those previously vaccinated against COVID-19 were more comfortable discussing COVID-19 vaccines (92%, p < .001) or HPV vaccines (76%, p < .001) with OHCPs compared to those who were unvaccinated against COVID-19. African American/Black patients were less comfortable discussing vaccines, irrespective of vaccination status. CONCLUSIONS: OHCP can play a vital role in increasing the overall COVID-19 and HPV vaccination status of the public, as demonstrated by the high acceptance of dental involvement in both vaccine campaigns. Racial disparity in vaccination attitude is a public health challenge that needs to be addressed.

Characterizing discourses about COVID-19 vaccines on Twitter: a topic modeling and sentiment analysis approach.

BACKGROUND: Evidence-based health communication is crucial for facilitating vaccine-related knowledge and addressing vaccine hesitancy. To that end, it is important to understand the discourses about COVID-19 vaccination and attend to the publics' emotions underlying those discourses. METHODS: We collect tweets related to COVID-19 vaccines from March 2020 to March 2021. In total, 304,292 tweets from 134,015 users are collected. We conduct a Latent Dirichlet Allocation (LDA) modeling analysis and a sentiment analysis to analyze the discourse themes and sentiments. RESULTS: This study identifies seven themes of COVID-19 vaccine-related discourses. Vaccine advocacy (24.82%) is the most widely discussed topic about COVID-19 vaccines, followed by vaccine hesitancy (22.29%), vaccine rollout (12.99%), vaccine facts (12.61%), recognition for healthcare workers (12.47%), vaccine side effects (10.07%), and vaccine policies (4.75%). Trust is the most salient emotion associated with COVID-19 vaccine discourses, followed by anticipation, fear, joy, sadness, anger, surprise, and disgust. Among the seven topics, vaccine advocacy tweets are most likely to receive likes and comments, and vaccine fact tweets are most likely to receive retweets. CONCLUSIONS: When talking about vaccines, publics' emotions are dominated by trust and anticipation, yet mixed with fear and sadness. Although tweets about vaccine hesitancy are prevalent on Twitter, those messages receive fewer likes and comments than vaccine advocacy messages. Over time, tweets about vaccine advocacy and vaccine facts become more dominant whereas tweets about vaccine hesitancy become less dominant among COVID-19 vaccine discourses, suggesting that publics become more confident about COVID-19 vaccines as they obtain more information.

Mpox Perceptions and Vaccine Advocacy among the Healthcare Workers of Solid Organ Transplant Centers: A Multicenter, Cross-Sectional Survey in Saudi Arabia.

BACKGROUND: In response to the global Mpox outbreaks, this survey aimed to assess the knowledge, perceptions, and advocacy of Mpox vaccines among solid organ transplant healthcare workers (HCWs) in Saudi Arabia. METHODS: A cross-sectional survey was conducted among solid organ transplant HCWs in Saudi Arabia from 15 August to 5 September 2022. A total of 199 responses were received from participants primarily working in the kidney (54.8%) and liver (14.6%) transplant units. RESULTS: The survey found that most participants were aware of the 2022 Mpox outbreak, but the majority were more concerned about COVID-19 than Mpox. While the majority of participants thought laboratory personnel and HCWs in direct contact with Mpox patients should receive the vaccine, less than 60% believed that all HCWs should be vaccinated. Additionally, over half of the participants lacked knowledge of animal-human transmission of the virus. CONCLUSION: The results highlight the need for increased education on Mpox among transplant HCWs in Saudi Arabia, particularly regarding the virus's transmission dynamics and vaccines. This education is crucial to improve HCWs' understanding of this emerging disease, especially given their vulnerability during the COVID-19 pandemic.

Experiencing herd immunity in virtual reality increases COVID-19 vaccination intention: Evidence from a large-scale field intervention study.

This study investigates the impact of an immersive virtual reality (VR) simulation of herd immunity on vaccination intentions and its potential underlying mechanisms. In this preregistered field study, N = 654 participants were randomly assigned to one of the three VR conditions: (1) Gamified Herd Immunity; (2) Gamified Herd Immunity + Empathy (with additional narrative elements); (3) Control (gamified with no vaccination-related content). In the Gamified Herd Immunity simulation, participants embodied a vulnerable person and navigated a wedding venue trying to avoid getting infected. A total of 455 participants with below maximum intentions to take a novel vaccine and without severe cybersickness were analyzed. The Gamified Herd Immunity + Empathy and the Gamified Herd Immunity conditions increased vaccination intentions by 6.68 and 7.06 points on a 0-100 scale, respectively, compared to 1.91 for the Control condition. The Gamified Herd Immunity + Empathy condition enhanced empathy significantly more than the Gamified Herd Immunity condition but did not result in higher vaccination intentions. Experienced presence was related to the change in vaccination intentions. The results suggest that VR vaccination communication can effectively increase vaccination intentions; the effect is not solely due to the technological novelty and does not depend on empathy.

Are we saying it right? Communication strategies for fighting vaccine hesitancy.

Vaccine hesitancy is a multi-faceted phenomenon, deeply rooted in cultural, socioeconomic and personal background. Communication is deemed fundamental in fighting vaccine hesitancy. Medical communication should be accessible, relying both on an emotional approach and accurate information. Trained professionals should curate communication with the public.

Caregiver perceptions of the broader societal benefits of vaccination: A path toward sustainable vaccine advocacy in India.

Over the last decade growing public health evidence suggests that, in addition to health-related benefits, there are also social and economic benefits of vaccination. Research to understand how caregivers in low-and-middle-income countries perceive these social and economic benefits, or if these benefits factor into their vaccination decisions for their children, has been limited. Leveraging qualitative strategies to gain more nuanced insights into caregiver perceptions of vaccination benefits has also been significantly underexplored. We conducted in-depth interviews with 13 caregivers of children, at which point we reached saturation, in Mewat District, Haryana, an area in India with low vaccination coverage. Interview results suggest that caregivers of children associate positive health outcomes with vaccination programs, and some additional social and economic benefits beyond improved health outcomes. Caregivers also shared how local advocacy and gaps in vaccination programs can affect their perceptions of vaccination benefits. Qualitatively exploring the perceived benefits provides a unique understanding of the value that caregivers assign to vaccination and complements existing knowledge on factors that dissuade caregivers from vaccination. These insights will allow researchers to better identify and design context-specific advocacy strategies to strengthen vaccination programs in communities with low vaccine uptake and acceptance.

A self-administered virtual reality intervention increases COVID-19 vaccination intention.

Effective interventions for increasing people's intention to get vaccinated are crucial for global health, especially considering COVID-19. We devised a novel intervention using virtual reality (VR) consisting of a consultation with a general practitioner for communicating the benefits of COVID-19 vaccination and, in turn, increasing the intention to get vaccinated against COVID-19. We conducted a preregistered online experiment with a 2×2 between-participant design. People with eligible VR headsets were invited to install our experimental application and complete the ten minute virtual consultation study at their own discretion. Participants were randomly assigned across two age conditions (young or old self-body) and two communication conditions (with provision of personal benefit of vaccination only, or collective and personal benefit). The primary outcome was vaccination intention (score range 1-100) measured three times: immediately before and after the study, as well as one week later. Five-hundred-and-seven adults not vaccinated against COVID-19 were recruited. Among the 282 participants with imperfect vaccination intentions (<100), the VR intervention increased pre-to-post vaccination intentions across intervention conditions (mean difference 8.6, 95% CI 6.1 to 11.1,p<0.0001). The pre-to-post difference significantly correlated with the vaccination intention one week later, ρ=0.20,p<0.0001. The VR intervention was effective in increasing COVID-19 vaccination intentions both when only personal benefits and personal and collective benefits of vaccination were communicated, with significant retention one week after the intervention. Utilizing recent evidence from health psychology and embodiment research to develop immersive environments with customized and salient communication efforts could therefore be an effective tool to complement public health campaigns.

Vaccination as a social contract.

Most vaccines protect both the vaccinated individual and the society by reducing the transmission of infectious diseases. In order to eliminate infectious diseases, individuals need to consider social welfare beyond mere self-interest-regardless of ethnic, religious, or national group borders. It has therefore been proposed that vaccination poses a social contract in which individuals are morally obliged to get vaccinated. However, little is known about whether individuals indeed act upon this social contract. If so, vaccinated individuals should reciprocate by being more generous to a vaccinated other. On the contrary, if the other doesn't vaccinate and violates the social contract, generosity should decline. Three preregistered experiments investigated how a person's own vaccination behavior, others' vaccination behavior, and others' group membership influenced a person's generosity toward respective others. The experiments consistently showed that especially compliant (i.e., vaccinated) individuals showed less generosity toward nonvaccinated individuals. This effect was independent of the others' group membership, suggesting an unconditional moral principle. An internal metaanalysis (n = 1,032) confirmed the overall social contract effect. In a fourth experiment (n = 1,212), this pattern was especially pronounced among vaccinated individuals who perceived vaccination as a moral obligation. It is concluded that vaccination is a social contract in which cooperation is the morally right choice. Individuals act upon the social contract, and more so the stronger they perceive it as a moral obligation. Emphasizing the social contract could be a promising intervention to increase vaccine uptake, prevent free riding, and, eventually, support the elimination of infectious diseases.

How baby's first shot determines the development of maternal attitudes towards vaccination.

BACKGROUND: The attitude towards vaccination is a major determinant of vaccination behavior; this also includes parents' attitudes towards the immunization of their child. Negative attitudes have been associated with vaccine hesitancy and outbreaks of infectious diseases throughout the globe. This study aimed to assess how and why attitudes become more pro-vaccine or vaccine-skeptical over time, and which sources are especially influential in this process. METHODS: Prospective cohort study with measurements at time of recruitment during pregnancy and at +3, +6 and +14 months after childbirth with cross-sectional control groups. In total, 351 women entered the longitudinal analyses, while 204, 215 and 173 women were recruited in the cross-sectional control groups, respectively. Inclusion criteria were: (i) being at least 18 years of age, (ii) pregnant, (iii) primigravida, and (iv) living in Germany. RESULTS: During pregnancy mothers reported rather positive prior experiences with vaccinations. However, their judgment turned significantly more negative after the first vaccination experience with their child. Mixed-effects models showed that these changes were significantly related to increased risk perceptions and concerns about vaccination, which then had a negative impact on the vaccination attitude. In contrast, gaining more vaccine-related knowledge over time positively influenced attitude formation. CONCLUSIONS: During the first year of their child's life maternal attitudes towards vaccination are formed and guide future decisions whether to vaccinate or not vaccinate a child. Strategies should be implemented that improve mothers' experiences when their newborn is vaccinated to prevent the development of vaccine hesitancy.

Advocating for efforts to protect African children, families, and communities from the threat of infectious diseases: report of the First International African Vaccinology Conference.

One means of improving healthcare workers' knowledge of and attitudes to vaccines is through running vaccine conferences which are accessible, affordable, and relevant to their everyday work. Various vaccinology conferences are held each year worldwide. These meetings focus heavily on basic science with much discussion about new developments in vaccines, and relatively little coverage of policy, advocacy, and communication issues. A negligible proportion of delegates at these conferences come from Africa, home to almost 40% of the global burden of vaccine-preventable diseases. To the best of our knowledge, no major vaccinology conference has ever been held on the African continent apart from World Health Organization (WHO) meetings. The content of the first International African Vaccinology Conference was planned to be different; to focus on the science, with a major part of discussions being on clinical, programmatic, policy, and advocacy issues. The conference was held in Cape Town, South Africa, from 8 to 11 November 2012. The theme of the conference was "Advocating for efforts to protect African children, families, and communities from the threat of infectious diseases". There were more than 550 registered participants from 55 countries (including 37 African countries). There were nine pre-conference workshops, ten plenary sessions, and 150 oral and poster presentations. The conference discussed the challenges to universal immunisation in Africa as well as the promotion of dialogue and communication on immunisation among all stakeholders. There was general acknowledgment that giant strides have been made in Africa since the global launch of the Expanded Programme on Immunisation in 1974. For example, there has been significant progress in introducing new and under-utilised vaccines; including hepatitis B, Haemophilus influenza type b, pneumococcal conjugate, rotavirus, meningococcal A conjugate, and human papillomavirus vaccines. In May 2012, African countries endorsed the Global Vaccine Action Plan at the World Health Assembly. However, more than six million children remain incompletely vaccinated in Africa leading to more than one million vaccine-preventable deaths annually. In addition, there are persistent problems with leadership and planning, vaccine stock management, supply chain capacity and quality, provider-parent communication, and financial sustainability. The conference delegates agreed to move from talking to taking concrete actions around children's health, and to ensure that African governments commit to saving children's lives. They would advocate for lower costs of immunisation programmes in Africa, perhaps through bulk buying and improved administration of vaccine rollout through the New Partnership for Africa's Development.

Influenza vaccines: an Asia-Pacific perspective.

This article provides an overview of some aspects of seasonal, pre-pandemic and pandemic influenza vaccines and initiatives aimed to increase influenza vaccine use within the Asia-Pacific region. Expanding the use of influenza vaccines in the Asia-Pacific region faces many challenges. Despite the recent regional history for the emergence of novel viruses, SARS, the H5N1 and H7N9, and the generation of and global seeding of seasonal influenza viruses and initiatives by WHO and other organisations to expand influenza awareness, the use of seasonal influenza vaccines remains low. The improvement in current vaccine technologies with the licensing of quadrivalent, live-attenuated, cell culture-based, adjuvanted and the first recombinant influenza vaccine is an important step. The development of novel influenza vaccines able to provide improved protection and with improved manufacturing capacity is also advancing rapidly. However, of ongoing concern are seasonal influenza impact and the low use of seasonal influenza vaccines in the Asia-Pacific region. Improved influenza control strategies and their implementation in the region are needed. Initiatives by the World Health Organization (WHO), and specifically the Western Pacific Regional Office of WHO, are focusing on consistent vaccine policies and guidelines in countries in the region. The Asian-Pacific Alliance for the Control of Influenza (APACI) is contributing through the coordination of influenza advocacy initiates.

Addressing heterogeneous parental concerns about vaccination with a multiple-source model: a parent and educator perspective.

Previous models of vaccine education have not addressed differences in levels and motives of vaccine concerns in parents. These differences may require changes in education approaches based on type of parental concern. Addressing vaccine concerns will require a multi-modal approach involving more than just a pediatrician or primary health care provider, as well as more than one educational approach.