Confidence in Vaccines

A special issue of Vaccines (ISSN 2076-393X).

Deadline for manuscript submissions: closed (31 January 2013) | Viewed by 68493

Special Issue Editors

Johns Hopkins School of Hygiene and Public Health, 615 N. Wolfe St., Ste. 5515, Baltimore, MD 21205, USA
Interests: optimizing the prevention of childhood infectious diseases through the use of vaccines
Special Issues, Collections and Topics in MDPI journals
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medical, London WC1E 7HT, UK
Interests: public trust in vaccines; socio-cultural and political determinants of vaccine acceptance; risk assessment of vaccine delivery strategies

Special Issue Information

Dear Colleagues,

Vaccines have been one of the greatest medical and public health achievements, greatly reducing disease and death from many once common childhood diseases. Memory of these diseases is often distant for parents, the public, and health care providers. Attention can shift from fear of these diseases to fear of the vaccines effectively used to prevent them. Mature immunization programs must maintain high rates of vaccine acceptance, often without circulating disease as a reminder, potentially indefinitely. Parental concerns about vaccine safety have resulted in reductions in vaccine coverage and consequent resurgence of disease in many countries with pertussis in the 1980’s and more recently with measles containing vaccines. Polio eradication efforts experienced a major setback as a result of refusal to be vaccination. Health care providers are considered the most credible source for vaccine information for most parents, however these diseases are a distant memory or a textbook chapter for many health care providers in the developed world. This special issue will focus on understanding, improving and sustaining confidence in vaccines. Articles will include original research and review articles on knowledge, attitudes and practices of parents, the public, and health care providers as well as editorials on what can and should be done to improve and sustain public confidence in vaccines.

Dr. Daniel A. Salmon
Dr. Heidi J. Larson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • vaccine acceptance
  • vaccine refusal
  • vaccine knowledge
  • vaccine attitudes,
  • vaccine beliefs
  • exemptions

Published Papers (8 papers)

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Research

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346 KiB  
Communication
A Multidisciplinary Research Agenda for Understanding Vaccine-Related Decisions
by Heidi Larson, Julie Leask, Sian Aggett, Nick Sevdalis and Angus Thomson
Vaccines 2013, 1(3), 293-304; https://doi.org/10.3390/vaccines1030293 - 18 Jul 2013
Cited by 52 | Viewed by 11775
Abstract
There is increasingly broad global recognition of the need to better understand determinants of vaccine acceptance. Fifteen social science, communication, health, and medical professionals (the “Motors of Trust in Vaccination” (MOTIV) think tank) explored factors relating to vaccination decision-making as a step to [...] Read more.
There is increasingly broad global recognition of the need to better understand determinants of vaccine acceptance. Fifteen social science, communication, health, and medical professionals (the “Motors of Trust in Vaccination” (MOTIV) think tank) explored factors relating to vaccination decision-making as a step to building a multidisciplinary research agenda. One hundred and forty seven factors impacting decisions made by consumers, professionals, and policy makers on vaccine acceptance, delay, or refusal were identified and grouped into three major categories: cognition and decision-making; groups and social norms; and communication and engagement. These factors should help frame a multidisciplinary research agenda to build an evidence base on the determinants of vaccine acceptance to inform the development of interventions and vaccination policies. Full article
(This article belongs to the Special Issue Confidence in Vaccines)
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523 KiB  
Communication
Post Approval Human Papillomavirus Vaccine Uptake Is Higher in Minorities Compared to Whites in Girls Presenting for Well-Child Care
by Jennifer Young Pierce, Jeffrey E. Korte, Laura A. Carr, Catherine B. Gasper and Susan C. Modesitt
Vaccines 2013, 1(3), 250-261; https://doi.org/10.3390/vaccines1030250 - 17 Jul 2013
Cited by 7 | Viewed by 6611
Abstract
Since introduction of the human papillomavirus (HPV) vaccine, there remains low uptake compared to other adolescent vaccines. There is limited information postapproval about parental attitudes and barriers when presenting for routine care. This study evaluates HPV vaccine uptake and assesses demographics and attitudes [...] Read more.
Since introduction of the human papillomavirus (HPV) vaccine, there remains low uptake compared to other adolescent vaccines. There is limited information postapproval about parental attitudes and barriers when presenting for routine care. This study evaluates HPV vaccine uptake and assesses demographics and attitudes correlating with vaccination for girls aged 11–12 years. A prospective cohort study was performed utilizing the University of Virginia (UVA) Clinical Data Repository (CDR). The CDR was used to identify girls aged 11–12 presenting to any UVA practice for a well-child visit between May 2008 and April 2009. Billing data were searched to determine rates of HPV vaccine uptake. The parents of all identified girls were contacted four to seven months after the visit to complete a telephone questionnaire including insurance information, child’s vaccination status, HPV vaccine attitudes, and demographics. Five hundred and fifty girls were identified, 48.2% of whom received at least one HPV vaccine dose. White race and private insurance were negatively associated with HPV vaccine initiation (RR 0.72, 95% CI 0.61–0.85 and RR 0.85, 95% CI 0.72–1.01, respectively). In the follow-up questionnaire, 242 interviews were conducted and included in the final cohort. In the sample, 183 (75.6%) parents reported white race, 38 (15.7%) black race, and 27 (11.2%) reported other race. Overall 85% of parents understood that the HPV vaccine was recommended and 58.9% of parents believed the HPV vaccine was safe. In multivariate logistic regression, patients of black and other minority races were 4.9 and 4.2 times more likely to receive the HPV vaccine compared to their white counterparts. Safety concerns were the strongest barrier to vaccination. To conclude, HPV vaccine uptake was higher among minority girls and girls with public insurance in this cohort. Full article
(This article belongs to the Special Issue Confidence in Vaccines)
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Article
Are Recent Medical Graduates More Skeptical of Vaccines?
by Michelle J. Mergler, Saad B. Omer, William K.Y. Pan, Ann Marie Navar-Boggan, Walter Orenstein, Edgar K. Marcuse, James Taylor, M. Patricia DeHart, Terrell C. Carter, Anthony Damico, Neal Halsey and Daniel A. Salmon
Vaccines 2013, 1(2), 154-166; https://doi.org/10.3390/vaccines1020154 - 29 Apr 2013
Cited by 16 | Viewed by 12571
Abstract
Rates of delay and refusal of recommended childhood vaccines are increasing in many U.S. communities. Children’s health care providers have a strong influence on parents’ knowledge, attitudes, and beliefs about vaccines. Provider attitudes towards immunizations vary and affect their immunization advocacy. One factor [...] Read more.
Rates of delay and refusal of recommended childhood vaccines are increasing in many U.S. communities. Children’s health care providers have a strong influence on parents’ knowledge, attitudes, and beliefs about vaccines. Provider attitudes towards immunizations vary and affect their immunization advocacy. One factor that may contribute to this variability is their familiarity with vaccine-preventable diseases and their sequelae. The purpose of this study was to investigate the association of health care provider year of graduation with vaccines and vaccine-preventable disease beliefs. We conducted a cross sectional survey in 2005 of primary care providers identified by parents of children whose children were fully vaccinated or exempt from one or more school immunization requirements. We examined the association of provider graduation cohort (5 years) with beliefs on immunization, disease susceptibility, disease severity, vaccine safety, and vaccine efficacy. Surveys were completed by 551 providers (84.3% response rate). More recent health care provider graduates had 15% decreased odds of believing vaccines are efficacious compared to graduates from a previous 5 year period; had lower odds of believing that many commonly used childhood vaccines were safe; and 3.7% of recent graduates believed that immunizations do more harm than good. Recent health care provider graduates have a perception of the risk-benefit balance of immunization, which differs from that of their older counterparts. This change has the potential to be reflected in their immunization advocacy and affect parental attitudes. Full article
(This article belongs to the Special Issue Confidence in Vaccines)
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539 KiB  
Article
Anticipated HIV Vaccine Acceptability among Sexually Active African-American Adult Women
by Julia Painter, Clare Cene-Kush, Alaina Conner, Carrie Cwiak, Lisa Haddad, Mark Mulligan and Ralph DiClemente
Vaccines 2013, 1(2), 88-104; https://doi.org/10.3390/vaccines1020088 - 08 Apr 2013
Cited by 24 | Viewed by 6136
Abstract
An HIV vaccine, once it becomes available, could reduce vulnerability to HIV among African-American women. The purpose of this study was to assess determinants of HIV vaccine acceptability among African-American women across hypothetical levels of vaccine efficacy. Participants were recruited from a hospital-based [...] Read more.
An HIV vaccine, once it becomes available, could reduce vulnerability to HIV among African-American women. The purpose of this study was to assess determinants of HIV vaccine acceptability among African-American women across hypothetical levels of vaccine efficacy. Participants were recruited from a hospital-based family planning clinic in Atlanta, GA serving low-income patients (N = 321). Data were collected from audio-computer assisted surveys administered in the clinic waiting room. Psychosocial survey items were guided by Risk Homeostasis Theory (RHT) and Social Cognitive Theory (SCT). Multivariate logistic regression was used to identify determinants of acceptability for two hypothetical HIV vaccines with 50% and 90% efficacy. Overall, 63% of participants would accept a vaccine with 50% efficacy and 85% would accept a vaccine with 90% efficacy. In multivariate analyses, odds of acceptability for a vaccine with 50% efficacy were higher among participants with greater perceived HIV vaccine benefits (AOR = 1.13, p < 0.001) and lower among participants with more than high school education (AOR = 0.47, p = 0.033) and greater perceived costs of HIV vaccination (AOR = 0.95, p = 0.010). Odds of acceptability for a vaccine with 90% efficacy were higher among participants with greater perceived costs of unprotected sex (AOR = 1.08, p = 0.026), HIV vaccine benefits (AOR = 1.23, p < 0.001) and self-efficacy for sex refusal (AOR = 1.11, p = 0.044). HIV vaccine acceptability was high, particularly for a vaccine with 90% efficacy. Findings suggest that demographic and psychosocial factors may impact acceptability of an eventual HIV vaccine. Once an HIV vaccine is available, interventions to maximize uptake may benefit from using RHT and SCT constructs to target relevant psychosocial factors, such as perceived benefits and perceived costs of vaccination. Full article
(This article belongs to the Special Issue Confidence in Vaccines)

Review

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629 KiB  
Review
Sustaining Vaccine Confidence in the 21st Century
by Karin Hardt, Ruprecht Schmidt-Ott, Steffen Glismann, Richard A. Adegbola and François P. Meurice
Vaccines 2013, 1(3), 204-224; https://doi.org/10.3390/vaccines1030204 - 24 Jun 2013
Cited by 24 | Viewed by 12981
Abstract
Vaccination provides many health and economic benefits to individuals and society, and public support for immunization programs is generally high. However, the benefits of vaccines are often not fully valued when public discussions on vaccine safety, quality or efficacy arise, and the spread [...] Read more.
Vaccination provides many health and economic benefits to individuals and society, and public support for immunization programs is generally high. However, the benefits of vaccines are often not fully valued when public discussions on vaccine safety, quality or efficacy arise, and the spread of misinformation via the internet and other media has the potential to undermine immunization programs. Factors associated with improved public confidence in vaccines include evidence-based decision-making procedures and recommendations, controlled processes for licensing and monitoring vaccine safety and effectiveness and disease surveillance. Community engagement with appropriate communication approaches for each audience is a key factor in building trust in vaccines. Vaccine safety/quality issues should be handled rapidly and transparently by informing and involving those most affected and those concerned with public health in effective ways. Openness and transparency in the exchange of information between industry and other stakeholders is also important. To maximize the safety of vaccines, and thus sustain trust in vaccines, partnerships are needed between public health sector stakeholders. Vaccine confidence can be improved through collaborations that ensure high vaccine uptake rates and that inform the public and other stakeholders of the benefits of vaccines and how vaccine safety is constantly assessed, assured and communicated. Full article
(This article belongs to the Special Issue Confidence in Vaccines)
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397 KiB  
Review
Kaiser Permanente Vaccine Study Center: Highlights of 2009–2012
by Roger Baxter and Nicola P. Klein
Vaccines 2013, 1(2), 139-153; https://doi.org/10.3390/vaccines1020139 - 25 Apr 2013
Cited by 1 | Viewed by 6063
Abstract
The Kaiser Permanente Vaccine Study Center is a specialized research organization in Oakland, California. They have been an active vaccine research group for many years, and have participated in and led a multitude of vaccine studies. This article will review the last three [...] Read more.
The Kaiser Permanente Vaccine Study Center is a specialized research organization in Oakland, California. They have been an active vaccine research group for many years, and have participated in and led a multitude of vaccine studies. This article will review the last three years of research activities. Full article
(This article belongs to the Special Issue Confidence in Vaccines)

Other

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218 KiB  
Opinion
Trust in Vaccines: Why It Takes More than Good Faith
by Norman Begg
Vaccines 2013, 1(3), 343-347; https://doi.org/10.3390/vaccines1030343 - 12 Aug 2013
Cited by 12 | Viewed by 5576
Abstract
This Vaccines issue on “Confidence in Vaccines” provides sound evidence through multiple perspectives of life-saving impacts when vaccination programs are effectively implemented in a population. Yet there remain challenges to achieving this impact, including scientific, medical, manufacturing, policy-related and logistical issues. Additionally, socio-cultural, [...] Read more.
This Vaccines issue on “Confidence in Vaccines” provides sound evidence through multiple perspectives of life-saving impacts when vaccination programs are effectively implemented in a population. Yet there remain challenges to achieving this impact, including scientific, medical, manufacturing, policy-related and logistical issues. Additionally, socio-cultural, religious and political agendas can come into play, taking public health hostage and sometimes allowing the circulation of myths regarding vaccination. All of these challenges play a role in public confidence in vaccines and vaccination. What we trust, we embrace. What we do not trust, we do not embrace. Full article
(This article belongs to the Special Issue Confidence in Vaccines)
342 KiB  
Concept Paper
A Threat- and Efficacy-Based Framework to Understand Confidence in Vaccines among the Public Health Workforce
by Daniel J. Barnett, Nicole A. Errett and Lainie Rutkow
Vaccines 2013, 1(2), 77-87; https://doi.org/10.3390/vaccines1020077 - 08 Apr 2013
Cited by 24 | Viewed by 5945
Abstract
The Extended Parallel Process Model (EPPM) is an established threat- and efficacy-based behavioral framework for understanding health behaviors in the face of uncertain risk. A growing body of research has applied this model to understand these behaviors among the public health workforce. In [...] Read more.
The Extended Parallel Process Model (EPPM) is an established threat- and efficacy-based behavioral framework for understanding health behaviors in the face of uncertain risk. A growing body of research has applied this model to understand these behaviors among the public health workforce. In this manuscript, we aim to explore the application of this framework to the public health workforce, with a novel focus on their confidence in vaccines and perceptions of vaccine injury compensation mechanisms. We characterize specific connections between EPPM’s threat and efficacy dimensions and relevant vaccine policy frameworks and highlight how these connections can usefully inform training interventions for public health workers to enhance their confidence in these vaccine policy measures. Full article
(This article belongs to the Special Issue Confidence in Vaccines)
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