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Promoting Vaccine Acceptance
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Promoting Vaccine Acceptance

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (30 June 2019) | Viewed by 19221

Special Issue Editor

Prof. Dr. José Tuells

E-Mail Website1 Website2
Guest Editor
Department of Public Health, University of Alicante, 03690 Alicante, Spain
Interests: vaccines; preventable diseases; vaccine hesitancy; vaccines safety; vaccines logistics; history of vaccinology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In his seminal study1, Melvin Glasser, an active promoter of the polio vaccine, investigated the reasons why a population accepted or rejected a vaccine.

This was the first time a study on vaccine acceptance was performed. Sixty years later, the acceptance of vaccines continues to be a concern and a subject of study for health authorities, researchers, and vaccine stakeholders.

Paradoxically, over the last ten years, vaccination resistance or refusal has grown significantly despite the fact that the number of new vaccines is greater than ever before.

As a result, some immuno-preventable diseases that were in the process of being eradicated have reappeared, causing epidemic outbreaks (measles for example). Prospects of eradication have been pushed back (e.g. polio) and, in other cases, public controversies have emerged (e.g. influenza, HPV).

The population's concerns regarding the safety or effectiveness of some vaccines have led to a loss of confidence. There is also limited awareness of the severity of certain diseases, in addition to other factors such as the quality of the vaccination services. These elements affect vaccination acceptance and lead to the emerging concept of vaccine hesitancy2.

Let us not forget the impact of inadequate communication: the press, the Internet, online networks, and social actors are taking center stage, replacing professional recommendations and spreading further uncertainty.

In this Special Issue of Medicina, we invite you and your colleagues to submit original articles, reviews, comments, or new hypotheses aimed at fostering vaccine acceptance.

1 Glasser MA. A study of the public's acceptance of the Salk vaccine program. Am. J. Public Health Nations Health. 1958, 48, 141–6.

2 MacDonald NE. SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine 2015, 33, 4161–4.

Prof. Dr. José Tuells
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. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccine acceptance
  • vaccine hesitancy
  • social networks
  • public sphere
  • communication
  • health behaviours
  • vaccine coverage
  • vaccine advocacy
  • public policies
  • myths
  • rumours
  • minorities
  • Internet
  • health literacy
  • compulsory vaccination

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Published Papers (4 papers)

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Research

Jump to: Review

11 pages, 616 KiB  
Article
Knowledge and Attitudes about the Flu Vaccine among Pregnant Women in the Valencian Community (Spain)
by Noelia Rodríguez-Blanco and José Tuells
Medicina 2019, 55(8), 467; https://doi.org/10.3390/medicina55080467 - 11 Aug 2019
Cited by 8 | Viewed by 4452
Abstract
Background and Objectives: To describe the knowledge and attitudes related to the acceptance of the flu vaccine during pregnancy in women, from two Health Departments of the Valencian Community (VC), during the 2015–2016 season, after receiving prenatal care. Materials and Methods: A prospective [...] Read more.
Background and Objectives: To describe the knowledge and attitudes related to the acceptance of the flu vaccine during pregnancy in women, from two Health Departments of the Valencian Community (VC), during the 2015–2016 season, after receiving prenatal care. Materials and Methods: A prospective observational study was conducted during the annual vaccine season of women ascribed to prenatal care. A midwife offered flu vaccine advice and afterwards conducted a telephone poll of a representative sample, in order to find out the reason for accepting or rejecting the vaccine. Results: Of the 1017 expectant women who received advice about the vaccine, 77.4% (95% CI: 74.8–79.9%) declared their intention to vaccinate. After the recommendation, the vaccine coverage was 61.6%, with a percentage of accordance of 98.8% (95% CI: 98.0–99.6%) between the coverage declared and the Nominal Vaccination Registry (NVR) of the VC. Additionally, 67.2% of the expectant women were interviewed (n = 683). Most were aware of the recommendation and identified the health center and the midwife as the main sources of information. The internet was a consistent source in favor of vaccination 80.8% (n = 42). The obstetric variables (risk during the pregnancy, end of pregnancy, and feeding the newborn) did not have a statistically significant relationship with the vaccination. The women declared a high adherence to the vaccinations present in the child vaccination calendar, but rejected (31.3%) the flu vaccine, as they had not received it previously and did not want it because of their expectant state. Conclusions: The women positively evaluated the effectiveness and safety of the vaccines. However, with the flu vaccine, “not being previously vaccinated” and the “doubts about its safety” represented more than half of the reasons put forth for its rejection. Ensuring that the flu vaccine is perceived as more effective and acceptable through the messages directed towards the expectant mothers, directly through the midwives or through the communication media and social networks, will result in an increase of vaccine coverage. Full article
(This article belongs to the Special Issue Promoting Vaccine Acceptance)
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20 pages, 1401 KiB  
Article
Qualitative Assessment of Vaccine Hesitancy in Romania
by David Miko, Carmen Costache, Horațiu Alexandru Colosi, Vlad Neculicioiu and Ioana Alina Colosi
Medicina 2019, 55(6), 282; https://doi.org/10.3390/medicina55060282 - 17 Jun 2019
Cited by 37 | Viewed by 7196
Abstract
Background and objectives: Health systems all over the world are confronted with an alarming rise of cases in which individuals hesitate, delay, and even refuse vaccination, despite availability of quality vaccine services. In order to mitigate and combat this phenomenon, which are now [...] Read more.
Background and objectives: Health systems all over the world are confronted with an alarming rise of cases in which individuals hesitate, delay, and even refuse vaccination, despite availability of quality vaccine services. In order to mitigate and combat this phenomenon, which are now defined by the World Health Organization (WHO) as vaccine hesitancy (VH), we must first understand the factors that lead to its occurrence in an era characterized by wide access to safe and effective vaccines. To achieve this, we conducted field testing of the Vaccine Hesitancy Scale (VHS), as it was developed by the Strategic Advisory Group of Experts Working Group (SAGE WG), in Cluj-Napoca city, Cluj County, Romania. The scale is designed to quantify VH prevalence in a population, establish which vaccines generate the highest percentage of hesitancy, and allow a qualitative assessment of the individual’s reasons for hesitance. Materials and Methods: We conducted an observational cross-sectional survey, which was comprised of descriptive, analytical, and qualitative elements regarding VH. The necessary sample size was 452 individuals. The VHS and Matrix of Determinants (recommended by SAGE WG) for reasons people gave to justify their hesitance, was interpreted by qualitative thematic analysis (QTA) to ensure the validity and reliability in detecting hesitancy across various cultural settings and permit global comparisons. Results: We found a VH of 30.3% and 11.7% of parents reported refusing to vaccinate their child. Among the VH responders, the varicella vaccine generated 35% hesitancy, measles vaccine 27.7%, Human Papillomavirus (HPV) 24.1%, and mumps vaccine 23.4%, respectively. The QTA values for percent agreement ranged from 91% to 100%. Cohen’s Kappa values ranged from 0.45 to 0.95. Contextual influences identified for VH were “media,” “leaders and lobbies,” and “perception of the pharmaceutical industry.” Individual and group influences for VH were “beliefs,” “knowledge,” and “risk/benefits (perceived).” Vaccine and vaccination specific issues for VH were “risk/benefit (rational)” and “health care practitioners (trustworthiness, competence).” Conclusions: One-third of the investigated population had expressed VH, and a further one-third of these had refused a vaccine for their child. Chicken Pox, Measles, Mumps, Rubella (MMR), and HPV vaccines generated the most hesitation. Negative information from the media was the most frequently evoked reason for VH. Full article
(This article belongs to the Special Issue Promoting Vaccine Acceptance)
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14 pages, 273 KiB  
Article
Effects of Maternal Decisional Authority and Media Use on Vaccination for Children in Asian Countries
by Minsung Sohn, Leesa Lin and Minsoo Jung
Medicina 2018, 54(6), 105; https://doi.org/10.3390/medicina54060105 - 7 Dec 2018
Cited by 12 | Viewed by 3177
Abstract
Background and objectives: It is now accepted that vaccination is a critical public health strategy in preventing child morbidity and mortality. Understanding factors that promote vaccination is a critical first step. The objective of this study was to investigated associations of maternal decisional [...] Read more.
Background and objectives: It is now accepted that vaccination is a critical public health strategy in preventing child morbidity and mortality. Understanding factors that promote vaccination is a critical first step. The objective of this study was to investigated associations of maternal decisional authority and media use on vaccination for children in six South and Southeast Asian countries. Materials and Methods: Data come from demographic and health surveys conducted in Bangladesh, Cambodia, Indonesia, Nepal, Pakistan, and the Philippines between 2011 and 2014 (N = 45,168 women). Main outcome variables were four types of basic vaccination for children. Independent variables were maternal decisional authority and media use. Hierarchical multivariable regression analyses were performed to examine associations. Results: Children of mothers who had more decisional authority were more likely to be vaccinated compared to those participants who did not have such authority. The likelihood to have their children vaccinated was higher among women who frequently used media than those who did not use media. Conclusions: Maternal decisional authority and media use are related to improved vaccination for children. To increase vaccination rates in developing countries in South and Southeast Asia, programs and policies that promote maternal decisional authority and the use of media for health need to be implemented to help families and local communities. Full article
(This article belongs to the Special Issue Promoting Vaccine Acceptance)

Review

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10 pages, 297 KiB  
Review
Interventions to Increase the Rate of Influenza and Pneumococcal Vaccination in Patients with Chronic Obstructive Pulmonary Disease: A Scoping Review
by Samuel P. Trethewey, Neil Patel and Alice M. Turner
Medicina 2019, 55(6), 277; https://doi.org/10.3390/medicina55060277 - 15 Jun 2019
Cited by 6 | Viewed by 3410
Abstract
Background and Objective: Current evidence suggests that patients with chronic obstructive pulmonary disease (COPD) should receive influenza and pneumococcal vaccinations. Despite international guidelines recommending vaccination in patients with COPD, many patients remain unvaccinated. Reasons for vaccine non-acceptance are multifaceted and are likely to [...] Read more.
Background and Objective: Current evidence suggests that patients with chronic obstructive pulmonary disease (COPD) should receive influenza and pneumococcal vaccinations. Despite international guidelines recommending vaccination in patients with COPD, many patients remain unvaccinated. Reasons for vaccine non-acceptance are multifaceted and are likely to be influenced by multiple psychosocial factors and pre-existing health beliefs. The aim of this review was to identify interventions which have been shown to effectively increase vaccination rates in patients with COPD. Materials and Methods: A structured search of PubMed returned 491 titles. Following title and abstract screening, seven full-text articles reporting on 6 unique interventional studies were extracted for narrative synthesis. A variety of interventions were investigated which, for the purposes of this review, were grouped into patient-focussed, clinician-focussed and mixed interventions. Results: Three papers reported findings from clinical trials (2 unique studies) and 4 papers reported findings from before-after studies. Two studies were conducted in the primary care setting, the remaining studies were conducted in secondary and tertiary care. Most studies reported both influenza and pneumococcal vaccination rates. These studies suggest that multimodal interventions, which target multiple aspects of evidence-based care and use both patient-focussed and clinician-focussed techniques, may have the greatest impact on vaccination rates in patients with COPD. Conclusions: Further, adequately powered, high quality studies are needed. It is crucial for individual institutions to monitor their own vaccination rates to determine if there is scope for performance improvement. Full article
(This article belongs to the Special Issue Promoting Vaccine Acceptance)
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