Search Results (20)

Background: Vaccinations are crucial for preventing infectious diseases. Parental knowledge and attitudes significantly impact vaccination decisions. Methods: This study analyzed parental knowledge and opinions on childhood vaccinations (focus: measles, pertussis) and assessed vaccination coverage rates in Radomsko, Poland. A cross-sectional study (Jan–Mar 2025) combined the following: (1) parent questionnaires (children aged 6–11 years), including opinions based on the validated VAX scale and (2) analysis of official vaccination coverage data (sanitary inspection). Statistical analysis included descriptive statistics and logistic regression; results are presented as odds ratios (OR). Results: A total of 459 parents participated (mean age 38.9 years, 95% female, 67% Master’s-level education). Conclusions: Most correctly identified measles (92%) and pertussis (85%) vaccines as mandatory. Considerable confusion existed about newer mandatory vaccines and varicella (78% incorrectly thought mandatory). Analysis revealed the influence of both knowledge and opinions from the VAX scale on vaccination decisions. Higher parental education significantly increased vaccination adherence for pertussis (OR = 2.03; p < 0.001) and both diseases (OR = 1.83; p < 0.001). While general vaccination awareness was high (97%), detailed knowledge of Poland’s mandatory schedule was alarmingly low, especially for newer vaccines. Parental education level is a key determinant of both accurate knowledge and vaccination compliance. Targeted educational interventions are urgently needed to improve parental understanding and support public health goals. Full article

Background: Immunocompromised and clinically fragile individuals are at increased risk of herpes zoster (HZ), but vaccine uptake remains low due to organizational barriers and vaccine hesitancy (VH). This study aimed to evaluate the impact of a multidisciplinary hospital-based counseling model on attitudes toward the recombinant adjuvanted zoster vaccine (RZV). The primary objective was to assess changes in VH over time using the Vaccination Attitudes Examination (VAX) scale; secondary objectives included identifying factors associated with VH, evaluating vaccine safety, and monitoring post-vaccination HZ incidence. Methods: A prospective cohort study was conducted in a large research hospital in Rome, in collaboration with the Local Health Authority. Eligible patients were offered individualized counseling and administered two doses of the RZV. VH was assessed using the 12-item VAX scale at baseline and at one-year follow-up. Multivariable linear regression analysis was performed to investigate associations between baseline characteristics and VH scores. Results: Between July 2022 and July 2023, 178 patients were enrolled, of whom 90 completed the one-year follow-up. Baseline VH was moderate (mean VAX: 2.291/6.000); higher scores were significantly associated with younger age, female sex, and rheumatologic disease (p < 0.05). After the intervention, VAX scores improved significantly across all subscales, particularly in trust in vaccine safety and benefits (p < 0.001). RZV was well tolerated; adverse events were mild and transient. Breakthrough HZ occurred in 3.33% of cases during follow-up. Conclusions: A multidisciplinary hospital-based model effectively improved vaccine attitudes and acceptance in fragile patients. Tracking VH over time with validated tools offers insights for scaling targeted interventions in high-risk groups. Full article

Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study aims to assess vaccine-related perceptions and behaviors among these student populations in an Italian university. Methods: A cross-sectional survey was conducted between November 2022 and February 2024 at the University of Rome “Tor Vergata”. A structured, anonymous questionnaire, including the Vaccination Attitudes Examination (VAX) scale, vaccine knowledge items, and sources of information, was administered to students in nursing (n = 205), pediatric nursing (n = 46), and midwifery (n = 21). Statistical analyses included descriptive statistics, ANOVA, post hoc tests, and Mann–Whitney U tests. Results: Among the 272 participants, 20.6% reported refusing at least one recommended vaccine, and 18.4% delayed vaccination for non-medical reasons. Vaccine knowledge and confidence increased significantly with academic progression (p < 0.001). Midwifery students showed both the highest concern for long-term vaccine effects and the greatest confidence in vaccine safety. Institutional and scientific sources were the most trusted, though traditional and non-institutional media also influenced perceptions, particularly among midwifery students. Conclusions: Despite high COVID-19 vaccine uptake, VH persists among health professional students. Discipline-specific patterns highlight the need for early, targeted educational strategies to enhance vaccine literacy and reduce hesitancy. Tailored training may empower future professionals to become informed and credible advocates for vaccination. Full article

Introduction: Vaccination protects pregnant women against dangerous infectious diseases and contributes to disease prevention for the child until their vaccination schedule begins. Vaccination behaviour is related to attitudes concerning vaccine prevention. Materials and Methods: This cross-sectional, non-representative study was conducted among Polish mothers using a diagnostic survey. We used the Vaccination Attitudes Examination (VAX) Scale. The author’s questionnaire included questions concerning experiences with adult and maternal vaccinations, as well as sociodemographic data. Results: Among the 375 respondents, more than half (n = 208, 55.47%) received at least one vaccine during pregnancy. The majority of respondents had a university education (n = 356, 94.93%). There was no statistically significant difference in terms of receiving vaccines during pregnancy between respondents with and without a healthcare education (p = 0.230). A logistic regression model indicated that women who were vaccinated outside pregnancy for COVID-19 (OR 4.61, 2.60–8.22) and influenza (OR 7.14, 3.58–14.25) were statistically significantly more likely to be vaccinated during pregnancy. There were statistically significant differences between women who were vaccinated during pregnancy and those who did not receive maternal immunisation in three subscales of the VAX Scale: Mistrust of Vaccine Benefit, Concerns about Commercial Profiteering, and Preference for Natural Immunity (p < 0.001). The most frequently indicated reason for a woman’s decision to be vaccinated was concern for the health and safety of the unborn child (n = 196, 94.23%). In contrast, women who were not vaccinated reported fear for the health and safety of the unborn child (n = 88, 52.69%). Conclusions: A key point may be to contribute to the vaccinology education of healthcare professionals, who play an important role in pregnant women’s decision to be vaccinated. However, our results may be disrupted because the majority of the women in our study had a university education. Full article

Vaccination among pregnant and breastfeeding women is critical for protecting this vulnerable population and their children. COVID-19 vaccination is recommended both during pregnancy and breastfeeding; however, we still do not fully understand the determinants that influence hesitancy towards COVID-19 vaccination. This study aimed to identify the determinants of vaccine hesitancy in pregnant and breastfeeding, puerperium women. A multicenter, cross-sectional study, involving 435 pregnant and breastfeeding women, was conducted. Vaccination hesitancy was evaluated by administering the Vaccination Attitudes (VAX) Scale and the Zung Anxiety Self-Assessment Scale (SAS) was adopted to measure anxiety levels. Overall, 14% of the participants reported that they did not receive the COVID-19 vaccine, and 78.3% received their first dose during pregnancy or while breastfeeding. The descriptive statistics for the VAX scale showed a total mean score of 3.35 (±1.6), and 75% of participants reported an anxiety index equal to or lower than the threshold. Vaccine hesitancy increased as “adverse events after vaccination” increased (p < 0.01), while SAS levels positively correlated with the participants’ mean age (p < 0.05). Investigating the factors influencing vaccine hesitancy enables the development of targeted health policies and SARS-CoV-2 vaccination programs. Full article

Background: Vaccine hesitancy (VH) has increased over the past decade with large geographical variations between countries, posing a threat to global public health. This phenomenon is growing in the general population as well as among healthcare workers (HCWs), who are the most reliable source of vaccine-related information for patients. Special attention must therefore be paid to medical students, who are the future HCWs. Methods: We conducted a cross-sectional study (November 2022–January 2023) on all the Albanian and Italian students attending medical science courses at the Catholic University “Our Lady of Good Counsel” (Tirane, Albania) to investigate VH and the factors contributing to it (using the Vaccination Attitude Examination Scale-VAX), including COVID-19 vaccination. Vaccine knowledge was assessed using the Zingg and Siegrist Scale. Students were asked to voluntarily answer an anonymous questionnaire. Results: 689 questionnaires were collected (58.8% Albanians, 72.3% female; 70.4% aged 20–25 years; 70.4% attending the Medicine and Surgery course). Generally, students showed low VH, especially Italians (p < 0.001); however, some hesitancy was observed regarding the potential long-term effects of vaccines, especially among Albanians (p < 0.05). The results also showed a significant difference in vaccine knowledge scores between different course years (χ²  =  90.058; df  =  40; p = < 0.001) and different degree courses (χ²  =  89.932; df = 40; p  = < 0.001). With regard to COVID-19 vaccination, being of Albanian origin significantly increases the risk of not being vaccinated (OR = 7.215; 95%CI 3.816–13.640, p < 0.001), highlighting possible differences in vaccine coverage and policy between the two countries. Conclusion: Vaccine hesitancy should be addressed at early stages during medical sciences courses, in order to protect future healthcare workers, to preserve essential health services, and reduce the risk of further pandemics. Full article

People with HIV (PWH) incur a higher risk of COVID-19-related morbidity and mortality rates, yet less is known about COVID-19 vaccine uptake and hesitancy in this group. We conducted a cross-sectional study in Freetown, Sierra Leone, from April to June 2022, using the VAX scale, a validated instrument, to assess attitudes towards COVID-19 vaccination and calculate the hesitancy (VAX) scores. We used generalized linear models to identify the factors associated with vaccine hesitancy. Overall, 490 PWH were enrolled (71.4% female, median age: 38 years, median CD4 count: 412 cells/mm³). About 17.3% received ≥1 dose of a COVID-19 vaccine. The mean VAX score was 43.14 ± 7.05, corresponding to 59.9% participants being vaccine-hesitant. A preference for natural immunity (65.8%) and concerns about profiteering (64.4%) were the commonest reasons for hesitancy, followed by a mistrust of vaccine benefits (61.4%) and worries about future effects (48.0%). In the adjusted regression analysis, being a Muslim (β = 2.563, p < 0.001) and having an urban residence (β = 1.709, p = 0.010) were associated with greater vaccine hesitancy, while testing for COVID-19 was associated with reduced vaccine hesitancy (β = −3.417, p = 0.027). These findings underscore the importance of addressing vaccine hesitancy as a critical element boosting COVID-19 vaccine uptake among PWH. Full article

Background and Objectives: This present study was aimed at exploring hyperarousal and aberrant salience in a sample of the Italian general population to understand their possible role in the acceptance of anti-COVID-19 vaccination. Materials and Methods: Sociodemographic data questions, the “Acceptance of Vaccination” measure, the Hyperarousal Scale (H-Scale), and the Aberrant Salience Inventory (ASI) were sent as an unpaid online survey to the general population (age range 18–80 years) within the Italian territory. Results: The enrolled subjects were divided into two subgroups: “Pro-vax” (n = 806; 87.4%) and “No-vax” (n = 116; 12.6%). Statistical analysis showed significant differences between groups in the “Education Level” (p = 0.001) category, higher in the “Pro-vax” group, and in the ASI “Senses Sharpening” (p = 0.007), “Heightened Emotionality” (p = 0.008), and “Heightened Cognition” (p = 0.002) subscales with the “Total Score” (p = 0.015), all higher in “No-vax” subjects. Furthermore, a linear regression model evidenced that only ”Education Level” (β = 0.143; p < 0.0001) and “Senses Sharpening” (β = −0.150; p = 0.006) were, respectively, direct and inverse predictors of “Acceptance of Vaccination”. Conclusions: Our results show that several subthreshold conditions, such as somatosensory amplification, anxiety traits, and panic experiences, should be taken into account by authoritative sources involved in health education, communication, and policy to alleviate public concerns about vaccine safety, for the present and also future pandemics, and to provide more inclusive, informed, and accurate public health preventive and treatment programs. Full article

Over the past decades, vaccination has proven to be largely beneficial to global health. Despite vaccine efficacy, the French population has been recently affected by more anti-vaccination attitudes and vaccine refusal, and it is therefore necessary to validate tools to study this health issue. The Vaccination Attitudes Examination scale (VAX) is a 12-item questionnaire targeting adults that assesses general attitudes towards vaccination. The aims of the study were to translate and adapt the original English version of the scale into French and to test the psychometric properties of the scale in a French-population-based sample of adults. We included 450 French speaking adults that completed the French VAX and other questionnaires to assess convergent and divergent validities. Exploratory and confirmatory factor analyses showed that the French version of the VAX replicated the factorial structure of the original scale. Moreover, it demonstrated high internal consistency, good convergent and divergent validities, and excellent temporal stability. Furthermore, scores on the scale differentiated vaccinees from non-vaccinee respondents. Results on the scale provide us with insight into factors involved in vaccine hesitancy in France, therefore allowing French authorities and policy makers to address these specific concerns and improve vaccine acceptance rates in this country. Full article

Background. Instruments designed to assess individual differences in predispositions towards vaccination are useful in predicting vaccination-related outcomes. Despite their importance, there is relatively little evidence regarding the conditions under which these instruments are more predictive. The current research was designed to improve the ability of these kinds of instruments to predict vaccination advocacy by considering the certainty associated with the responses to vaccination scales. Method. Across two studies, participants completed the Beliefs about Medicines Questionnaire BMQ scale (Study 1) or the Vaccination Attitudes Examination (VAX) scale (Study 2). The certainty participants had in their responses to each scale was either measured (Study 1) or manipulated (Study 2). Intentions to advocate in favor of vaccination served as the criterion measure in both studies. Results. As expected, the scales significantly predicted vaccination advocacy, contributing to enhancing the predictive validity of the instruments used in the studies. Most relevant, certainty moderated the extent to which these scales predicted vaccination advocacy, with greater consistency between the initial scores and the subsequent advocacy willingness obtained for those with higher certainty. Conclusions. Certainty can be useful to predict when the relationship between vaccination-related cognitions (i.e., beliefs or attitudes) and advocacy willingness is likely to be stronger. Full article

The COVID-19 pandemic illustrated that intolerance of uncertainty (IU) can hinder problem-solving and lead to avoidance of ambiguous situations. Furthermore, people tend to lack confidence in decisions made in ambiguous contexts. We wanted to investigate the impact of IU on intentions to get vaccinated, to vaccinate one’s children, and to recommend the vaccine in situations with varying degrees of perceived uncertainty. We first conducted a pretest to select six scenarios with different levels of perceived uncertainty. In the core study, 485 participants answered for each of the six scenarios whether they would get vaccinated, vaccinate their children (or imagine doing so, for individuals without children), and whether they would recommend the vaccine. They also completed the IUS-12 (Intolerance of Uncertainty scale) and the VAX (Vaccination Attitudes Examination). Results showed that perceived uncertainty did not influence our measures, but the IUS-12 and VAX predicted the difference in score between the most and least uncertain scenarios. An indirect effect of the IUS-12 on decision confidence through the VAX was found, but with no direct effect. We conclude that, even if future studies should refine these results, Public Policies should be more focused on factors such as IU and attitudes toward vaccination. Full article

Background: Having a valid tool to assess attitudes toward vaccination and identify the concerns that drive vaccine refusal can facilitate population studies and help guide public health interventions. The objective of this study has been to adapt the Vaccination Attitudes Examination (VAX) scale in Colombian university students and to study its psychometric properties in a non-probabilistic sample of 1074 Colombian university students. Methods: A confirmatory factor analysis was used to study the factorial structure. A structural equation model was tested to study concurrent validity and to check whether the factors predicted having received the coronavirus vaccine. Gender-based measurement invariance was also studied for the best model. Results: The results support the structure of four related factors. The composite reliability index was good for all the factors, but the average variance extracted was not as good for the second factor. There was strong measurement invariance by gender, and two factors are good predictors of being vaccinated or not. Conclusions: The VAX has shown construct and concurrent validity and is a reliable tool for evaluating attitudes towards vaccines in university students in Colombia. It may help guide the implementation of actions for the National Vaccination Plan and institutional policies. Full article

Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in this coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the relationship between societal adaptation and vaccine worries and the mediating effects of posttraumatic stress disorder (PTSD) indicators in HCWs. A total of 435 HCWs (327 women and 108 men) were recruited. Their levels of societal adaptation were evaluated using the Societal Influences Survey Questionnaire (SISQ). Their severity and frequency of PTSD symptoms were examined using the Disaster-Related Psychological Screening Test (DRPST). The severity of vaccine worries was assessed using the Vaccination Attitudes Examination (VAX) Scale. The relationships among societal adaptation, PTSD, and vaccine worries were examined using structural equation modeling. The severity of societal adaptation was positively associated with both the severity of PTSD and the severity of vaccine worries. In addition, the severity of PTSD indicators was positively associated with the severity of vaccine worries. These results demonstrated that the severity of societal adaptation was related to the severity of vaccine worries, either directly or indirectly. The indirect relationship was mediated by the severity of PTSD. Societal adaptation and PTSD should be taken into consideration by the community of professionals working on vaccine hesitancy. Early detection and intervention of PTSD should be the objectives for programs aiming to lower vaccine hesitancy among HCWs. Full article

To achieve herd immunity to a disease, a large portion of the population needs to be vaccinated, which is possible only when there is broad acceptance of the vaccine within the community. Thus, policymakers need to understand how the general public will perceive the vaccine. This study focused on the degree of COVID-19 vaccine hesitancy and refusal and explored sociodemographic correlations that influence vaccine hesitancy and refusal. A cross-sectional online survey was conducted among the adult population of India. The survey consisted of basic demographic questions and questions from the Vaccination Attitudes Examination (VAX) Scale. Multinomial logistical regression was used to identify correlates of vaccine hesitancy and refusal. Of the 1582 people in the study, 9% refused to become vaccinated and 30.8% were hesitant. We found that both hesitancy and refusal predictors were nearly identical (lower socioeconomic status, female gender, and older age groups), except for three groups (subjects aged 45–64 years, those with approximate income <10,000 INR/month, and those residing in rural households) that showed slightly higher odds of vaccine hesitancy than refusal. We need to address the underlying sociodemographic determinants and formulate public awareness programs to address specific subgroups that are at higher risk of rejecting the vaccine and convert those who are undecided or hesitant into those willing to accept the vaccine. Full article

Critical consciousness development represents a building block in the formation of health-related attitudes and behaviours. One of the most studied health-related behaviours in the previous year is COVID-19 vaccination behaviour. The present study examines critical consciousness, COVID-19 vaccination attitudes and vaccination behaviour in a consistent sample of young adults (N = 1185). Participants were residents of Romania, aged 18 to 41 years. The Critical Consciousness Scale—Short Form (CCS-S) and the Vaccination Attitudes Examination (VAX) Scale were used. The results demonstrate the mediating role of two types of vaccination attitude—lack of confidence in the promoted vaccine benefits and worries about unforeseen effects—in the relationship between critical reflection and vaccination behaviour. Communication is fundamental in an initiative aimed at changing behaviour. When shaping a health-related campaign, communication and dialogue must be horizontal and characterised by empathy and mutual recognition to determine favourable health-related behaviour. Full article