Search Results (561)

Background/Objectives: Seasonal influenza imposes a significant burden on pediatric public health. Despite official recommendations and full insurance coverage, vaccination rates among children in Slovakia remain critically low. This study aims to analyze the attitudes, beliefs, and determinants of parental hesitancy regarding childhood influenza vaccination in the post-pandemic context. Methods: A single-center cross-sectional survey was conducted between February and March 2025 using convenience sampling among parents of children attending a pediatric immunoallergology center. An anonymous questionnaire collected data on demographics, risk perception, and attitudes. Data from 301 parents were analyzed using descriptive statistics, chi-squared tests, and odds ratios (OR) to identify key predictors of hesitancy. Results: Only 27.6% of parents expressed willingness to vaccinate their children, while 42.5% were opposed and 29.9% hesitant. Statistical analysis revealed no significant association between parental university education and vaccination intent (p > 0.05), indicating that vaccine hesitancy in this specific setting was present across all educational backgrounds. However, the source of information proved to be a critical determinant: consulting a pediatrician significantly increased the odds of acceptance (OR = 6.32; 95% CI: 3.54–11.28), whereas reliance on the internet and social media was a significant predictor of refusal (OR = 0.29; 95% CI: 0.17–0.50). The primary reported barrier was fear of adverse effects (70.4%), which significantly outweighed doubts about efficacy (30.2%). Conclusions: Parental hesitancy in Slovakia is a widespread phenomenon pervasive across all educational backgrounds, driven primarily by safety concerns and digital misinformation. The contrast between the protective influence of pediatricians and the negative impact of digital media underscores that clinical encounters are currently the most effective firewall against hesitancy. Public health strategies must therefore pivot from general education to empowering pediatricians with active, presumptive communication strategies. Full article

Background/Objectives: The COVID-19 pandemic caused over seven million deaths globally as of July 2024. In an attempt to bring the pandemic under control, immunization was implemented as the main preventive strategy. This study aimed to investigate the knowledge, attitudes, and practices (KAP) of hospitalized patients and healthcare workers (HCWs) regarding COVID-19 vaccination, as well as the factors contributing to COVID-19 vaccination rates. Methods: This cross-sectional, survey-based KAP study was conducted between November 2024 and February 2025 in five hospitals across five cities of the Republic of Srpska, Bosnia and Herzegovina. Results: There were 571 respondents, 68% of whom were female, with an average age of 39.17 ± 14.74 years; one-third held a university degree. The study sample consisted of patients and healthcare workers (HCWs) (59% vs. 41%). During the pandemic period, 46.6% of respondents were diagnosed with COVID-19, with a higher prevalence among healthcare workers compared to patients (54.2% vs. 41.2%). Among the 55.2% of respondents who were vaccinated, HCWs were more often vaccinated than patients (70.9% vs. 44.2%) and more likely to know that vaccines protect against severe forms of disease and death (80.8% vs. 68.5%). Patients more often believed that vaccination against COVID-19 may lead to sterility in young patients (11.3% vs. 6%) and were more often afraid of vaccination compared to the occurrence of COVID-19 (35.6% vs. 24.8%). Regression analyses showed that independent predictors of COVID-19 vaccination were older age (p < 0.001), higher education level (p = 0.039), knowledge of vaccine production technology, and the belief that vaccinated individuals have milder symptoms of the disease (p = 0.002). Conversely, the belief that the COVID-19 situation was overblown was negatively associated with vaccination (p = 0.004). Conclusions: HCWs had better knowledge, more positive attitudes, and better vaccination practices against COVID-19 in comparison to patients. However, there are still certain dilemmas and hesitations among HCWs toward COVID-19 vaccination. Full article

Background: Vaccinations are essential to protect travelers from infectious diseases, especially in high-risk destinations. However, awareness and adherence to vaccination recommendations vary, influenced by communication, personal beliefs, and behavior. Methods: A focus group was conducted in February 2025 at a local health authority in central Italy, specifically within its travel clinic, to explore travelers’ awareness, attitudes, and behaviors regarding vaccination. The discussion was analyzed using the “3Cs” Vaccine Hesitancy model. Participants were purposively selected to ensure diversity and representativeness. Discussions included past travel experiences, knowledge of required vaccines, motivations for immunization, and barriers to access. Results: Four key thematic areas emerged: socio-cultural/environmental factors, psychological/emotional influences, knowledge/information access, and general health perceptions. Communication gaps often weakened belief in vaccine efficacy and necessity. Cultural background, past experiences, and risk perception heavily influenced decisions. Discussion: Although vaccination is widely viewed as a protective measure, vaccine hesitancy persists due to misinformation and limited institutional trust. The COVID-19 pandemic intensified both awareness and skepticism. The 3Cs model clarified hesitancy levels and barriers, emphasizing the need for effective communication and trust-building. Conclusions: Enhancing access to accurate information, strengthening healthcare professionals’ communicative role, and reducing economic obstacles are crucial. Tailored awareness campaigns and integrated health policies are essential to increasing vaccine uptake, safeguarding traveler health, and limiting global disease spread. Patient or Public Contribution: Members of the public contributed to this study by participating in a focus group, where they shared their personal experiences, perceptions, and opinions regarding travel-related vaccinations. Their insights provided valuable qualitative data that helped inform the study’s findings. However, they were not involved in the study design, the analysis of the data, or the preparation of the manuscript. The role of participants was limited to the data collection phase of the study. Full article

Background/Objectives: This study aims to evaluate COVID-19 parental vaccine hesitancy (CPVH) and refusal among parents of children between 5 and 11 years and to identify potential factors influencing them. A secondary aim was to assess knowledge, concerns, and beliefs associated with COVID-19 and immunization. Methods: This cross-sectional study was conducted among parents of children between 5 and 11 years using an anonymous, self-administered questionnaire. Sociodemographic characteristics, knowledge, concerns, and beliefs regarding COVID-19 and immunization in children; CPVH according to Parent Attitudes about Childhood Vaccines short scale; COVID-19 vaccination status and intention; and sources of information about COVID-19 vaccination were investigated. Results: Among 506 participating parents, only 12.7% correctly answered all six knowledge items. High CPVH was found in 60.1% of respondents and was more prevalent among younger parents and those with lower knowledge levels. Compared to having received no information on COVID-19 vaccination, high CPVH was positively associated with having received information from informal sources and trusting them and negatively associated with information from formal ones. More than half (58.3%) had vaccinated their child, and 38.5% had no intention to vaccinate their child against COVID-19. High CPVH, lower knowledge levels, and a need for further information were significant predictors of vaccine refusal. Conversely, refusal was negatively associated with parental COVID-19 vaccination status, and with having received information from formal and from both formal and informal sources compared to not having received information. Conclusions: The findings highlight the need for establishing and investing in platforms to promote vaccine awareness and dispelling misinformation among parents. Full article

Background/Objectives: Seasonal influenza, pneumococcal disease, and COVID-19 pose major public health challenges, particularly for individuals with chronic illnesses. This study examined vaccination coverage for influenza, pneumococcal disease, and SARS-CoV-2 among patients with chronic liver disease and cirrhosis and explored the sociodemographic and clinical factors influencing it. Methods: A cross-sectional study, conducted from March 2022 to July 2023 at two university hepatology outpatient clinics in Athens, Greece. The study population consisted of patients with a diagnosis of chronic liver disease (hepatocellular carcinoma and hepatitis) and liver cirrhosis. Results: A convenience sample size of 300 patients (age ≥ 30) participated. Regarding their vaccination, 88.3% were vaccinated against SAR-COVID-19, 44.8% against pneumococcus, and 54.7% against seasonal influenza this year. Patients’ belief that annual vaccination is the best method for influenza prevention was found to be significantly higher among older patients and those with comorbidities. Additionally, patients who had been vaccinated against seasonal influenza (this year or every year), against pneumococcus, or SARS-CoV-2 agreed significantly that annual vaccination is the best method for influenza prevention. In addition, patients who were informed about vaccination by their doctor/nurse agreed significantly more with that. Multiple logistic regression found that a four times greater probability of being fully vaccinated according to the national vaccination program was found in patients who were informed about vaccination by a doctor/nurse. Moreover, as patients’ age increased, so did the probability of being fully vaccinated. Conclusions: The study’s findings are significant and can be utilized within national public health initiatives and by healthcare professionals during patient interactions, ensuring that younger patients and those apprehensive about vaccine efficacy and safety receive focused attention to facilitate adherence to annual vaccinations and all vaccines included in national programs. Full article

High-risk human papillomavirus (HPV), including types 16–18, is the established cause of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix. While preventive vaccination is highly effective in preventing infection from becoming reconstituted following treatment of existing disease, its use among cervical intraepithelial neoplasia (CIN)-positive females has remained sporadic. The following review provides an update on the current state of evidence about the acceptance, awareness, or perception of HPV vaccination by women following a diagnosis or treatment of CIN. Methods: A narrative synthesis of literature from the publication period of 2010 to 2025 was performed on PubMed, Scopus, and Google Scholar. Surveys that quantified literature on post-CIN vaccination attitudes, risk perceptions, or behavioral factors were considered. Results: Acceptance levels varied from 20–95% across all continents. The highest acceptance levels (≥80%) among the populations belong to the European and Oceanian groups, followed by moderate acceptance among the North Americans (60–80%), which was influenced by financial costs, misconceptions, and sociocultural stigmas. Several systemic-level features in Europe and Oceania have been shown to be consistently associated across these regions with high acceptance rates. These features include public funding of HPV vaccine delivery universally in these regions and reminder and recall systems established in their electronic health records. In these two regions, provider recommendation demonstrates particular significance because there is follow-up care after treatment of CIN. In these regions, mass awareness about HPV conducted in conjunction with their cervical screening programs increases baseline knowledge and favorability towards HPV vaccination. The lowest levels (20–70%) of awareness of HPV diseases and vaccination programs among Asians and Africans can be attributed to obstacles that include misconceptions about fertility concerns. In the case of Asia, there are various socially ingrained stigma factors that contribute to the poor awareness and acceptance levels. These factors include the possibility of being perceived as promiscuous, embarrassment linked to STI conditions, as well as the possibility of rejection from partners and in-laws. In particular regions, there might be stigmas attached to HPV vaccination that cause tension within married women who perceive the vaccine as an indicator of being unfaithful. Also, distrust from the general community has been driven by past incidents, including the halting of proactive HPV vaccine recommendations in Japan in 2013. Moreover, there are numerous myths concerning infertility and menstruation linked to poor vaccine acceptance. The key determinant of acceptance levels was physician endorsement, lack of knowledge of the association of HPV-CIN, or the belief that there is no need for vaccination after treatment. Conclusion: The acceptance of HPV vaccination among women following CIN is influenced by educational level, the structure of the healthcare system, and sociocultural factors. Incorporating evidence-based cervical vaccination counseling into follow-up care after biopsy could help increase its acceptance and prevent recurrent high-grade lesions. Full article

Background/Objectives: Cervical cancer is one of the most common cancers among women of reproductive age, with 80% of the cases occurring in developing countries. Cervical cancer is largely preventable by effective screening programs. This study assessed the knowledge, attitudes, cultural beliefs, and screening practices related to cervical cancer among women in the rural community of Lutubeni, Eastern Cape Province. Methods: A descriptive cross-sectional study was conducted among 95 women aged 25 years or older attending Lutubeni Clinic. Data was collected using a structured, validated questionnaire covering demographics, reproductive health, knowledge of cervical cancer, attitudes, cultural perceptions, and screening practices. Statistical analysis involved descriptive summaries, chi-square tests, and binary logistic regression. Results: Most participants exhibited poor knowledge of cervical cancer symptoms (47.4%) and risk factors (61.1%), with only 3.2% demonstrating good overall knowledge. Vaginal bleeding (60.0%) and foul-smelling discharge (50.5%) were the most recognized symptoms. Only 40.0% were aware of human papillomavirus (HPV) vaccination. While 87.4% knew about cervical cancer screening, only 55.8% had ever been screened. Of these, 43.2% had screened only once, primarily at the clinic (33.7%), mostly initiated by health professionals (41.1%). Positive attitudes toward screening were observed in 52.6%, while 88.4% held cultural beliefs that hindered open discussion about sexual health. Statistically significant factors associated with screening uptake included educational level (p = 0.047), knowledge of symptoms (p = 0.04), risk factors (p < 0.0001), prevention (p < 0.0001), treatment (p = 0.001), and attitudes (p < 0.0001). Independent predictors of poor screening practice were holding an associate degree (OR = 0.04, p = 0.042), having good preventive knowledge (OR = 0.02, p = 0.012), and having negative attitudes (OR = 36.22, p = 0.005). Conclusions: High awareness alone does not guarantee participation in cervical cancer screening in rural South Africa. Interventions must address cultural barriers, stigma, and negative perceptions while strengthening health education that links HPV vaccination with screening awareness. The unexpected association between associate degree attainment and poor screening underscores the complexity of behavioral determinants and warrants further investigation in larger cohorts. Full article

Background: During pregnancy, mothers and their infants are at increased risk for complications due to COVID-19 infection, influenza, and pertussis. At the time of writing, the previous advisory committee on immunization practices (ACIP) recommended that pregnant women receive the COVID-19 vaccine, influenza, tetanus-toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, as well as respiratory syncytial virus vaccinations during pregnancy. The COVID-19 pandemic greatly impacted routine vaccinations especially among medically underserved women in the South. The barriers to recommended vaccinations during pregnancy for medically underserved women in the South are unclear and require further investigation. The purpose of this study is to examine the attitudes, opinions, and beliefs of a multiracial pregnant cohort from diverse backgrounds in Central Tennessee about their experiences with the vaccines that are recommended during pregnancy. The vaccines included in the study are COVID-19, flu, and Tdap because RSV was not yet FDA-approved for pregnant women at the launch of this study. Methods: In this study, we focus on medically underserved women in Nashville, Tennessee, and the surrounding rural counties regarding vaccine acceptance and initiation of the COVID-19, influenza, and the Tdap vaccines. This study involved 208 pregnant people (100%) aged 18–49 years. All respondents were pregnant at the time of the study. The study consisted of a 26 question Redcap survey about participants’ beliefs, attitudes, opinions, and experiences with the COVID-19, flu, and Tdap vaccines during their pregnancy. Results: The randomly selected participants in the cohort were 40.4% White, 31.7% Black, 21.6% Hispanic, and 6.3% other race/ethnicity. The mothers in the cohort were young, with an average age of 27 years, most were married, and 52.8% had an annual household income before taxes of less than USD 35,000. Only 19.2% of the mothers in this study were very confident of the safety of the COVID-19 vaccine, compared to 32.7% for both the flu and Tdap vaccines. Overall, primary care providers were identified as the most trusted messengers for both disease and vaccine information for COVID-19, flu, and Tdap. However, only 11 participants out of 208 received all three of the ACIP recommended vaccines during their pregnancies in the study, barring the time-dependent vaccination for Tdap. The most common reasons for not receiving these vaccines involved concerns for the safety of themselves and their babies and a fear of needles. Conclusions: Education and awareness of ACIP-recommended vaccines during pregnancy needs improvement, and the support of primary care providers as the main driver of pregnancy vaccine initiation is essential. Full article

Background: Pertussis is a respiratory infection that represents a significant threat worldwide, especially for infants. The global incidence of pertussis is on the rise, with 20–40 million cases occurring every year. Maternal vaccination offers protection to newborns and, therefore, is recommended by numerous healthcare organizations. The aim of this study was to systematically assess the level of knowledge regarding pertussis and the pertussis vaccine, as well as the willingness to receive the vaccine among pregnant women, and identify the most significant reasons for vaccine hesitancy among the obstetric population. Methods: A systematic literature search was conducted in the Web of Science, Embase, and Scopus databases between 1 April 2024, and 31 July 2024. Our search strategy aimed to identify studies published from 1 January 2014 to July 2024 in order to capture a decade’s worth of the most recent evidence and updates in maternal pertussis vaccination. Results: We screened 955 articles altogether, with 11 studies included in the analysis. The general awareness of pertussis infection prior to participation in the study varied from 5% in a study performed in Turkey to 95.9% in the Norwegian population. Moreover, the willingness to receive the vaccine ranged from 11.2% in the Turkish population to 94.8% in the Netherlands. Several statistically important factors affecting the decision have been identified, such as belief in safety and effectiveness, fear of adverse reactions, or healthcare professional recommendation. Conclusions: The general awareness regarding pertussis vaccine in pregnant women differs significantly depending on the population studied. However, it remains unsatisfactory even in populations with a high declared level of knowledge if asked specific questions. Presented results may indicate the need for studies on the efficacy of educational interventions for raising awareness about the meaning of pertussis immunization during pregnancy and preventing infection among neonates. Full article

Background/Objective: While no human monkeypox (MPXV) infections have been reported in Palestine, the rapid global increase in cases, including in neighboring countries, necessitates proactive public health preparedness. This study aimed to assess Palestinians’ willingness to receive MPXV vaccination and to identify associated predictors in the context of a potential outbreak. Methods: A cross-sectional online survey was conducted in September 2024. The questionnaire gathered data on participants’ sociodemographic characteristics, risk perceptions, Vaccine Trust Indicator (VTI) scores, vaccination history, and willingness to receive an MPXV vaccine. Bivariate analyses were performed using Pearson’s chi-square test, and a multivariate logistic regression model was employed to identify the determinants of MPXV vaccination willingness. Results: The overall willingness to receive MPXV vaccination was low (28.8%). Key findings included significant public misconceptions and concerns: 33% of respondents believed that natural immunity from infection was sufficient, while 43% expressed concerns about potential adverse effects, similar to those associated with COVID-19 vaccines. Furthermore, nearly 60% of participants stated they would decline a free MPXV vaccine. Multivariate analysis revealed that prior COVID-19 vaccination (aOR = 3.07, p < 0.05), a moderate VTI score (aOR = 6.65, p < 0.05), and prior influenza vaccination (aOR = 4.00, p < 0.05) were significant predictors of MPXV vaccination willingness. Willingness to pay for the vaccine also positively influenced vaccination intent. One of the common misconceptions found was the belief that having received a smallpox vaccination prior reduces the need for an MPXV vaccination. Conclusions: The willingness to receive an MPXV vaccine in Palestine is suboptimal. Prior vaccination behaviors and general trust in vaccines are key determinants of acceptance. These findings underscore the critical need for public health strategies focused on strengthening trust in vaccine efficacy and safety, along with targeted health education to enhance community preparedness for a potential MPXV outbreak. Full article

Background/Objectives: This longitudinal study investigated psychosocial predictors of COVID-19 vaccine intentions before vaccine availability (July 2020) and vaccine uptake or ongoing intent after widespread vaccine rollout (April 2021) using constructs from the Health Belief Model (HBM) and a measure of trust in government. Methods: A U.S. adult sample (N = 142) completed surveys at two time points: prior to and following the release of COVID-19 vaccines. Key predictors included demographics, trust in government, and HBM constructs. Hierarchical logistic regression was used to predict vaccine intent and uptake at both time points. Results: At Time 1, intent to vaccinate was significantly predicted by higher perceived susceptibility (p = 0.038), greater perceived benefits (p < 0.001), and lower perceived barriers (p = 0.002). Trust in government was not a significant predictor. At Time 2, vaccine uptake/ongoing intent was significantly predicted by higher trust in government (p = 0.047), greater perceived benefits (p < 0.001), and lower perceived barriers (p = 0.002). Perceived susceptibility was no longer a significant predictor. Between time points, trust in government and self-efficacy increased, while perceived severity and barriers decreased. Conclusions: Perceived benefits and barriers were robust predictors of vaccine behavior across both time points. Trust in government became a stronger predictor once vaccines were available, underscoring the importance of building and maintaining public trust throughout a health crisis. Messaging should emphasize vaccine benefits, proactively address barriers, and adapt over time as public perceptions shift. These findings inform strategies for enhancing vaccine confidence and readiness in future pandemics. Full article

Attitudes towards COVID-19 and lived experiences during the pandemic depended greatly on people’s level of education. This study extends a previous analysis of vaccine hesitancy as a function of formal education and examines additional indicators from the COVID-19 Trends and Impacts Survey for the United States during 2021–2022. The monthly values for social and health-related activities and constraints, testing and vaccination decisions, and information-seeking behaviours, as well as trust and beliefs, often varied markedly between education-defined classes. Many indicators present a significant gap between the attitudes and experiences of better-educated groups, represented by college/university graduates and those with post-graduate studies, on the one hand, and less-educated groups, including those with only high school or some college education, on the other hand. These patterns suggest that the academic and professional-managerial classes, which supply the vast majority of societal decision-makers, may be ill-equipped to understand and respect the needs and worries of the working class in an emergency situation such as the COVID-19 pandemic. Given growing concerns about the benefit–harm balance of many government policies, a more inclusive pandemic response could have been achieved by respecting and adopting the common sense, scepticism, and outright opposition of the less-educated groups vis-a-vis restrictions and public health measures. Full article

Background/Objectives: HPV vaccination uptake among adolescents and young adults in the US remains low, and coverage in the Midwest falls short of the Healthy People 2030 goal of 80%. Methods: A cross-sectional survey of adolescents and young adults was conducted to identify facilitators and barriers to HPV vaccination uptake among adolescents and young adults in the Midwest. Results: Out of 1306 individuals aged 13–26 years, 397 (30.4%) were fully vaccinated (2–3 doses), 124 (9.5%) had received one dose, 324 (24.8%) were unvaccinated, and 461 (35.3%) were unsure of their vaccination status. Awareness of HPV vaccines (OR: 2.4, 95% CI: 1.6, 3.6), beliefs about vaccine effectiveness (OR: 1.8, 95% CI: 1.1, 2.9), family support (OR: 2.3 95% CI: 1.4, 3.8) and knowing someone with cervical cancer (OR: 1.8, 95% CI: 1.2, 2.7) were associated with increased odds of full vaccination. Beliefs in vaccine safety (OR: 2.0, 95%CI: 1.0, 3.9) and having health insurance coverage (OR: 1.9, 95% CI: 1.0, 3.5) were associated with increased odds of initiated vaccination (i.e., receiving at least one dose). Concerns about vaccine side effects (OR: 0.5, 95% CI: 0.3, 0.8) and not receiving recommendations from doctors were significantly associated with decreased odds of full vaccination (OR: 0.5, 95% CI: 0.3, 0.8) or initiated vaccination (OR: 0.5% CI: 0.2, 0.9). Clinician recommendations and awareness also reduced the likelihood of unknown vaccination status. Race-stratified analyses suggested heterogeneity in predictors across racial/ethnic groups. Conclusions: Our findings support the need for multi-level interventions aimed at increasing HPV vaccination initiation and completion in the Midwest. Full article

Childhood immunization is one of the most effective public health measures, yet inequities remain in marginalized populations across Asia, where parental adherence is essential to sustaining the Expanded Program on Immunization. This narrative review examines determinants of adherence among under-five children in disadvantaged communities. Following PRISMA guidelines, searches of PubMed, Scopus, and Google Scholar identified studies published between 2015 and 2025, with earlier key works included as relevant. Twenty-one studies from South, Southeast, and East Asia were analyzed. Five domains were associated with adherence: socioeconomic and access factors, where maternal education, household income, and possession of immunization cards were positive predictors, while remote residence was a barrier; trust, cultural beliefs, and social norms, with misinformation and vaccine controversies reducing uptake, and provider trust and supportive norms improving it; migration and mobility, as migrant, stateless, and left-behind children had lower coverage due to weak registration and disrupted caregiving; household and caregiver dynamics, where decision-making by family or community members shaped uptake, while large family size and maternal employment limited adherence; and health system capacity, with inadequate infrastructure and follow-up hindering coverage and integration with maternal–child health services facilitating it. Addressing these intersecting barriers through equity-focused strategies is critical to achieving universal immunization coverage. Full article

Background/Objectives: With declining vaccine coverage and rising concerns regarding vaccines, vaccine-preventable diseases are rising. Many research studies have examined approaches to enhance the acceptance of vaccines, but the integration of these approaches into practice has been limited. Thus, the objective was to identify recent evidence surrounding provider–patient communication tools and approaches related to vaccination confidence. Methods: A systematic review following PRISMA methodology was conducted. Using a pre-specified search strategy aligned with the research objective and performed in PubMed, CINAHL, and Web of Science, articles were evaluated by two researchers independently, with a third resolving discrepancies, at the title and abstract screening, full-text review, quality assessment, and data extraction phases. Extraction data were descriptively analyzed, including the impact on vaccine acceptance, and synthesized thematically. Results: From the 2291 studies which underwent screening, a total of, 143 articles were included. Most studies were conducted in the United States, in the outpatient setting, and utilized physicians and nurses to deliver the intervention. Many vaccines were covered, with the greatest number of studies focusing on influenza, HPV, and pneumococcal vaccines. The three predominant communication approaches and tools utilized were provider-focused training, direct patient education/materials, and provider–patient communication strategies. These strategies often focused on addressing knowledge gaps, health beliefs, and common concerns. Over two-thirds of studies increased vaccine acceptance following communication interventions. Conclusions: To address vaccine concerns, it is important to ensure providers have the education and training necessary as well as tools to address underlying causes of concerns. When equipped, providers are able to improve vaccine acceptance. Full article