Search Results (71)

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

The uptake of the COVID-19 and seasonal influenza (SI) vaccines have decreased in Europe and especially in Malta. The present study aimed to investigate the attitudes toward COVID-19 and SI vaccines and determine if individuals perceive that these vaccines are relevant to protect their health and identify reasons for their responses. A cross-sectional study using an anonymous questionnaire, informed by the Theory of Planned Behavior, addressing behavior beliefs and attitudes, and targeted at adult residents in Malta, was designed on Google Forms and disseminated using social media between January and March 2024. A total of 555 responses were received. The majority of respondents did not take/intend to take the COVID-19 (75%, n = 417) or SI (64.3%, n = 362) vaccines, with females being less likely to do so (p = 0.033). Perceived lack of safety (31.3%, n = 174) was the primary reason for rejecting the COVID-19 vaccine, and perceived lack of a threat from SI (26%, n = 144) was the reason for rejecting the SI vaccine. Those having chronic conditions were positively associated with uptake of both vaccines. In the post-pandemic era, these vaccines are not envisaged as having a major role in protecting one’s health. A high degree of skepticism especially toward the combined COVID-19 and SI vaccine in terms of safety, mostly in women, is still present. Full article

Background: Elderly patients with chronic lower respiratory diseases (CLRDs) demonstrate an increased susceptibility to complications arising from influenza. Influenza vaccination remains the most effective strategy against influenza-related diseases among elderly CLRD patients. This study aimed to evaluate the influenza vaccination status of older CLRD patients and the factors affecting influenza vaccination. Methods: Using population-based health registries, we analyzed the longitudinal uptake of influenza vaccination among elderly patients with CLRDs in Ningbo from the 2018/19 season to the 2022/23 season. A multivariate logistic regression analysis was performed to identify behavioral determinants influencing influenza vaccination among elderly CLRD patients under Ningbo’s post-pandemic free vaccination policy. Results: An average of 487,309 older patients with CLRDs were included in our analysis for each season. The influenza vaccination rate increased from 3.59% in 2018/19 to 43.32% in the 2022/23 influenza season. There was a significant increase in the proportion of timely influenza vaccinations prior to November 15, rising from 3.01% before the COVID-19 pandemic to 33.90% during the pandemic period. The multivariate logistic regression analysis indicated that both the COVID-19 pandemic and free vaccination policy significantly promoted influenza vaccine uptake. Older CLRD patients with comorbidities such as diabetes, hypertension, or cancer exhibited higher influenza vaccination coverage, whereas those who have experienced acute cardiovascular events showed a lower vaccination rate. Additionally, a prior vaccination history significantly influenced uptake. Conclusions: Despite the significant improvement in vaccination rates, coverage among elderly patients with CLRDs remains below the WHO target. Addressing this gap requires integrated interventions that combine expanding the population eligible for free vaccinations, community mobilization efforts, and effective communication regarding cardiovascular safety to mitigate vaccine hesitancy within high-risk groups. Full article

Background/Objectives: Influenza vaccination plays a crucial role in reducing morbidity and mortality among older adults; however, uptake remains suboptimal, particularly in the post-COVID-19 pandemic. In many settings, countries have not recovered their influenza vaccine coverage rates to the same level as pre-COVID. Therefore, this scoping review systematically identified the behavioral and social drivers (BeSD) influencing influenza vaccination among older adults using the BeSD framework. Methods: A systematic search across five databases included quantitative, qualitative, and mixed-methods studies involving individuals aged 60 years and older. Data were charted across four BeSD domains: thinking and feeling, social processes, motivation, and practical issues. Results: Thirty-nine studies from 24 countries were included. Key barriers encompassed safety concerns, misinformation, financial burdens, logistical challenges, and cultural and language barriers. While motivation was positively associated with vaccination intentions, the transition from intention to behavior remains underexplored, and practical issues have received comparatively limited research attention. Conclusions: These findings underscore the need for multifaceted, behaviorally informed interventions and greater inclusion of under-resourced settings to support equitable influenza vaccination strategies for healthy aging. Full article

Congenital Rubella Syndrome (CRS) results from maternal infection with the rubella virus during pregnancy, particularly in the first trimester, when the risk of vertical transmission and severe fetal damage is highest. CRS is characterized by a broad spectrum of congenital anomalies, including sensorineural hearing loss, congenital heart defects, cataracts, neurodevelopmental delay, and behavioral disorders. Despite the absence of specific antiviral therapies, active immunization remains the only effective strategy to prevent rubella infection and its congenital consequences. Global immunization efforts, particularly in the Americas, have led to the elimination of rubella and CRS in several countries. However, challenges persist in the post-elimination era, including declining vaccine coverage, vaccine hesitancy, and setbacks caused by the COVID-19 pandemic. Diagnosis relies on maternal serology, fetal imaging, postnatal antibody testing, and molecular techniques. Management requires long-term, multidisciplinary follow-up due to the complex and lifelong sequelae affecting sensory, motor, and cognitive development. This review highlights the clinical, epidemiological, and pathophysiological aspects of CRS, while emphasizing the urgent need to maintain high vaccination coverage and strengthen surveillance systems. Sustained public health commitment is essential to prevent the reemergence of rubella and protect future generations from this preventable syndrome. Full article

Background: The MVA-BN vaccine is considered effective for preventing mpox in key populations, based on observational studies, though no randomized trials have yet confirmed its effectiveness. Observational studies published to date rely on retrospective analyses of routine data, often missing information on relevant risk factors for mpox. Methods: Multi-country target trial emulation study with prospective data collection. Between 1 September 2022 and 15 June 2023, we recruited individuals eligible for mpox vaccination based on clinical history and exposure behaviors via healthcare centers and social venues in Spain, Peru, Panama, and Chile. Vaccinated individuals were paired with unvaccinated counterparts matched by mpox risk factors, country, recruitment date, and age. Follow-up continued via periodic surveys until 31 March 2024. The primary endpoint was symptomatic mpox occurrence ≥14 days post-vaccination. Results: The primary analysis included 1028 individuals (514 vaccinated, 514 unvaccinated) with a median follow-up time of 9.3 months (IQR 4.7–13.7). Mpox occurred in eight participants (0.8%): three vaccinated and five unvaccinated (HR 0.6; 95% CI 0.21–1.70). Adverse reactions were reported by 731 (49.6%) participants, predominantly skin reactions (703/1475; 47.7%), while systemic reactions occurred in 107 (7.3%). Long-lasting erythema at the injection site was reported in 450/1058 (42.5%) participants, persisting >6 months in 107 of them (23.8%). Conclusions: The low incidence of mpox during the study period resulted in a limited number of endpoint events, precluding robust conclusions on the efficacy of the MVA-BN vaccine as pre-exposure prevention for mpox. However, our analysis, which accounted for key confounders such as exposure behaviors, yielded results consistent with previous studies suggesting the effectiveness of the vaccine in the mpox setting. Full article

Background/Objectives. Bovine botulism, although relatively rare, presents significant economic losses due to high mortality rates and restrictions on livestock product trade. Vaccination remains the most effective strategy for preventing botulism-related mortality. This study evaluated the efficacy of a bivalent recombinant vaccine targeting the C-terminal portion of the heavy chain (Hc) of botulinum neurotoxin serotype C (BoNT/C) (Hc BoNT/C) and botulinum neurotoxin serotype D (BoNT/D) (Hc BoNT/D) in inducing neutralizing antibodies against these toxins and their mosaic variants BoNT/CD and BoNT/DC in cattle. This comparison aims to improve the design of an optimal recombinant vaccine for preventing bovine botulism caused by the most common serotypes. Methods. Twenty, four-month-old Holstein Friesian calves were randomly assigned to two groups of ten animals: vaccinated group and control group. Sera were collected at various time points to assess antibody titers using ELISA and neutralizing antibody titers using a mouse protection assay. Neutralizing antibody titers were compared to those obtained with a commercially available toxoid vaccine. Results. The recombinant vaccine elicited significant increases in anti-HcBoNT/C and anti-HcBoNT/D IgG antibody levels in vaccinated animals compared to controls animals with no adverse effects. Specifically, post-vaccination, the calves showed no local reactions (swelling, warmth) or behavioral changes suggestive of systemic illness. Neutralizing antibody titers against BoNT/C and BoNT/D were significantly higher in the recombinant vaccine group compared to the toxoid vaccine group. However, the recombinant vaccine showed lower neutralizing activity against BoNT/DC compared to the toxoid vaccine. Conclusions. The bivalent recombinant vaccine demonstrated promising immunogenicity in cattle, inducing high neutralizing antibody titers against BoNT/C and BoNT/D. While effective against these toxins, the lower efficacy against BoNT/DC highlights the need for further research to optimize the vaccine formulation, potentially by incorporating a BoNT/DC Hc component, to provide broader protection against bovine botulism. Full article

Public health officials reported increases in stigma, discrimination, and verbal and physical abuse during the coronavirus (COVID-19) pandemic. This study, conducted in Vietnam, examined how stigma, fear of the virus, self-protective behaviors, and threats to and loss of resources during the pandemic were associated with post-traumatic stress and belief in vaccine effectiveness. Participants were 380 persons (237 women, 129 men, 14 unreported) who completed measures assessing demographics, stigma experienced during the pandemic, resource loss, fear about becoming infected with the virus, self-protective actions to avoid illness, post-traumatic stress, and belief in COVID-19 vaccination effectiveness. Hierarchical multiple regression showed post-traumatic stress was positively associated with COVID-19 stigma personal experience, minimizing the COVID-19 threat, personal characteristic and support resource loss, perceived susceptibility to illness, and fear of COVID-19. Vaccine support was positively associated with age, COVID-19 stigma personal experience, and self-protective behaviors to avoid illness, and negatively associated with number of people known who died due to the virus. The findings support the hypotheses and extend conservation of resources stress theory. The findings underscore the importance of promptly addressing stigma, enhancing public education, and addressing barriers to receiving the vaccine. Full article

Background/Objectives: Since the COVID-19 pandemic began, vaccination rates for preventable diseases, including influenza, have significantly dropped among racially and ethnically minoritized (REM) individuals in the United States. This study explored the effects of a community-based educational intervention designed to improve influenza vaccine literacy and acceptance among vulnerable REM individuals. Methods: The intervention included four 45 min interactive educational sessions on the influenza vaccine. The session attendees (18+) were invited to participate in a pre-/post-intervention study where an anonymous survey measured their post-COVID-19 pandemic attitudes, knowledge, and behaviors regarding the influenza virus and vaccine. To assess the effect of the intervention on vaccine literacy, we used a Mann–Whitney U test to test for differences between the pre-/post-intervention survey responses to seven knowledge-based questions. Descriptive statistics were employed to assess the impact of intervention on vaccine acceptance. Results: A total of 116 participants completed the pre-intervention survey, and 90 (78%) completed the post-intervention survey. All (100%) identified as REM, and 99% lived in highly vulnerable areas. Only 43% believed they were at risk for viral infection before the intervention, but 60% said the intervention helped them reassess their risk. We found significant differences in vaccine literacy when comparing the pre-/post-intervention survey responses, particularly regarding guideline-based vaccine recommendations (p < 0.05). Before the intervention, 65% of the participants indicated a high likelihood of receiving the influenza vaccine. In contrast, after the intervention, 81% of respondents indicated a high likelihood of being vaccinated, and 72% indicated that they were “extremely likely” to receive the immunization. Conclusions: Community-based educational interventions can have a positive impact on influenza vaccine literacy and acceptance among vulnerable REM populations in the post-COVID-19 era. Full article

Background/Objectives: Environmental enrichment (EE) devices are required in various countries and markets to promote animal welfare, with dual-purpose devices more likely to encourage adoption. We developed an EE device that allows pigs to self-administer liquids, designed to align with natural and play behaviors, and utilized a maternal pheromone (MP) to attract pigs to the device. This study aimed to evaluate the efficacy of this device in delivering vaccines for Erysipelas, Ileitis, Mycoplasma, and Influenza to growing pigs. Methods: Pigs were assigned to three treatments groups: Control (unvaccinated), Hand-Vaccinated (via oral gavage or intramuscular injection), and Self-Vaccinated using the EE device. Baseline samples were collected to determine initial antibody status, and serum and oral fluids’ IgG and IgA levels were measured post-vaccination to assess immune response. Four studies were conducted with 36 pigs (12 per treatment) over a 49-day period. Results: Self-vaccination pigs receiving the avirulent live Erysipelas vaccine developed oral and serum antibodies comparable to Hand-Vaccinated pigs. Pigs self-administering the avirulent live Lawsonia intracelluaris vaccine developed oral fluid antibodies. In contrast, pigs who received Mycoplasma or Influenza vaccines through self-vaccination exhibited significantly lower antibody levels compared to the Hand-Vaccinated group. Conclusions: These findings demonstrated that self-vaccination using EE devices for the oral administration of avirulent live vaccines offers benefits such as reduced labor and improved animal welfare. However, killed vaccines did not elicit sufficient antibody responses, suggesting the need for modified vaccine formulations or administration strategies to improve self-vaccination efficacy. Full article

The SARS-CoV-2 pandemic has reshaped the epidemiological landscape of respiratory diseases, with profound implications for seasonal influenza. Nonpharmaceutical interventions implemented globally during the pandemic significantly altered human behavior and reduced the prevalence of respiratory pathogens, including influenza. However, the post-pandemic resurgence of influenza activity to pre-pandemic levels highlights the persistent challenges posed by this virus. During the 2023–2024 influenza season in the United States, an estimated 40 million individuals contracted influenza, resulting in 470,000 hospitalizations and 28,000 deaths, with the elderly disproportionately affected. Pediatric mortality was also notable, with 724 deaths reported among children. This study examines trends in influenza incidence, vaccination rates, and mortality in the United States from the 2018–2019 through to the 2023–2024 influenza seasons. Additionally, it evaluates the interplay between influenza and SARS-CoV-2 during the pandemic, considering the impact of disrupted air travel, public health measures, and altered virus circulation dynamics. By integrating these insights, the study underscores the critical need for sustained vaccination campaigns and innovative public health strategies to mitigate the dual burden of respiratory diseases. Findings from this analysis highlight the urgency of strengthening prevention and surveillance systems to enhance pandemic preparedness and reduce the impact of respiratory pathogens in an evolving epidemiological landscape. Full article

Background/Objectives: Pleural effusion represents an accumulation of fluid in the pleural cavity, frequently associated with pneumonia. There has been a gradual increase in cases among children in recent years, with a notable rise during the post-pandemic period, potentially due to immune debt, decreased vaccination coverage, and changes in pathogen dynamics. Methods: We enrolled 66 children with pleural effusion treated at the Children’s Emergency Clinical Hospital, Brasov, between January 2019 and September 2024. We analyzed the data on demographics, symptoms, vaccination status, hospitalization, and treatments to assess the trends in the incidence and clinical features. Results: The median age was 5 years (ranging from 3 months to 17 years). Most patients were male (57.5%) from rural areas (34.8%). Only 40.9% fulfilled the vaccination schedule of Romania. We observed a rise in hospitalizations in the last two years, with 16 cases in 2023 and 15 in 2024, and most were being admitted in April (15.5%). Patients mainly had severe (36%) and medium (26%) acute respiratory failure. S. pneumoniae was the most common isolate with two cases each of serotype 1, 14, and 23A, and one case each of serotype 3, 31, and 34, followed by H. influenzae and P. aeruginosa. Treatment was mostly with ceftriaxone (69.6%), Vancomycin (63.6%), Meropenem (53.0%), and Teicoplanin (25.7%). Some children required thoracic drainage (34.8%). Complications like pneumothorax (16.6%), polyserositis (4.5%), and pneumomediastinum (3.0%) were found. Conclusions: The rise in pleural effusion cases may be influenced by various factors, such as changes in pathogen behavior or host immune responses following the pandemic. Further research is needed to understand these potential mechanisms. The emergence of non-PCV20 strains and the common occurrence of serotype 3 infections point out the need to study serotype trends and evaluate whether expanding vaccine programs could be beneficial. Full article

Social media is a crucial tool for health communication as it provides an immediate, wide-reaching platform to share information, correct misinformation, and promote health behaviors. The Health Belief Model (HBM) offers a structured approach for designing more effective social media messages by employing unique constructs predicting health behaviors, such as severity, susceptibility, benefits, barriers, and self-efficacy. While prior research has explored HBM constructs in health messages, most studies have collected the survey data with items lacking robust psychometric evidence, particularly in evaluating social media posts. This study addresses this gap by using Rasch Measurement Theory (RMT) to analyze the psychometric properties of HBM items evaluating social media posts promoting COVID-19 vaccination. The findings indicate that severity, benefits, and barriers are the most reliable HBM constructs in social media posts, while susceptibility and self-efficacy are underutilized in health messaging for social media. Also, dimensionality analysis confirms distinct patterns, but unexplained variance suggests that additional factors influence vaccine messaging, raising validity concerns. These results underscore the need to refine HBM-based message strategies by emphasizing overlooked constructs and improving item effectiveness. This study provides guidelines for using HBM-related measures in social media by establishing comprehensive psychometric properties, especially when applied in social media contexts. It also presents practical guidelines for designing and evaluating social media health messages, ensuring they effectively utilize HBM constructs to promote positive health behaviors. Future research should explore measurement invariance and content creators’ emphasis on HBM constructs, leveraging high-engagement tweets while expanding to diverse perspectives for broader applicability. Full article

In recent years, polarization on social media has risen significantly. Social platforms often feature a range of topics that give rise to communities of users with diametrically opposed views, who tend to avoid engaging with others having different perspectives. We call these types of communities “diverging communities”. Examples include communities of supporters and skeptics of climate change or COVID-19 vaccines. In this paper, we aim to investigate this phenomenon. To do so, we first propose a formal definition of discording communities. We then present a framework for investigating the behavior of users of discording communities on a social platform. Our framework is general in that it can be adapted to any social platform where users discuss a topic that polarizes them into communities with diametrically opposed viewpoints rejecting confrontation. Our framework considers not only the structure of communities but also the content of the messages posted by their users. Finally, it can also handle the temporal evolution of the polarization level of both communities and their users. In addition to proposing a formal definition of diverging communities and presenting our framework, we illustrate the results of an extensive experimental campaign carried out on two case studies involving Reddit and X and show how our framework is able to identify a number of features that distinguish the users of one diverging community from the users of the other. Full article

Background: Human papilloma virus (HPV) affects both males and females, but in South Korea, vaccination rates for boys are significantly lower due to cultural stigma and limited awareness. Effective strategies are needed to close this gap. Methods: This study evaluated a 6-week smartphone-based HPV prevention program for mothers of school-aged boys, designed using the extended theory of planned behavior (E-TPB). The program aimed to enhance knowledge, attitudes, subjective norms, and self-efficacy, with the goal of increasing vaccination intention and uptake. The E-TPB incorporated knowledge as a key element to improve behavioral intention and vaccination uptake. A nonequivalent control group pre-test–post-test design included 54 mothers (28 in the experimental group and 26 in the control group). Results: The experimental group showed significant improvements in HPV knowledge (p < 0.001; d = 1.41), HPV vaccine knowledge (p < 0.001; d = 1.13), attitudes (p < 0.001; r = 0.48), subjective norms (p = 0.014; d = 0.61), self-efficacy (p < 0.001; r = 0.53), and vaccination intention (p < 0.001; r = 0.58). The experimental group achieved a vaccination uptake rate of 25.0%, compared to 4.0% in the control group, representing a six-fold increase (RR = 6.25; p = 0.033; h = 0.64). Conclusions: The program effectively addressed key factors influencing vaccination behavior, leading to significant increases in HPV vaccination rates among boys. Smartphone-based education shows promise in reducing gender disparities in vaccination uptake, though further studies with larger samples are needed to validate these findings. Full article