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Gitanjli Arora Deborah Lehman Sandhya Charlu Nicole Ross Adriana Ardy Bahareh Gordon Pia S. Pannaraj 《Vaccine》2019,37(6):857-862
Objective
A pilot study of pediatric residents to describe perceived benefits and effects of vaccines and educational influences on vaccine practice among pediatric residents.Study design
Eighty-seven residents, from two institutions in a region with relatively high vaccine hesitancy, responded to a survey conducted in 2014–2015.Results
Residents identified professional experiences with vaccine preventable diseases (VPDs) and observing pediatricians as most impactful to their vaccine beliefs. Residents who had observed pediatric faculty agreeing to alternative or delayed vaccinations were more likely to believe this to be acceptable vaccine practice (70.1% vs. 21.1%, χ2?=?17.778, p?<?0.001). Most residents (68 [79.1%]) reported feeling confident in their ability to discuss vaccines.Conclusions
Pediatricians must be equipped with accurate vaccine health beliefs to impact parental vaccine hesitancy. This study identifies important gaps in medical education, with pediatric residents reporting limitations in their professional experience with VPDs and high rates of observing alternative vaccination practice. 相似文献3.
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Introduction
Although FDA approved for over 10?years, uptake of the human papillomavirus (HPV) vaccination has been slow, particularly among states in the Deep South with high cervical cancer incidence and mortality. The purpose of this study was to explore variables associated with cervical cancer among survivors who were age-eligible for the HPV vaccine and to assess HPV vaccination history, barriers, perceptions, and other associated behaviors within this cohort.Methods
A mixed methods strategy was used for the study, first identifying eligible cervical cancer survivors from our institution and abstracting demographic and clinicopathologic medical record data. Twenty-three participants from this cohort then completed semi-structured qualitative telephone interviews regarding HPV vaccination participation, knowledge, and attitudes. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis.Results
Of the 464 cervical cancer patients treated at our institution from 2011 to 2016, 137 (30%) were under age 40 at diagnosis. Seventy-seven women with invasive disease were identified (median age?=?33?years), and 56% had been seen by a gynecologist within 5?years of diagnosis. Forty-six of these women met eligibility criteria for inclusion in the qualitative interview, of which 23 successfully completed (response rate?=?50%). Of those interviewed, the majority (84%) reported current access to regular medical care. While 90.9% did not receive any doses of HPV vaccination, 78.3% stated they likely would have been vaccinated if it had it been recommended. Four major themes were identified within the interviews: HPV knowledge, vaccine acceptability, healthcare engagement, and provider communication.Conclusions
Qualitative interviews revealed significant missed opportunities for prevention since most participants stated they would have been vaccinated if given the option. Substantial gaps in knowledge and mixed understanding HPV’s association with cervical cancer were observed, demonstrating potential missed opportunities for education and communication between providers of multiple specialties and their patients. 相似文献5.
Background
The current Ebola outbreak in Eastern Democratic Republic of the Congo (DRC) is the second largest in history and the first in which the recombinant Vesicular Stomatitis Virus – Zaire Ebolavirus (rVSV-ZEBOV) vaccine has been used at scale. We assessed side-effects, satisfaction, and attitudes toward the new vaccine.Methods
Cross-sectional survey questionnaire from a convenience sample of 90 vaccine recipients and 96 community controls in Eastern DRC.Results
Side-effects were reported in 75/90 (83%) vaccine recipients but only 5 (7%) and 4 (5%) reported arthralgia and rash, respectively. 76/90 (84%) vaccinees were classified as “promoters” (would recommend vaccine to others) and 6/90 (7%) as “detractors.” 69/96 (72%) of unvaccinated community controls would wish to be vaccinated if supply were available. 153/186 (82%) would accept vaccination for family members.Conclusions
The rVSV-ZEBOV vaccine was well tolerated, with high acceptability in the community during the current outbreak in the DRC. 相似文献6.
Fangjun Zhou Jing Xu Carla L. Black Helen Ding Bo-Hyun Cho Peng-Jun Lu Megan C. Lindley 《Vaccine》2019,37(14):1972-1977
Background
Infants younger than 6?months are at increased risk of complications and mortality from pertussis infection. In October 2012, the Advisory Committee on Immunization Practices revised its recommendation to include a Tdap dose during each pregnancy, ideally between 27 and 36?weeks gestation.Objective
Assess trends in Tdap vaccination coverage among privately insured pregnant women from 2009 to 2016 including timing of Tdap vaccination (before, during, or after pregnancy), trimester of vaccination for women vaccinated during pregnancy, and missed vaccination opportunities for unvaccinated women. Identify factors associated with vaccination during the optimal period of 27–36?weeks gestation.Study design
Retrospective analysis of privately insured women 15–49?years who delivered live births during 2009–2016 conducted using 2009–2016 MarketScan data. Tdap vaccination coverage and the timing of Tdap vaccine administration were assessed for women continuously enrolled from 6?months before pregnancy to 1?month after delivery. Multivariable logistic regression was performed to identify factors independently associated with receipt of Tdap vaccine at 27–36?weeks gestation.Results
Tdap vaccination coverage during pregnancy increased from 0.4% in 2009 to 6.2% in 2012 and to 53.2% in 2016. The proportion of vaccinated women receiving Tdap at 27–36?weeks gestation increased from <10% in 2009 to nearly 90% in 2016, with most vaccination occurring at 27–32?weeks gestation. Women of older age, residing in a metropolitan statistical area, residing outside the South, and having a capitated health insurance plan were more likely to receive Tdap at 27–36?weeks gestation than their counterparts. Among women not vaccinated during pregnancy, 77.7% had a pregnancy-related medical claim between 27 and 36?weeks gestation.Conclusion
Tdap vaccination coverage during pregnancy increased significantly from 2009 to 2016, with the greatest increase occurring after the revised Advisory Committee on Immunization Practices recommendation. Most women who did not receive Tdap vaccine had a missed vaccination opportunity during pregnancy, indicating potential for much higher vaccination coverage and consequent infant protection against pertussis. 相似文献7.
Cristina Stasi Mirko Monnini Valerio Cellesi Marco Salvadori Daniele Marri Mateo Ameglio Andrea Gabbuti Teresa Di Fiandra Fabio Voller Caterina Silvestri 《Vaccine》2019,37(11):1412-1417
Background and Aim
Vaccine against hepatitis B virus (HBV) is highly effective in preventing HBV infection. The aims of this study were to (1) increase the epidemiological knowledge on the impact of HBV in Tuscany region prisons by registering the results of serum screening on a clinical medical record and (2) increase the anti-HBV vaccination using an accelerated schedule.Methods
Our study population was composed of all detainees present in prisons and all constrained from freedom or at institutions in the Tuscany region and not vaccinated at these facilities from 1 December 2016 to 31 May 2017.Results
Of 17 detention facilities in the Tuscany region, 15 were enrolled in the study. On 28 February 2017, there were 3068 detainees present in these institutions. Considering the 1075 subjects screened for HBV serum markers, 730 (67.9%) were susceptible to infection and needed to be vaccinated. Five hundred and ninety-six agreed to be vaccinated (82%); 27 (2.5%) of our subjects had an isolated anti-HBc, 20 (1.9%) were HBV infected (HBsAg+), 127 (11.8%) had previous HBV infection (anti-HBs+, anti-HBc+ and HBsAg?), and 171 had been previously vaccinated. Five hundred and fifty-five inmates (95.1%) received the first vaccine dose, and 404 (83%) underwent the third dose at day 21.Conclusion
This study showed that of a high percentage of subjects who underwent screening, more than half needed to be vaccinated. Moreover, our study reached very high levels of vaccination coverage, considering both the entire enrolled population and the new inmates. 相似文献8.
A.F. Dempsey J. Pyrzanowski E.J. Campagna S. Lockhart S.T. O&#x;Leary 《Vaccine》2019,37(10):1307-1312
Objective
To assess secondary, parent-reported outcomes from a randomized controlled trial (RCT) of a provider communication intervention aimed at improving adolescent HPV vaccination.Methods
A paper survey was provided to a random sample of 777 parents of adolescents from 8 control and 8 intervention clinics participating in the larger trial. Chi-square or Fisher’s exact tests assessed associations between study arm and providers’ HPV vaccine communication strategies, parents’ vaccination attitudes and parent’s HPV vaccine acceptance. Exploratory analyses assessed the association between receipt of ‘very strong’ or presumptive HPV vaccine recommendation (regardless of study arm) and parent’s perceptions about their providers’ vaccine communication, and parents’ attitudes and acceptance of the HPV vaccine.Results
The response rate was 47%. There were no differences between study arms in parents’ report of how their provider communicated about the HPV vaccine, parent vaccination attitudes, or uptake of the HPV vaccine. Receipt of a ‘very strong’ recommendation was associated with greater perceived urgency for getting vaccinated, greater trust in the information received from the provider, decreased vaccine hesitancy, and increased vaccine receipt. Receipt of a presumptive recommendation was associated with a lower likelihood of having concerns about the vaccine’s safety, lower vaccine hesitancy, and an increased likelihood of vaccination. Neither recommendation strategy appeared to negatively impact parents’ visit experience or trust in the information being provided. Similar results were found in sub-analyses of vaccine hesitant parents.Conclusions
Providing very strong, presumptive HPV vaccine recommendations is associated with improved parent vaccination attitudes and acceptance, and does not seem to have significant negative impacts, even among parents who are vaccine hesitant. Response bias in our sample could explain why there were no reported differences between study arms in parents’ reports of how their adolescent’s providers communicated about the HPV vaccine. 相似文献9.
Patrick T. Wedlock Elizabeth A. Mitgang Assaf P. Oron Brittany L. Hagedorn Jim Leonard Shawn T. Brown Jennifer Bakal Sheryl S. Siegmund Bruce Y. Lee 《Vaccine》2019,37(17):2356-2368
Introduction
The lack of specific policies on how many children must be present at a vaccinating location before a healthcare worker can open a measles-containing vaccine (MCV) – i.e. the vial-opening threshold – has led to inconsistent practices, which can have wide-ranging systems effects.Methods
Using HERMES-generated simulation models of the routine immunization supply chains of Benin, Mozambique and Niger, we evaluated the impact of different vial-opening thresholds (none, 30% of doses must be used, 60%) and MCV presentations (10-dose, 5-dose) on each supply chain. We linked these outputs to a clinical- and economic-outcomes model which translated the change in vaccine availability to associated infections, medical costs, and DALYs. We calculated the economic impact of each policy from the health system perspective.Results
The vial-opening threshold that maximizes vaccine availability while minimizing costs varies between individual countries. In Benin (median session size?=?5), implementing a 30% vial-opening threshold and tailoring distribution of 10-dose and 5-dose MCVs to clinics based on session size is the most cost-effective policy, preventing 671 DALYs ($471/DALY averted) compared to baseline (no threshold, 10-dose MCVs). In Niger (median MCV session size?=?9), setting a 60% vial-opening threshold and tailoring MCV presentations is the most cost-effective policy, preventing 2897 DALYs ($16.05/ DALY averted). In Mozambique (median session size?=?3), setting a 30% vial-opening threshold using 10-dose MCVs is the only beneficial policy compared to baseline, preventing 3081 DALYs ($85.98/DALY averted). Across all three countries, however, a 30% vial-opening threshold using 10-dose MCVs everywhere is the only MCV threshold that consistently benefits each system compared to baseline.Conclusion
While the ideal vial-opening threshold policy for MCV varies by supply chain, implementing a 30% vial-opening threshold for 10-dose MCVs benefits each system by improving overall vaccine availability and reducing associated medical costs and DALYs compared to no threshold. 相似文献10.
Introduction
9-valent human papillomavirus vaccine (9vHPV) was approved by the Food and Drug Administration (FDA) in December 2014. 9vHPV is not recommended during pregnancy, but some women of childbearing age may be inadvertently exposed. This study aims to evaluate reports submitted to the Vaccine Adverse Event Reporting System (VAERS) of pregnant women exposed to 9vHPV.Methods
We searched the VAERS database, a national post-licensure vaccine safety surveillance system, for reports of pregnant women vaccinated with 9vHPV in the United States between December 10, 2014 and December 31, 2017. Disproportionate reporting of adverse events (AEs) was assessed using proportional reporting ratios (PRRs).Results
A total of 82 pregnancy reports were identified. Sixty reports (73.2%) did not describe an AE and were submitted only to report the vaccine exposure during pregnancy. The most frequently reported pregnancy-specific AE was spontaneous abortion (n?=?3; 3.7%), followed by vaginal bleeding (n?=?2; 2.4%). Among non-pregnancy-specific AEs, injection site reaction (n?=?3; 3.7%) was most common. No disproportionate reporting of any AE was found.Discussion
No unexpected AEs were observed among these pregnancy reports. 相似文献11.
Kriengkrai Prasert Jayanton Patumanond Prabda Praphasiri Supakit Siriluk Darunee Ditsungnoen Malinee Chittaganpich Fatimah S. Dawood Joshua A. Mott Kim A. Lindblade 《Vaccine》2019,37(6):783-791
Background
We conducted a two-year prospective cohort study to measure the effectiveness of trivalent inactivated influenza vaccine (IIV3) to prevent laboratory-confirmed influenza among community-dwelling Thai adults aged ≥65?years during 2015–16 and 2016–17 influenza seasons.Methods
In 2015, we enrolled a cohort of 3220 participants. Trained health volunteers collected baseline data and followed participants for two years with weekly surveillance for new or worsened cough with self-collection of nasal swabs. Vaccine effectiveness (VE) was estimated as 100%?×?(1- rate ratio of rRT-PCR -confirmed influenza) among vaccinated versus unvaccinated participants. Propensity score stratification was used to reduce differences between vaccinated and unvaccinated participants associated with access to and receipt of IIV3.Findings
During 2015–16 and 2016–17, 1666 (52%) and 1498 (48%) participants received IIV3, respectively. The overall incidence of influenza during the two seasons was 14.3/1000 person-years among vaccinated participants and 20.2/1000 person-years among unvaccinated participants. VE was ?4% (95% confidence interval [CI], ?83%–40%) during 2015–16 when there was poor antigenic match between the dominant circulating A/H3N2 viruses and the vaccine strain, and 50% (95% CI, 12–71%) during 2016–17 when circulating and vaccine strains were well-matched. Of all three influenza subtypes in both years, significant protection was observed only against Influenza A/H3N2 during 2016–17 (VE, 49%; 95% CI, 3–73%).Interpretation
During a season with well-matched circulating and vaccine strains, IIV3 was moderately effective against laboratory-confirmed influenza among older adults in Thailand. 相似文献12.
Daniel A. Norman Margie Danchin Paul Van Buynder Hannah C. Moore Christopher C. Blyth Holly Seale 《Vaccine》2019,37(16):2244-2248
Background
Influenza vaccination is recommended and funded for Australian children with medical comorbidities that increase their risk of severe influenza. Despite this, influenza vaccine coverage remains low within this population. We examined caregivers’ attitudes and practices for influenza vaccination in children with medical comorbidities.Methods
Cross-sectional surveys were conducted with caregivers of children (6?months to <18?years old) with medical comorbidities attending sub-speciality paediatric outpatient clinics at the Royal Children’s Hospital (Melbourne), Princess Margaret Hospital (Perth), and Leading Steps private paediatric clinic (Gold Coast). Multivariate linear regression was used to identify surveys responses predictive of receipt of influenza vaccination in 2017.Results
From the 611 surveys collected, 556 were suitable for analysis. Caregiver reported 2017 influenza vaccine coverage was 52.2% in children with medical comorbidities. Caregivers who believed influenza vaccines to be ≥50% effective were more likely to vaccinate their children (adjusted Odds Ratio [aOR]:3.79 (2.41; 5.96). Those who expressed concerns about vaccine side effects were less likely to vaccinate their children (aOR: 0.49 [95% CI: 0.30; 0.80]). Influenza vaccine uptake was significantly more likely for children who had been previously recommended influenza vaccination by their hospital-based physician (aOR: 4.33 [95% CI: 2.58; 7.27]) and had previously received a hospital-based vaccination (aOR: 3.11 [95% CI 1.79; 5.40]). Hospital-based physicians were also caregivers’ most commonly reported source of trusted vaccination information (63.5%). Whilst only 29.3% of caregivers reported their child had been recommended influenza vaccination during a previous admission, 80.1% of caregivers stated they were receptive to their child receiving potential future influenza vaccinations during hospitalisations.Conclusions
Reported influenza vaccination coverage in children with medical comorbidities remains inadequate. An important finding of this study is that influenza vaccination recommendation by children’s hospital physicians and previous vaccine receipt in hospital was associated with vaccine uptake. Opportunities for vaccination, especially during hospitalisation, must be examined. 相似文献13.
Darios Getahun Michael J. Fassett Morgan R. Peltier Harpreet S. Takhar Sally F. Shaw Theresa M. Im Vicki Y. Chiu Steven J. Jacobsen 《Vaccine》2019,37(13):1785-1791
Objective
Influenza vaccination during pregnancy is known to prevent severe influenza illness but its effects on other outcomes and the extent to which its safety is affected by timing of vaccination, maternal race/ethnicity and the type of vaccine is less clear. Therefore, we examined this in a large retrospective cohort.Methods
We analyzed medical and vaccination records from the Kaiser Permanente Southern California (KPSC) records and from the Kaiser Immunization Tracking System (2008–2016). The study included women who were pregnant with singletons during the influenza season. Odds ratios (OR) and their 95% confidence intervals (CI) were used to quantify the associations between immunization status during pregnancy and prenatal and postnatal outcomes after adjusting for confounders.Results
Of the 247,036 women in these analyses, 53% were vaccinated during their pregnancy. No association between influenza vaccination during pregnancy and adverse prenatal and neonatal outcomes were observed. Influenza vaccination is associated with reduced risk of influenza (OR: 0.49, 95% CI: 0.39–0.62), maternal fever (OR: 0.40, 95% CI: 0.35–0.45), preeclampsia (OR: 0.93, 95% CI: 0.90–0.96), placental abruption (OR: 0.89, 95% CI: 0.82–0.96), stillbirth (OR: 0.88, 95% CI: 0.78–0.99), and NICU admission (OR: 0.89, 95% CI: 0.87–0.92). Both active and inactive vaccines were found to be safe in vaccinated pregnant women regardless of timing of vaccination.Conclusions
This study found no evidence of adverse maternal and infant outcomes associated with seasonal influenza vaccine during pregnancy. On the contrary, vaccinated women were less likely to have adverse outcomes than unvaccinated women. The lack of increased adverse outcomes associated with influenza vaccination suggests that the benefits of vaccination during pregnancy to the woman and her child far outweigh any risk, if there is one, from the vaccination. 相似文献14.
Rulin C. Hechter Lei Qian Yi Luo Deborah S. Ling Grant Roger Baxter Nicola P. Klein Karen Valdez Nunley Laurie Aukes Cosmina Hogea Girishanthy Krishnarajah Brandon J. Patterson Theresa M. Im Hung Fu Tseng 《Vaccine》2019,37(1):195-201
Objective
The Advisory Committee on Immunization Practices recommends Hepatitis B (HepB) vaccine for previously unvaccinated adults <60?years with diabetes mellitus. This observational retrospective cohort study assessed the impact of implementing electronic provider reminders on HepB vaccine initiation and 3-dose series completion rates among insured adults with diabetes aged 19–59?years old.Research design and methods
Difference-in-difference (DID) analyses compared changes in vaccine initiation and completion rates (ratio of the rate ratio [RRR] and 95% confidence interval [CI]) during 12?months pre- and post-implementation between intervention and control sites. We examined trends in vaccine initiation and completion rates by plotting monthly rates during the study period. We also calculated the overall HepB vaccine coverage rates with 95% CI among all adults with diabetes aged 19–59?years old at the start and end date of the study period.Results
Baseline HepB vaccine initiation and completion rates were similar at both the intervention and control sites. Gender, age, and race/ethnicity distributions within both sites were similar during the 12?months pre- and post-implementation. DID analyses demonstrated statistically significant differences in the changes of the annual vaccine initiation rates (RRR: 70.7, 95% CI: 62.8–79.6) and the third dose completion rates (RRR?=?18.7, 95% CI: 14.2–24.8) between the two sites. The coverage increased significantly at the intervention site while it remained low at the control site.Conclusions
Use of provider reminders is highly effective in increasing both HepB vaccine initiation and series completion rates among adults with diabetes. 相似文献15.
Patrick T. Wedlock Elizabeth A. Mitgang Leila A. Haidari Wendy Prosser Shawn T. Brown Kirstin Krudwig Sheryl S. Siegmund Jay V. DePasse Jennifer Bakal Jim Leonard Joel Welling Robert Steinglass Frances Dien Mwansa Guissimon Phiri Bruce Y. Lee 《Vaccine》2019,37(4):637-644
Background
Frequently, a country will procure a single vaccine vial size, but the question remains whether tailoring the use of different size vaccine vial presentations based on populations or location characteristics within a single country could provide additional benefits, such as reducing open vial wastage (OVW) or reducing missed vaccination opportunities.Methods
Using the Highly Extensible Resource for Modeling Supply Chains (HERMES) software, we built a simulation model of the Zambia routine vaccine supply chain. At baseline, we distributed 10-dose Measles-Rubella (MR) vials to all locations, and then distributed 5-dose and 1-dose MR vials to (1) all locations, (2) rural districts, (3) rural health facilities, (4) outreach sites, and (5) locations with average MR session sizes <5 and <10 children. We ran sensitivity on each scenario using MR vial opening thresholds of 0% and 50%, i.e. a healthcare worker opens an MR vaccine for any number of children (0%) or if at least half will be used (50%).Results
Replacing 10-dose MR with 5-dose MR vials everywhere led to the largest reduction in MR OVW, saving 573,892 doses (103,161 doses with the 50% vial opening threshold) and improving MR availability by 1% (9%). This scenario, however, increased cold chain utilization and led to a 1% decrease in availability of other vaccines. Tailoring 5-dose MR vials to rural health facilities or based on average session size reduced cold transport constraints, increased total vaccine availability (+1%) and reduced total cost per dose administered (?$0.01) compared to baseline.Conclusions
In Zambia, tailoring 5-dose MR vials to rural health facilities or by average session size results in the highest total vaccine availability compared to all other scenarios (regardless of OVT policy) by reducing open vial wastage without increasing cold chain utilization. 相似文献16.
Meredith L. McMorrow Stefano Tempia Sibongile Walaza Florette K. Treurnicht Wayne Ramkrishna Eduardo Azziz-Baumgartner Shabir A. Madhi Cheryl Cohen 《Vaccine》2019,37(1):25-33
Background
Due to competing health priorities, low- and middle-income countries (LMIC) may need to prioritize between different influenza vaccine risk groups. Risk group prioritization may differ in LMIC based upon programmatic feasibility, country-specific prevalence of risk conditions and influenza-associated morbidity and mortality.Methods
In South Africa, we collected local disease burden data (both published and unpublished) and published vaccine efficacy data in risk groups and healthy adults. We used these data to aid policy makers with risk group prioritization for influenza vaccination. We used the following formula to assess potential vaccine averted disease in each risk group: rate of influenza-associated hospitalization (or death) per 100,000 population * influenza vaccine efficacy (VE). We further estimated the cost per hospital day averted and the cost per year of life saved by influenza vaccination.Results
Pregnant women, HIV-infected adults, and adults and children with tuberculosis disease had among the highest estimates of hospitalizations averted per 100,000 vaccinated and adults aged 65?years and older had the highest estimated deaths averted per 100,000 vaccinated. However, when assessing both the cost per hospital day averted (range: USD148-1,344) and the cost per year of life saved (range: USD112-1,230); adults and children with TB disease, HIV-infected adults and pregnant women had the lowest cost per outcome averted.Discussion
An assessment of the potential disease outcomes averted and associated costs may aid policymakers in risk group prioritization for influenza vaccination. 相似文献17.
Jiahui Lu Meiyin Luo Andrew Zi Han Yee Anita Sheldenkar Jerrald Lau May Oo Lwin 《Vaccine》2019,37(8):1046-1052
Background
This study examined the impact of superstitious beliefs on influenza vaccine uptake and investigated the role of health beliefs as underlying psychological mechanisms. It is hypothesized that superstitious beliefs predict greater perceived risks in influenza and vaccines, which in turn affect influenza vaccine uptake.Methods
A cross-sectional survey of Singaporeans and Singapore Permanent Residents aged between 21 and 70 (N?=?668) was conducted using computer-assisted telephone interviews. The survey covered beliefs in superstition, health beliefs in influenza and vaccines, and influenza vaccine uptake intention and behavior using the Health Belief Model. Path analysis was adopted to examine the hypothesized model.Results
Approximately 60% of the sample had never obtained influenza vaccination. The path analysis found that superstitious beliefs significantly predicted higher perceived barriers and lower perceived benefits of vaccines, which in turn predicted a lower intention to take influenza vaccine in the next year and/or a lower probability of ever taking influenza vaccine. In contrast, superstitious beliefs predicted higher perceived susceptibility and severity of influenza that in turn predicted higher influenza vaccine uptake intention and/or probability. Examining demographic variables and past experience on influenza as control and confounding factors did not significantly affect the results.Conclusion
The findings imply that beliefs in superstitions can have mixed effects on vaccine uptake and intention through shaping beliefs of the disease and vaccines. Significant implications in health education and persuasion on vaccine uptake are discussed. 相似文献18.
Mohamed F. Jalloh Sarah D. Bennett Didarul Alam Paryss Kouta Dalia Lourenço Mohammad Alamgir Leora R. Feldstein Daniel C. Ehlman Neetu Abad Neha Kapil Maya Vandenent Laura Conklin Brent Wolff 《Vaccine》2019,37(6):833-838
Background
In November 2017, the World Health Organization received initial reports of suspected diphtheria cases in camps established for displaced Rohingyas in Cox’s Bazar district, Bangladesh. By January 11, 2018, over 4,000 suspected cases of diphtheria and 30 deaths were reported. The Bangladesh government and partners implemented a diphtheria vaccination campaign in December 2017. Outbreak response staff reported anecdotal evidence of vaccine hesitancy. Our assessment aimed to understand vaccination barriers and opportunities to enhance vaccine demand among displaced Rohingyas in Bangladesh.Methods
In January 2018, we conducted a qualitative assessment consisting of nine focus group discussions and 15 key informant interviews with displaced Rohingyas in three camps. Participants included mothers and fathers with under five-year-old children, community volunteers, majhis (camp leaders), Islamic religious leaders, traditional and spiritual healers, and teachers. We recruited participants using purposive sampling, and analyzed the data thematically.Results
Across focus groups and in-depth interviews, trusted information sources cited by participants included religious leaders, elders, village doctors, pharmacists, majhis, and mothers trained by non-governmental organizations to educate caregivers. Treatment of diphtheria and measles was usually sought from multiple sources including traditional and spiritual healers, village doctors, pharmacies, and health clinics. Major barriers to vaccination included: various beliefs about vaccination causing people to become Christian; concerns about multiple vaccines being received on the same day; worries about vaccination side effects; and, lack of sensitivity to cultural gender norms at the vaccination sites.Conclusion
Although vaccination was understood as an important intervention to prevent childhood diseases, participants reported numerous barriers to vaccination. Strengthening vaccine demand and acceptance among displaced Rohingyas can be enhanced by improving vaccination delivery practices and engaging trusted leaders to address religious and cultural barriers using community-based channels. 相似文献19.
Julie Lynch Jason Last Philip Dodd Daniela Stancila Christine Linehan 《Disability and health journal》2019,12(1):65-71
Background
Health disparities and disparities in the provision of healthcare to people with disabilities remains a topic of concern. Research demonstrates that attitudes of healthcare providers contribute to this disparity. The approach to disability education and training in medical school warrants evaluation.Objectives
This study sought to investigate the efficacy of an educational intervention in cultivating positive attitudes towards disability in medical students, and determine the specific impact of an interaction-based hospital visit to patients undergoing neurological rehabilitation.Methods
Web-based questionnaires were distributed to medical students undertaking a 12-week ‘Understanding Disability’ module. Measures of anxiety, attitude, competency and empathy were obtained from 65 students at the beginning (T1), middle (T2) and end (T3) of the module. At T2, approximately half of the students had completed a hospital visit and half had not.Results
Scores changed significantly across all constructs between the beginning and end of the module suggesting a positive overall module effect. Findings confirmed a significant difference in anxiety and empathy levels between the group of students who had completed the visit to the rehabilitation hospital by the middle survey wave and those who had not, indicating a specific placement effect.Conclusions
Our findings suggest that interpersonal contact with individuals with disabilities has a distinct impact on the affective variables of anxiety and empathy. Previous research suggests that this contributes towards improved attitudes to disability. Overall, we provide strong evidence for the inclusion of contact-based educational interventions in medical school to enhance students' attitudes to disability. 相似文献20.
Laura P. Hurley Mandy A. Allison Lindsay Kim Sean T. O&#x;Leary Lori A. Crane Michaela Brtnikova Brenda L. Beaty Kristen E. Allen Sarah Poser Megan C. Lindley Allison Kempe 《Vaccine》2019,37(4):565-570