The relationship between parental source of information and knowledge about measles / measles vaccine and vaccine hesitancy

ObjectivesBased on the hypothesis that sources of information might affect knowledge and vaccine acceptance, our objectives were to study parental characteristics and sources of information regarding measles/measles vaccine, its relationship to correct knowledge and to administration of the measles vaccine.BackgroundAlthough measles eradication is potentially achievable, in 2018–2019 a worldwide resurgence of measles and measles-caused deaths occurred. The main driver was incomplete or no vaccination, designated as vaccine hesitancy (VH).MethodsA cross-sectional survey of 399 individuals dispersed all over the country was conducted. Research assistants interviewed parents with a 20-question survey which was previously validated. The questionnaire included four sections: demographics, major sources of information on measles/measles vaccine, knowledge about measles/measles vaccine, and status of child’s vaccination. Univariate and multivariate analyses explored associations between correct knowledge and VH.ResultsThe majority of respondents were between the ages of 25–39 (62%). Of these, 309 (77%) vaccinated their children against measles on time, 32 (8%) vaccinations were incomplete, and 58 (15%) did not vaccinate, for a total VH of 23%. Parents < 30 years-old and those with a single-child vaccinated less frequently (p < 0.001 and p = 0.002, respectively). Internet and social-media were the major source of information for 32% regarding measles/measles vaccine and for 49% regarding the measles outbreak; both sources were negatively associated with correct knowledge (p < 0.001). In the multivariate analysis, knowledge was independently associated with timely vaccine administration (p < 0.001) and internet or social-media as sources with higher VH (OR 2.52, 95%CI 1.18–5.37 and OR 2.44, 95%CI 1.01–5.91, respectively).ConclusionsSocial-media and internet are a common source of information on measles/measles vaccine (probably on other vaccines as well), and often associated with incorrect knowledge, which relates significantly to VH. Healthcare professionals should be aware of this prevailing behavior and respond accordingly in these platforms, with the aid of experts in social-networking.     

国产水痘减毒活疫苗接种的血清学免疫效果及成本效益分析

[目的 ]　观察不同代次、不同剂量的国产水痘减毒活疫苗的安全性和免疫效果 ,分析不同年龄组儿童水痘疫苗接种的经济效益。　 [方法 ]　随机分组 ,接种不同代次、不同剂量的国产水痘疫苗 ,对每组儿童进行人体反应性及免疫原性观察 ,用酶联免疫吸附法 (ELISA)测定水痘抗体 ,采用成本效益分析方法计算各年龄组效益费用比 (BCR)。　 [结果 ]　各组水痘疫苗免后副反应率及抗体水平差异均无显著性。免后 1～ 3月 ,抗体阳转率达到 96 %以上 ,几何平均滴度(GMT)达到 76 0以上。以后抗体逐渐下降 ,接种后 2年抗体阳转率为 81.40 %,GMT为 36 7.2 0。水痘疫苗接种后成本效益比值 ,2岁以下年龄组BCR值小于 1,3～ 7岁年龄组BCR值均大于 1,其中 6～ 7岁组经济效益最高。　 [结论 ]　不同代次、不同剂量的国产水痘疫苗副反应率较低 ,免疫效果好。 3～ 7岁组儿童接种水痘疫苗能获得正效益 ,应作为水痘疫苗免疫接种的首选对象。     

水痘疫苗在学校水痘疫情中的保护效力分析

目的 评价不同免疫策略下水痘疫苗在学校水痘暴发疫情中的保护效力.方法 在2019年中山市发生水痘暴发疫情的学校中,选取病例数较多(＞5例)的班级学生作为研究对象,采用回顾性队列研究的方法评价水痘疫苗的保护效力.结果 共有10个班级418名学生纳入研究,水痘疫苗总接种率为83.5％(349/418),1、2剂次接种率分别...     

Parental knowledge, attitudes, and demand regarding a vaccine to prevent varicella.

BACKGROUND: Maintenance of high immunization rates is challenged by frequent changes to the recommended immunization schedule. This study assessed parent-reported knowledge of, attitudes about, and demand for a new vaccine against varicella. METHODS: Six months following licensure of the varicella vaccine, a cross-sectional study was conducted by mailed survey among a sample of parents of 23- to 35-month-old children. Effective response rate was 65%. RESULTS: Three quarters of parents had heard about the vaccine to prevent varicella. The lay media was the most frequently mentioned source of information. Thirteen percent of parents had already obtained the vaccine for their child, another quarter planned to get it, and one half were undecided. The most frequently cited factor influencing parents who had obtained or intended to obtain the vaccine was their doctor's recommendation. For those undecided or not inclined to get the vaccine, insufficient information about the vaccine was the most frequently listed factor. CONCLUSION: Publicizing a new vaccine through the media may be effective in raising public awareness, but detailed information about the vaccine and the recommendation of providers is still important in a parent's decision about the vaccine for their child.     

Child and parental surveys about pre-hospitalization information provision

Background There is little available information about what children and parents would like to know about a forthcoming hospitalization and what they currently receive. Methods The current study was a survey of 102 children between the ages of 6 and 10 years and their parents recruited either from the Recovery Unit following day surgery or from the wards following overnight admissions at Sydney Children's Hospital, Australia. Information was obtained about each child's experience in hospital, the nature and format of information that they had received prior to the admission, and what information the child/parent thought would be helpful to receive. Results Parents recorded a total of 163 questions asked by children prior to their admission. Questions related to timing (e.g. duration of admission, length of procedure), pain, procedural information, anaesthesia, needles, whether parents can be present, activities to do in hospital, seeking explanations (‘Why’ questions), hospital environment, seeking reassurance and miscellaneous questions. Children who were satisfied with the amount of information they received before coming to hospital subsequently reported that they would be significantly less scared should they need to come back to hospital for a future procedure. A total of 46.7% of children received information about their hospitalization from their parent(s) and a further 12% from a doctor and parent. Conclusions Children were found to have many questions about a forthcoming hospitalization. Parents were found to have a major role as information providers. Further research is needed to assess parental confidence and competence to meet their child's information needs.     

Impact and effectiveness of childhood varicella vaccine program in Queensland,Australia

BackgroundIn November 2005, Australia introduced a publicly funded single dose of varicella vaccine for children aged 18-months. We describe the impact of this program on varicella hospitalisations in Queensland and provide the first assessment of single-dose varicella vaccine effectiveness in Australia since the program commenced.MethodsAge-standardised varicella hospitalisation rates were calculated for 2000–2014 and pre- and post-public funding period rates compared. Case-control studies were conducted to investigate the association between vaccine receipt and both varicella hospitalisations and uncomplicated varicella emergency department presentations. Cases were matched to controls from a population-based register by date of birth and state of residence. Vaccine effectiveness was calculated as (1 – odds ratio) × 100%.ResultsCompared to the pre-funded period (2000–2003), age-standardised varicella hospitalisation rates declined by more than 70% in 2011–2014 with varicella principal diagnosis rates declining from 5.7 to 1.6 per 100,000 population per year. Varicella vaccine effectiveness at preventing hospitalisation with a principal diagnosis of varicella among children aged 19-months to 6-years was 81.9% (95% confidence interval: 61.8–91.4%), while for emergency department presentations among children aged 19-months to 8-years it was 57.9% (95% confidence interval: 48.5–65.5%).ConclusionsIn Australia, the single-dose varicella vaccination program has substantially reduced varicella morbidity. The single-dose varicella vaccine schedule is moderately-to-highly effective against hospitalisation, but appears less effective against emergency department presentations.     

Effect of a vaccine information statement (VIS) on immunization status and parental knowledge,attitudes, and beliefs regarding infant immunization in Japan

BackgroundBecause of the overabundance of vaccination information on the internet, in the media, and on social media, providing clear and correct information on immunization is critical for parental decision-making. In 2018, the Japan Pediatric Society created and distributed a Vaccine Information Statement (VIS) to provide appropriate immunization information to caregivers. The objectives of the present study were to evaluate the effect of the VIS on immunization rates, adherence to schedule, and parental understanding of immunization in Japan.MethodsThis cross-sectional study was conducted at 18 centers in 2 prefectures in Japan. Caregivers were assigned to an intervention group, which received the VIS and a questionnaire when their child reached the age of 1 month, and a control group, which received only the questionnaire. Using the self-reported questionnaires, we evaluated vaccination rates and schedule adherence at age 2 months, and parental knowledge, attitudes, and beliefs regarding immunization. Three months later, the questionnaires were returned, and the findings were compared between the 2 groups.ResultsWe contacted 422 and 428 persons in the intervention and control groups, respectively, and 111/422 (26.3%) and 119/428 (27.8%) returned the surveys. Vaccination rates and adherence rates for the first dose of 4 recommended vaccines did not differ significantly (P > 0.25); however, there were some positive effects on items related to vaccine knowledge (P = 0.03), perceived benefits (P = 0.02), perceived barriers (P < 0.001), and perceived behavioral control (P = 0.01).ConclusionThe VIS improved parent comprehension of infant immunization. Future studies should examine if the effects of such an intervention persist and affect vaccine uptake throughout childhood.     

Impact of media reports regarding influenza vaccine on obstetricians’ vaccination practices

BackgroundIn 2017, three media stories regarding influenza vaccine may have impacted obstetricians’ (OB) influenza vaccination practices: reports of reduced influenza vaccine effectiveness, a severe influenza season, and a possible increased risk of miscarriage among pregnant women receiving 2009 H1N1 vaccine in the 1st trimester who had received H1N1 vaccine the previous season (later disproven).ObjectiveDescribe OB’s: (1) awareness of; (2) attitudes and experiences related to; and (3) reported alterations in practice as a result of these reports.MethodsA survey among a nationally representative sample of OBs April to June 2018.ResultsResponse rate was 65% (302/468). 88% of OBs were “very aware” of the severe season, 74% of lower effectiveness, and 25% of the miscarriage study (47% “completely unaware” of miscarriage study). Among those aware, 58%, 57%, and 16% reported ≥10% of pregnant patients initiated discussions about the severe season, lower effectiveness, and miscarriage study, respectively. Most (83%) agreed reports about increased severity increased their enthusiasm for recommending influenza vaccine; fewer agreed reports about the miscarriage study (18%) and lower vaccine effectiveness (12%) decreased their enthusiasm for recommending influenza vaccine. Providers were more likely to initiate discussion with patients about increased severity of the season than the other reports. However, 35% agreed the miscarriage study reports increased their concerns about influenza vaccine safety; 18% (n = 48) reported changing the way they recommended influenza vaccine. Of those, 17 (6% of all respondents) reported not recommending influenza vaccine to women during the 1st trimester and 26 (10% of all respondents) recommended it but were willing to delay until the 2nd trimester.ConclusionsDuring a season in which media stories could have influenced OB influenza vaccination behaviors in different directions, reports underscoring importance of influenza vaccine may have had more impact on OBs’ recommendations than reports questioning vaccine safety or effectiveness.     

Impact and cost effectiveness of pneumococcal conjugate vaccine in India

Background

World Health Organization has recommended the introduction of pneumococcal conjugate vaccine (PCV) in the childhood immunisation programme of all the countries in the world. In lieu of its introduction in India, there is a need to generate evidence on cost-effectiveness of this vaccine. The current study looks into the impact and cost-effectiveness of PCV vaccine in India.

Impact of combination MMRV vaccine on first-dose coverage for measles and varicella: a population-based study

Journal of Public Health - Combination vaccines decrease the number of needles required, addressing a common concern of parents. However, some parents are hesitant about combination vaccines and/or...     

高疫苗覆盖率下发生水痘暴发的流行因素研究

  目的  探索1剂次水痘疫苗高覆盖率下水痘暴发的流行因素及1剂次水痘疫苗的保护效果,为控制水痘暴发疫情、调整优化水痘免疫策略提供科学依据。  方法  采用1:2配对病例对照研究,对2018年发生于江苏省苏中地区一中心小学的一起水痘暴发疫情开展流行病学调查。水痘暴发的流行因素分析采用条件Logistic逐步回归分析。  结果  该疫情共持续14 d,共报告水痘确诊病例45例,其中突破病例占71.1%。突破病例的发热情况、出疹程度、病程与无免疫史病例相比均较轻(均有P < 0.05)。条件Logistic回归分析提示,参加课外辅导机构(OR=2.6,95% CI:2.0~3.2),有兄弟姐妹(OR=2.5,95% CI:2.1~4.3),无水痘疫苗接种史(OR=2.7,95% CI:2.4~4.2),与水痘患者接触史(OR=2.4,95% CI:1.1~5.3)是水痘暴发的流行因素。接种年限>5年,初次免疫年龄 < 15月龄是发生突破病例的潜在危险因素(均有P < 0.05)。1剂次水痘疫苗的总体保护效果为77.9%(95% CI:53.3%~92.1%)。  结论  突破病例临床症状较轻,1剂次水痘疫苗不足以控制水痘暴发疫情,其疫苗保护效果有限。建议采用2剂次水痘免疫策略。     

水痘疫苗在学校水痘暴发疫情中保护效果的病例对照研究

目的 评价接种1剂水痘疫苗在学校水痘暴发疫情中的保护效果(vaccine effectiveness, VE)。方法 采用1:2配对病例对照研究,收集中山市2013—2021年水痘暴发疫情调查资料,将病例数≥5例的班的所有病例（共942例）作为病例组,按1:2的比例选取同班、同年龄（±1岁）、同性别的1 884名健康儿童作为对照组,调查其水痘疫苗接种史,采用条件logistic回归分析水痘疫苗保护效果。结果 共调查3～14岁儿童2 826名,儿童接种1剂水痘疫苗的保护效果为58%（95%CI:50%～66%）,3～5岁、6～14岁儿童接种1剂水痘疫苗保护效果分别为75%（95%CI:62%～83%）和51%（95%CI:40%～61%）。儿童接种1剂后≤2年、3～5年、6～8年、≥9年的保护效果分别为78%（95%CI:66%～86%）、66%（95%CI:57%～74%）、51%（95%CI:36%～62%）、23%（95%CI:-11%～46%）。儿童接种1剂水痘疫苗的保护效果随接种后时间的延长而降低（趋势χ²=13.071,P<0.001）。结论 儿童接种1剂水痘疫苗有助于防控水痘暴发疫情,但其保护效果随接种后时间的延长而降低,难以阻断水痘传播。建议儿童及时接种2剂水痘疫苗,以预防学校水痘暴发疫情。     

Perceived need of a parental decision aid for the HPV vaccine: content and format preferences

The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process.     

水痘减毒活疫苗安全性与免疫原性观察

目的 评价水痘减毒活疫苗的安全性及免疫原性.方法 按随机、双盲的抽样原则,以国产水痘疫苗为对照,对600名1～12岁儿童接种水痘减毒活疫苗,在接种前后分别采集受试者血清,同时观察其临床反应,利用膜免疫荧光法（FAMA法）检测收集到的血清的水痘抗体滴度,并用统计学方法对结果进行分析.结果 试验苗和对照苗不良事件总反应率分别为30.5%和35.0%,二者比较无统计学差异.水痘易感者血清抗体阳转率分别为100.0%和98.73%;抗体GMT分别为1： 48.6和1： 39.0.水痘非易感者血清抗体4倍增长率分别为89.33%和77.42%;抗体GMT分别为1： 139.10和1： 153.07.两组抗体阳转率无显著性差异,但易感者接种试验疫苗组受试者抗体GMT高于接种对照疫苗组.结论 试验疫苗有良好的安全性和免疫原性,可用于预防水痘-带状疱疹病毒感染.     

Immunological considerations regarding parental concerns on pediatric immunizations

Despite the fundamental role of vaccines in the decline of infant mortality, parents may decide to decline vaccination for their own children. Many factors may influence this decision, such as the belief that the infant immune system is weakened by vaccines, and concerns have been raised about the number of vaccines and the early age at which they are administered. Studies focused on the infant immune system and its reaction to immunizations, summarized in this review, show that vaccines can overcome those suboptimal features of infant immune system that render them more at risk of infections and of their severe manifestations. In addition, many vaccines have been shown to improve heterologous innate and adaptive immunity resulting in lower mortality rates for fully vaccinated children. Thus, multiple vaccinations are necessary and not dangerous, as infants can respond to several antigens as well as when responding to single stimuli. Current immunization schedules have been developed and tested to avoid vaccine interference, improve benefits and reduce side effects compared to single administrations. The infant immune system is therefore capable, early after birth, of managing several antigenic challenges and exploits them to prompt its development.     

Parents' Internet use for information about HPV vaccine

Purpose

The Internet is an increasingly common source of health-related information. We sought to examine associations between parents’ Internet information-seeking and their knowledge, attitudes and beliefs about human papillomavirus (HPV) vaccine.

Methods

We interviewed parents within a year after approval of HPV vaccine for females and males. Participants were North Carolina parents with daughters ages 10–18 surveyed by telephone in Fall 2007 (n = 773); and a national sample of parents with sons ages 11–17 surveyed online in Fall 2010 (n = 115). We used multivariate regression to examine associations of past and intended Internet seeking for HPV vaccine information with knowledge and health belief model-related constructs.

Results

Among parents of daughters, having heard of HPV vaccine through the Internet (8%) was associated with higher HPV knowledge, perceived likelihood of HPV, and vaccination willingness, and with receiving a doctor's recommendation. It was also associated with lower perceived vaccine harms, uncertainty, and anticipated regret. Parents of sons who heard of HPV vaccine through the Internet (10%) perceived greater barriers to vaccination than parents who learned about HPV vaccine for males through other sources. Intended future Internet information-seeking among parents of daughters (69%) was more likely if they perceived a lower likelihood that their daughters would get HPV if they were vaccinated (all p < .05).

Conclusions

Our findings suggest a positive influence of accessing information on the Internet about HPV vaccine. It was associated with higher knowledge and mostly positive parental attitudes and beliefs.     

Current status and prospects of live varicella vaccine

Since its development in 1974 the Oka strain live attenuated varicella vaccine has been tested in healthy and immunocompromised adults and children. Its safety and efficacy have been established and it is now licensed for general use in Japan and Korea, and for immunocompromised patients in several other countries. Possibilities for the future include its use to prevent zoster in the elderly, its incorporation in a multivalent vaccine and its use as a vehicle to express foreign genes in recombinant vaccines.     

水痘疫苗保护效果的病例对照研究

目的分析儿童接种水痘疫苗后的保护效果,探讨接种1剂次水痘疫苗的保护效果随时间推移而改变的规律,根据研究结果对无锡地区水痘疫苗免疫策略制定提出建议。方法对病例与对照开展流行病学调查,收集调查对象人口学、水痘疫苗接种史等信息,比较两组水痘疫苗接种情况,探讨接种后的保护效果及其效果随时间推移而发生衰减的规律。结果共纳入研究对象942例,其中病例组324例,对照组618例。水痘疫苗总体保护率为55%(95%CI:42%～65%),1剂次水痘疫苗的保护率为26.6%(95%CI:3.3%-44.3%),2剂次水痘疫苗的保护率为67.8%(95%CI:21.3%～86.9%)。接种后<1年、1～年、2～年、3～年、4～年水痘疫苗保护率分别为79.3%、52.7%、33.0%、26.9%、13.6%(■=8.258,P<0.05)。结论仅接种1剂次水痘疫苗预防疾病的效果较差,提倡免疫程序更改为2剂次,可显著提升水痘疫苗保护效果。1剂次水痘疫苗保护率不持久,接种后疫苗保护效果逐年递减,建议在接种3年后加强接种1剂次水痘疫苗。     

水痘疫苗在学校和幼儿园水痘暴发疫情中保护效力的回顾性队列研究

目的 评价水痘疫苗在学校和幼儿园水痘暴发疫情中的保护效力。方法 选择中山市2013-2014年有水痘暴发疫情的学校和幼儿园,采用回顾性队列研究方法评价水痘疫苗的保护效力。结果 共有1 278名学生纳入研究对象,水痘疫苗效力为52.7%（95% CI：43.3%～60.6%）;分层分析发现,接种年限为≤2年、3～年、5～年、7～年和≥9年的疫苗效力分别为71.0%（95% CI：57.7%～80.1%）、59.5%（95% CI：45.8%～69.7%）、52.6%（95% CI：33.7%～66.1%）、27.8%（95% CI：-11.5%～53.2%）和14.9%（95% CI：-20.6%～40.0%）,χ²_趋势检验显示：水痘疫苗效力随接种年限的延长呈逐步递减的趋势,差异有统计学意义（χ²_趋势=68.3,P<0.001）。结论 接种水痘疫苗有利于控制学校和幼儿园水痘暴发疫情;但由于水痘疫苗效力随接种年限延长逐步递减,建议实施儿童接种2剂水痘疫苗的免疫策略,从而减少学校和幼儿园的水痘暴发疫情。