Dataset Information

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates.

ABSTRACT:

Introduction

Influenza morbidity and mortality are significant in the countries of South America, yet influenza vaccination is as low as 56.7% among pregnant women, reaching 76.7% of adults with chronic diseases. This article measures the relative values for the vaccination hesitancy indicators of confidence, complacency and convenience by risk-groups in urban areas of five countries of South America with contrasting vaccination rates, analyzing their association with sociodemographic variables and self-reported immunization status.

Methods

An exit survey was applied to 640 individuals per country in Brazil, Chile, Paraguay, Peru and Uruguay, distributed equally across risk groups of older adults, adults with risk factors, children ?6 and pregnant women. Indicators were constructed for vaccine confidence, complacency and convenience. Analysis of variance and multiple logistic analysis was undertaken.

Results

Adults with risk factors are somewhat more confident of the influenza vaccine yet also more complacent. Convenience is higher for mothers of minors. Children and older adults report higher levels of vaccination. The 3Cs are more different across countries than across risk groups, with values for Chile higher for confidence and those for Uruguay the lowest. Complacency is lower in Brazil and higher in Uruguay. Results suggest that confidence and complacency affect vaccination rates across risk groups and countries.

Conclusions

Influenza vaccine confidence, complacency and convenience have to be bolstered to improve effective coverage across all risk groups in the urban areas of the countries studied. The role played by country contextual and national vaccination programs has to be further researched in relation to effective coverage of influenza vaccine.

SUBMITTER: Gonzalez-Block MA

PROVIDER: S-EPMC7732123 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates.

González-Block Miguel Ángel MÁ Gutiérrez-Calderón Emilio E Pelcastre-Villafuerte Blanca Estela BE Arroyo-Laguna Juan J Comes Yamila Y Crocco Pedro P Fachel-Leal Andréa A Noboa Laura L Riva-Knauth Daniela D Rodríguez-Zea Berenice B Ruoti Mónica M Sarti Elsa E Puentes-Rosas Esteban E

PloS one 20201211 12

<h4>Introduction</h4>Influenza morbidity and mortality are significant in the countries of South America, yet influenza vaccination is as low as 56.7% among pregnant women, reaching 76.7% of adults with chronic diseases. This article measures the relative values for the vaccination hesitancy indicators of confidence, complacency and convenience by risk-groups in urban areas of five countries of South America with contrasting vaccination rates, analyzing their association with sociodemographic va ...[more]

PMID: 33306744

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Project description:Background and objectives Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population. Methodology A cross-sectional study was carried out from November 2020 to March 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. The google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed. Results Of the 421 participants, 68.4% were women. Non-healthcare workers were 55.8% of respondents. Of vaccine-hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Perception of COVID-19 vaccine was explored, which revealed 12.6% of individuals agreed the vaccine was not safe as it came out too fast, 50.6% were worried about experiencing side-effects, 18% believed the vaccine will not offer protection and 5.9% believed the vaccine would cause death. Low Practice of standard operating procedure (SOP) in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p = 0.040, 95% CI: 1.082–26.330) followed by High complacency (p = 0.026) and Moderate Complacency (OR: 0.212, p = 0.007, 95% CI: 0.069–0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p = 0.042, 95% CI: 0.109–0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p = 0.049, 95% CI: 0.093–0.993) for vaccination. Conclusion Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake. MeSH words Vaccine hesitancy; vaccination intention, COVID-19 vaccine, vaccine confidence, complacency, convenience.

Project description:Vaccine hesitancy, associated with medical mistrust, confidence, complacency and knowledge of vaccines, presents an obstacle to the campaign against the coronavirus disease 2019 (COVID-19). The relationship between vaccine hesitancy and conspiracy beliefs may be a key determinant of the success of vaccination campaigns. This study provides a conceptual framework to explain the impact of pathways from conspiracy beliefs to COVID-19 vaccine hesitancy with regard to medical mistrust, confidence, complacency and knowledge of vaccines. A non-probability study was conducted with 1015 respondents between 17 April and 28 May 2021. Conspiracy beliefs were measured using the coronavirus conspiracy scale of Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS), and vaccine conspiracy beliefs scale. Medical mistrust was measured using the Oxford trust in doctors and developers questionnaire, and attitudes to doctors and medicine scale. Vaccine confidence and complacency were measured using the Oxford COVID-19 vaccine confidence and complacency scale. Knowledge of vaccines was measured using the vaccination knowledge scale. Vaccine hesitancy was measured using the Oxford COVID-19 vaccine hesitancy scale. Confirmatory factor analysis (CFA) was used to evaluate the measurement models for conspiracy beliefs, medical mistrust, confidence, complacency, and knowledge of vaccines and vaccine hesitancy. The structural equation modeling (SEM) approach was used to analyze the direct and indirect pathways from conspiracy beliefs to vaccine hesitancy. Of the 894 (88.1%) respondents who were willing to take the COVID-19 vaccine without any hesitancy, the model fit with the CFA models for conspiracy beliefs, medical mistrust, confidence, complacency and knowledge of vaccines, and vaccine hesitancy was deemed acceptable. Conspiracy beliefs had significant direct (β = 0.294), indirect (β = 0.423) and total (β = 0.717) effects on vaccine hesitancy; 41.0% of the total effect was direct, and 59.0% was indirect. Conspiracy beliefs significantly predicted vaccine hesitancy by medical mistrust (β = 0.210), confidence and complacency (β = 0.095), knowledge (β = 0.079) of vaccines, explaining 29.3, 11.0, and 13.2% of the total effects, respectively. Conspiracy beliefs significantly predicted vaccine hesitancy through the sequential mediation of knowledge of vaccines and medical mistrust (β = 0.016), explaining 2.2% of the total effects. Conspiracy beliefs significantly predicted vaccine hesitancy through the sequential mediation of confidence and complacency, and knowledge of vaccines (β = 0.023), explaining 3.2% of the total effects. The SEM approach indicated an acceptable model fit (χ2/df = 2.464, RMSEA = 0.038, SRMR = 0.050, CFI = 0.930, IFI = 0.930). The sample in this study showed lower vaccine hesitancy, and this study identified pathways from conspiracy beliefs to COVID-19 vaccine hesitancy in China. Conspiracy beliefs had direct and indirect effects on vaccine hesitancy, and the indirect association was determined through medical mistrust, confidence, complacency, and knowledge of vaccines. In addition, both direct and indirect pathways from conspiracy beliefs to vaccine hesitancy were identified as intervention targets to reduce COVID-19 vaccine hesitancy.

Project description:BackgroundNovel coronavirus disease 2019 (COVID-19) vaccine hesitancy is a barrier to achieving herd immunity, and thus, a prominent public health concern. This study aimed to identify the determinants of COVID-19 vaccine hesitancy based on the World Health Organization's '3Cs' model (i.e., confidence, complacency, and convenience) in the United States (U.S.) and Canada.MethodsData from 7678 adults ages 18 or older were collected from the four most populous U.S. States, specifically New York, California, Florida, and Texas, and from English-speaking Canada at three timepoints, in May and July 2020, and March 2021 using a web-based survey (www.covid19-database.com). Sociodemographic information was collected, and comprehensive psychological assessments were administered. Univariate analyses were performed to identify the individual determinants of vaccine hesitancy, which were categorized as: 1) vaccine confidence, 2) vaccine complacency, 3) sociodemographic, and 4) other psychological factors. A series of models were computed using these categorizations.ResultsMistrust of vaccine benefit (β(SE) = 0.67(0.01), p<0.001, partial η2 = 0.26) and lower perceived seriousness of COVID-19 (β(SE) = 0.68(0.02), p<0.001, partial η2 = 0.12) were the principal determinants of vaccine hesitancy. Right-wing political affiliation (β(SE) = 0.32(0.02), p<0.001, partial η2 = 0.03), higher risk propensity (β(SE) = 0.24(0.02), p<0.001, partial η2 = 0.03), and less negative mental health effects of the COVID-19 pandemic (β(SE) = 0.20(0.01), p<0.001, partial η2 = 0.03) were the main sociodemographic and psychological determinants. Other sociodemographic determinants included younger age, women, race, and employment status. Lack of vaccine confidence and complacency explained 38% and 21% of the variance in vaccine hesitancy, respectively; whereas, sociodemographic and psychological determinants explained 13% and 11% of the variance in vaccine hesitancy, respectively.DiscussionTargeted and tailored public health interventions that enhance the public's confidence in vaccines and emphasize the risk and seriousness of COVID-19 may address COVID-19 vaccine hesitancy. Efforts directed toward specific marginalized and underserved groups may be required to promote vaccine confidence.

Dataset Information

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates.

Introduction

Methods

Results

Conclusions

Publications

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates.

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