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Demographics of Vaccine Hesitancy in Chandigarh, India.

ABSTRACT: The impact of vaccine hesitancy on childhood immunization in low- and middle-income countries remains largely uncharacterized. This study describes the sociodemographic patterns of vaccine hesitancy in Chandigarh, India. Mothers of children <5 years old were sampled from a two-stage cluster, systematic sample based on Anganwadi child care centers in Chandigarh. Vaccine hesitancy was measured using a 10-item Vaccine Hesitancy Scale, which was dichotomized. A multivariable logistic regression assessed the association between socioeconomic factors and vaccine hesitancy score. Among 305 mothers, >97% of mothers thought childhood vaccines were important, effective, and were a good way to protect against disease. However, many preferred their child to receive fewer co-administered vaccines (69%), and were concerned about side effects (39%). Compared to the "other caste" group, scheduled castes or scheduled tribes had 3.48 times greater odds of vaccine hesitancy (95% CI: 1.52, 7.99). Those with a high school education had 0.10 times the odds of vaccine hesitancy compared to those with less education (95% CI: 0.02, 0.61). Finally, those having more antenatal care visits were less vaccine hesitant (?4 vs. <4 visits OR: 0.028, 95% CI: 0.1, 0.76). As India adds more vaccines to its Universal Immunization Program, consideration should be given to addressing maternal concerns about vaccination, in particular about adverse events and co-administration of multiple vaccines.

SUBMITTER: Wagner AL

PROVIDER: S-EPMC7844137 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Demographics of Vaccine Hesitancy in Chandigarh, India.

Wagner Abram L AL Shotwell Abigail R AR Boulton Matthew L ML Carlson Bradley F BF Mathew Joseph L JL

Frontiers in medicine 20210115

The impact of vaccine hesitancy on childhood immunization in low- and middle-income countries remains largely uncharacterized. This study describes the sociodemographic patterns of vaccine hesitancy in Chandigarh, India. Mothers of children <5 years old were sampled from a two-stage cluster, systematic sample based on Anganwadi child care centers in Chandigarh. Vaccine hesitancy was measured using a 10-item Vaccine Hesitancy Scale, which was dichotomized. A multivariable logistic regression asse ...[more]

PMID: 33521011

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Project description:BACKGROUND:Vaccine hesitancy has been little studied in low- and middle-income countries but is a potential concern because vaccine refusal may increase the burden of infectious diseases and impede control efforts. The aim of this study was to compare vaccine hesitancy between locals, long-time city residents, and non-locals, who have more recently moved to the city from either other urban or rural areas, in Shanghai, China. METHODS:Parents of infants ?3 months of age were surveyed at immunization clinics in Shanghai, China. Participants completed a paper questionnaire utilizing the 10-item Vaccine Hesitancy Scale, which was developed by the World Health Organization Strategic Advisory Group of Experts on Immunization. Items were grouped based on internal consistency, and regressed onto demographic variables using a negative binomial model. RESULTS:In total, 1,188 (92.5%) individuals participated. For most items on the scale, parents expressed positive beliefs about vaccines. However, about half of parents somewhat or strongly agreed that new vaccines carried more risks than older vaccines, and 71.6% somewhat or strongly agreed that they were concerned about serious adverse effects. Seven items from the Vaccine Hesitancy Scale were highly correlated and mapped onto "lack of confidence"; the other three items were analysed separately. Compared to mothers, fathers had less lack of confidence (?: -0.06, 95% CI: -0.12, -0.01), and individuals living in the outer suburbs (?: 0.13, 95% CI: 0.01, 0.25) and rural non-locals (?: 0.10, 95% CI: 0.02, 0.18) had greater lack of confidence in vaccines compared to their urban or local counterparts, respectively. DISCUSSION:Shanghai parents professed confidence in certain vaccine benefits, but vaccine messaging could focus on addressing misconceptions about vaccines for diseases no longer common, newer vaccines, and adverse effects associated with vaccination. These messages may need to be separately tailored to locals and non-locals, who have differing concerns.

Project description:Background: During the ongoing COVID-19 pandemic, trust within a community in the projected schemes or strategies to combat COVID-19 depends on the confidence generated and launched by the government and medical employees toward the public. The "vaccination intention" within a community is determined by a range of factors, which include sociodemographic features, personal beliefs, and attitude toward vaccination. Methods: A nationwide survey was conducted involving 2000 people using a Tencent questionnaire platform. One-way ANOVA was conducted for age, education, and occupation with vaccination intention for the COVID-19 vaccine. Correlation analysis was conducted between sources, trust, and vaccination intention indicating both types of sources (official and unofficial sources) and both types of trust (trust in the social environment and in vaccines). Results: The reception of the sources of information on the COVID-19 vaccine was significantly higher from official sources (M = 5.54, SD = 1.37) and government officials (M = 5.68, SD = 1.499) compared with that from experts in medicine (M = 5.39, SD = 1.511). Among the unofficial sources, "chatting and communicating with family and friends" scored the highest (M = 4.84, SD = 1.649). In the statistics on people's trust in all aspects involved in vaccines, the level of trust in the social environment was significantly higher and more concentrated than in vaccines (M = 5.67, SD = 1.129). The level of trust in government (M = 5.80, SD = 1.256) was slightly higher than in medical personnel (M = 5.53, SD = 1.199). People's willingness to be vaccinated was generally high (M = 78.15, SD = 22.354). The demographic factors were not influential in vaccination intention. Both sources (official and unofficial sources) and trust (trust in the social environment and in vaccines) are significantly and positively correlated with vaccination intention. Information receptions from official and unofficial sources were significant positive predictors of trust in the social environment, but they were not significant predictors of trust in vaccines. The mediating effect of trust in vaccines on the relationship between receiving information from official and unofficial sources and vaccination intention was insignificant. Conclusions: This study revealed that trust in the environment is an important channel linking people's information reception and vaccination intention, explores a new path for health information communication, and attempts to provide new ideas for health information dissemination and promotion.

Project description:ObjectivesIndia's Covid-19 vaccination campaign engaged frontline workers (FLWs) to encourage vaccination among vulnerable segments of society. The FLWs report encountering a variety of barriers to vaccination and are often unsuccessful despite multiple visits to the same person. This cross-sectional study aims to pinpoint which of these barriers drive vaccine hesitancy among these segments, to help streamline vaccine communication, including FLW training, to better safeguard the population.MethodsTrained field enumerators contacted 893 individuals from five states across India and collected self-reported assessments of fifteen vaccination barriers (identified through discussions with FLWs), current vaccination status and future vaccination intentions, and covariates (demographics/comorbidities). Factor analysis of the fifteen barriers yielded two factors, one relating to fear of vaccine adverse effects and a second focused on peripheral concerns regarding the vaccine. The covariates significantly associated with current vaccination status were combined under a latent class regime to yield three cluster types (health access, financial strength, and demographics). The primary analysis examined the effect of the two barrier factors, the covariate clusters, and comorbidity, on current vaccination status and future vaccine intentions.ResultsFear of vaccine adverse effects was the primary driver of vaccine hesitancy; peripheral concerns frequently mentioned by the FLWs had no impact. Although cluster membership and the presence of comorbidities predicted vaccine uptake, neither of them materially altered the effect of fear of vaccine adverse effects with the following exception: fear of adverse effects was not associated with vaccination status among young Muslim men.ConclusionSubject to limitations, these results indicate that interventions to decrease vaccine hesitancy should focus primarily on fear associated with vaccines rather than spend resources trying to address peripheral concerns.

Project description:Meghalaya, a state in the northeastern region of India, had a markedly low vaccine uptake compared to the other states in the country when COVID-19 vaccines were being rolled out in 2021. This study aimed to characterize the distinct vaccine-hesitant subpopulations in healthcare and community settings in Meghalaya state in the early days of the vaccination program. We used data from a cross-sectional survey that was administered to 200 healthcare workers (HCWs) and 200 community members, who were a priori identified as 'vaccine-eligible' and 'vaccine-hesitant,' in Shillong city, Meghalaya, in May 2021. The questionnaire collected information on participants' sociodemographic characteristics, COVID-19 history, and presence of medical comorbidities. Participants were also asked to provide a dichotomous answer to a set of 19 questions, probing the reasons for their hesitancy towards COVID-19 vaccines. A multiple correspondence analysis, followed by an agglomerative hierarchical cluster analysis, was performed to identify the distinct clusters of vaccine-hesitant participants. We identified seven clusters: indecisive HCWs (n = 71), HCWs skeptical of COVID-19 and COVID-19 vaccines (n = 128), highly educated male tribal/clan leaders concerned about infertility and future pregnancies (n = 14), less educated adults influenced by leaders and family (n = 47), older adults worried about vaccine safety (n = 76), middle-aged adults without young children (n = 56), and highly educated ethnic/religious minorities with misinformation (n = 8). Across all the clusters, perceived logistical challenges associated with receiving the vaccine was identified as a common factor contributing to vaccine hesitancy. Our study findings provide valuable insights for local and state health authorities to effectively target distinct subgroups of vaccine-hesitant populations with tailored health messaging, and also call for a comprehensive approach to address the common drivers of vaccine hesitancy in communities with low vaccination rates.

Project description:BackgroundThe World Health Organization has recommended that individual governments identify vaccine hesitancy areas. It is proposed that the governments, with the aid of local organizations, educate and implement social insights on the vaccination so that high population levels are covered with this safe immune program.MethodsA longitudinal online survey covered 3000 adults from India. We examined the demography, behavioral (socio-economic) attitude, vaccine hesitancy, vaccine resistance for the COVID-19 vaccine. The specific reasons for the COVID-19 vaccine decline were also evaluated.ResultsOur survey revealed 59% definite response, 29% low-level response, and 7% high-level response for vaccine hesitancy, while 6% had resistant views on the COVID-19 vaccine. Individuals who had higher income levels, lived in a society, maintained social distancing, had downloaded the COVID-19 update app, showed a positive attitude towards their government, and more confidence in their healthcare system were more inclined towards the vaccination. On the contrary, individuals who had overstated the risks of COVID-19 and had a religious and populistic attitude towards vaccination were more hesitant/resistant to vaccination. The respondents who declined vaccine administration were further evaluated for their specific reason for their response. The most common reasons for declining the COVID-19 vaccine were post-vaccine scare of adverse health effects and accepting the information spread by social media.ConclusionsThe results in our study show that by identifying population "hot spots" that have negative or unclear information on the COVID-19 vaccination, these "hot spots" can be addressed by involving friendly organizations that can clear their strong disbeliefs and increase the percentage of vaccine-definite people within the population. The role of government-induced COVID-19 vaccine policy measures can always be beneficial to cause this shift from disbelief to confidence within the population.

Project description:BackgroundCholera infection continues to be a threat to global public health. The current cholera pandemic associated with Vibrio cholerae El Tor has now been ongoing for over half a century.Methodology/principal findingsThirty-eight V. cholerae El Tor isolates associated with a cholera outbreak in 2009 from the Chandigarh region of India were characterised by a combination of microbiology, molecular typing and whole-genome sequencing. The genomic analysis indicated that two clones of V. cholera circulated in the region and caused disease during this time. These clones fell into two distinct sub-clades that map independently onto wave 3 of the phylogenetic tree of seventh pandemic V. cholerae El Tor. Sequence analyses of the cholera toxin gene, the Vibrio seventh Pandemic Island II (VSPII) and SXT element correlated with this phylogenetic position of the two clades on the El Tor tree. The clade 2 isolates, characterized by a drug-resistant profile and the expression of a distinct cholera toxin, are closely related to the recent V. cholerae isolated elsewhere, including Haiti, but fell on a distinct branch of the tree, showing they were independent outbreaks. Multi-Locus Sequence Typing (MLST) distinguishes two sequence types among the 38 isolates, that did not correspond to the clades defined by whole-genome sequencing. Multi-Locus Variable-length tandem-nucleotide repeat Analysis (MLVA) identified 16 distinct clusters.Conclusions/significanceThe use of whole-genome sequencing enabled the identification of two clones of V. cholerae that circulated during the 2009 Chandigarh outbreak. These clones harboured a similar structure of ICEVchHai1 but differed mainly in the structure of CTX phage and VSPII. The limited capacity of MLST and MLVA to discriminate between the clones that circulated in the 2009 Chandigarh outbreak highlights the value of whole-genome sequencing as a route to the identification of further genetic markers to subtype V. cholerae isolates.

Dataset Information

Demographics of Vaccine Hesitancy in Chandigarh, India.

Publications

Demographics of Vaccine Hesitancy in Chandigarh, India.

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