Longitudinal Pathways to Influenza Vaccination Vary With Socio-Structural Disadvantages

Background Although influenza vaccination can prevent influenza-related deaths, uptake remains low, particularly in disadvantaged populations. Purpose A theoretical model of psychological pathways to vaccination accounting for the direct and moderating role of socio-structural factors was tested. The study sought to understand the joint contributions of psychological (i.e., knowledge, attitudes, and intention) and socio-structural factors (i.e., income, education, and insurance) to influenza vaccination, prospectively. Methods A nationally representative empaneled sample of over 3,000 U.S. adults answered questions about vaccination knowledge, attitudes, and intentions, as well as actual vaccination across five timepoints from September 2018 to May 2019. Socio-structural factors were examined as moderators. Results Findings revealed strong positive associations between knowledge and attitudes, attitudes and intentions, as well as intentions and subsequent vaccination. Importantly, health insurance moderated the associations between attitudes and intentions and between intentions and vaccination, such that those without insurance had weaker associations between attitudes and intentions and between intentions and vaccination. In addition, education moderated the path from knowledge to attitude and from intentions to vaccination, such that people with lower educational attainment had weaker associations between knowledge and attitudes and between intentions and vaccination. Conclusions Socio-structural factors act as barriers to the influence of knowledge on attitudes, attitudes on intentions, and intentions on behavior. Future research needs to be mindful of the specific paths disrupted by social disadvantages and examine ways to intervene to decrease those effects.

How skeptics could be convinced (not persuaded) to get vaccinated against COVID-19

Central to the SARS-CoV-2 pandemic strategy, COVID-19 vaccination depends on the population’s uptake decisions. Because at least 60% of the population needs to be vaccinated, but fewer, for example, in Germany are expected to do so, it is important to know how to convince those who are undecided or skeptical. According to the health care standard of enabling citizens to make informed decisions based on balanced information (boosting) – instead of persuasion or seduction (nudging) – a comparison of benefits and harms of having or not having the vaccination would be required to inform these groups. With the help of a representative survey, we investigated the contribution of fact boxes, an established intervention format for informed intentions. Study 1 shows the development of knowledge and evaluation of COVID-19 vaccinations by German citizens between Nov 2020 and Feb 2021. Study 2 reveals objective information needs and subjective information requirements of those laypeople at the end of Nov. Study 3 shows that the fact box format is effective for risk communication about COVID-19. Based on these insights, a fact box on the efficacy and safety of mRNA-vaccines was implemented with the help of a national health authority. Study 4 shows that fact boxes increase vaccination knowledge and positive evaluations of the benefit-harm ratio of vaccination in skeptics and undecideds. Our results demonstrate that simple fact boxes can be an effective boost of informed decision making among undecided and skeptical people, and that informed decisions can lead to more positive vaccination evaluations of the public.

Vaccination Knowledge and Perception among Pharmacy Undergraduates in a Northern Public University in Malaysia

Introduction: Worldwide, pharmacists are one of the advocates and practitioners which are commonly overlooked in improving vaccine hesitancy.Objectives: The aim of this study is to explore the vaccination knowledge and perception level as well as the sources of information sought, to support the importance in including the topic within the existing pharmacy curriculum.Methods: A cross sectional study using a validated and tested 43-itemed questionnaire were conducted among pharmacy students in USM. It included 4 domains of demographic data, knowledge on vaccination, perception towards vaccination and source of information on vaccination. Scoring and grouping of knowledge and perception level is based on modified Bloom’s cut-off point. A confidence interval of 95%, p value ≤ 0.05. Chi-square, ANOVA and the Kruskal-Wallis test were considered for the analysis of data.Results: Among 478 eligible pharmacy undergraduates, 311 (65%) participated and completed the questionnaire with a majority of female’s respondents (76.5%). Nearly 72.1% of the students had fair level of knowledge and 90% had good perception level towards vaccination. Online resource shown to be the favourable source of information onvaccination(84.2%). Furthermore, there was a statistically significant knowledge difference across the age, study year and races, (p=.02), (p<0.05) and (p<0.05) respectively. On the other hand, the level of perception shown to have a significant association with nationality (p=0.016), gender (p=0.049) and race(p=0.002).Conclusion: Majority of the students were shown to have fair knowledge and good perception towards vaccination, suggesting the need of implementing vaccination content delivery in the existing curricula to ensure better understanding and practice towards vaccination advocacy.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S28

Enhancement of Vaccination Attitude and Flu Vaccination Coverage among Pregnant Women Attending Birthing Preparation Course

Most vaccinations are recommended within the 15th month of life, in order to reduce risks and to protect children from the initial stages of their lives. A vaccination training session was carried out during the birthing preparation course, aimed at increasing the attitude toward vaccination in maternal-child age. A questionnaire on vaccination awareness was administered before and after the training session and on-site flu vaccination was offered to women and their companions. The percentage of participants who consider the preparatory course a useful tool to obtain information about vaccines increases significantly from 30.34% at pre-intervention to 64.56% at post-intervention (p < 0.001). There is a significant increase in the mean number of vaccinations that the participants want their children to get. The number of participants believing that there is no relationship between vaccination and autism rose from 41.05 to 72.97% (p < 0.001). In total, 48 out of 119 (40.34%) pregnant women participating in the course and 39 companions were vaccinated for influenza. Vaccination knowledge and attitude significantly increased after a training session dedicated to vaccination as a part of the pregnant pre-birth course, whose aim can be therefore extended to the management of the health of the child, well beyond the period of pregnancy, according to the life-course approach to health.

Understanding the Influence of Individual and Systemic Factors on Vaccination Take-Up in European Citizens Aged 55 or Older

Background: High vaccination coverage provides extensive public health benefits. Hence, increasing vaccination rates is an important policy goal within the EU and worldwide. We aim to evaluate individual and systemic parameters associated with vaccination in European Union citizens aged 55 or older, using data from the Special Eurobarometer 488. Methods: Linear probability and probit models are estimated to analyze the determinants of vaccination take-up. Further, descriptive analyses are used to explore how the reasons for not having a vaccination differ by welfare regime. Results: High knowledge about the effectiveness and safety of vaccination increases the probability of receiving a vaccination during the past five years by 26 percentage points (pp), medium knowledge increases it by 15 pp. Focusing on the specific case of the flu, official recommendations increase this probability by, on average, 6 pp; while having to pay out-of-pocket for a recommended vaccination decreases it by, on average, 10 pp. Furthermore, the differences for no vaccination differ widely across welfare systems and television is the primary source for information about vaccination. Conclusions: Reported vaccination rates in Europe fall far below targets set by official recommendations. Increasing vaccination knowledge and offering vaccinations free of charge can help to increase vaccination rates. A specific focus should be put on reaching individuals with potential difficulties of access such as those living alone and unemployed.

Knowledge, attitudes and behaviours towards vaccination: a survey of university students in Europe

Background Immunisation programs are still facing substantial challenges in achieving target coverage rates. This has been attributed to the growing negative individual vaccination attitudes and behaviours. Most of the current studies assessing vaccination knowledge, attitude and beliefs targets adults. However, young people represent future parents and health care professionals. The objective of this study was to investigate vaccination knowledge attitudes and behaviours among university medical and non-medical students in Europe. Methods We performed a cross-sectional online survey between April and July 2018. The study participants were students attending different faculties at the University of Antwerp, Belgium and the University of Pisa, Italy. We described sample characteristics. The effect of risk factors was tested with univariate and multivariate logistic regressions. Results A total of 2079 participants completed the survey including 873 medical students and 1206 from other faculties. The average of vaccination knowledge, attitudes, and confidence was respectively 5.51 (SD: 1.41), 4.66 (SD: 0.14) and 5.28 (SD: 0.57) on the 6-points scale. Our respondents demonstrated a high level of awareness with respect to their vaccination history. In total, 67.7% (n = 1407) reported to have received at least one vaccine in the previous five years; only 6.0% (n = 35) did not receive any vaccine in the previous 10 years. According to logistic regression analysis Italian students had significantly higher knowledge, attitude and confidence scores than Belgium respondents. Students of medicine scored significantly higher compared to non-medical students. Conclusions In order to reduce the gaps in vaccinations knowledge between non-medical and medical students we should plan educational interventions. In this way the number of future sceptical parents could be decreased. Further studies are required to explain the differences between countries. Key messages Young adults are the parents and the health care professionals of the future, for this reason their vaccination knowledge attitudes and behaviours should be carefully monitored. European non-medical students have lower vaccinations knowledge, attitudes and confidence compared with medical student. In order to fill these gaps, we should plan educational interventions.