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.

Influenza vaccination hesitancy in large urban centers in South America. Qualitative analysis of confidence, complacency and convenience across risk groups

“…The importance of confidence as a factor in vaccine hesitancy was also observed by the survey arm of our study which obtained quantitative information on the 3Cs for the same risk groups, countries and socioeconomic groups, reporting that individuals with a higher composite indicator of influenza vaccine confidence also had higher probability of being vaccinated in the last year [ 15 ]. This study also suggested higher vaccine confidence and vaccine uptake levels in Chile and lower in Paraguay and Uruguay, supporting the qualitative study results we are now reporting.…”

“…A representative survey of health facility clients in the same neighborhoods undertaken as a part of the same research project to explore quantitative determinants of vaccine hesitancy showed that between 26.9 and 38.8% of elderly adults and adults with risk factors, respectively, had up to primary education, as against pregnant women and mothers of children, among whom only between 8.1 and 9.3% had such lower education levels. Participants from Paraguay and Uruguay tended to have lower education levels across risk groups when compared to participants from the other countries [ 15 ].…”

Attitudes and Acceptance of COVID-19 Vaccination Among Nurses and Midwives in Cyprus: A Cross-Sectional Survey

“…Previous research indicated public unwillingness to receive new vaccines during a pandemic (18)(19)(20). The factors that determine public decision for vaccination are complex (21)(22)(23). WHO proposed the "3C" model of vaccine hesitancy that includes three aspects: confidence, convenience, complacency, and a table with vaccine hesitancy influences; contextual, individual and group; and vaccine/vaccination-related issues (24,25).…”

Validation of a Scale to Measure the Perception of SARS-CoV-2 Vaccines Acceptance: The VAC-COVID-19 Scale

“…Its respective items allow us to know the reasons for existing myths at the global level, including possible negative influences of powerful groups, the question on the origin of the vaccine (repercussions according to the country that developed it), among other information related to antivaccination movements-mainly transmitted by social networks and the media, which have broadly and quickly disseminated information without considering their accuracy and veracity [17]. Moreover, in the first factor, questions were also asked about the trust that the population has in the health organizations and systems, including the World Health Organization, since in many countries there is a degree of mistrust on their own health systems and vaccination programs [18]. Therefore, using the knowledge gained from answering these questions, it becomes possible to help guide the health authorities to develop specific strategies to increase the trust of the population in SARS-CoV-2 vaccines.…”