Understanding the determinants of vaccine hesitancy and vaccine confidence among adolescents: a systematic review

Cadeddu, Chiara; Castagna, Carolina; Sapienza, Martina; Lanza, Teresa Eleonora; Messina, Rosaria; Chiavarini, Manuela; Ricciardi, Walter; Waure, Chiara de

doi:10.1080/21645515.2021.1961466

Cited by 35 publications

(34 citation statements)

References 52 publications

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“…Evidently, the most-cited reason for general population hesitancy toward vaccination is safety concerns. 13 Furthermore, a lack of awareness and a low perception of the severity of preventable illnesses, traits that are commonly reported also among adolescents, 14 and a strong belief in alternative medicine have often been cited as elements associated with hesitancy. 13 In addition to a segment of population that refuses vaccines, the novelty of the disease and concerns over safety and efficacy of the vaccine have generated a sizable proportion of people indicating reluctance to getting vaccinated against COVID-19, as shown in previous surveys conducted in the general population in different countries.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers

Regazzi

Marziali

Lontano

et al. 2022

Human Vaccines & Immunotherapeutics

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Vaccine hesitancy in healthcare workers (HCWs) has been studied for various contagious diseases, but there is still insufficient knowledge about this phenomenon for COVID-19. We developed and validated a knowledge, attitude, and practice survey of 39 questions to assess Italian HCWs’ hesitancy toward vaccination in general (general hesitancy), COVID-19 vaccination (COVID-19 hesitancy), and public health injunctive measures (refusal of obligations). The survey was administered through a web platform between July and November 2021. Three multivariable logistic regressions were performed to evaluate the association between the explored dimensions of hesitancy and the potential determinants investigated. Out of 2,132 respondents with complete answers, 17.0% showed to be generally hesitancy toward vaccination, 32.3% were hesitant on COVID-19 vaccination, while 18.8% were categorized as refusing obligations. A significant protective effect against all three dimensions of hesitancy was found for increasing fear of COVID-19, advising COVID-19 vaccination to relatives and patients, having received flu vaccination in the previous year and having higher levels of education. Better self-rated knowledge about COVID-19 vaccines and reading up institutional sources were significantly protective against general and COVID-19 hesitancy, while being a physician rather than another healthcare professional was protective only against COVID-19 hesitancy. Conversely, increasing age and referring to colleagues to expand knowledge about COVID-19 were positively associated with COVID-19 hesitancy. The determinants of general hesitancy, COVID-19 hesitancy and the refusal of obligations are mostly overlapping. Given the great influence they exert on patients and communities, it is pivotal to limit HCWs vaccine hesitancy through appropriate training activities.

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Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers

Regazzi

Marziali

Lontano

et al. 2022

Human Vaccines & Immunotherapeutics

Self Cite

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“…A recent systematic review of primarily quantitative studies found that concerns about vaccine side effects and the lack of detailed vaccine information were two of the main reasons of hesitancy among adolescents [80].…”

Section: Discussionmentioning

confidence: 99%

What do adolescents think about vaccines? Systematic review of qualitative studies

Mitchell

Lim²,

Gill³

et al. 2022

PLOS Glob Public Health

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Adolescence presents a key opportunity to build vaccine-related health literacy and promote vaccine confidence and uptake. Although adolescents are central to vaccination programs, their views around vaccines are frequently underrepresented in qualitative literature. We reviewed qualitative studies to systematically identify and summarize existing evidence on adolescents’ own understanding of vaccines and experiences with vaccine decision-making, including self-consent when applicable. CINAHL; Embase; Ovid Medline; and Psych Info database searches were last updated on May 28, 2022. Data pertaining to general study characteristics, participant demographics, and qualitative content were extracted independently by two reviewers and analyzed using textual narrative synthesis. Out of 3559 individual records, 59 studies were included. The majority of the studies were conducted in high-income countries and 75% focused on human papilloma virus vaccines, with the remaining studies looking at COVID-19, meningococcal, hepatitis B and influenza vaccines or adolescent experiences with vaccines in general. Adolescent self-consent was explored in 7 studies. Perspectives from sexual and gender minorities were lacking across studies. Adolescents often had limited understanding of different vaccines and commonly perceived vaccine information to be directed towards their parents rather than themselves. Many adolescents felt school-based vaccine education and information available through healthcare providers were insufficient to make informed decisions about vaccines. While adolescents described obtaining vaccine information from traditional and online media, face-to-face interactions and opinions from trusted adults remained important. Adolescents generally relied on their parents for vaccine-decision making, even when self-consent was an option. A notable exception to this included marginalized adolescents who could not rely on parents for health-related advice. Qualitative literature about adolescent vaccines would be enriched by studies examining vaccines other than the HPV vaccine, studies examining adolescent vaccine programs in low and middle-income countries, and by deliberately eliciting vaccine experiences of adolescent with diverse sexual orientation and gender identities.

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“…Despite a significant improvement in costs, there are still children who did not manage to complete the vaccination. The potential reasons which these children did not manage to complete the vaccination might be due to parent’s hesitation towards vaccination, or a lack of trust in healthcare providers/the government [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

The Implementation and Impact of a Revised National Childhood Immunization Schedule in an Urban Asian Community

Tan

Aau

et al. 2022

Vaccines

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Changes to the national childhood immunization schedule (NCIS) can have a potential impact on vaccine uptake in the community. The NCIS in Singapore has undergone several revisions over the years, with the most recent modification on 1 November 2020. The new NCIS includes, as routine, the influenza and the varicella vaccine, as well as two combination vaccines, the measles, mumps, rubella and varicella vaccine (MMRV), and the hexavalent diphtheria, acellular pertussis, tetanus, haemophilus influenza b, injectable polio, and hepatitis B vaccine (6-in-1). This retrospective database study aims to assess the effect of the new NCIS on (a) the vaccination uptake of children at 6 and 12 months and (b) the cost difference to the healthcare system and to parents. One-year vaccination data from two cohorts of children immunized according to the old (n = 10,916) and new NCIS (n = 10,299) were extracted, respectively, from their electronic medical records. The vaccine uptake at 6 and 12 months increased by 10.8 and 2.1%, respectively, with the new NCIS as compared to the old NCIS. The mean number of required visits to the primary care clinic for each child was reduced from six to four. There is an estimated 6.41% cost reduction with the new NCIS.

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Understanding the determinants of vaccine hesitancy and vaccine confidence among adolescents: a systematic review

Cited by 35 publications

References 52 publications

Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers

Knowledge, attitudes, and behaviors toward COVID-19 vaccination in a sample of Italian healthcare workers

What do adolescents think about vaccines? Systematic review of qualitative studies

The Implementation and Impact of a Revised National Childhood Immunization Schedule in an Urban Asian Community

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