Vaccine hesitancy and cognitive biases: Evidence for tailored communication with parents

Casigliani, Virginia; Menicagli, Dario; Fornili, Marco; Lippi, Vittorio; Chinelli, Alice; Stacchini, Lorenzo; Arzilli, Guglielmo; Scardina, Giuditta; Baglietto, Laura; Lopalco, Pietro Luigi; Tavoschi, Lara

doi:10.1016/j.jvacx.2022.100191

Cited by 15 publications

(6 citation statements)

References 48 publications

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“…The WHO defined vaccine hesitancy as a “delay in acceptance or refusal of vaccination despite the availability of vaccination services”, influenced by several factors including issues of confidence (do not trust vaccine or provider), complacency (that is people who do not perceive a need for a vaccine, do not value the vaccine), and convenience (in terms of easiness of access to vaccination). Vaccine-hesitant individuals are a heterogeneous group who show varying degrees of indecision about specific vaccines or vaccination in general [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Actual COVID-19 Vaccine Uptake in a Cohort of Essential Workers: An Area-Based Longitudinal Study in the Province of Prato, Italy

Lastrucci

Lorini²,

Stacchini³

et al. 2022

IJERPH

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Identifying determinants of COVID-19 vaccine uptake is essential for developing effective strategies for promoting vaccination. This longitudinal study aimed to explore predictors of actual COVID-19 vaccine uptake in workers involved in essential services during the first lockdown period in the Prato Province (Italy). All essential workers were invited and surveyed before COVID-19 vaccine approval (96.5% participation rate). Participants were followed up to evaluate their actual COVID-19 vaccination uptake using the vaccination register. Multinomial models were performed to assess predictors of delayed vaccination or non-vaccination. A total of 691 participants were included, of whom 21.7% had delayed the vaccination and 4.4% were unvaccinated. Participants with a sufficient level of health literacy were 50.2% in the vaccinated-on-time group and 32.3% in the unvaccinated group. The multinomial model predictors of delayed vaccination were work type (OR = 0.51), age between 50 and 59 years (OR = 1.82), and influenza vaccination uptake in the last season (OR = 2.51). Predictors of being unvaccinated were work type (OR = 0.33) and attitudes related to attributing less importance to COVID-19 preventive measures (OR = 0.47). Findings showed distinct predictors for COVID-19 vaccination delay and for being unvaccinated. Being unvaccinated seems to be associated with a general skepticism toward prevention measures.

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Section: Introductionmentioning

confidence: 99%

Determinants of Actual COVID-19 Vaccine Uptake in a Cohort of Essential Workers: An Area-Based Longitudinal Study in the Province of Prato, Italy

Lastrucci

Lorini²,

Stacchini³

et al. 2022

IJERPH

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“…Of note, vaccine hesitancy, defined as the “delay in acceptance or refusal of vaccination despite availability of vaccination services,” is a worldwide cause of concern. 39 Several cognitive biases can affect the decision-making process surrounding vaccines, thus increasing vaccine hesitancy in the population. 40 In our study, availability biases and the tendency to attribute higher weight to factors that could readily be recalled were noted, as respondents were more aware of COVID-19 vaccines due to the recency of the COVID-19 pandemic and thereby attributed lower weight to HZ vaccines.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude, and practice toward herpes zoster (HZ) and HZ vaccination: Concept elicitation findings from a multi-country study in the Asia Pacific

Chen,

Shantakumar,

et al. 2024

Human Vaccines & Immunotherapeutics

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Herpes zoster (HZ) is a prevalent disease characterized by a painful rash. A multi‑country study was conducted to elicit public and physician knowledge, attitude, and practice (KAP) toward HZ disease and vaccination for the assessment of local factors influencing HZ vaccine perceptions in four Asian-Pacific countries/territories One-to-one qualitative interviews were conducted in 2022, among the public (people aged ≥ 50 years, adults with parents aged ≥ 50 years, zoster vaccine live-vaccinated individuals aged ≥ 50 years in Republic of Korea, and HZ patients; n = 78) and physicians (general practitioners and specialists; n = 24). Themes surrounding KAP toward HZ and HZ vaccination were summarized using a thematic analysis. A substantial knowledge gap related to HZ was observed among the public, including its causes, long-term impacts, and the at-risk population. There was a low perceived risk of HZ and low general awareness of HZ vaccine availability, although country/territory-specific differences existed. Fear of HZ-associated pain contributed toward vaccination intent among HZ patients and adults with parents aged ≥ 50 years. HZ-naïve adults who were encouraged to receive the vaccine by others were not motivated to do so due to optimism bias. Physicians were perceived to be a reliable source of information. However, physicians did not always proactively discuss HZ vaccination due to time constraints and a perceived need to prioritize other vaccinations including influenza and pneumococcal vaccines. Initiatives are needed to improve public awareness of HZ and its complications, in terms of overall impact on individuals and society, and highlight the important role of physicians in recommending vaccination.

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“… 49 All of these factors, in conjunction with other cognitive biases, pose a risk of spreading to other forms of vaccination, including those intended for childhood use. 50 Although there was an increase in coverage in 2021, it has not yet reached the pre-pandemic levels. 51…”

Section: Discussionmentioning

confidence: 99%

“…While the tools used in our study were effective in measuring VH, they did not capture all the factors that contribute to this phenomenon. For instance, cognitive biases and individual psychological profiles are important factors that should be considered in the design of communication strategies, as noted by Casigliani et al 50 This new perspective must be closely evaluated and included in future studies on vaccine hesitancy.…”

Section: Discussionmentioning

confidence: 99%

Assessing vaccine hesitancy and health literacy using a new Italian vaccine confidence index and a modified Italian medical term recognition test: A cross-sectional survey on Italian parents

Arzilli,

Stacchini,

Casigliani

et al. 2023

Human Vaccines & Immunotherapeutics

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The decline in children’s vaccination coverage and the resurgence of preventable infectious diseases draw attention to parents’ vaccine hesitancy. Our study introduces two validated tools to independently assess vaccine hesitancy and health literacy among parents with school-age children. We developed a Vaccine Confidence Index (VCI) from 10 Likert items, exploring their relationships through exploratory and confirmatory factor analyses. We modified the IMETER (Italian medical term recognition test) to measure health literacy. We assessed the internal consistency of the modified IMETER and the 10 Likert items using Cronbach’s alpha test (α) and McDonald’s omega total coefficient (ω) with good results (ω = 0.92, α = 0.90; ω = 0.87, α = 0.82 respectively). We used these tools within a questionnaire conducted on 743 parents recruited from pediatric clinic waiting rooms in Italy, collecting demographic data, information sources on vaccines and vaccine-preventable diseases knowledge. The VCI resulting from factor analyses consisted of six items on a ten-point Likert scale, reflecting the ratio of positive to negative items. The survey revealed significant variations in the VCI according to individual features such as education, use of social networks, or Health institutions as sources of information. Multivariate logistic regression identified an association between vaccine intention and the VCI. Health literacy was functional for 91.2% of participants, but knowledge about vaccine-preventable diseases was generally low. The VCI showed no significant association with health literacy and vaccine-preventable diseases knowledge. The VCI and the modified IMETER effectively assess vaccination attitude and health literacy, offering valuable public health tools for tailoring vaccination campaigns to hesitant population subgroups.

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Vaccine hesitancy and cognitive biases: Evidence for tailored communication with parents

Cited by 15 publications

References 48 publications

Determinants of Actual COVID-19 Vaccine Uptake in a Cohort of Essential Workers: An Area-Based Longitudinal Study in the Province of Prato, Italy

Determinants of Actual COVID-19 Vaccine Uptake in a Cohort of Essential Workers: An Area-Based Longitudinal Study in the Province of Prato, Italy

Knowledge, attitude, and practice toward herpes zoster (HZ) and HZ vaccination: Concept elicitation findings from a multi-country study in the Asia Pacific

Assessing vaccine hesitancy and health literacy using a new Italian vaccine confidence index and a modified Italian medical term recognition test: A cross-sectional survey on Italian parents

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