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      Hesitancy toward Childhood Vaccinations: Preliminary Results from an Albanian Nursing Staff's Investigation

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          Abstract

          Healthcare professionals are important models for their patients since their individual knowledge and attitudes toward vaccination can influence the patient's willingness to adhere to vaccination campaigns. After developing a structured questionnaire, it was administered to a sample of nursing staff working in public vaccination centers in Albania (December 2020-January 2021), in order to conduct a preliminary investigation aimed at describing knowledge, attitudes, beliefs, and hesitancy toward childhood vaccinations. Among the sample of nurses involved in the administration of vaccines (n.64, 92% females), most of them were confident about vaccines and favorable to childhood vaccinations (90%). However, when specifically investigating beliefs, nearly a quarter of the sample showed to be hesitant; 22% were unsure or partially agreed that vaccines might cause conditions such as autism and multiple sclerosis. A high risk of hesitancy was identified in the youngest staff especially when their work experience was below 10 years or when they graduated less than 10 years before (OR: 5.3, CI: 1.4–19.5; and OR: 4.2 CI: 1.2–14.6). Similarly, a low acceptance rate (54%) was detected for future childhood SARS-CoV-2 vaccines among the nurses, which is a sign of high levels of vaccine hesitancy. With regard to knowledge about childhood vaccine contraindications, none of the nurses identified all the ten correct answers, while only 13% answered at least six questions correctly. These preliminary results highlight the need of investigating more Albanian nursing staff's knowledge and attitudes toward child vaccinations, therefore investing in tailored training. Due to the ongoing Covid-19 pandemic and the roll-out of mass vaccination, the role of healthcare workers remains crucial and needs more support to manage the changing public opinion as well as quickly evolving vaccine technologies.

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          Most cited references17

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          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            Vaccine hesitancy: the next challenge in the fight against COVID-19

            Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. Coincident with the rapid developments of COVID-19 vaccines globally, concerns about the safety of such a vaccine could contribute to vaccine hesitancy. We analyzed 1941 anonymous questionnaires completed by healthcare workers and members of the general Israeli population, regarding acceptance of a potential COVID-19 vaccine. Our results indicate that healthcare staff involved in the care of COVID-19 positive patients, and individuals considering themselves at risk of disease, were more likely to self-report acquiescence to COVID-19 vaccination if and when available. In contrast, parents, nurses, and medical workers not caring for SARS-CoV-2 positive patients expressed higher levels of vaccine hesitancy. Interventional educational campaigns targeted towards populations at risk of vaccine hesitancy are therefore urgently needed to combat misinformation and avoid low inoculation rates.
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              Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

              Summary Background There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. Methods In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Findings Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. Interpretation To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. Funding European Commission, Wellcome, and Engineering and Physical Sciences Research Council.
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                Author and article information

                Contributors
                Journal
                Nurs Res Pract
                Nurs Res Pract
                nrp
                Nursing Research and Practice
                Hindawi
                2090-1429
                2090-1437
                2022
                9 September 2022
                : 2022
                : 7814488
                Affiliations
                1Faculty of Medicine, Catholic University of “Our Lady of Good Counseil”, Tirane, Albania
                2Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
                3Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
                4Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
                5Faculty of Pharmacy, Catholic University of “Our Lady of Good Counseil”, Tirane, Albania
                6Faculty of Medicine, Tirana Medical University, Tirane, Albania
                Author notes

                Academic Editor: Maria H. F. Grypdonck

                Author information
                https://orcid.org/0000-0001-7811-5201
                https://orcid.org/0000-0002-6772-2310
                https://orcid.org/0000-0001-6192-8775
                https://orcid.org/0000-0002-3924-9917
                Article
                10.1155/2022/7814488
                9481372
                0a51be33-eb4f-4bc4-aa3c-caaa9fe993a3
                Copyright © 2022 Enkeleda Gjini et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 December 2021
                : 6 July 2022
                : 24 August 2022
                Funding
                Funded by: HAP Health for all Project
                Categories
                Research Article

                Nursing
                Nursing

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