Propiedades psicométricas de la Escala Dispvac: evidencia de la validez de contenido interna, externa y fiabilidad / Psychometric properties of Dispvac Scale: evidence of its content, internal validity, external validity, and reliability

Resumen Introducción: una de las barreras al acceso a la vacunación contra las enfermedades infecciosas es la reticencia a la vacunación, la cual suele medirse o asociarse a una poca disposición para vacunarse, actitudes antivacunas o la probabilidad reportada de obtener una vacuna. Sin embargo, no existe un consenso en la forma en la cual este constructo es medido. Objetivo: el propósito de este artículo es identificar las propiedades psicométricas y la estructura factorial de la nueva Escala Dispvac en una muestra colombiana. Método: se realizó un diseño psicométrico para identificar las propiedades psicométricas de la escala con una muestra de 1131 participantes (masculino: 37.30%, femenino 61.90%, otro: 0.79%; media edad: 25.84, SD edad: 10.19), a través de un muestreo por conveniencia. Se realizó un análisis factorial exploratorio, un análisis factorial confirmatorio, un análisis de fiabilidad y la validez convergente. Resultados: se sugieren dos factores: actitudes cognitivas hacia la vacunación y legitimidad percibida de las autoridades al requerir la vacunación que comprende la prueba. La prueba Dispvac se correlaciona de manera negativa con la Escala VAX. Conclusiones: los dos factores que comprenden la Escala Dispvac sugieren que la intención a vacunarse implica también creencias sobre la autoridad/instituciones en vacunación.

Abstract Introduction: One of the main barriers to access to vaccination against infectious diseases is vaccine hesitancy, which is usually measured or associated to a low disposition to receive vaccination, anti-vaccine attitudes or the reported probability to receive a vaccine. However, there is no consensus in the way this construct is measured. Objective: The objective of this study it to identify the psychometric properties and the factorial structure of the Scale Dispvac in a Colombian sample. Method: To this goal, a psychometric design was made to identify the psychometric properties of the new scale making use of 1131 participants (male: 37.30%, female: 61.90%, other: 0.79%; age mean: 25.84, age SD: 10.19), through a convenience sampling. We conducted an exploratory factorial analysis, a confirmatory factorial analysis, a reliability analysis, and the convergent validity. Results: Two factors are suggested: Cognitive attitudes towards vaccination and perceived legitimacy of authorities to require vaccination. The Dispvac Scale is negatively correlated with the VAX Scale. Conclusions: The mentioned factors suggest that intention to vaccinate also implies beliefs on the authority in vaccination.

Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Incidência de anafilaxia relacionada às vacinas do Programa Nacional de Imunizações / Incidence of vaccine-related anaphylaxis from Brazil's National Immunization Program

A incidência de anafilaxia pós-vacinal é um evento de saúde raro e carece de melhor detalhamento no Brasil. Neste estudo, objetivou-se descrever a incidência de anafilaxia como evento supostamente atribuído à vacinação e imunização (ESAVI) das vacinas do Programa Nacional de Imunizações (PNI).Foi realizado estudo retrospectivo com dados extraídos do sistema de notificação de ESAVI do PNI entre 01/2021 e 05/2023 com aceitação na Plataforma Brasil e aprovação ética. Foram identificados 84 casos encerrados com o descritor "anafilaxia" ou "choque anafilático" entre 290.101 eventos adversos notificados, concentrados principalmente nas regiões Sul e Sudeste. Crianças de 0 a 9 anos foram predominantemente afetadas, com maior incidência em mulheres e indivíduos brancos. A anafilaxia associou-se em números absolutos principalmente às vacinas COVID-19, destacando os fabricantes AstraZeneca/Fiocruz (vetor viral), Pfizer Comirnaty (RNAm) e CoronaVac (inativada), e a maior taxa de incidência foi com a vacina antirrábica (2,8 por milhão de doses aplicadas). A incidência global foi de 0,14/milhão de doses aplicadas. Entre os desfechos não foi relatado óbito. A subnotificação de casos é relevante e sublinha a importância de manter sistemas robustos de vigilância e manejo de reações alérgicas em programas de vacinação. Este estudo segue tendências mundiais da raridade da anafilaxia relacionada às vacinas. Os dados reforçam a segurança das vacinas COVID-19 e demais vacinas existentes no PNI, independente da demografia analisada.

Vaccine-related anaphylaxis is a rare health event, and its incidence requires further investigation in Brazil. The objective of this study was to describe the incidence of anaphylaxis as an event supposedly attributed to vaccination and immunization (ESAVI) associated with the Brazilian National Immunization Program (PNI). A retrospective study was conducted with data extracted from the PNI ESAVI notification system between January 2021 and May 2023, with ethical approval and registration in Plataforma Brasil. Among 290,101 adverse events reported, 84 cases closed with the descriptor "anaphylaxis" or "anaphylactic shock" were identified, mainly concentrated in the South and Southeast regions. Children aged 0 to 9 years were predominantly affected, with a higher incidence in women and white individuals. In absolute numbers, anaphylaxis was associated mainly with the AstraZeneca/Fiocruz (viral vector), Pfizer Comirnaty (mRNA), and CoronaVac (inactivated virus) COVID-19 vaccines, while the highest relative incidence was with the anti-rabies vaccine (2.8 cases per million doses administered). The overall incidence was 0.14 per million vaccine doses. No deaths were reported. Underreporting of vaccine-related anaphylaxis is relevant and highlights the importance of maintaining robust systems for surveillance and management of allergic reactions within vaccination programs. This study corroborates global trends in the rarity of vaccine-related anaphylaxis. The low incidence of this event, regardless of recipient demographics, provides further evidence of the safety of COVID-19 vaccines and other vaccines included in the PNI.

Vaccine hesitancy amongst the tribal population of India: a comparative scenario between COVID-19 vaccination and routine immunization

Vaccine hesitancy plays a crucial role in slowing down the efforts towards achieving an immunized and healthy society, particularly, children and women. VH is very conspicuous among the economically marginalized tribal and indigenous population. Previous research papers have not presented a comparative scenario between VH for RI and COVID-19 and have not discussed in detail different reasons behind VH from the gender perspective among tribal population. The key research question for this systematic review is whether the vaccine hesitancy for routine child vaccination among the tribal population will reduce or escalate or show no change after COVID-19 vaccination drive. This paper using Google Scholar database identified the research paper and reports, published between 2013 and 2023, and synthesized the factors contributing to vaccine hesitancy among the tribal population. While hesitancy due to reasons such as the safety and trust concerns, related to vaccines and the government; strong dependency on natural remedies; decision making dominated by social and cultural norms prevailing since ages; emerged as the key resistant in case of routine immunization among the tribal population, these were observed to be similar, to a large extent, in case of COVID-19, as well, in spite of two different age groups being the target of the vaccination drive. The paper identified key enablers and barriers of vaccine acceptance, which will be insightful for policy makers, healthcare agencies and professionals working to eliminate VH among tribal and indigenous population.

The Investigation and Analysis of the Situation of COVID-19 Vaccination and Vaccination Willingness in HIV/AIDS Population in Yunnan Province / 昆明医科大学学报

Objective To investigate the vaccination status and vaccination willingness of novel coronavirus in HIV/AIDS population in Yunnan.Methods From October 2021 to June 2022,a questionnaire survey was conducted among 2180 HIV/AIDS patients in Kunming,Qujing,Yuxi,Zhaotong,Puer,Baoshan,Lincang,Honghe,Wenshan,Xishuangbanna,Dali,Dehong and Nujiang prefectures.The questionnaire included age,sex,education,nationality,education level,vaccination,adverse reactions within 7 days after the vaccination,safety of COVID-19 vaccine,awareness of effectiveness,vaccination willingness and so on.Results Among the subjects,2109 completed 3 injections,accounting for 96.74%,and 71 were not vaccinated,accounting for 3.26% .Within 7 days of inoculation,local adverse reactions occurred in 116 cases,accounting for 5.50%,and systemic adverse reactions occurred in 56 cases,accounting for 2.66% .Injection site pain,fatigue and muscle pain accounted for the highest proportion of adverse symptoms in different sex,age and the Han nationality,while the proportion of minority adverse reactions was very low,and there was no difference among the different sex and age(P>0.05).The main reasons for the reluctance of HIV/AIDS population to be vaccinated were(recommended by doctors)that HIV/AIDS patients could not be vaccinated(67.61%)and may have serious adverse reactions after the vaccination(19.72%).The factors affecting the vaccination were found by logistic regression analysis,whether they were worried about infecting novel coronavirus(OR = 0.121,95% CI = 0.083～0.640,P<0.001)and how much they knew about COVID-19 vaccine(OR = 28.932,95% CI = 15.469～54.115,P<0.001),safety of vaccination(OR = 13.953,95% CI = 4.819～40.404,P<0.001)and belief in the preventive effect of vaccine(OR = 14.017,95% CI = 4.752～41.348,P<0.001)were significant factors affecting vaccination.Among the 13 prefectures and cities,Dehong(20),Zhaotong(21)and Lincang(14)had the largest number of unvaccinated people.Conclusion After the mass vaccination,the rate of adverse reaction in HIV/AIDS population is low,the symptoms are mild,the correct and scientific advice and guidance from doctors and the full understanding of the harmfulness of the disease,the safety,prevention and effectiveness of the vaccine are the key to complete vaccination and put an end to vaccine hesitancy.

Ethical Dilemma in Global Vaccine Cooperation and Its Countermeasures: Taking the Global Eradication of Smallpox as an Example / 中国医学伦理学

Vaccine cooperation is an important means to deal with global infectious diseases. However, the cooperation cannot be achieved overnight. Ethical dilemma is one of the obstacles that hinders vaccine cooperation. Reviewing the history, the most successful vaccine collaboration to date has been the global smallpox eradication program. In the process of eradicating smallpox, there were also many ethical dilemmas, including the international pattern of the US-Soviet hegemony, which impacted the mutual help between countries, the ethical disputes of the vaccine itself hindering solidarity and cooperation among actors, and the vaccine coercion adopted to overcome vaccine hesitancy undermining the principle of proportionality among the freedom, equality and efficacy. The ethical dilemmas of vaccine cooperation were resolved by shaping professional and scientific consensus among medical professional groups, reaching consensus on cooperation between leading countries and developing countries, and integrating local culture to improve vaccination methods. Finally, in 1980, the world successfully eradicated smallpox. The case of smallpox eradication provides us lessons for vaccine cooperation against COVID-19 and the construction of a community of common health for mankind today.

Psychometric properties and reliability of the Brazilian version of Parent Attitudes about Childhood Vaccine (PACV-BR) / Propriedades psicométricas e confiabilidade da versão brasileira do Parent Attitudes about Childhood Vaccine (PACV-BR)

ABSTRACT Objective: To evaluate the psychometric properties and reliability of the Brazilian version of the tool Parent Attitudes about Childhood Vaccine (PACV-BR). Methods: The sample included 110 parents of children up to two years old served by Family Health Basic Units. The tool's internal consistency and factor validity were respectively assessed by Cronbach's alpha and exploratory factor analysis (EFA). The test-retest reliability was assessed by the intraclass correlation coefficient (ICC). Results: The EFA results indicated a proper structural adequacy of the PACV-BR (15 items and two factors). The reliability generated Cronbach's alpha values between 0.715 and 0.854 for the items, of 0.918 for the tool as a whole, of 0.877 for factor 1 and of 0.825 for factor 2, in addition to an ICC of 0.984. Conclusions: The PACV-BR showed evidence of construct validity and reliability.

RESUMO Objetivo: Avaliar as propriedades psicométricas e a confiabilidade da versão brasileira do instrumento Parent Attitudes about Childhood Vaccine (PACV-BR). Métodos: A amostra incluiu 110 pais de crianças de até dois anos atendidas em Unidades Básicas de Saúde da Família. A consistência interna e a validade fatorial do instrumento foram avaliadas, respectivamente, pelo alfa de Cronbach e pela análise fatorial exploratória (EFA). A confiabilidade teste-reteste foi avaliada pelo coeficiente de correlação intraclasse (ICC). Resultados: Os resultados da AFE indicaram adequação estrutural do PACV-BR (15 itens e dois fatores). A confiabilidade indicou valores de alfa de Cronbach entre 0,715 e 0,854 para os itens, de 0,918 para o instrumento como um todo, de 0,877 para o fator 1 e de 0,825 para o fator 2, além de ICC de 0,984. Conclusões: O PACV-BR apresentou evidências de validade de construto e confiabilidade.

COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: A survey of unvaccinated adults

Background: Concerns and misconceptions surrounding coronavirus disease 2019 (COVID-19) vaccines may account for vaccine hesitancy and low uptake. Aim: To determine prevalence of COVID-19 vaccine hesitancy, vaccine-related misconceptions, and predictors of vaccine hesitancy among South Africans. Setting: Community setting in five districts in KwaZulu- Natal province. Methods: Between August 20, 2021, and September 27, 2021, we conducted a cross-sectional survey, interviewing 300 unvaccinated adults amid the national vaccination campaign. Predictors of hesitancy were identified through multivariable logistic regression analysis. Results: Participants had a median age of 29 years (IQR: 23­39), 86.7% were Black African, 63.2% were male, 53.3% resided in rural communities, and 59.3% (95% CI: 53.8% ­ 64.9%) were classified as vaccine hesitant. The primary reason for not vaccinating was a lack of trust in the vaccine (62.1%). Factors associated with reduced vaccine hesitancy included age (participants aged 35­49 years: OR: 0.28, 95% CI: 0.18­0.64, p = 0.003; participants over 50 years: OR: 0.18, 95% CI: 0.07­0.47, p = 0.0004), previous COVID-19 infection (OR: 0.31, 95% CI: 0.11­0.87, p = 0.03), and receiving vaccine information from healthcare workers (OR: 0.32, 95% CI: 0.10­1.0, p = 0.05). Unemployed (OR: 2.14, 95% CI: 1.1­4.2, p = 0.03) and self-employed individuals (OR: 2.98, 95% CI: 1.27­7.02, p = 0.01) were more likely to be vaccine hesitant. Conclusion: COVID-19 vaccine hesitancy rates are high in KwaZulu-Natal. Uptake could be enhanced by healthcare workers leading information campaigns with messages targeting younger individuals, the unemployed, and the self-employed. Contribution: This survey provides evidence to improve COVID-19 vaccination uptake in South Africa.

Hesitação vacinal infantil e COVID-19: uma análise a partir da percepção dos profissionais de saúde / Childhood vaccine hesitancy and COVID-19: an analysis based on the perception of health professionals / La reticencia vacunal infantil y la COVID-19: un análisis a partir de la percepción de los profesionales de la salud

Resumo: Este artigo apresenta os resultados de uma pesquisa sobre a percepção dos profissionais de saúde sobre a hesitação vacinal infantil relacionada à COVID-19. Baseado no constructo teórico da hesitação vacinal, foi realizada uma pesquisa qualitativa com 86 trabalhadores da atenção primária à saúde (APS) em quatro municípios de quatro estados brasileiros e no Distrito Federal. A análise temática foi realizada e obtiveram-se três categorias: medo, desinformação em vacina e papel dos profissionais de saúde. O medo como motivo de hesitação vacinal gerou reflexões sobre a condução da pandemia pelo Governo Federal, principalmente no que tange à governabilidade por meio desse afeto, e sobre as consequências do uso das plataformas digitais na população. O medo relacionou-se ao fato de a vacina ainda ser percebida como experimental; às possíveis reações adversas; à ausência de estudos de longo prazo; à falsa percepção de risco reduzido da COVID-19 em crianças; e às condutas do Governo Federal geradoras de insegurança nos efeitos da vacina. A desinformação em vacina relacionou-se às fake news sobre a vacina e suas reações; ao fenômeno da infodemia e desinformação; e à ausência de orientação e conhecimento sobre vacinas. Por fim, o trabalho discute o papel fundamental dos profissionais de saúde da APS no aumento da cobertura vacinal devido à confiabilidade perante a população e à proximidade com os territórios, fatores que possibilitam reverter o medo e a desinformação diante das vacinas. Ao longo do trabalho, buscou-se apresentar as convergências entre o conteúdo dos temas delineados e os determinantes da hesitação vacinal e refletir sobre possibilidades para a reconstrução da alta adesão às vacinas infantis.

Abstract: This article presents the results of a study on health professionals' perceptions of childhood vaccine hesitancy related to COVID-19. Based on the theoretical construct of vaccine hesitancy, a qualitative study was conducted with 86 primary health care (PHC) workers in four municipalities in four Brazilian states and in the Federal District. A thematic analysis was performed and three categories were obtained: fear, misinformation about vaccines, and the role of health professionals. Fear as a reason for vaccine hesitancy has led to reflections on the Brazilian Federal Government's management of the pandemic, especially regarding governability and the consequences of the use of digital platforms on the population. Fear was related to the vaccine still being perceived as experimental; to the adverse reactions it may cause; to the lack of long-term studies; to the false perception of reduced risk of COVID-19 in children; and to the Federal Government's behavior, which creates uncertainty about the effects of the vaccine. Vaccine misinformation was related to fake news about the vaccine and its reactions; the phenomenon of infodemic and misinformation; and the lack of guidance and knowledge about vaccines. Finally, the article discusses the fundamental role of PHC workers in increasing vaccination coverage due to the trust among the population and proximity to the territories, factors that enable the reversal of fear and misinformation about vaccines. Throughout the study, authors' sought to show the convergences between the content of the themes outlined and the determinants of vaccine hesitancy and to consider possibilities for rebuilding high adherence to childhood vaccines.

Resumen: Este artículo presenta los resultados de una encuesta sobre la percepción de los profesionales de la salud acerca de la reticencia vacunal infantil relacionada con la COVID-19. Con base en el constructo teórico de la reticencia vacunal, se realizó una encuesta cualitativa con 86 trabajadores de la atención primaria de salud (APS) en 4 municipios de 4 estados brasileños y en el Distrito Federal. Se realizó un análisis temático y se obtuvieron tres categorías: miedo, desinformación sobre vacunas y papel de los profesionales de la salud. El miedo como motivo de reticencia vacunal dio lugar a reflexiones sobre el manejo de la pandemia por parte del Gobierno Federal, sobre todo en lo que respecta a la gobernabilidad por medio de esta afección y las consecuencias del uso de plataformas digitales en la población. El temor se relacionó con el hecho de que la vacuna todavía se percibe como experimental; con las reacciones adversas que puedan provocar; con la ausencia de estudios a largo plazo; con la falsa percepción de riesgo reducido de COVID-19 en niños y con las conductas del Gobierno Federal que generan inseguridad sobre los efectos de la vacuna. La desinformación sobre las vacunas se relacionó con noticias falsas sobre la vacuna y sus reacciones; el fenómeno de la infodemia y la desinformación; y la ausencia de orientación y conocimiento sobre las vacunas. Finalmente, el trabajo discute el papel fundamental de los profesionales de la salud de la APS en el aumento de la cobertura vacunal debido a su confiabilidad entre la población y cercanía a los territorios, factores que permiten revertir el miedo y la desinformación respecto a las vacunas. A lo largo del trabajo, se buscó presentar las convergencias entre el contenido de los temas delineados y los determinantes de la reticencia vacunal y reflexionar sobre las posibilidades para la reconstrucción de una alta adhesión a las vacunas infantiles.

Barriers and facilitators to vaccination in Latin America: a thematic synthesis of qualitative studies / Barreras y facilitadores de la vacunación en América Latina: síntesis temática de estudios cualitativos / Barreiras e facilitadores para a vacinação na América Latina: síntese temática de estudos qualitativos

Vaccines are often undervalued or underused for a variety of reasons, and vaccine hesitancy is a global challenge that threatens vaccine acceptance and the goals of immunization programs. This review aimed to describe the barriers and facilitators to vaccination in Latin America. The study design was a systematic review and thematic synthesis of qualitative studies reporting on the knowledge or attitudes of adults, parents of children at vaccination age, adolescents and health professionals towards vaccination in Latin America. The databases searched were PubMed, CENTRAL, Scopus, LILACS, SciELO, and CINAHL. A total of 56 studies were included. Facilitators included vaccination being recognized as an effective strategy for preventing infectious diseases and as a requirement for access to social assistance programs, schooling or employment. Recommendations from health professionals and positive experiences with health services were also identified as facilitators. The main barriers were lack of information or counseling, structural problems such as shortages of vaccines and limited hours of operation, the inability to afford over-the-counter vaccines or transportation to health facilities, certain religious beliefs, misconceptions and safety concerns. Qualitative research can contribute to understanding perceptions and decision-making about vaccination and to designing policies and interventions to increase coverage.

Las vacunas suelen estar subvaloradas o desaprovechadas por diversas razones. La vacilación ante las vacunas es un desafío global y representa una amenaza para la aceptación de las vacunas y para los objetivos de los programas de inmunización. El objetivo de esta revisión es describir las barreras y los facilitadores de la vacunación en América Latina. El diseño del estudio fue una revisión sistemática y una síntesis temática de estudios cualitativos sobre conocimientos o actitudes de adultos, padres de niños en edad de vacunación, adolescentes y profesionales de la salud sobre la vacunación en América Latina. Las bases de datos analizadas fueron PubMed, CENTRAL, Scopus, LILACS, SciELO y CINAHL. Se incluyeron 56 estudios. Los facilitadores incluyeron la idea de que la vacunación era reconocida como una estrategia eficaz para prevenir enfermedades infecciosas y un requisito para el acceso a la asistencia social, la escolaridad o el empleo. También se identificaron como factores facilitadores las recomendaciones de los profesionales de la salud y las experiencias positivas con los servicios de salud. Los principales obstáculos fueron la falta de información o asesoramiento, problemas estructurales como la escasez de vacunas y los horarios de funcionamiento limitados, la imposibilidad de pagar vacunas no provistas de forma gratuita o de desplazarse a los centros de salud, ciertas creencias religiosas, conceptos erróneos sobre las vacunas y preocupaciones por la seguridad. La investigación cualitativa puede contribuir a la comprensión de las percepciones y a la toma de decisiones sobre la vacunación y al desarrollo de políticas e intervenciones para aumentar la cobertura de vacunación.

As vacinas são frequentemente subvalorizadas ou subutilizadas por uma série de razões. A hesitação vacinal é um desafio global, sendo uma ameaça à aceitação das vacinas e aos objetivos dos programas de imunização. O objetivo desta revisão é descrever barreiras e facilitadores para a vacinação na América Latina. O desenho do estudo foi uma revisão sistemática e síntese temática de estudos qualitativos sobre conhecimento ou atitudes de adultos, pais de crianças em idade de vacinação, adolescentes e profissionais de saúde sobre vacinação na América Latina. As bases de dados analisadas foram PubMed, CENTRAL, Scopus, LILACS, SciELO e CINAHL. Foram incluídos 56 estudos. Os facilitadores incluíram a ideia de que a vacinação era reconhecida como uma estratégia eficaz para prevenir doenças infecciosas e um requisito para o acesso à assistência social, escolaridade ou emprego. Além disso, recomendações de profissionais de saúde e experiências positivas com serviços de saúde também foram identificados como fatores facilitadores. Os principais obstáculos foram a falta de informação ou aconselhamento, problemas estruturais como escassez de vacinas e horário limitado de funcionamento, incapacidade de comprar vacinas pagas ou se transportar para unidades de saúde, certas crenças religiosas, concepções erradas sobre vacinas e preocupações de segurança. A pesquisa qualitativa pode contribuir para a compreensão das percepções e tomadas de decisão sobre a vacinação e para o desenvolvimento de políticas e intervenções para aumentar a cobertura vacinal.

Description of vaccination coverage and hesitancy obtained by epidemiological survey of children born in 2017-2018, in Belo Horizonte and Sete Lagoas, Minas Gerais, Brazil / Descripción de la cobertura de vacuna y de las vacunaciones obtenidas por la encuesta epidemiológica de niños nacidos en 2017-2018, en Belo Horizonte y Sete Lagoas, Minas Gerais / Descrição da cobertura e da hesitação vacinal obtida por inquérito epidemiológico de crianças nascidas em 2017-2018, em Belo Horizonte e Sete Lagoas, Minas Gerais

ABSTRACT Objective To describe vaccination coverage and hesitation for the basic children's schedule in Belo Horizonte and Sete Lagoas, Minas Gerais state, Brazil. Methods Population-based epidemiological surveys performed from 2020 to 2022, which estimated vaccine coverage by type of immunobiological product and full schedule (valid and ministered doses), according to socioeconomic strata; and reasons for vaccination hesitancy. Results Overall coverage with valid doses and vaccination hesitancy for at least one vaccine were, respectively, 50.2% (95%CI 44.1;56.2) and 1.6% (95%CI 0.9;2.7), in Belo Horizonte (n = 1,866), and 64.9% (95%CI 56.9;72.1) and 1.0% (95%CI 0.3;2.8), in Sete Lagoas (n = 451), with differences between socioeconomic strata. Fear of severe reactions was the main reason for vaccination hesitancy. Conclusion Coverage was identified as being below recommended levels for most vaccines. Disinformation should be combated in order to avoid vaccination hesitancy. There is a pressing need to recover coverages, considering public health service access and socioeconomic disparities.

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RESUMO Objetivo Descrever as coberturas e hesitação das vacinas do calendário básico infantil em Belo Horizonte e Sete Lagoas, Minas Gerais. Métodos Inquéritos epidemiológicos de base populacional realizados de 2020 a 2022, para estimar coberturas vacinais por tipo de imunobiológico e esquema completo (doses válidas e aplicadas) segundo estratos socioeconômicos, e os motivos de hesitação vacinal. Resultados A cobertura global com doses válidas e a hesitação vacinal de pelo menos uma vacina foram, respectivamente, de 50,2% (IC95% 44,1;56,2) e 1,6% (IC95% 0,9;2,7), em Belo Horizonte (n = 1.866), e de 64,9% (IC95% 56,9;72,1) e 1,0% (IC95% 0,3;2,8), em Sete Lagoas (n = 451), com diferenças entre os estratos. O receio de reações graves foi o principal motivo de hesitação vacinal. Conclusão Identificou-se coberturas abaixo do preconizado para a maioria das vacinas. A desinformação deve ser combatida, evitando-se a hesitação vacinal. Há necessidade premente de recuperar as coberturas, considerando acesso ao SUS e disparidades socioeconômicas.

"Eu vivo num mundo muito burguês, não moro na periferia": não vacinação infantil e a intersecção entre raça, classe e gênero / "Yo vivo en un mundo muy burgués, no vivo en la periferia": no vacunación infantil y la intersección entre raza, clase y género / "I live in a very bourgeois world, I don't live in the outskirts": childhood non-vaccination and the intersection of race, class and gender

O artigo analisa como os marcadores raça, gênero, classe social e espacialidade se interseccionam e se refletem nas tomadas de decisão em saúde, mais especificamente na (não) vacinação infantil. Trata-se de pesquisa qualitativa conduzida nas cidades de Florianópolis (SC) e São Luís (MA), Brasil, com famílias com crianças de até seis anos de idade. Neste artigo, examinam-se, por meio de análise temática, as narrativas das/dos 19 responsáveis de Florianópolis que optaram por não vacinar total ou parcialmente a(s) criança(s) sob sua responsabilidade. Gênero revela-se um importante marcador na tomada de decisão no âmbito intrafamiliar, enquanto classe social, raça e espacialidade surgem como importantes marcadores na percepção de quem são os "nós" que não precisam das vacinas e os "outros" que precisam. Os achados são discutidos pelo referencial da interseccionalidade e de estudos teóricos sobre branquitude e parentalidade neoliberal.(AU)

El artículo analiza cómo los marcadores de raza, género, clase social y espacialidad se cruzan y se reflejan en las tomas de decisión en salud, más específicamente en la (no) vacunación infantil. Se trata de una investigación cualitativa realizada en las ciudades de Florianópolis (Estado de Santa Catarina) y São Luís (Maranhão), Brasil, con familias de niños de hasta seis años de edad. En este artículo se analiza, por medio de análisis temático, las narrativas de los 19 responsables de Florianópolis que optaron por no vacunar total o parcialmente a los niños bajo su responsabilidad. El género se revela como un importante marcador en la toma de decisión en el ámbito intrafamiliar, mientras que la clase social, raza y espacialidad surgen como importantes marcadores en la percepción de quiénes son los "nosotros" que no necesitan las vacunas y los "otros" que las necesitan. Los hallazgos se discuten a partir del referencial de la interseccionalidad y de estudios teóricos sobre la blanquitud y la parentalidad neoliberal.(AU)

This article analyzes how race, gender, social class and spatiality markers intersect and are reflected in health decision-making, more specifically in childhood (non)vaccination. This qualitative study was conducted in two Brazilian cities: Florianópolis (SC) and São Luís (MA), and included families with children up to six years old. This article analyzes the narratives of 19 caregivers in Florianópolis who chose not to vaccinate (fully or partially) the child(ren) under their responsibility. In-depth interviews and thematic content analysis were conducted. Gender was an important marker in intra-family decision-making, while social class, race and spatiality emerged as important markers in the perception of who are the "us" who don't need vaccines and the "others" who do. The findings are discussed using the theoretical framework of whiteness and neoliberal parenting studies.(AU)

Vaccination coverage and delay in vaccination of infants born in 2017 and 2018 in municipalities in the Southern region of Brazil: National Vaccination Coverage Survey 2020 / Cobertura vacunal y retraso en la vacunación de lactantes nacidos en 2017 y 2018 en municipios de la región Sur de Brasil: Encuesta Nacional de Cobertura de Vacunación 2020 / Cobertura vacinal e atraso na vacinação de lactentes nascidos em 2017 e 2018 em municípios da região Sul do Brasil: Inquérito Nacional de Cobertura Vacinal

ABSTRACT Objective To evaluate vaccination coverage and delay in vaccine dose administration in infants in six municipalities in the Southern region of Brazil. Methodology National Vaccination Coverage Survey 2020, with infants born alive in 2017 and 2018, carried out from September 2020 to March 2022. Coverage of doses administered, doses administered on time and delay in dose administration were evaluated. Results For 4681 infants analyzed, coverage for vaccines recommended up to 24 months was 68.0% (95%CI 63.9;71.8%) for doses administered and 3.9% (95%CI 2.7%;5.7%) for doses administered on time. Delay time for the majority of late vaccinations was ≤ 3 months. For some boosters, 25% of vaccine administration was delayed by ≥ 6 months. Conclusion In addition to tracking vaccine defaulters, strategies are needed to encourage compliance with the vaccination schedule at the recommended ages.

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RESUMO Objetivo Avaliar as coberturas vacinais e o atraso nas doses de vacinas em lactentes em seis municípios da região Sul do Brasil. Metodologia Inquérito Nacional de Cobertura Vacinal 2020, com lactentes nascidos vivos em 2017 e 2018, realizado entre setembro de 2020 e março de 2022. Foram avaliadas as coberturas de doses aplicadas, doses em dia e o tempo de atraso da aplicação. Resultados Para 4.681 lactentes analisados, as coberturas para vacinas indicadas até os 24 meses foram de 68,0% (IC95% 63,9;71,8) para doses aplicadas e 3,9% (IC95% 2,7;5,7) para doses em dia. A maioria das aplicações em atraso foi ≤ 3 meses. Para alguns reforços, 25% das aplicações atrasaram ≥ 6 meses. Conclusão Além da busca de faltosos às vacinas, são necessárias estratégias para estímulo ao cumprimento do esquema de vacinação nas idades preconizadas.

Hesitação vacinal entre profissionais de saúde em hospital universitário / Indecisión a las vacunas entre profesionales de la salud en un hospital universitario / Vaccine hesitancy among healthcare professionals at a university hospital

Resumo Objetivo Analisar os fatores associados à hesitação vacinal entre os profissionais de saúde de um hospital universitário. Métodos Estudo transversal, descritivo e analítico, desenvolvido em um hospital universitário federal de Pernambuco, entre os meses de junho e novembro de 2022, com trabalhadores de saúde da instituição com formação de nível médio e superior. Foram analisadas as variáveis preditoras aspectos socioeconômicos, ocupacionais, histórico de reação vacinal, medos relativos às vacinas e aspectos das dimensões do modelo dos 3Cs (confiança, conveniência e complacência) com o desfecho hesitação vacinal, definido como atraso ou recusa da vacinação, apesar da disponibilidade desse serviço. Utilizou-se a regressão logística binária, segundo o método stepwise backward, para verificar as associações (p < 0,05). Resultados Participaram 283 trabalhadores de saúde, sendo estatisticamente associados à hesitação vacinal o medo de eventos supostamente atribuíveis à vacinação ou imunização (OR: 2,047; IC:1,165-3,595; p = 0,013), ter acontecido algo que os fizesse desacreditar na eficácia das vacinas (OR: 2,964; IC: 1,265-6,944; p = 0,012) e disponibilidade do imunobiológico na unidade de saúde no momento da atualização do cartão (OR: 0,314; IC: 0,136-0,723; p = 0,006). Conclusão Observou-se que o medo de eventos supostamente atribuíveis à vacinação ou imunização aumenta em duas vezes a chance de hesitação vacinal; que ter acontecido algo que fizesse desacreditar na eficácia das vacinas eleva em quase três vezes; e que a disponibilidade do imunobiológico na unidade de saúde no momento da atualização do cartão diminui a ocorrência desse fenômeno.

Resumen Objetivo Analizar los factores asociados a la indecisión a las vacunas entre profesionales de la salud de un hospital universitario. Métodos Estudio transversal, descriptivo y analítico, llevado a cabo en un hospital universitario federal del estado de Pernambuco, entre los meses de junio y noviembre de 2022, con trabajadores de la salud de la institución, cuya formación era de nivel medio y superior. Se analizaron las variables predictoras aspectos socioeconómicos, ocupacionales, antecedentes de reacciones a vacunas, miedos relacionados con las vacunas y aspectos de las dimensiones del modelo de las 3C (confianza, conveniencia y complacencia) con el resultado indecisión a las vacunas, definido como retraso o rechazo a la vacunación, a pesar de la disponibilidad del servicio. Se utilizó la regresión logística binaria, de acuerdo con el método stepwise backward, para verificar las relaciones (p<0,05). Resultados Participaron 283 trabajadores de la salud. La indecisión a las vacunas se relacionó estadísticamente con el miedo de eventos supuestamente atribuibles a la vacunación o inmunización (OR: 2,047; IC:1,165-3,595; p = 0,013), con algún hecho que los hiciera desacreditar de la eficacia de las vacunas (OR: 2,964; IC: 1,265-6,944; p = 0,012) y con la disponibilidad del inmunobiológico en la unidad de salud en el momento da la actualización del carnet (OR: 0,314; IC: 0,136-0,723; p = 0,006). Conclusión Se observó que el miedo de eventos supuestamente atribuibles a la vacunación o inmunización aumenta dos veces la probabilidad de indecisión a las vacunas, que la existencia de algún hecho que los hiciera desacreditar de la eficacia de las vacunas eleva casi tres veces la indecisión y que la disponibilidad del inmunobiológico en la unidad de salud en el momento da la actualización del carnet disminuye la incidencia de este fenómeno.

Abstract Objective To analyze the factors associated with vaccine hesitancy among healthcare professionals at a university hospital. Methods This is a cross-sectional, descriptive and analytical study, developed at a federal university hospital in Pernambuco, between June and November 2022, with institution healthcare workers with high school and higher education. The predictor variables socioeconomic and occupational aspects, history of vaccine reactions, fears related to vaccines and aspects of 3Cs model (confidence, compliance, convenience) dimensions with the outcome vaccine hesitancy, defined as delay or refusal of vaccination, despite the availability of this service, were analyzed. Binary logistic regression was used, according to the stepwise backward method, to verify associations (p < 0.05). Results A total of 283 healthcare workers participated, with vaccine hesitancy being statistically associated with fear of Events Supposedly Attributable to Vaccination or Immunization (OR: 2.047; CI: 1.165-3.595; p = 0.013), having something happen that made them disbelieve in vaccine effectiveness (OR: 2.964; CI: 1.265-6.944; p = 0.012) and immunobiological agent availability in the health unit to update the card (OR: 0.314; CI: 0.136-0.723; p = 0.006). Conclusion It was observed that: fear of Events Supposedly Attributable to Vaccination or Immunization increases the chance of vaccine hesitancy by two times; the fact that something happened that led to disbelief in vaccine effectiveness increases it by almost three times; and immunobiological agent availability in the health unit to update the card reduces the occurrence of this phenomenon.

Cobertura vacinal e taxa de abandono nas capitais do nordeste brasileiro entre 2018 e 2022 / Vaccination coverage and abandonment rate in Northeastern Brazilian capitals between 2018 and 2022 / Cobertura de vacunación y tasa de abandono en las capitales del Noreste Brasileño entre 2018 y 2022

Introdução: O Programa Nacional de Imunizações presente na Atenção Primária à Saúde coordena o processo de imunização e o torna mais eficaz, porém esse sistema enfrenta problemas como a falta de acesso à internet e desabastecimento de imunizantes, que prejudicam a cobertura vacinal da população e dificultam o registro eletrônico dos dados indicadores, além de aumentar a taxa de abandono vacinal. Objetivo:Analisar os indicadores de Cobertura Vacinal e Taxa de Abandono nas capitais do Nordeste nos últimos cinco anos. Metodologia:Estudo epidemiológico, quantitativo e descritivo. As nove capitais do Nordeste do Brasil foram selecionadas para o estudo. A temática abordada é a Taxa de Abandono Vacinal e a Cobertura Vacinal nos últimos cinco anos nas capitais. Os dados foram coletados através doSistema de Informação do Programa Nacional de Imunização e armazenadosno Microsoft Excel. Resultados:Quanto às taxasde cobertura vacinal, Fortaleza teve o maior percentual, com 74,87%. Maceió obteve o segundo maior índice, com 66,12%. Em relação às taxas de abandono vacinal, Salvador registrou o maior número,com 27,39% nos últimos cinco anos. Não obstante, João Pessoaobteve a menor taxa, com 16,08%. Conclusões:Verificou-se que Fortaleza teve a maiorCobertura Vacinal e Salvador teve a maiorTaxa de Abandono Vacinal.Algumas capitais tiveram redução naCobertura Vacinal e aumento na Taxa de Abandono Vacinalno período pandêmico, indicando a necessidade de mais pesquisas sobre o impacto da Covid-19 e a circulação de informações equivocadas sobre vacinação. Logo, a atuação da atenção primária à saúde é crucial para reverter essa tendência, trabalhando na implementação de campanhas de imunização e na educação em saúde (AU).

Introduction: The National Immunization Program present in Primary Health Carecoordinates the immunization process and makes it more effective, but this system faces problems such as lack of internet access and shortages of immunizers, which underminethe population's vaccination coverage and hinderthe electronic recording of indicator data, besides increasing the vaccination abandonment rate.Objective: To analyze the Vaccination Coverage and AbandonmentRate indicators in theNortheasterncapitalsover the last five years.Methodology: Epidemiological, quantitative and descriptive study. The nine capitals of NortheasternBrazil were selected for the study. The themesaddressed arethe VaccinationAbandonment Rate andtheVaccinationCoverage overthe last five years in the capitals. The data was collected through the National Immunization Program Information System and stored in Microsoft Excel.Results:As for vaccination coverage rates, Fortaleza had the highest percentage, with 74.87%. Maceió obtainedthe second highest index, with 66.12%. Regardingvaccinationabandonment rates, Salvador recordedthe highest number,with 27.39% over the last five years. Nonetheless, João Pessoa obtainedthe lowest rate, with 16.08%. Conclusions:It was found that Fortaleza had the highest Vaccination Coverage and Salvador had the highest VaccinationAbandonment Rate.Some capitals had a reduction in Vaccination Coverage and an increase in the VaccinationAbandonment Rate in the pandemic period, indicating the need for more research aboutthe impact of Covid-19 and the circulation of misinformation about vaccination. Therefore, the role of primary health care is essential forreversing this trend, working on the implementation of immunization campaignsand health education (AU).

Introducción:El Programa Nacional de Inmunizaciónpresente en la Atención Primariade Saludcoordina el proceso de inmunización y lo hace más eficaz, pero este sistema se enfrenta a problemas como la falta de acceso a internet y la escasez de inmunizadores, queperjudicanla cobertura de vacunación de la población y dificultan el registro electrónico de los datos de los indicadores, además de aumentar la tasa de abandono de vacunación.Objetivo:Analizar los indicadores de Cobertura de Vacunación y Tasa de Abandono en las capitales del Nordeste en los últimos cinco años.Metodología:Estudio epidemiológico, cuantitativo y descriptivo. Fueron seleccionadas para el estudio las nueve capitales del Nordeste de Brasil. LostemasabordadossonlasTasa de Abandono deVacunacióny la Cobertura de Vacunación en los últimos cinco años en las capitales. Los datos se recogieron a través del Sistema de Información del Programa Nacional de Inmunización y se almacenaron en Microsoft Excel.Resultados:En cuanto a las tasas de cobertura de vacunación, Fortaleza tuvo el porcentaje más elevado, con un74,87%. Maceióobtuvo lasegunda tasa más alta, con un66,12%. En cuanto a las tasas de abandono de vacunación, Salvador registró la cifra más alta, con un27,39% en los últimos cinco años. Sin embargo, João Pessoa obtuvola tasa más baja, con un16,08%.Conclusiones:Se notó queFortaleza tuvo la mayor Cobertura de Vacunación y Salvadortuvola mayor Tasa de Abandono de Vacunación. Algunas capitales tuvieron una reducción de la Cobertura de Vacunacióny un aumento de la Tasa de Abandono de Vacunacióndurante el período pandémico, indicandola necesidad de más investigaciones sobre el impacto de laCovid-19 y la circulación de información errónea sobre la vacunación. Por lo tanto, el rolde la atención primaria de salud es crucial para revertiresta tendencia, trabajando en la implementación de campañas de inmunización y educación sanitaria (AU).

Aceptación y reticencia a las vacunas contra COVID-19 en ingresantes a una universidad pública peruana durante la tercera ola pandémica

Introducción. Los estudiantes universitarios influyen en las decisiones de su familia y comunidad a favor de la vacunación. Objetivo. Identificar las principales razones para la aceptación o reticencia vacunal contra COVID-19 en ingresantes a una universidad pública. Métodos. Estudio transversal en una muestra de 408 estudiantes. Se preguntó si había completado las tres dosis de vacuna contra COVID-19 y la principal razón para la aceptación o reticencia vacunal. Se realizó un análisis descriptivo, se aplicó la prueba chi cuadrado y exacta de Fisher. Resultados. El 85,5% aceptó la vacuna principalmente por no querer contagiar a familiares (38,1%) y no querer enfermarse (27,8%). El 14,5% fue reticente, especialmente por prolongados tiempos de espera en vacunatorios (37,3%) y lejanía de los centros de vacunación (13,6%). Conclusiones. En los universitarios estudiados, el temor a la enfermedad impulsó la aceptación de la vacuna contra COVID-19 y la inaccesibilidad a los servicios de salud generó la reticencia.

Introduction. University students influence their family and community decisions in favor of vaccination. Objective. To identify the main reasons for COVID-19 vaccine acceptance or hesitancy among university entrants. Methods. A cross-sectional study in a sample of 408 students. We asked whether the student had completed the three doses the COVID-19 vaccine and the main reason for vaccine acceptance or hesitancy. A descriptive analysis was performed, the chi-square test and Fisher's exact were applied. Results. 85.5% accepted vaccination mainly because they did not want to infect family members (38.1%) and did not want to get sick (27.8%). 14.5% were hesitancy especially due to long waiting times in vaccination centers (37.3%) and distance from vaccination centers (13.6%). Conclusions. In the university students studied, the fear of disease drove COVID-19 vaccine acceptance and inaccessibility to health services generated vaccine hesitancy among university entrants.

Implementação da prática avançada de enfermagem no enfrentamento do atraso vacinal: um relato de experiência / Implementation of advanced practice nursing in coping with vaccine delay: an experience report

OBJETIVO: Descrever a implementação de práticas avançadas de enfermagem para abordar o atraso na imunização em crianças menores de dois anos de idade. MÉTODO: Trata-se de um relato de experiência que monitorou a situação vacinal de crianças menores de dois anos e descreveu práticas avançadas de enfermagem para melhorar a adesão à vacinação. RESULTADOS: Foi monitorado o estado vacinal das crianças e realizadas ações e intervenções individuais e coletivas, como consultas individuais, buscas ativas, ligações telefônicas e mensagens via aplicativo de celular, educação continuada e produção de materiais educativos para conscientização entre a comunidade, pais/responsáveis e profissionais de saúde sobre a importância de manter o calendário vacinal atualizado, conforme proposto pelo Programa Nacional de Imunizações. CONCLUSÃO: As intervenções neste relatório demonstraram implicações importantes para a saúde pública e podem sugerir que as práticas avançadas de enfermagem têm um impacto positivo na melhoria da cobertura vacinal.

OBJECTIVE: To describe the implementation of advanced practice nursing to address delayed immunization in children under two years of age. METHOD: This experience report monitored the immunization status of children under two years of age and described advanced practice nursing to improve immunization compliance. RESULTS: The immunization status of children was monitored, and individual and collective actions and interventions were carried out, such as individual consultations, active searches, telephone calls and messages via a mobile phone application, ongoing education, and the production of educational materials to raise awareness among the community, parents/guardians and health professionals about the importance of keeping the immunization schedule up to date, as proposed by the Brazilian National Immunization Program. CONCLUSION: The interventions in this report have demonstrated important public health implications and may suggest that advanced nursing practices positively impact improving immunization coverage.

A cross sectional survey on COVID-19 vaccination coverage at urban health center of a district in central Gujarat

Background: COVID-19 vaccination can lead to herd immunity when a sufficient proportion of population is vaccinated. Effectiveness of vaccination coverage depends on the population’s willingness to be vaccinated completely. Aim and objective was to estimate COVID-19 vaccination coverage and to determine reasons for its acceptance and non-acceptance in urban field practice area of medical college attached with tertiary care hospital. Methods: A cross-sectional house to house survey was conducted among the households (n=1346) under an urban health training centre (UHTC) of a medical college in central Gujarat after the second wave of COVID-19. All the beneficiaries above the age of 18 years residing in the house-holds coming under the field area were included in the study. The data was collected using Epi-collect 5 mobile based applications. Beneficiaries who had taken two doses of COVID-19 vaccine were counted as fully immunized. Vaccination coverage was calculated different for first and second dose. Facilitators and barriers for COVID-19 vaccination were shown with appropriate diagram. Results: Out of the 1832 participants in the survey, vaccination coverage was 78.22% for first dose and 37.23% for second dose. Most common motivation (81%) behind taking vaccination was “good health”. Among the non-users for COVID-19 vaccination, 36.8% did not take the vaccine due to fear of adverse reactions. Conclusions: Vaccination coverage is average in the urban area surveyed. Majority of the population is motivated to take the vaccine to protect themselves from COVID-19. The main reason for not taking vaccine was fear of side-effect of vaccine.

Acceptance and awareness regarding influenza vaccine among healthcare workers in a tertiary care centre, Kerala

Background: The seasonal Influenza is a contagious respiratory illness. The most important step in preventing flu is to get a flu vaccination each year along with everyday preventive actions. The objective of this research was to study the acceptance and awareness of Influenza vaccine among health care workers of a tertiary care centre, Kerala and to explore the preventive practices. Methods: This study was a hospital based cross sectional study conducted among 204 health care workers in a tertiary centre in Kerala. A simple random sampling technique was adopted. Data was collected using self-administered pretested semi structured questionnaires. Results: 165 (80.9%) are aware of the Influenza vaccine while 39 (19.1%) are not aware of the Influenza vaccine. 30 (14.7%) has received at least one dose of Influenza vaccine in last five years while 174 (85.2%) has not received the vaccine. 161(78.9%) says they are willing to get vaccinated against Influenza while 43(21.1%) are not willing to get vaccinated. Conclusions: Even though there is good awareness about Influenza vaccine, the number of vaccine recipients is less than ideal. However, majority are willing to take Influenza vaccine in the future which shows good acceptance.

Decisão de profissionais de saúde sobre sua vacinação anti-Covid-19: revisão integrativa / Decision of health professionals about their anti-COVID-19 vaccination: integrative review

RESUMO A decisão vacinal de profissionais de saúde tem sido observada em diferentes países, devido ao seu comportamento de hesitação frente à vacinação contra a Covid-19, que pode interferir no controle da pandemia. Pretendeu-se identificar os fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 em publicações de julho de 2020 a julho de 2022. Foi realizada uma revisão integrativa da literatura nas bases de dados PubMed, Scopus, Web of Science e Cinahl. Das 439 publicações, foram escolhidos 35 artigos para análise. As características sociodemográficas da decisão vacinal revelaram que profissionais não médicos, principalmente enfermeiros, apresentaram maior hesitação. O estudo revelou fatores associados à hesitação vacinal, tais como: dúvidas sobre a eficácia das vacinas e o processo de produção, insegurança pela escassez de estudos, medo dos efeitos colaterais e informações veiculadas em mídias sociais. Em relação à aceitação e à recomendação vacinal, ressaltam-se a vacinação prévia contra a influenza, a confiança na eficácia das vacinas e o receio pelo risco de contágio por Covid-19. A identificação dos fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 foi estratégica em relação à ampliação da cobertura vacinal, tanto para a proteção da saúde dos profissionais quanto para a da população.

ABSTRACT The vaccine decision of health professionals has been observed in different countries, due to their hesitation behavior in the face of vaccination against COVID-19, which can interfere with the control of the pandemic. It was intended to identify the factors associated with the vaccination decision of health professionals against COVID-19 in publications from July 2020 to July 2022. An Integrative Literature Review was carried out in PubMed, Scopus, Web of Science and CINAHL databases. Of the 439 publications, 35 articles were chosen for analysis. The sociodemographic characteristics of the vaccine decision revealed that non-medical professionals, mainly nurses, had greater vaccine hesitancy. The study revealed factors associated with vaccine hesitancy, such as: doubts about the effectiveness of vaccines and the production process, insecurity due to lack of studies, fear of side effects and information conveyed on social media. Regarding vaccine acceptance and recommendation, prior vaccination against influenza, confidence in the effectiveness of vaccines and fear of the risk of contagion by COVID-19 stand out. Identifying the factors associated with the vaccination decision of health professionals against COVID-19 was strategic in relation to expanding vaccination coverage, both to protect the health of professionals and the population.