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1.
Front Public Health ; 9: 801176, 2021.
Article in English | MEDLINE | ID: covidwho-1701305

ABSTRACT

Rather than concentrating primarily on children and adolescents, there has been a shift in the discourse around immunisation to encompass a whole-of-life approach. Despite this acknowledgement and ongoing high burdens of vaccine preventable diseases in adults, coverage for some adult risk groups remains sub-optimal. This study aimed to explore key informant's and stakeholder's perceptions of factors impacting provision of immunisation programs for Australian adults and to identify strategies to promote acceptance and uptake. Semi-structured telephone interviews were undertaken with people involved in adult immunisation program delivery, advocacy, policy or research between September 2020 and June 2021. Transcripts were inductively analysed, with the resulting themes categorised into the five influences on vaccination gaps that have informed program planning in other countries: Access, Affordability, Awareness, Acceptance and Activation. Participants spoke of improvements in the provision of vaccines to adults, however, ongoing challenges persisted. Participants agreed that the focus or emphasis of policies and the promotion/communication strategies has been on childhood vaccination in Australia, however there is a sense that the "pendulum has swung." These included understanding of eligibility amongst the Australian population and the reluctance of some health providers to dedicate time to exploring immunisation needs with adult patients. In comparison to the childhood vaccination program, there has been a lack of data available on coverage for adult vaccines on the national immunisation program. This has contributed to the ongoing challenges of identifying and promoting certain vaccines. At a government level, questions were raised about why the Australian government has never set an aspirational target for adult vaccination (i.e., influenza or pneumococcal) coverage. While significant improvements have been made in adult immunisation uptake, there are still gaps across the program. While the system remains under stress because of the COVID-19 pandemic, it is not appropriate to implement any additional programs. There needs to be strong commitment to establish the value of adult vaccination in the eyes of community members, policy makers and healthcare professionals. Having a national adult immunisation strategic plan would help advance action.


Subject(s)
COVID-19 , Influenza Vaccines , Adolescent , Adult , Australia/epidemiology , Child , Humans , Immunization , Life Change Events , Pandemics , SARS-CoV-2 , Vaccination
2.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328879

ABSTRACT

Community and religious leaders, as well as other natural leaders, from culturally and linguistically diverse (CaLD) backgrounds have been posited as a gateway into communities, acting as information intermediaries that enabler or broker public health messages about the COVID-19 pandemic. However, there are currently limitations regarding our understanding of the capacity, role and reach of these leaders. In-depth interviews were undertaken to understand the perceptions of those working in services and other social support roles focused on CaLD communities towards the role and impact of information intermediaries in promoting and supporting COVID-19 public health communication and engagement activities. Forty-six semi-structured telephone interviews were undertaken with key stakeholders who have an active role in the delivery of services and other social support to CaLD communities in Australia. Four key themes emerged related to the role of information intermediaries during the interviews. Ideas around the role they fulfil in “bridging the gap” and supporting the delivery of pandemic related information into communities. Participants suggested that there had been a failure by Federal government agencies to recognise the role of these stakeholders early in the pandemic, as well as a failure to provide sufficient resources and support. However, concerns were also raised that information may be inappropriately interpreted or translated by the community information intermediaries or potentially blocked, if the message does not align with the broker’s own beliefs. Finally, concerns were raised about the potential for burn-out amongst information intermediaries. It is critical that in preparing and responding to pandemics and other disasters, that there is recognition of the role of community leaders and other information intermediaries and that resources are identified to enhance and sustain their involvement.

3.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328668

ABSTRACT

Background: Since the emergence of COVID-19, issues have been raised regarding the approach used to engage with culturally, and linguistically diverse (CaLD) communities during this public health crisis. This study aimed to understand the factors impacting communication and engagement efforts during the COVID-19 pandemic from the perspective of key CaLD community stakeholders and opinion leaders. Methods Forty-six semi-structured telephone interviews were undertaken with key stakeholders who have an active role (established prior to the pandemic) in the delivery of services and other social support to CaLD communities in Australia. Results Seven key themes emerged: (1) the digital divide and how to really connect with people;(2) information voids being filled by international material;(3) differentiating established with new and emerging community needs;(4) speaking COVID-19;(5) ineffectiveness of direct translations of English language resources;(6) Coordination is needed to avoid duplication and address gaps and (7) recognising the improvements in governments’ approach. Conclusion It is critical that alliances be set up that can be activated in the future to reduce issues around resource development, translation, and dissemination of messages to minimise gaps in the response. Financial assistance must be provided in a timely way to community organisations to support the development and dissemination of culturally appropriate communication materials.

4.
Vaccines (Basel) ; 9(12)2021 Dec 11.
Article in English | MEDLINE | ID: covidwho-1572685

ABSTRACT

Higher weight status, defined as body mass index (BMI) ≥ 30 kg/m2, is frequently described as a risk factor for severity and susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (known as COVID-19). Therefore, study groups in COVID-19 vaccine trials should be representative of the weight spectrum across the global population. Appropriate subgroup analysis should be conducted to ensure equitable vaccine outcomes for higher weight people. In this study, inclusion and exclusion criteria of registered clinical trial protocols were reviewed to determine the proportion of trials including higher weight people, and the proportion of trials conducting subgroup analyses of efficacy by BMI. Eligibility criteria of 249 trial protocols (phase I, II, III and IV) were analysed; 51 protocols (20.5%) specified inclusion of BMI > 30, 73 (29.3%) specified exclusion of BMI > 30, and 125 (50.2%) did not specify whether BMI was an inclusion or exclusion criterion, or if BMI was included in any 'health' screenings or physical examinations during recruitment. Of the 58 protocols for trials in phase III and IV, only 2 (3.4%) indicated an intention to report subgroup analysis of vaccine efficacy by weight status. Higher weight people appear to be significantly under-represented in the majority of vaccine trials. This may result in reduced efficacy and acceptance of COVID-19 vaccines for higher weight people and exacerbation of health inequities within this population group. Explicit inclusion of higher weight people in COVID-19 vaccine trials is required to reduce health inequities.

5.
BMJ Open ; 11(5): e050114, 2021 05 25.
Article in English | MEDLINE | ID: covidwho-1243716

ABSTRACT

INTRODUCTION: Vaccination is a public health strategy that aims to reduce the burden of viral illness, especially important for populations known or likely to be at increased risk for inequitable outcomes due to the disease itself or disparities in care accessed and received. The role of weight status in COVID-19 susceptibility and disease burden remains unclear. Despite this, higher weight is frequently described as a definitive risk factor for both susceptibility and disease severity. Therefore, COVID-19 vaccine trials should recruit a study group representative of the full weight spectrum, and undertake appropriate subgroup analysis by weight status to evaluate response and titrate dose regimes where indicated to ensure equitable outcomes for higher weight people. METHODS AND ANALYSIS: We aim to review inclusion and exclusion criteria of clinical trial protocols registered with ClinicalTrials.gov, ISRCTN Register, the WHO official vaccine trial register, and 'The COVID-19 Vaccine Tracker'. To determine the number of trials including higher weight (body mass index >30 kg/m2) individuals and the number of trials conducting efficacy subgroup analyses by weight status. Screening, data extraction and quality appraisal of trial protocols will be completed independently by a minimum of two reviewers. Clinical trials will be assessed for risk of bias using the Risk of Bias-2 tool. We will conduct a descriptive analysis of extracted data. The following subsets are proposed: participation of higher weight people in COVID-19 vaccine trials by trial phase, country and vaccine platform. ETHICS AND DISSEMINATION: Ethical approval was not required for this review. The results of this rapid review will be presented at appropriate conferences and published in a suitable peer reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020226573.


Subject(s)
COVID-19 , Overweight , Vaccines , COVID-19 Vaccines , Clinical Trials as Topic , Eligibility Determination , Humans , Review Literature as Topic , SARS-CoV-2 , Treatment Outcome
6.
Vaccine ; 39(26): 3467-3472, 2021 06 11.
Article in English | MEDLINE | ID: covidwho-1240641

ABSTRACT

BACKGROUND: There has been a recent recognized shift towards a whole-of-life or life-course approach to immunisation. However, coverage amongst at-risk adults for recommended vaccines continues to be suboptimal. This study examined the perceptions of middle and older aged Australian adults towards hospital-based immunization programs and their previous exposures to receiving vaccines via tertiary care. METHODS: A cross-sectional survey was conducted with Australian adults 45 years and older in late 2019 to capture influenza and pneumococcal vaccine uptake, exposure to hospital-based immunization programs, missed opportunities to vaccinate and receptiveness towards the promotion and/or delivery of vaccines in the hospital setting. RESULTS: Only 13 respondents reported receiving a vaccine at hospital, yet 72.2% (931/1292) indicated that they were willing to be vaccinated in that setting. Amongst those who attended hospital during 2019 and were eligible for vaccination, 57.2% and 28.3% of respondents were not immunized for pneumococcal and influenza, respectively. Missed opportunities for both vaccines were significantly higher amongst those at low-risk for influenza (≤65 years (low-risk): 52.9%, ≤65 years (high-risk): 18.3%, >65 years: 15.1%; p < 0.001) and pneumococcal (≤65 years (low-risk): 79.1%, ≤65 years (high-risk): 52.4%, >65 years: 44%; p < 0.001). Among those with a missed opportunity for hospital-based vaccination, the most common reason for not getting immunized was a lack of recommendation. Most (86.4%) reported that their general practitioner was the person or group they trusted most to receive vaccine information from. CONCLUSIONS: The findings from this Australian study support international work that shows very low rates of opportunistic vaccination in hospitals despite national recommendations to vaccinate prior to discharge. Considering the need for high levels of uptake of the COVID-19 vaccine, hospitals may need to be considered to opportunistically capture those not accessing the vaccine in other settings.


Subject(s)
COVID-19 , Influenza Vaccines , Adult , Aged , Australia , COVID-19 Vaccines , Cross-Sectional Studies , Hospitals , Humans , Immunization , Immunization Programs , Middle Aged , Pneumococcal Vaccines , SARS-CoV-2 , Vaccination
7.
Infect Dis Health ; 26(1): 38-47, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1065109

ABSTRACT

BACKGROUND: The COVID-19 pandemic has highlighted the role of international travel in spreading infections. Travellers visiting friends and relatives (VFR) are at higher risk of acquiring infections than other travellers, therefore improving the travel health behaviour of these travellers is important. Ethnic Chinese are one of the largest migrant groups in many countries, yet there have been no published studies regarding this population as VFR travellers. We present findings of a study of Australian Chinese VFR travellers relevant to the pandemic response. METHODS: In 2013, five focus groups were conducted with Australian Chinese VFR travellers, exploring topics such as vaccines, face masks, outbreaks and travel health seeking behaviour. Participants were aged 18 years or older and had travelled to China for VFR purposes in the preceding 18 months. Sessions were recorded and transcribed, and thematic analysis was undertaken. RESULTS: Participants viewed VFR travel as low risk, and underestimated the risks associated with travelling during an outbreak. However, they were generally willing to receive pre-travel vaccination specifically for an outbreak, but not otherwise. Attitudes towards face masks and other infection control measures were mixed. Multiple factors influenced their travel health behaviour, including low risk awareness, misconceptions, and cultural barriers to seeking health care. CONCLUSION: Our research found that Chinese VFR travellers undertake suboptimal precautions related to VFR travel, associated with an underestimation of risks. While they share many characteristics with other VFR travellers, unique cultural health beliefs should be taken into account when developing risk communication and educational interventions as part of a pandemic response.


Subject(s)
COVID-19/prevention & control , Health Behavior/ethnology , Health Knowledge, Attitudes, Practice , Masks , Transients and Migrants/psychology , Vaccines , Adolescent , Adult , Aged , Australia/epidemiology , COVID-19/epidemiology , COVID-19/psychology , Female , Health Education , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Transients and Migrants/education , Travel , Young Adult
8.
BMC Infect Dis ; 21(1): 120, 2021 Jan 28.
Article in English | MEDLINE | ID: covidwho-1054806

ABSTRACT

BACKGROUND: As immunisation program launches have previously demonstrated, it is essential that careful planning occurs now to ensure the readiness of the public for a COVID-19 vaccine. As part of that process, this study aimed to understand the public perceptions regarding a future COVID-19 vaccine in Australia. METHODS: A national cross-sectional online survey of 1420 Australian adults (18 years and older) was undertaken between 18 and 24 March 2020. The statistical analysis of the data included univariate and multivariable logistic regression model analysis. RESULTS: Respondents generally held positive views towards vaccination. Eighty percent (n = 1143) agreed with the statement that getting myself vaccinated for COVID-19 would be a good way to protect myself against infection. Females (n = 614, 83%) were more likely to agree with the statement than males (n = 529, 78%) (aOR = 1.4 (95% CI: 1.1-1.8); P = 0.03), while 91% of those aged 70 years and above agreed compared to 76% of 18-29-year-olds (aOR = 2.3 (95% CI:1.2-4.1); P = 0.008). Agreement was also higher for those with a self-reported chronic disease (aOR = 1.4 (95% CI: 1.1-2.0); P = 0.04) and among those who held private health insurance (aOR = 1.7 (95% CI: 1.3-2.3); P < 0.001). Beyond individual perceptions, 78% stated that their decision to vaccinate would be supported by family and friends. CONCLUSION: This study presents an early indication of public perceptions towards a future COVID-19 vaccine and represents a starting point for mapping vaccine perceptions. To support an effective launch of these new vaccines, governments need to use this time to understand the communities concerns and to identify the strategies that will support engagement.


Subject(s)
Attitude to Health , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , SARS-CoV-2/immunology , Vaccination/psychology , Adolescent , Adult , Aged , Australia/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Surveys and Questionnaires , Vaccination/statistics & numerical data , Young Adult
10.
PLoS One ; 15(6): e0235112, 2020.
Article in English | MEDLINE | ID: covidwho-611134

ABSTRACT

BACKGROUND: Since the emergence of SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) in late 2019, communities have been required to rapidly adopt community mitigation strategies rarely used before, or only in limited settings. This study aimed to examine the attitudes and beliefs of Australian adults towards the COVID-19 pandemic, and willingness and capacity to engage with these mitigation measures. In addition, we aimed to explore the psychosocial and demographic factors that are associated with adoption of recommended hygiene-related and avoidance-related behaviors. METHODS: A national cross-sectional online survey of 1420 Australian adults (18 years and older) was undertaken between the 18 and 24 March 2020. The statistical analysis of the data included univariate and multivariate logistic regression analysis. FINDINGS: The survey of 1420 respondents found 50% (710) of respondents felt COVID-19 would 'somewhat' affect their health if infected and 19% perceived their level of risk as high or very high. 84·9% had performed ≥1 of the three recommended hygiene-related behaviors and 93·4% performed ≥1 of six avoidance-related behaviors over the last one month. Adopting avoidance behaviors was associated with trust in government/authorities (aOR: 6.0, 95% CI 2.6-11·0), higher perceived rating of effectiveness of behaviors (aOR: 4·0, 95% CI: 1·8-8·7), higher levels of perceived ability to adopt social distancing strategies (aOR: 5.0, 95% CI: 1·5-9.3), higher trust in government (aOR: 6.0, 95% CI: 2.6-11.0) and higher level of concern if self-isolated (aOR: 1.8, 95% CI: 1.1-3.0). INTERPRETATION: In the last two months, members of the public have been inundated with messages about hygiene and social (physical) distancing. However, our results indicate that a continued focus on supporting community understanding of the rationale for these strategies, as well as instilling community confidence in their ability to adopt or sustain the recommendations is needed.


Subject(s)
Communicable Disease Control , Coronavirus Infections/psychology , Health Knowledge, Attitudes, Practice , Pneumonia, Viral/psychology , Adult , Australia/epidemiology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Health Communication , Humans , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Surveys and Questionnaires , Television
11.
Pharmacy (Basel) ; 8(2)2020 May 04.
Article in English | MEDLINE | ID: covidwho-165165

ABSTRACT

This study assessed Australian Hajj pilgrims' knowledge, attitude and practices throughout their Hajj journey to understand their health behaviors, use of preventative measures and development of illness symptoms. A prospective cohort study with data collection at three phases (before, during and after Hajj) was conducted among Australian pilgrims between August and December 2015. Baseline data were collected from 421 pilgrims before Hajj, with 391 providing follow-up data during Hajj and 300 after their home return. Most participants (78% [329/421]) received one or more recommended vaccines; travel agents' advice was the main factor affecting vaccination uptake. Most participants (69% [270/391]) practiced hand hygiene with soap and sanitizers frequently, followed by disposable handkerchief use (36% [139/391]) and washing hands with water only (28% [111/391]). During Hajj 74% (288/391) of participants reported one or more illness symptoms, 86% (248/288) of these symptoms were respiratory. Cough was less often reported among pilgrims who received vaccinations, cleaned their hands with soap or alcoholic hand rubs, while a runny nose was less common among those who frequently washed their hands with plain water but was more common among those who used facemasks. This study reveals that most Australian Hajj pilgrims complied with key preventative measures, and that tour group operators' advice played an important role in compliance. Pilgrims who were vaccinated and practiced hand hygiene were less likely to report infection symptoms.

12.
Infect Dis Health ; 25(3): 197-204, 2020 08.
Article in English | MEDLINE | ID: covidwho-30934

ABSTRACT

BACKGROUND: International students frequently return to their country of origin to visit friends and relatives (VFR), and are at increased risk of travel-associated infections. Little is known of their travel health seeking behaviours. China is the biggest source of international students studying in Australia and the unprecedented epidemic of COVID-19 in China makes this an important area of research. METHODS: Focus groups of Chinese international students were conducted to explore travel health-related knowledge, attitudes and practices. Eligible participants were studying in Sydney, and had travelled to China and Hong Kong to visit friends and relatives in the preceding 18 months. A variety of topics were explored, using a focus group guide. Thematic analysis was undertaken on the transcripts using nVivo software. The list of codes and themes were not pre-determined but developed through content analysis. RESULTS: Two focus groups were held with a total of 28 participants. Risk perception about VFR travel was generally low among Chinese international students. Pre-travel healthcare was not sought. Students strongly relied on the Internet, social media, parents and friends in China for travel health advice. CONCLUSION: This research provides insights into Chinese international students as VFR travellers. It confirms students could be a risk population for importations of infections such as COVID-19 because of low risk perception and lack of seeking travel health advice. This can inform health promotion strategies for students.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Travel-Related Illness , Adolescent , Adult , COVID-19 , Coronavirus Infections/etiology , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Perception , Pneumonia, Viral/etiology , Risk , SARS-CoV-2 , Students , Vaccination , Young Adult
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