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1.
Vaccines (Basel) ; 10(1)2021 Dec 21.
Article in English | MEDLINE | ID: covidwho-1580372

ABSTRACT

Healthcare workers' COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey to healthcare workers in hospitals, primary care and aged or disability care settings (12 February-26 March 2021). The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework informed survey design and framing of results. Binary regression results adjusted for demographics provide risk differences between those intending and not intending to accept a COVID-19 vaccine. In total, 3074 healthcare workers completed the survey. Primary care healthcare workers reported the highest intention to accept a COVID-19 vaccine (84%, 755/898), followed by hospital-based (77%, 1396/1811) and aged care workers (67%, 243/365). A higher proportion of aged care workers were concerned about passing COVID-19 to their patients compared to those working in primary care or hospitals. Only 25% felt they had sufficient information across five vaccine topics, but those with sufficient information had higher vaccine intentions. Approximately half thought vaccines should be mandated. Despite current high vaccine rates, our results remain relevant for booster programs and future vaccination rollouts.

2.
Aust N Z J Public Health ; 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1570283

ABSTRACT

OBJECTIVE: Tailored communication is necessary to address COVID-19 vaccine hesitancy and increase uptake. We aimed to understand the information needs, perceived benefits and barriers to COVID-19 vaccination of people prioritised, but hesitant to receive the vaccine. METHOD: In this qualitative study in Victoria, Australia (February-May 2021), we purposively sampled hesitant adults who were health or aged/disability care workers (n=20), or adults aged 18-69 with comorbidities or aged ≥70 years ('prioritised adults'; n=19). We thematically analysed interviews inductively, then deductively organised themes within the World Health Organization Behavioural and Social Drivers of vaccination model. Two stakeholder workshops (n=12) explored understanding and preferences for communicating risks and benefits. We subsequently formed communication recommendations. RESULTS: Prioritised adults and health and aged care workers had short- and long-term safety concerns specific to personal circumstances, and felt like "guinea pigs". They saw vaccination as beneficial for individual and community protection and travel. Some health and aged care workers felt insufficiently informed to recommend vaccines, or viewed this as outside their scope of practice. Workshop participants requested interactive materials and transparency from spokespeople about uncertainty. Conclusions and public health implications: Eleven recommendations address communication content, delivery and context to increase uptake and acceptance of COVID-19 vaccines.

3.
Expert Rev Vaccines ; 2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1545817
4.
BMJ Glob Health ; 6(9)2021 09.
Article in English | MEDLINE | ID: covidwho-1504162

ABSTRACT

INTRODUCTION: Understanding barriers to childhood vaccination is crucial to inform effective interventions for maximising uptake. Published systematic reviews include different primary studies, producing varying lists of barriers. To make sense of this diverse body of literature, a comprehensive level of summary and synthesis is necessary. This overview of systematic reviews maps all potential parent-level barriers to childhood vaccination identified in systematic reviews. It synthesises these into a conceptual framework to inform development of a vaccine barriers assessment tool. METHODS: We applied Joanna Briggs methodology, searching the Epistemonikos review database and reference lists of included reviews to June 2020. Systematic reviews of qualitative or quantitative data on parent-level barriers to routine vaccination in preschool-aged children were included. Reviews addressing influenza, reporting non-modifiable determinants or reporting barriers not relevant to parents were excluded. Where possible, we extracted review details, barrier descriptions and the number, setting and design of primary studies. Two authors independently screened search results and inductively coded barrier descriptions. RESULTS: We screened 464 papers, identifying 30 relevant reviews with minimal overlap. Fourteen reviews included qualitative and quantitative primary studies, seven included quantitative and seven included qualitative studies only. Two did not report included study designs. Two-thirds of reviews (n=20; 67%) only included primary studies from high-income countries. We extracted 573 barrier descriptions and inductively coded these into 64 unique barriers in six overarching categories: (1) Access, (2) Clinic or Health System Barriers, (3) Concerns and Beliefs, (4) Health Perceptions and Experiences, (5) Knowledge and Information and (6) Social or Family Influence. CONCLUSIONS: A global overview of systematic reviews of parent-level barriers to childhood vaccine uptake identified 64 barriers to inform development of a new comprehensive survey instrument. This instrument will assess both access and acceptance barriers to more accurately diagnose the reasons for under-vaccination in children in different settings.


Subject(s)
Parents , Vaccination , Child , Child, Preschool , Delivery of Health Care , Humans , Qualitative Research , Systematic Reviews as Topic
7.
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
9.
Australian Journal of General Practice ; 49(10):625-629, 2020.
Article in English | ProQuest Central | ID: covidwho-847463

ABSTRACT

[...]as has been shown in previous mass vaccination programs, planning for vaccine program rollout and community engagement to optimise vaccine confidence and uptake in Australia needs to commence beforehand, not when the vaccines become available.5 Consistent with its existing role in vaccination programs, primary care professional are anticipated to play a key part in educating patients and carers about the vaccine, administering the vaccine, recording uptake and reporting adverse events following immunisation. There are currently 17 vaccines in phase I trials and 10 vaccines in phase II/III clinical trials (28 August 2020).6 Traditional vaccine development is a lengthy process, usually taking 10-15 years or more, with a distinct, linear sequence of steps and high attrition rate.7 The usual steps include pre-clinical development, safety testing (phase I), safety and immunogenicity testing (phase II) and then safety and efficacy testing (phase III), prior to licensure, production at scale and introduction into the population (Figure 1). Comprehensive post-marketing surveillance to track vaccine safety for these expected adverse events, as well as to detect postulated rarer adverse events such as antibody-enhanced disease, will also be essential to maintain vaccine confidence and achieve high vaccine acceptance and uptake. The WHO10 and the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunisation Practice (ACIP)11 are currently advising a risk- and aged-based approach for prioritisation of COVID-19 vaccine target groups.

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