Decision-making in Arab and Jewish society about the human papillomavirus (HPV) vaccination and the seasonal influenza vaccination

Research Framework: Examining the behavioral, cognitive, social, cultural and logistic factors that affect health behavior and influence decision-making has become more and more important in the field of public health. Most studies indicate that Arab minority groups in Western countries are usually less compliant in vaccinating their children. On the other hand, an examination of vaccination compliance among the Arab population of Israel before the coronavirus crisis reveals a different picture marked by very high vaccination compliance, even relative to the Jewish majority. According to recent figures from the Ministry of Health (2019), the compliance rates in the Arab population for the seasonal influenza vaccination and the human papillomavirus (HPV) vaccination are almost twice as high as the compliance rates in the Jewish population for the same vaccinations. In addition, it is interesting to note that prior to the coronavirus crisis no groups in Arab society exhibited vaccination hesitancy, in contrast to the situation in Jewish society. Objective: The current study seeks to investigate the decision-making process of mothers in Arab society with respect to two vaccinations: the HPV vaccination and the seasonal influenza vaccination. Further, it seeks to examine the variables related to this process and their correlation with the emotional and cognitive considerations manifested in the process of making decisions about vaccinations.Research methodology: This study is based on a sequential explanatory design. The first stage entailed gathering and analyzing the qualitative data: a) content analysis of 18 explanatory materials published by the health maintenance organizations and the Ministry of Health that were designed to promote the HPV vaccination in the Arab society;b) conducting in-depth interviews with mothers from Arab society and health professionals (N=70 mothers and N=20 nurses from Arab society). Based on this stage, a quantitative questionnaire was constructed and answered by different subgroups from the representative sample of the investigated population: N=693, comprising six subgroups (Muslims, Christians, Northern Bedouins, Druse, secular Jews, religious Jews). A total of 693 mothers participated in the study. The participants included mothers from almost the entire spectrum of the Israeli population. The Arab population was defined as the primary research population, while the national Jewish population (secular and religious/traditional groups) served for comparison purposes. The ultra-Orthodox population was not included in the study. The mixed research method adopted in this study facilitated integration of the perspectives and means for understanding the relevant considerations in vaccination compliance (Creswell, 2013). Data triangulation made it possible to achieve better cross-checking of the data and to develop strong and validated arguments backed up by data collected from subgroups in the Arab population, while using the Jewish population as a control group (Creswell, 2013). Main findings: The research findings indicate that for the most part the decision-making process of mothers in Arab society relies upon an automatic system (as defined by Kahneman, 2011) based on various emotional heuristics emerging from this study. We described the research findings along two paths: 1) variables we referred to as internal socialcultural variables that are inherent in the social structure of the Arab population;2) variables we called external variables that are related to how the health system conveys information on the issue of vaccinations to Arab society. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Pharmacists' attitudes toward influenza vaccination: does the COVID-19 pandemic make a difference?

Background: Influenza vaccine uptake in most European countries remains low, despite the World Health Organization's target of 75%. Community pharmacists play a vital role in promoting vaccination; however, they have been reported to be vaccine-hesitant. This study aimed to investigate changes in pharmacists' attitudes toward influenza vaccination since the onset of the COVID-19 pandemic, as well as their COVID-19 vaccination intentions. Methods: In December 2020, all members of the Swiss Association of Pharmacists were invited to participate in an online, cross-sectional survey. This study assessed pharmacists' attitudes toward influenza vaccination by surveying influenza vaccine uptake during the 2019-20 influenza season and possible reasons for their decision(s), in addition to their intention to receive COVID-19 and seasonal influenza vaccination(s) during the 2020-21 influenza season. Descriptive analysis and multinomial logistic regression were used to assess predictors of vaccine uptake and intention. Results: Of 5900 Swiss pharmacists, 569 (9.6%) completed the survey. The self-reported influenza vaccination coverage among pharmacists during the 2019-20 season was 48.0%. The primary reason for vaccine uptake was the belief that all healthcare workers should be vaccinated, whereas the main reason for refusal was a lack of concern about contracting influenza. The proportions of participants who intend to accept influenza and COVID-19 vaccinations in the 2020-2021 season, when available, were 63.3% and 66.5%, respectively. The most important predictor of high willingness to be vaccinated against influenza in 2020-21 was vaccination history (OR = 3.73; 95% CI = 1.47-9.50), while the most critical predictor of willingness to be vaccinated against COVID-19 was the intention to be vaccinated against influenza (OR = 3.45; 95% CI = 1.74-6.84). Conclusions: Findings indicated that although pharmacists' readiness to accept seasonal influenza vaccination significantly increased during the COVID-19 pandemic, influenza vaccine uptake among them remains suboptimal. This is consistent with what has been reported in the literature.

Decision-making in Arab and Jewish society about the human papillomavirus (HPV) vaccination and the seasonal influenza vaccination

Research Framework: Examining the behavioral, cognitive, social, cultural and logistic factors that affect health behavior and influence decision-making has become more and more important in the field of public health. Most studies indicate that Arab minority groups in Western countries are usually less compliant in vaccinating their children. On the other hand, an examination of vaccination compliance among the Arab population of Israel before the coronavirus crisis reveals a different picture marked by very high vaccination compliance, even relative to the Jewish majority. According to recent figures from the Ministry of Health (2019), the compliance rates in the Arab population for the seasonal influenza vaccination and the human papillomavirus (HPV) vaccination are almost twice as high as the compliance rates in the Jewish population for the same vaccinations. In addition, it is interesting to note that prior to the coronavirus crisis no groups in Arab society exhibited vaccination hesitancy, in contrast to the situation in Jewish society. Objective: The current study seeks to investigate the decision-making process of mothers in Arab society with respect to two vaccinations: the HPV vaccination and the seasonal influenza vaccination. Further, it seeks to examine the variables related to this process and their correlation with the emotional and cognitive considerations manifested in the process of making decisions about vaccinations.Research methodology: This study is based on a sequential explanatory design. The first stage entailed gathering and analyzing the qualitative data: a) content analysis of 18 explanatory materials published by the health maintenance organizations and the Ministry of Health that were designed to promote the HPV vaccination in the Arab society;b) conducting in-depth interviews with mothers from Arab society and health professionals (N=70 mothers and N=20 nurses from Arab society). Based on this stage, a quantitative questionnaire was constructed and answered by different subgroups from the representative sample of the investigated population: N=693, comprising six subgroups (Muslims, Christians, Northern Bedouins, Druse, secular Jews, religious Jews). A total of 693 mothers participated in the study. The participants included mothers from almost the entire spectrum of the Israeli population. The Arab population was defined as the primary research population, while the national Jewish population (secular and religious/traditional groups) served for comparison purposes. The ultra-Orthodox population was not included in the study. The mixed research method adopted in this study facilitated integration of the perspectives and means for understanding the relevant considerations in vaccination compliance (Creswell, 2013). Data triangulation made it possible to achieve better cross-checking of the data and to develop strong and validated arguments backed up by data collected from subgroups in the Arab population, while using the Jewish population as a control group (Creswell, 2013). Main findings: The research findings indicate that for the most part the decision-making process of mothers in Arab society relies upon an automatic system (as defined by Kahneman, 2011) based on various emotional heuristics emerging from this study. We described the research findings along two paths: 1) variables we referred to as internal socialcultural variables that are inherent in the social structure of the Arab population;2) variables we called external variables that are related to how the health system conveys information on the issue of vaccinations to Arab society. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Application and Outcome Evaluation of a Social Marketing Intervention to Increase Seasonal Influenza Vaccination among University Students.

Seasonal flu vaccination rates among university students are exceedingly low and research focused on voluntarily influencing vaccination uptake is limited. This study outlines the development, implementation, and evaluation of a theory-driven social marketing vaccination intervention following the co-create-build-engage (CBE) framework. This study drew upon a pre-intervention segmentation study and co-created interventions targeted at receptive segments. The intervention delivered a significant 343% increase in vaccination rates using a difference-in-difference analysis. Online communication channels effectively engaged students to register for and receive their flu vaccine Almost 90% of students who received vaccinations signed up in the first two weeks of the intervention program indicating that those who can be motivated will act early in the flu season. Financial incentives, as found in previous studies, were confirmed as highly effective in increasing awareness and influencing vaccination uptake behaviours. Friend referral incentives were also found to be influential in motivating vaccination uptake. Suggestions are provided for future research and practical implementation of interventions on university campuses to motivate flu vaccination and other health behaviours.

Parental Willingness and Associated Factors of Pediatric Vaccination in the Era of COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

A significant decline in pediatric vaccination uptake due to the COVID-19 pandemic has been documented. Little is known about the parental willingness and associated factors of pediatric vaccination during the COVID-19 pandemic. An extensive literature search in the databases of PubMed, Scopus, Web of Science, and EBSCOhost were conducted. A total of 20 eligible studies published from 2020-2022 were included for systematic summary by a thematic analysis, among which 12 studies were included in a meta-analysis conducted with R-4.2.1. The prevalence of parental willingness to childhood/routine vaccination and seasonal influenza vaccination was 58.6% (95%CI 2.8-98.6%) and 47.3% (95%CI 25.3-70.5%). Moreover, there is no sufficient evidence of significant change in parental willingness to childhood/routine vaccination, human papillomavirus vaccination, or pneumococcal conjugate vaccination during the pandemic. However, a significant increase in parental willingness to vaccinate their children against seasonal influenza was found. In addition to the factors of parental vaccination willingness/hesitancy that are well-studied in literature, children/parents' history of COVID-19 and children's perceived vulnerability to COVID-19 were associated with parental willingness. Developing synergetic strategies to promote COVID-19 vaccination together with other pediatric vaccination is warranted during the pandemic. This may help to improve and/or catch up the vaccine uptake of children during and/or after the COVID-19 pandemic.

Increasing Seasonal Influenza Vaccination among University Students: A Systematic Review of Programs Using a Social Marketing Perspective.

The health and economic consequences of seasonal influenza present great costs to communities. Promoting voluntary uptake of the seasonal influenza vaccine among university students, particularly during the COVID-19 pandemic, can deliver protective effects for both individuals and the wider community. Vaccine uptake will be greatest when more of the social marketing benchmarks are applied. This systematic review summarizes evidence from programs aiming to increase seasonal influenza vaccination among university students. Six major electronic databases for health promotion studies (PubMed, EBSCO, ProQuest, Ovid, Web of Science, and ScienceDirect) were searched in November 2021 to capture peer-reviewed studies reporting field trials that have sought to increase seasonal influenza vaccination in university student populations, without any restrictions regarding the publication period. Following PRISMA guidelines, this paper identified 12 peer-reviewed studies that were conducted in the field in the United States, Australia, and Spain. Three studies were targeted at healthcare students and the rest focused on wider university student populations. Studies were narratively summarized, evidence of social marketing principles were identified, and quantitative outcomes were meta-analyzed. The findings indicate that none of the field studies, even a self-classified social marketing study, had adopted all eight of the social marketing benchmarks in program design and implementation. The two studies that only used promotion, but not other marketing-mix and social marketing principles, reported increases in students' intention to be vaccinated but not actual behavior. Given that change is more likely when more social benchmarks are applied, this paper identifies activities that can be included in flu vaccine programs to improve flu vaccine uptake rates. The analysis highlights a lack of field studies focusing on increasing rates of vaccination behavior as research outcomes in countries beyond the United States.

Identification of groups at high risk for under-coverage of seasonal influenza vaccination: A national study to inform vaccination priorities during the COVID-19 pandemic.

PURPOSE: Seasonal influenza vaccination is an important public health strategy to reduce preventable illness, hospitalization, and death. Because of overlapping risk factors for severe illness from seasonal influenza and COVID-19, uptake of the seasonal influenza vaccination has heightened importance during the COVID-19 pandemic. We analyzed receipt of seasonal influenza vaccination among COVID-19 priority groups and further examined socio-demographic and behavioral factors associated with receiving the seasonal influenza vaccine among US adults. METHODS: Using the 2018 National Health Interview Survey, we classified 24,772 adults into four COVID-19 priority groups: healthcare workers, medically vulnerable, non-healthcare essential workers, and the general population. We performed multiple logistic regression to compare the relative odds of receiving the influenza vaccine by COVID-19 priority group, socio-demographics, and health-related factors. RESULTS: Healthcare workers, medically vulnerable adults, essential workers, and the general population comprised 8.9%, 58.4%, 6.6%, and 26.1 % of the US population, respectively. Compared with healthcare workers, the adjusted odds ratio (aOR) of receiving influenza vaccine were significantly lower in medically vulnerable adults (aOR=0.43, 95% CI=0.37, 0.48), essential workers (aOR=0.28, 95% CI=0.23, 0.34), and the general population (aOR=0.32, 95% CI=0.28, 0.37). Being young, male, Black, and having no health insurance were associated with lower relative odds of receiving the flu vaccine. CONCLUSIONS: Patterns of influenza vaccine cause concern for under-coverage of populations at high risk for both seasonal influenza and COVID-19. Achieving optimal protection against vaccine-preventable respiratory illness in US adults will require emphasis on those employed outside of the healthcare sector, younger age groups, and adults with lower socioeconomic resources.

Motivating Seasonal Influenza Vaccination and Cross-Promoting COVID-19 Vaccination: An Audience Segmentation Study among University Students.

In the response to the coronavirus pandemic, much attention has been invested in promoting COVID-19 vaccination. However, the impact of seasonal influenza should not be neglected, particularly during the winter influenza surge. Currently, most influenza vaccination campaigns target at healthcare workers or high-risk population groups, while COVID-19 vaccination programmes are targeting the whole population as a single homogeneous group. There is limited research on the promotion of influenza vaccination for university students who study, live, and socialise in close contact with a large variety of people on campus, resulting in a low vaccination rate among this underserved group. Thus, a vaccination programme tailored for university students should be developed to increase protection against influenza-like illnesses and complications, and to help achieve herd immunity across populations who spread viruses. WHO has advocated the potential value of social marketing in vaccination campaigns and highlighted the need for audience segmentation as a major prerequisite component of intervention design. This study aims to identify distinct and homogeneous groups of university students based on sociodemographic, psychographic, and behavioural attributes to inform interventions. Two-step cluster analysis was applied in a sample size of 530 university students and revealed four segments that demonstrate statistically significant differences in their attitudes, behaviours, intentions, and responses to promotion messages about seasonal influenza and COVID-19 vaccination. The findings provide a detailed understanding of segment characteristics among university students that can be applied to develop an effective social marketing campaign that can motivate influenza vaccination and cross-promote uptake of the COVID-19 vaccine.

Demand and motivation for influenza vaccination among healthcare workers before and during the COVID-19 era: a cross-sectional survey.

Protection of healthcare workers (HCWs) against influenza is essential for patient health and a functional health system. The study aimed to analyze the demand for seasonal influenza vaccination (SIV) among various groups of HCWs in a tertiary care hospital before and during the COVID-19 pandemic and to identify their motives for this season's SIV. Before this influenza season (2020/21), the hospital management offered free SIV to all HCWs and promoted it on the internal network. Out of 4,167 HCWs, 630 HCWs expressed interest in SIV and were vaccinated in the hospital. They filled in a total of 603 self-administered pen-and-paper questionnaires. The mean age of the respondents (374 females and 229 males) was 45 ± 12 years. Physicians accounted for 48% of the vaccinated persons but for only 24% (p < .001) of all HCWs to whom SIV was offered. Only 16% of respondents vaccinated this year also received SIV before the last season (2019/20), with the proportion of physicians (19%) being statistically significantly higher than that of non-physicians (13%, p = .045) and the proportion of chronically ill HCWs (22%) being higher than that of healthy individuals (13%, p = .004). Most frequently, respondents' motivation to get vaccinated this year was self-protection (61%), that is concerns about contracting influenza together with COVID-19 or alone, followed by family protection (58%) and patient protection (53%). In conclusion, COVID-19 contributed to an increased demand for SIV among HCWs and the threat of contracting it together with influenza was the most frequent motive.