RESUMEN
HPV vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls 9-14. From November to December 2021, a cross-sectional study was conducted among parents of girls 9-14 in China through a web-based anonymous online questionnaire survey. Descriptive epidemiological analysis was used to analyze parental acceptability. Hierarchical regression analysis and structural equation modeling were to determine associated factors. A total of 5623 participants were included in the analysis. 21.2% girls had received HPV vaccine, and 94.3% parents intended to receive vaccination for their daughters, the Kappa values between them was -0.016. 31.9% of vaccinated mothers had received HPV vaccine for their daughters, vaccination history had a positive impact on behavior (ß = 0.048). Attitude (ß = 0.186), subjective norms (ß = 0.148) and perceived behavioral control (ß = 0.648) had a positive impact on intention. Vaccination intention mediated the relationships between attitude (ß = 0.044), subjective norms (ß = 0.035), and perceived behavioral control (ß = 0.154) with behavior. There is a gap between vaccination intention and behavior in parents of girls 9-14. Perceived behavior control had a strong association on HPV vaccination behavior.
Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Humanos , Femenino , Adolescente , Masculino , Estudios Transversales , Infecciones por Papillomavirus/prevención & control , Teoría del Comportamiento Planificado , Padres , China , Vacunación , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de SaludRESUMEN
BACKGROUND: It was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy toward routine childhood vaccination and hesitancy toward the COVID-19 vaccine during the ongoing COVID-19 pandemic. OBJECTIVE: This study aims to assess changes in trends of parental attitudes toward routine childhood vaccines and COVID-19 vaccinations across different time periods in China. METHODS: Three waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu Province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests were used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness. RESULTS: Overall, 2881, 1038, and 1183 participants were included in the survey's three waves. Using the Vaccine Hesitancy Scale, 7.8% (225/2881), 15.1% (157/1038), and 5.5% (65/1183) of parents showed hesitancy to childhood vaccination (P<.001), and 59.3% (1709/2881), 64.6% (671/1038), and 92% (1088/1183) of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (P<.001). In all three surveys, "concerns about vaccine safety and side effects" was the most common reason for refusal. CONCLUSIONS: There has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions are needed to mitigate public concerns about vaccine safety.
Asunto(s)
COVID-19 , Vacunas , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Niño , Estudios Transversales , Humanos , Pandemias , Padres , Vacunación , Vacilación a la VacunaciónRESUMEN
BACKGROUND: Vaccine hesitancy was listed as one of the top 10 issues threatening global health in 2019. The objectives of this study were to (a) use an extended protection motivation theory (PMT) with an added trust component to identify predictors of vaccine hesitancy and (b) explore the predictive ability of vaccine hesitancy on vaccination behavior. METHODS: We conducted an online questionnaire from February 9 to April 9, 2021, in China. The target population was Chinese residents aged 18 and over. A total of 14,236 responses were received. Structural equation modeling was used to test the extended PMT model hypotheses. RESULTS: A total of 10,379 participants were finally included in this study, of whom 52.0% showed hesitancy toward vaccination. 2854 (27.5%) participants reported that they got flu shots in the past year, and 2561 (24.7%) participants were vaccinated against COVID-19. 2857 (27.5%) participants engaged in healthcare occupation. The model explained 85.7% variance of vaccine hesitancy. Self-efficacy was the strongest predictor, negatively associated with vaccine hesitancy (ß = -0.584; p < .001). Response efficacy had a negative effect on vaccine hesitancy (ß = -0.372; p < .001), while threat appraisal showed a positive effect (ß = 0.104; p < .001). Compared with non-health workers, health workers showed more vaccine hesitancy, and response efficacy was the strongest predictor (ß = -0.560; p < .001). Vaccine hesitancy had a negative effect on vaccination behavior (ß = -0.483; p < .001), and the model explained 23.4% variance of vaccination behavior. CONCLUSIONS: This study demonstrates that the extended PMT model is efficient in explaining vaccine hesitancy. However, the predictive ability of vaccine hesitancy on vaccination behavior is limited.
Asunto(s)
COVID-19 , Motivación , Adolescente , Adulto , Vacunas contra la COVID-19 , China/epidemiología , Estudios Transversales , Humanos , SARS-CoV-2 , Vacunación , Vacilación a la VacunaciónRESUMEN
Evidence for the validity and reliability of the World Health Organization's 10-item vaccine hesitancy scale (VHS) in different settings is not sufficient, especially for criteria validity. This study aimed to assess the validity and reliability of the VHS using child vaccination data in China. A cross-sectional survey was performed with parents of 19-48-month-old children at six vaccination clinics in Wuxi City between September and October 2020. The VHS was revised to category A (expanded program on immunization, EPI) VHS and category B (Non-EPI) VHS. Factor analysis was used to confirm the latent domain and to assess the model structure. The average variance extracted (AVE) was calculated to assess convergent validity, and Cronbach's α and composite reliability (CR) were used to determine internal consistency. The association between VHS scores and children's vaccination status was examined to assess criteria validity using logistic regression. The survey response rate was 75.3% (n = 802). Two factors were identified, explaining 64.60% and 63.34% of the common variance in categories A and B VHS, respectively. The Cronbach's α of > 0.7 and CR of >0.7 in the scale indicated the VHS has acceptable internal consistency. The AVE values indicated that convergent validity was not ideal for the VHS. There were no statistically significant associations between VHS scores and vaccination status, indicating that the criterion validity was not ideal. The VHS needs improvement before becoming a standard survey tool.
Asunto(s)
Vacilación a la Vacunación , Vacunación , Niño , Preescolar , China , Estudios Transversales , Humanos , Lactante , Padres , Aceptación de la Atención de Salud , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Organización Mundial de la SaludRESUMEN
Norovirus (NoV) is a major cause of sporadic cases and outbreaks of acute gastroenteritis (AGE), thereby imposing threat to health globally. It is unclear how quantitation of wastewater NoV reflects the incidence of human AGE infections; therefore, we conducted this systematic review and meta-analysis of published NoV wastewater surveillance studies. A literature search was performed, and all studies on NoV wastewater surveillance were identified. Quantitative results were evaluated. The results showed that the overall detection rate of NoV in wastewater was 82.10% (95% confidence interval [CI]: 74.22-89.92%); NoV concentration was statistically significant in terms of season (P < 0.001), with higher concentration in spring and winter. There were positive correlations between NoV GII concentration in wastewater and GII AGE cases (rs = 0.51, 95% CI: 0.18-0.74, I2 = 0%), total AGE cases (rs = 0.40, 95% CI: 0.15-0.61, I2 = 23%) and NoV outbreaks (rs = 0.47, 95% CI: 0.30-0.62, I2 = 0%). Results of cross-correlation analysis of partial data indicated that variations in GII concentration were consistent with or ahead of those in the number of AGE cases. The diversity of NoV genotypes in wastewater was elucidated, and the dominant strains in wastewater showed a consistent temporal distribution with those responsible for human AGE. Our study demonstrated the potential association of NoV detected in wastewater with AGE infections, and further studies are needed to confirm this conclusion.