rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2023-26-3-205-211ecacbyrosped-10Research ArticleСОЦИАЛЬНАЯ ПЕДИАТРИЯSOCIAL PEDIATRICSПриверженность вакцинации медицинских работников и различных групп населенияCommitment of health workers and various population groups to vaccinationhttps://orcid.org/0000-0003-3248-5519СутовскаяДиана ВладимировнаSutovskayaDiana V.

Доцент каф. педиатрии № 2, ФГБОУ ВО КубГМУ Мин­здрава России

e-mail: dsutovskaya@bk.ru

Associate Professor of the Department of pediatrics No. 2, Kuban State Medical University, Krasnodar, 350063, Russian Federation

e-mail: dsutovskaya@bk.ru 

dsutovskaya@bk.ruhttps://orcid.org/0000-0003-1649-5493ПыжьяноваПолина АлександровнаPyzhyanovaPolina A.

Студент педиатрического факультета ФГБОУ ВО КубГМУ Минздрава России

e-mail: polinapzh@mail.ru

polinapzh@mail.ruhttps://orcid.org/0000-0002-8704-1213ГабдуллинаЕкатерина ВладимировнаGabdullinaEkaterina V.

Студент педиатрического факультета ФГБОУ ВО КубГМУ Минздрава России

e-mail: skrypkina.yekaterina@yandex.ru

skrypkina.yekaterina@yandex.ruhttps://orcid.org/0000-0003-0813-7434МакунцАнастасия АшотовнаMakuntsAnastasia A.

Студент педиатрического факультета ФГБОУ ВО КубГМУ Минздрава России

e-mail: nazaryana7@gmail.com

nazaryana7@gmail.comhttps://orcid.org/0000-0001-6351-3848КузьменкоАнна ВитальевнаKuzmenkoAnna V.

Студент педиатрического факультета ФГБОУ ВО «КубГМУ Мин­здрава России

e-mail: Ankuzm23@gmail.com

Ankuzm23@gmail.comФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РоссииKuban State Medical University202309082023263205211Copyright © Сутовская Д.В., Пыжьянова П.А., Габдуллина Е.В., Макунц А.А., Кузьменко А.В., 20232023Сутовская Д.В., Пыжьянова П.А., Габдуллина Е.В., Макунц А.А., Кузьменко А.В.Sutovskaya D.V., Pyzhyanova P.A., Gabdullina E.V., Makunts A.A., Kuzmenko A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/10Актуальность

Актуальность. Относительно стабильные показатели заболеваемости по большинству контролируемых инфекций смещают фокус внимания населения с необходимости вакцинации на вероятность развития поствакцинальных осложнений.

Цель работы — определить приверженность различных групп населения и медицинских работников вакцинопрофилактике, провести анализ причин формирования антипрививочного скепсиса.

Материалы и методы

Материалы и методы. Проведён опрос для выявления отношения к вакцинации 1939 респондентов: 485 врачей различных специальностей (163 педиатров, 86 хирургов, 85 акушеров-гинекологов, 76 неврологов, 75 неонатологов), 117 медсес­тер, 295 родителей, 1042 студентов технического и медицинского профилей. Оценка значимости различий проводилась с использованием t-критерия Стьюдента.

Результаты

Результаты. Установлен недостаточный уровень приверженности населения вакцинопрофилактике: 43,1% родителей прививают детей выборочно, 35,4% — согласно Национальному календарю, 17,1% категорически отказываются, 4,4%  ссылаются на медицинский отвод. Основная причина отказов — боязнь осложнений (30%). Менее половины опрошенных (45,6%) получают информацию от медицинских работников, у 49,1% основным источником служат СМИ. Среди медицинских работников приверженность вакцинопрофилактике наибольшая среди педиатров (86,1%), существенно ниже она у неврологов (35,6%), хирургов (43,7%), акушеров-гинекологов (62,6%), медицинских сестёр (79,5%). Основной причиной недоверия к вакцинации является боязнь поствакцинальных осложнений (61,5%), узкие специалисты чаще выбирают ответ «лучше переболеть» (26,5%). Среди студентов медицинского университета значительно выше приверженность к вакцинации у учащихся старших курсов педиатрического факультета (63,6%) по сравнению со студентами младших курсов (40,8%) и лечебного факультета (48,8%). Однако 5% опрошенных студентов не планируют прививать своих детей в будущем. Более негативное отношение к вакцинации у студентов политехнического вуза — только 36,4% вакцинированы согласно Национальному календарю, 30% не планируют прививать своих детей в будущем.

Заключение

Заключение. Очевидна необходимость введения дополнительных обучающих программ по вакцинопрофилактике с целью повышения осведомлённости медицинских работников в данном вопросе, что позволит аргументированно обосновывать важность иммунизации пациентам и их родителям.

Участие авторов

Участие авторов: Сутовская Д.В. — концепция и дизайн исследования, редактирование; Сутовская Д.В., Пыжьянова П.А., Габдуллина Е.В., Кузьменко А.В. — сбор и обработка материала; Сутовская Д.В., Макунц А.А. — статистическая обработка; Сутовская Д.В., Пыжьянова П.А., Габдуллина Е.В. — написание текста. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. 

Поступила 17

Поступила 17.04.2023Принята к печати 16.05.2023Опубликована 27.06.2023

Introduction

Introduction. The relatively stable incidence of most controlled infections shifts the focus of public attention from the need for vaccination to the likelihood of post-vaccination complications.

Aim

Aim. To examine the adherence of various population groups and health workers to vaccine prophylaxis and analyze the reasons for anti-vaccination scepticism.

Materials and methods

Materials and methods. A survey was conducted on the attitudes towards vaccination among one thousand nine hundred thirty nine respondents including 485 doctors of various specialties (163 pediatricians, 86 surgeons, 85 obstetricians-gynecologists, 76 neurologists, 75 neonatologists), 117 nurses, 295 parents, 1042 students. The significance of differences was assessed using Student’s t-test.

Results

Results. An insufficient level of adherence to vaccine prophylaxis has been established: 43.1% of parents vaccinate their children selectively, 35.4% according to the national calendar, 17.1% refuse categorically, and 4.4% have a medical refusal. The main reason for refusal is fear of complications (30%). Less than half receive information from health workers (45.6%), the main source being the media (49.1%). Among health workers, adherence to vaccine prophylaxis is highest among pediatricians (86.1%), significantly lower among neurologists (35.6%), surgeons (43.7%), obstetricians-gynecologists (62.6%), nurses (79.5%). The main reason for distrust of vaccination is fear of post-vaccination complications, narrow specialists more often choose the answer “better to get sick”. Among medical university students there is a significantly higher adherence among senior students in paediatrics (63.6%) compared to students in undergraduate (40.8%) and medical school (48.8%). However, 5% of those surveyed do not plan to vaccinate their children in the future. Polytechnic students have a more negative attitude towards vaccination accounted for only 36.4% vaccinated according to the National Calendar and 30% do not plan to vaccinate their children in the future.

Conclusion

Conclusion. There is a clear need for additional training programs on vaccination to raise the awareness of health care workers on this issue, which will provide a strong rationale for the importance of immunization to patients and their parents.

Contribution

Contribution: Sutovskaya D.V. — concept and design of research, editing; Sutovskaya D.V., Pyzhyanova P.A., Gabdullina E.V., Kuzmenko A.V. — collection and processing of material; Sutovskaya D.V., Makunts A.A. — statistical processing; Sutovskaya D.V., Pyzhyanova P.A., Gabdullina E.V. — writing the text. All coauthors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgement

Acknowledgement. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: April 17, 2023Accepted: May 16, 2023Published: June 27, 2023

детивакцинацияиммунопрофилактикаприверженность вакцинациигруппы населенияimmunizationvaccinationthe adherence to vaccinationpopulationReferencesSela Y., Grinberg K., Nissanholtz-Gannot R. The dilemma of compulsory vaccinations-ethical and legal considerations. Healthcare (Basel). 2023; 11(8): 1140. https://doi.org/10.3390/healthcare11081140Sela Y., Grinberg K., Nissanholtz-Gannot R. The dilemma of compulsory vaccinations-ethical and legal considerations. Healthcare (Basel). 2023; 11(8): 1140. https://doi.org/10.3390/healthcare11081140Bauer K.A., Johnson K., Stephenson J.J., Visaria J., Chung H., York W., et al. Rate of preventative vaccine use and vaccine beliefs among a commercially insured population. Vaccine. 2020; 38(45): 7087–93. https://doi.org/10.1016/j.vaccine.2020.09.001Bauer K.A., Johnson K., Stephenson J.J., Visaria J., Chung H., York W., et al. Rate of preventative vaccine use and vaccine beliefs among a commercially insured population. Vaccine. 2020; 38(45): 7087–93. https://doi.org/10.1016/j.vaccine.2020.09.001Sauer M., Vasudevan P., Meghani A., Luthra K., Garcia C., Knoll M.D., et al. Situational assessment of adult vaccine preventable disease and the potential for immunization advocacy and policy in low- and middle-income countries. Vaccine. 2021; 39(11): 1556–64. https://doi.org/10.1016/j.vaccine.2021.01.066Sauer M., Vasudevan P., Meghani A., Luthra K., Garcia C., Knoll M.D., et al. Situational assessment of adult vaccine preventable disease and the potential for immunization advocacy and policy in low- and middle-income countries. Vaccine. 2021; 39(11): 1556–64. https://doi.org/10.1016/j.vaccine.2021.01.066Nguyen K.H., Zhao R., Mullins C., Corlin L., Beninger P., Bednarczyk R.A. Trends in vaccination schedules and up-to-date status of children 19-35 months, United States, 2015-2020. Vaccine. 2023; 41(2): 467–75. https://doi.org/10.1016/j.vaccine.2022.11.023Nguyen K.H., Zhao R., Mullins C., Corlin L., Beninger P., Bednarczyk R.A. Trends in vaccination schedules and up-to-date status of children 19-35 months, United States, 2015-2020. Vaccine. 2023; 41(2): 467–75. https://doi.org/10.1016/j.vaccine.2022.11.023Valdez R.B., Romero K.S. Improving adult vaccination status in the United States. Healthcare (Basel). 2021; 9(11): 1411. https://doi.org/10.3390/healthcare9111411Valdez R.B., Romero K.S. Improving adult vaccination status in the United States. Healthcare (Basel). 2021; 9(11): 1411. https://doi.org/10.3390/healthcare9111411Costantino C., Casuccio A., Restivo V. Vaccination and vaccine effectiveness: a commentary of special issue editors. Vaccines (Basel). 2020; 8(3): 545. https://doi.org/10.3390/vaccines8030545Costantino C., Casuccio A., Restivo V. Vaccination and vaccine effectiveness: a commentary of special issue editors. Vaccines (Basel). 2020; 8(3): 545. https://doi.org/10.3390/vaccines8030545Opri R., Zanoni G., Caffarelli C., Bottau P., Caimmi S., Crisafulli G., et al. True and false contraindications to vaccines. Allergol. Immunopathol. (Madr). 2018; 46(1): 99–104. https://doi.org/10.1016/j.aller.2017.02.003Opri R., Zanoni G., Caffarelli C., Bottau P., Caimmi S., Crisafulli G., et al. True and false contraindications to vaccines. Allergol. Immunopathol. (Madr). 2018; 46(1): 99–104. https://doi.org/10.1016/j.aller.2017.02.003Guillari A., Polito F., Pucciarelli G., Serra N., Gargiulo G., Esposito M.R., et al. Influenza vaccination and healthcare workers: barriers and predisposing factors. Acta Biomed. 2021; 92(S2): e2021004. https://doi.org/10.23750/abm.v92iS2.11106Guillari A., Polito F., Pucciarelli G., Serra N., Gargiulo G., Esposito M.R., et al. Influenza vaccination and healthcare workers: barriers and predisposing factors. Acta Biomed. 2021; 92(S2): e2021004. https://doi.org/10.23750/abm.v92iS2.11106Geoghegan S., O’Callaghan K.P., Offit P.A. Vaccine safety: myths and misinformation. Front. Microbiol. 2020; 11: 372. https://doi.org/10.3389/fmicb.2020.00372Geoghegan S., O’Callaghan K.P., Offit P.A. Vaccine safety: myths and misinformation. Front. Microbiol. 2020; 11: 372. https://doi.org/10.3389/fmicb.2020.00372Орлова Н.В., Федулаев Ю.Н., Филатова М.Н., Орлова С.Ю. Влияние средств массовой информации и социальных сетей на формирование общественного мнения о вакцинацииПедиатрия. Consilium Medicum. 2020; (4): 17–24. https://doi.org/10.26442/26586630.2020.4.200531 https://elibrary.ru/fztbgnOrlova N.V., Fedulaev Yu.N., Filatova M.N., Orlova S.Yu. Influence of the media and social media on public opinion about vaccination. Consilium Medicum. 2020; (4): 17–24. https://doi.org/10.26442/26586630.2020.4.200531 https://elibrary.ru/fztbgn (in Russian)Галицкая М.Г., Фисенко А.П., Таточенко В.К., Макарова С.Г., Давыдова И.В., Курдуп М.К. и др. Вакцинопрофилактика и её противники в современном мире. Российский педиатрический журнал. 2021; 24(6): 424–32. https://doi.org/10.46563/1560-9561-2021-24-6-424-432 https://elibrary.ru/nbwmubGalitskaya M.G., Fisenko A.P., Tatochenko V.K., Makarova S.G., Davydova I.V., Kurdup M.K., et al. Vaccine prophylaxis and its opponents in the modern world. Rossiyskiy pediatricheskiy zhurnal. 2021; 24(6): 424–32. https://doi.org/10.46563/1560-9561-2021-24-6-424-432 https://elibrary.ru/nbwmub (in Russian)Haire B., Komesaroff P., Leontini R., Raina MacIntyre C. Raising rates of childhood vaccination: the trade-off between coercion and trust. J. Bioeth. Inq. 2018; 15(2): 199–209. https://doi.org/10.1007/s11673-018-9841-1Haire B., Komesaroff P., Leontini R., Raina MacIntyre C. Raising rates of childhood vaccination: the trade-off between coercion and trust. J. Bioeth. Inq. 2018; 15(2): 199–209. https://doi.org/10.1007/s11673-018-9841-1Dubé È., Ward J.K., Verger P., MacDonald N.E. Vaccine hesitancy, acceptance, and anti-vaccination: Trends and future prospects for public health. Annu. Rev. Public Health. 2021; 42: 175–91. https://doi.org/10.1146/annurev-publhealth-090419-102240Dubé È., Ward J.K., Verger P., MacDonald N.E. Vaccine hesitancy, acceptance, and anti-vaccination: Trends and future prospects for public health. Annu. Rev. Public Health. 2021; 42: 175–91. https://doi.org/10.1146/annurev-publhealth-090419-102240Fues Wahl H., Wikman Erlandson B., Sahlin C., Nyaku M., Benĉina G. Analysis of vaccine messages on social media (Twitter) in Scandinavia. Hum. Vaccin. Immunother. 2022; 18(1): 2026711. https://doi.org/10.1080/21645515.2022.2026711Fues Wahl H., Wikman Erlandson B., Sahlin C., Nyaku M., Benĉina G. Analysis of vaccine messages on social media (Twitter) in Scandinavia. Hum. Vaccin. Immunother. 2022; 18(1): 2026711. https://doi.org/10.1080/21645515.2022.2026711Лопушов Д.В., Трифонов В.А., Имамов А.А., Сабаева Ф.Н., Шайхразиева Н.Д., Фазулзянова И.М. Отношение медицинских работников к вакцинации на современном этапе. Казанский медицинский журнал. 2018; 99(5): 812–7. https://doi.org/10.17816/KMJ2018-812 https://elibrary.ru/vaqxdgLopushov D.V., Trifonov V.A., Imamov A.A., Sabaeva F.N., Shaykhrazieva N.D., Fazulzyanova I.M. The attitude of health workers to vaccination at the present stage. Kazanskiy meditsinskiy zhurnal. 2018; 99(5): 812–7. https://doi.org/10.17816/KMJ2018-812 https://elibrary.ru/vaqxdg (in Russian)Olusanya O.A., Bednarczyk R.A., Davis R.L., Shaban-Nejad A. Addressing parental vaccine hesitancy and other barriers to childhood/adolescent vaccination uptake during the coronavirus (COVID-19) pandemic. Front. Immunol. 2021; 12: 663074. https://doi.org/10.3389/fimmu.2021.663074Olusanya O.A., Bednarczyk R.A., Davis R.L., Shaban-Nejad A. Addressing parental vaccine hesitancy and other barriers to childhood/adolescent vaccination uptake during the coronavirus (COVID-19) pandemic. Front. Immunol. 2021; 12: 663074. https://doi.org/10.3389/fimmu.2021.663074Bechini A., Bonanni P., Moscadelli A., Lauri S., Tiscione E., Levi M., et al. A project to elaborate strategies and actions of multi-purpose health communication on vaccine preventable infectious diseases in order to increase vaccination coverage in the population. Epidemiol. Prev. 2019; 43(1): 71–5. https://doi.org/10.19191/EP19.1.P71.023Bechini A., Bonanni P., Moscadelli A., Lauri S., Tiscione E., Levi M., et al. A project to elaborate strategies and actions of multi-purpose health communication on vaccine preventable infectious diseases in order to increase vaccination coverage in the population. Epidemiol. Prev. 2019; 43(1): 71–5. https://doi.org/10.19191/EP19.1.P71.023Murray E., Bieniek K., Del Aguila M., Egodage S., Litzinger S., Mazouz A., et al. Impact of pharmacy intervention on influenza vaccination acceptance: a systematic literature review and meta-analysis. Int. J. Clin. Pharm. 2021; 43(5): 1163–72. https://doi.org/10.1007/s11096-021-01250-1Murray E., Bieniek K., Del Aguila M., Egodage S., Litzinger S., Mazouz A., et al. Impact of pharmacy intervention on influenza vaccination acceptance: a systematic literature review and meta-analysis. Int. J. Clin. Pharm. 2021; 43(5): 1163–72. https://doi.org/10.1007/s11096-021-01250-1Odone A., Dallagiacoma G., Frascella B., Signorelli C., Leask J. Current understandings of the impact of mandatory vaccination laws in Europe. Expert. Rev. Vaccines. 2021; 20(5): 559–75. https://doi.org/10.1080/14760584.2021.1912603Odone A., Dallagiacoma G., Frascella B., Signorelli C., Leask J. Current understandings of the impact of mandatory vaccination laws in Europe. Expert. Rev. Vaccines. 2021; 20(5): 559–75. https://doi.org/10.1080/14760584.2021.1912603Maltezou H.C., Theodoridou K., Ledda C., Rapisarda V., Theodoridou M. Vaccination of healthcare workers: is mandatory vaccination needed? Expert. Rev. Vaccines. 2019; 18(1): 5–13. https://doi.org/10.1080/14760584.2019.1552141Maltezou H.C., Theodoridou K., Ledda C., Rapisarda V., Theodoridou M. Vaccination of healthcare workers: is mandatory vaccination needed? Expert. Rev. Vaccines. 2019; 18(1): 5–13. https://doi.org/10.1080/14760584.2019.1552141Гирина А.А., Петровский Ф.И., Заплатников А.Л. Приверженность врачей-педиатров иммунопрофилактике инфекционных болезней: современное состояние проблемы. РМЖ. Мать и дитя. 2020; 3(4): 290–4. https://doi.org/10.32364/2618-8430-2020-3-4-290-294 https://elibrary.ru/cgnlpsGirina A.A., Petrovskiy F.I., Zaplatnikov A.L. Pediatricians adherence to immunoprophylaxis of infectious diseases: current state of the problem. RMZh. Mat’ i ditya. 2020; 3(4): 290–4. https://doi.org/10.32364/2618-8430-2020-3-4-290-294 https://elibrary.ru/cgnlps (in Russian)Mizuta A.H., Succi G.M., Montalli V.A.M., Succi R.C.M. Perceptions on the importance of vaccination and vaccine refusal in a medical school. Rev. Paul. Pediatr. 2019; 37(1): 34–40. https://doi.org/10.1590/1984-0462/;2019;37;1;00008Mizuta A.H., Succi G.M., Montalli V.A.M., Succi R.C.M. Perceptions on the importance of vaccination and vaccine refusal in a medical school. Rev. Paul. Pediatr. 2019; 37(1): 34–40. https://doi.org/10.1590/1984-0462/;2019;37;1;00008Verger P., Botelho-Nevers E., Garrison A., Gagnon D., Gagneur A., Gagneux-Brunon A., et al. Vaccine hesitancy in health-care providers in Western countries: a narrative review. Expert. Rev. Vaccines. 2022; 21(7): 909–27. https://doi.org/10.1080/14760584.2022.2056026Verger P., Botelho-Nevers E., Garrison A., Gagnon D., Gagneur A., Gagneux-Brunon A., et al. Vaccine hesitancy in health-care providers in Western countries: a narrative review. Expert. Rev. Vaccines. 2022; 21(7): 909–27. https://doi.org/10.1080/14760584.2022.2056026Wheelock A., Ives J. Vaccine confidence, public understanding and probity: time for a shift in focus? J. Med. Ethics. 2022; 48(4): 250–5. https://doi.org/10.1136/medethics-2020-106805Wheelock A., Ives J. Vaccine confidence, public understanding and probity: time for a shift in focus? J. Med. Ethics. 2022; 48(4): 250–5. https://doi.org/10.1136/medethics-2020-106805Giubilini A., Douglas T., Savulescu J. The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue. Med. Health Care Philos. 2018; 21(4): 547–60. https://doi.org/10.1007/s11019-018-9829-yGiubilini A., Douglas T., Savulescu J. The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue. Med. Health Care Philos. 2018; 21(4): 547–60. https://doi.org/10.1007/s11019-018-9829-yКупрюшин А.С., Мельников В.Л., Вишнякова Ж.С., Митрофанова Н.Н. Правовые аспекты отказа от проведения прививочных мероприятий. Современные проблемы науки и образования. 2015; (3): 80. https://doi.org/10.17513/spno.2015.3 https://elibrary.ru/tyshpvKupryushin A.S., Mel’nikov V.L., Vishnyakova Zh.S., Mitrofanova N.N. Legal aspects of the exclusion of activities vaccination. Sovremennye problemy nauki i obrazovaniya. 2015; (3): 80. https://doi.org/10.17513/spno.2015.3 https://elibrary.ru/tyshpv (in Russian)N’konzi J.N., Chukwu C.W., Nyabadza F. Effect of time-varying adherence to non-pharmaceutical interventions on the occurrence of multiple epidemic waves: A modeling study. Front. Public Health. 2022; 10: 1087683. https://doi.org/10.3389/fpubh.2022.1087683N’konzi J.N., Chukwu C.W., Nyabadza F. Effect of time-varying adherence to non-pharmaceutical interventions on the occurrence of multiple epidemic waves: A modeling study. Front. Public Health. 2022; 10: 1087683. https://doi.org/10.3389/fpubh.2022.1087683Laurenz M., von Eiff C., Borchert K., Jacob C., Seidel K., Schley K. Vaccination rates and adherence in pneumococcal conjugate vaccination in mature born infants before and after vaccination schedule change – a claims database analysis. Vaccine. 2021; 39(24): 3287–95. https://doi.org/10.1016/j.vaccine.2021.04.029Laurenz M., von Eiff C., Borchert K., Jacob C., Seidel K., Schley K. Vaccination rates and adherence in pneumococcal conjugate vaccination in mature born infants before and after vaccination schedule change – a claims database analysis. Vaccine. 2021; 39(24): 3287–95. https://doi.org/10.1016/j.vaccine.2021.04.029González-Cano-Caballero M., García-Gámez M., Fernández-Fernández E., Fernández-Ordoñez E., Cano-Caballero M.D., Guerra-Marmolejo C. Continuing education programme on vaccines for primary healthcare professionals: mixed-method protocol. BMJ Open. 2022; 12(6): e060094. https://doi.org/10.1136/bmjopen-2021-060094González-Cano-Caballero M., García-Gámez M., Fernández-Fernández E., Fernández-Ordoñez E., Cano-Caballero M.D., Guerra-Marmolejo C. Continuing education programme on vaccines for primary healthcare professionals: mixed-method protocol. BMJ Open. 2022; 12(6): e060094. https://doi.org/10.1136/bmjopen-2021-060094Omidvar Tehrani S., Perkins D.D. Community health resources, globalization, trust in science, and voting as predictors of COVID-19 vaccination rates: a global study with implications for vaccine adherence. Vaccines (Basel). 2022; 10(8): 1343. https://doi.org/10.3390/vaccines10081343Omidvar Tehrani S., Perkins D.D. Community health resources, globalization, trust in science, and voting as predictors of COVID-19 vaccination rates: a global study with implications for vaccine adherence. Vaccines (Basel). 2022; 10(8): 1343. https://doi.org/10.3390/vaccines10081343

The authors declare that there are no conflicts of interest present.