Commitment of health workers and various population groups to vaccination

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. 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. 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. 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. 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:
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. The study had no sponsorship.

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

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

1. Sela 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/healthcare11081140

2. Bauer 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.2020.09.001

3. Sauer 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.2021.01.066

4. Nguyen 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.2022.11.023

5. Valdez R.B., Romero K.S. Improving adult vaccination status in the United States. Healthcare (Basel). 2021; 9(11): 1411. https://doi.org/10.3390/healthcare9111411

6. Costantino 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/vaccines8030545

7. Opri 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.2017.02.003

8. Guillari 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.v92iS2.11106

9. Geoghegan S., O’Callaghan K.P., Offit P.A. Vaccine safety: myths and misinformation. Front. Microbiol. 2020; 11: 372. https://doi.org/10.3389/fmicb.2020.00372

10. Orlova 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)

11. Galitskaya 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)

12. 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/s11673-018-9841-1

13. Dubé 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-090419-102240

14. Fues 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/10.1080/21645515.2022.2026711

15. Lopushov 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)

16. 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.2021.663074

17. Bechini 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.P71.023

18. Murray 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/s11096-021-01250-1

19. Odone 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/10.1080/14760584.2021.1912603

20. Maltezou 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/10.1080/14760584.2019.1552141

21. Girina 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)

22. 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;00008

23. Verger 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/10.1080/14760584.2022.2056026

24. Wheelock 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-2020-106805

25. Giubilini 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-y

26. Kupryushin 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)

27. 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.2022.1087683

28. Laurenz 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.2021.04.029

29. González-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-2021-060094

30. Omidvar 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