Abram L Wagner1, Aubree Gordon2, Veronica L Tallo3, Artan Simaku4, Rachael M Porter5, Laura J Edwards6, Enkeleda Duka4, Ilham Abu-Khader7, Lionel Gresh8, Cristina Sciuto6, Eduardo Azziz-Baumgartner5, Silvia Bino4, Felix Sanchez9, Guillermina Kuan10, Joanne N de Jesus3, Eric A F Simões11, Danielle R Hunt6, Ali K Arbaji7, Mark G Thompson5. 1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. 2. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. Electronic address: gordonal@umich.edu. 3. Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines. 4. Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania. 5. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. 6. Abt Associates, Inc., Atlanta, GA, USA. 7. The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan. 8. Sustainable Sciences Institute, Managua, Nicaragua. 9. Hospital Infantil Manuel de Jesús Rivera, Ministry of Health, Managua, Nicaragua. 10. Sustainable Sciences Institute, Managua, Nicaragua; Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua. 11. Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
Abstract
BACKGROUND: Despite a large burden of influenza in middle income countries, pediatric vaccination coverage remains low. The aims of this study were to (1) describe mothers' knowledge and attitudes about influenza illnesses and vaccination, and (2) identify characteristics associated with mothers' intent to vaccinate their child. METHODS: From 2015 to 2017, infants 0-11 months old in Nicaragua, Philippines, Jordan, and Albania were enrolled from community settings and hospitals. Interviewers administered a questionnaire to their mothers. Mothers of infants aged 6-11 months rated their intention (small-to-moderate vs. large chance) to accept pediatric vaccination if it was offered at no-cost. The importance of knowledge, attitudes, and sociodemographic characteristics in predicting influenza vaccination intention was measured as the mean decrease in Gini index when that factor was excluded from 1000 decision trees in a random forest analysis. RESULTS: In total, 1,308 mothers were enrolled from the community setting and 3,286 from the hospital setting. Prevalence of at least some knowledge of influenza illness ranged from 34% in Philippines to 88% in Albania (in the community sample), and between 23% in Philippines to 88% in Jordan (in the hospital sample). In the community sample, most mothers in Albania (69%) and Philippines (58%) would accept the influenza vaccine, and these proportions were higher in the hospital sample for all countries except Albania (48%) (P < 0.0001). Perceived vaccine safety (mean decrease in Gini index = 61) and effectiveness (55), and perceived knowledge of influenza vaccine (45) were the most important predictors of influenza vaccination intention in models that also included country and community versus hospital sample. CONCLUSION: Intent to vaccinate infants aged 6-11 months in four middle income countries was tied primarily to knowledge of the vaccine and perceptions of vaccine safety and effectiveness. These findings were noted among mothers interviewed in the community and mothers of recently hospitalized infants.
BACKGROUND: Despite a large burden of influenza in middle income countries, pediatric vaccination coverage remains low. The aims of this study were to (1) describe mothers' knowledge and attitudes about influenza illnesses and vaccination, and (2) identify characteristics associated with mothers' intent to vaccinate their child. METHODS: From 2015 to 2017, infants 0-11 months old in Nicaragua, Philippines, Jordan, and Albania were enrolled from community settings and hospitals. Interviewers administered a questionnaire to their mothers. Mothers of infants aged 6-11 months rated their intention (small-to-moderate vs. large chance) to accept pediatric vaccination if it was offered at no-cost. The importance of knowledge, attitudes, and sociodemographic characteristics in predicting influenza vaccination intention was measured as the mean decrease in Gini index when that factor was excluded from 1000 decision trees in a random forest analysis. RESULTS: In total, 1,308 mothers were enrolled from the community setting and 3,286 from the hospital setting. Prevalence of at least some knowledge of influenza illness ranged from 34% in Philippines to 88% in Albania (in the community sample), and between 23% in Philippines to 88% in Jordan (in the hospital sample). In the community sample, most mothers in Albania (69%) and Philippines (58%) would accept the influenza vaccine, and these proportions were higher in the hospital sample for all countries except Albania (48%) (P < 0.0001). Perceived vaccine safety (mean decrease in Gini index = 61) and effectiveness (55), and perceived knowledge of influenza vaccine (45) were the most important predictors of influenza vaccination intention in models that also included country and community versus hospital sample. CONCLUSION: Intent to vaccinate infants aged 6-11 months in four middle income countries was tied primarily to knowledge of the vaccine and perceptions of vaccine safety and effectiveness. These findings were noted among mothers interviewed in the community and mothers of recently hospitalized infants.
Authors: Abram L Wagner; Zhuoying Huang; Jia Ren; Megan Laffoon; Mengdi Ji; Leah C Pinckney; Xiaodong Sun; Lisa A Prosser; Matthew L Boulton; Brian J Zikmund-Fisher Journal: Am J Prev Med Date: 2020-11-12 Impact factor: 5.043
Authors: Karen Lutrick; Katherine D Ellingson; Zoe Baccam; Patrick Rivers; Shawn Beitel; Joel Parker; James Hollister; Xiaoxiao Sun; Joe K Gerald; Kenneth Komatsu; Elizabeth Kim; Bonnie LaFleur; Lauren Grant; Young M Yoo; Archana Kumar; Julie Mayo Lamberte; Benjamin J Cowling; Sarah Cobey; Natalie J Thornburg; Jennifer K Meece; Preeta Kutty; Janko Nikolich-Zugich; Mark G Thompson; Jefferey L Burgess Journal: JMIR Res Protoc Date: 2021-05-26