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Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps
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Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 207162

Special Issue Editor

Dr. Davide Gori

E-Mail Website
Guest Editor
Department of Biomedical and Neuromotor Sciences, University of Bologna, 401261 Bologna, Italy
Interests: vaccine hesitancy; epidemiology; public health; vaccine campaigns
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Globally, infant and childhood vaccine coverage rates are still not high enough, with outbreaks of vaccine preventable diseases occurring frequently even in high-income countries. Vaccine hesitancy is one of the factors explaining suboptimal percentages of vaccination coverage, defined by the SAGE group as a “delay in acceptance or refusal of vaccines despite availability of vaccine services”. The decision not to vaccinate or delay vaccine shots comes from a complex decision-making process influenced by numerous factors related to population, context, environment, historical period and single vaccine.
This recent-years worldwide increase in vaccine hesitancy has lead the World Health Organization to list vaccine hesitancy as one of its top 10 health threats facing the world in 2019. This has led several high-, middle- and low income countries to enact, strengthen or contemplate mandatory and/or recommended infant and childhood immunization in order to address this novel gap.
This Special Issue focuses on the knowledge and strategies to reduce vaccine hesitancy and improve vaccination coverage rates in the group of infant and childhood. Submission of original articles, systematic reviews, short communications, and other types of article on related topics are welcome. Manuscripts will follow standard Journal peer-review practices, and those accepted for publication will appear in the special issue on Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps.

Prof. Davide Gori
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccine hesitancy
  • child immunizations
  • vaccination coverage rates
  • interventions and strategies
  • rationales, issues and knowledge
  • vaccine-preventable diseases
  • adverse events
  • vaccine uptake

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Published Papers (12 papers)

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Editorial

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4 pages, 193 KiB  
Editorial
Mass Immunization and Vaccine Hesitancy in Children and Their Families: A Long and Winding Road Ahead to Address without a Second Thought
by Davide Gori, Marco Montalti and Federica Guaraldi
Vaccines 2021, 9(7), 752; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9070752 - 06 Jul 2021
Cited by 2 | Viewed by 2800
Abstract
In 2019, vaccine hesitancy (VH), defined by the SAGE working group as “delay in acceptance or refusal of vaccination despite availability of vaccination services” [...] Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)

Research

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13 pages, 3969 KiB  
Article
Hesitancy of Arab Healthcare Workers towards COVID-19 Vaccination: A Large-Scale Multinational Study
by Eyad Qunaibi, Iman Basheti, Mohamed Soudy and Iyad Sultan
Vaccines 2021, 9(5), 446; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9050446 - 02 May 2021
Cited by 77 | Viewed by 14925
Abstract
Background: Health care workers (HCWs) are at increased risk of acquiring and transmitting COVID-19 infection. Moreover, they present role models for communities with regards to attitudes towards COVID-19 vaccination. Hence, hesitancy of HCWs towards vaccination can crucially affect the efforts aiming to contain [...] Read more.
Background: Health care workers (HCWs) are at increased risk of acquiring and transmitting COVID-19 infection. Moreover, they present role models for communities with regards to attitudes towards COVID-19 vaccination. Hence, hesitancy of HCWs towards vaccination can crucially affect the efforts aiming to contain the pandemic. Previously published studies paid little attention to HCWs in Arab countries, which have a population of over 440 million. Objectives: To assess the rates of COVID-19 vaccine hesitancy in Arabic-speaking HCWs residing in and outside Arab countries, and their perceived barriers towards vaccination. Methods: A cross-sectional study based on an online survey was conducted from 14–29 January 2021, targeting Arabic-speaking HCWs from all around the world. Results: The survey recruited 5708 eligible participants (55.6% males, 44.4% females, age 30.6 ± 10 years) from 21 Arab countries (87.5%) and 54 other countries (12.5%). Our analysis showed a significant rate of vaccine hesitancy among Arabic-speaking HCWs residing in and outside of Arab countries (25.8% and 32.8%, respectively). The highest rates of hesitancy were among participants from the western regions of the Arab world (Egypt, Morocco, Tunisia, and Algeria). The most cited reasons for hesitancy were concerns about side effects and distrust of the expedited vaccine production and healthcare policies. Factors associated with higher hesitancy included age of 30–59, previous or current suspected or confirmed COVID-19, female gender, not knowing the vaccine type authorized in the participant’s country, and not regularly receiving the influenza vaccine. Conclusion: This is the first large-scale multinational post-vaccine-availability study on COVID-19 vaccine hesitancy among HCWs. It reveals high rates of hesitancy among Arab-speaking HCWs. Unless addressed properly, this hesitancy can impede the efforts for achieving widespread vaccination and collective immunity. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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9 pages, 461 KiB  
Article
Would Parents Get Their Children Vaccinated Against SARS-CoV-2? Rate and Predictors of Vaccine Hesitancy According to a Survey over 5000 Families from Bologna, Italy
by Marco Montalti, Flavia Rallo, Federica Guaraldi, Lapo Bartoli, Giulia Po, Michela Stillo, Paola Perrone, Lorena Squillace, Laura Dallolio, Paolo Pandolfi, Davide Resi, Maria Pia Fantini, Chiara Reno and Davide Gori
Vaccines 2021, 9(4), 366; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9040366 - 10 Apr 2021
Cited by 102 | Viewed by 6554
Abstract
In the near future, COVID-19 vaccine efficacy trials in larger cohorts may offer the possibility to implement child and adolescent vaccination. The opening of the vaccination for these strata may play a key role in order to limit virus circulation, infection spreading towards [...] Read more.
In the near future, COVID-19 vaccine efficacy trials in larger cohorts may offer the possibility to implement child and adolescent vaccination. The opening of the vaccination for these strata may play a key role in order to limit virus circulation, infection spreading towards the most vulnerable subjects, and plan safe school reopening. Vaccine hesitancy (VH) could limit the ability to reach the coverage threshold required to ensure herd immunity. The aim of this study was to investigate the prevalence and determinants of VH among parents/guardians toward a potentially available COVID-19 vaccination for children and adolescents. An online survey was performed in parents/guardians of children aged <18 years old, living in Bologna. Overall, 5054 questionnaires were collected. A vast majority (60.4%) of the parents/guardians were inclined to vaccinate, while 29.6% were still considering the opportunity, and 9.9% were hesitant. Highest vaccine hesitancy rates were detected in female parents/guardians of children aged 6–10 years, ≤29 years old, with low educational level, relying on information found in the web/social media, and disliking mandatory vaccination policies. Although preliminary, these data could help in designing target strategies to implement adherence to a vaccination campaign, with special regard to web-based information. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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13 pages, 686 KiB  
Article
Access to Vaccination Information and Confidence/Hesitancy towards Childhood Vaccination: A Cross-Sectional Survey in China
by Fanxing Du, Tracey Chantler, Mark R. Francis, Fiona Yueqian Sun, Xuan Zhang, Kaiyi Han, Lance Rodewald, Hongjie Yu, Shiyi Tu, Heidi Larson and Zhiyuan Hou
Vaccines 2021, 9(3), 201; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9030201 - 28 Feb 2021
Cited by 21 | Viewed by 3323
Abstract
Access to vaccination information could influence public attitudes towards vaccination. This study investigated the number and types of vaccination-related information sources, and estimated their associations with vaccine confidence and hesitancy in China. In January 2019, we conducted a cross-sectional survey in China, and [...] Read more.
Access to vaccination information could influence public attitudes towards vaccination. This study investigated the number and types of vaccination-related information sources, and estimated their associations with vaccine confidence and hesitancy in China. In January 2019, we conducted a cross-sectional survey in China, and 2122 caregivers with children <6 years completed self-administered questionnaires. Logistic regressions were used to assess associations between caregivers’ primary information sources and vaccine confidence/hesitancy. A majority (72%) of caregivers had multiple sources of vaccination-related information. The proportions of caregivers reporting professional sources, media, and peers as primary information sources were 81%, 63%, and 26%. Internal migrants were less likely to get information from professional sources; more educated and wealthier caregivers reported more information sources and were more likely to get information from media and peers. Caregivers who reported professional information sources had significantly higher odds of being confident about the safety of vaccines and lower odds of being hesitant toward vaccination than those who did not. Caregivers who reported the media as a primary information source had significantly higher odds of being hesitant toward vaccination than those who did not. To address vaccine hesitancy, it is essential to promote universal access to professional vaccination-related information sources, and to use the media to disseminate evidence-based information and clarify misinformation. Health communication should target internal migrants, and more educated and wealthier caregivers. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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13 pages, 288 KiB  
Communication
The Model of “Informed Refusal” for Vaccination: How to Fight against Anti-Vaccinationist Misinformation without Disregarding the Principle of Self-Determination
by Stefano D’Errico, Emanuela Turillazzi, Martina Zanon, Rocco Valerio Viola, Paola Frati and Vittorio Fineschi
Vaccines 2021, 9(2), 110; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020110 - 01 Feb 2021
Cited by 21 | Viewed by 5868
Abstract
Vaccines are arguably a public health success story as well as an incredibly cost-effective medical resource. Despite this, worldwide concerns about their safety are growing, with the risk of increased morbidity and mortality in vaccine-preventable diseases because of vaccine refusal. The global political [...] Read more.
Vaccines are arguably a public health success story as well as an incredibly cost-effective medical resource. Despite this, worldwide concerns about their safety are growing, with the risk of increased morbidity and mortality in vaccine-preventable diseases because of vaccine refusal. The global political trend in developed countries is to increasingly reduce mandates and the compulsory nature of vaccination programs. This is due to strong opposition from anti-vaccination movements and groups. While these have existed since the beginnings of vaccinology, they have recently gained a strong foothold through massive exploitation of the media and especially the internet. This has led to widespread misinformation and greater difficulty for governments and health institutions in dealing with parents’ concerns and misconceptions. Common strategies in order to maintain a high degree of public acceptance of vaccines include the enhancement of adverse effect reporting systems, the enrichment of scientific literature, and the dissemination of targeted information to parents and health care providers. Vaccine risk perception, in fact, largely exceeds the evidence and is linked to well-known general population cognitive bias, which must be recognized and corrected. Although there is no doubt about the convenience of universal vaccination, a lively international debate is underway with regard to the legitimacy of mandatory vaccination programs. Most scientists agree that the individual’s right to self-determination should be preserved. The only way to simultaneously protect the right to health is to introduce an informed refusal model, which aims to guarantee the highest coverage rates for vaccination. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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11 pages, 1874 KiB  
Article
COVID-19 Infection and Previous BCG Vaccination Coverage in the Ecuadorian Population
by Daniel Garzon-Chavez, Jackson Rivas-Condo, Adriana Echeverria, Jhoanna Mozo, Emmanuelle Quentin, Jorge Reyes and Enrique Teran
Vaccines 2021, 9(2), 91; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020091 - 27 Jan 2021
Cited by 5 | Viewed by 4845
Abstract
The Bacillus Calmette–Guérin (BCG) is a well-known vaccine with almost a century of use, with the apparent capability to improve cytokine production and epigenetics changes that could develop a better response to pathogens. It has been postulated that BCG protection against SARS-CoV-2 has [...] Read more.
The Bacillus Calmette–Guérin (BCG) is a well-known vaccine with almost a century of use, with the apparent capability to improve cytokine production and epigenetics changes that could develop a better response to pathogens. It has been postulated that BCG protection against SARS-CoV-2 has a potential role in the pandemic, through the presence of homologous amino acid sequences. To identify a possible link between BCG vaccination coverage and COVID-19 cases, we used official epidemic data and Ecuadorian Ministry of Health and Pan American Health Organization vaccination information. BCG information before 1979 was available only at a national level. Therefore, projections based on the last 20 years were performed, to compare by specific geographic units. We used a Mann–Kendall test to identify BCG coverage variations, and mapping was conducted with a free geographic information system (QGIS). Nine provinces where BCG vaccine coverage was lower than 74.25% show a significant statistical association (χ2 Pearson’s = 4.800, df = 1, p = 0.028), with a higher prevalence of cases for people aged 50 to 64 years than in younger people aged 20 to 49 years. Despite the availability of BCG vaccination data and the mathematical models needed to compare these data with COVID-19 cases, our results show that, in geographic areas where BCG coverage was low, 50% presented a high prevalence of COVID-19 cases that were young; thus, low-coverage years were more affected. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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12 pages, 1879 KiB  
Article
Vaccine Hesitancy on Social Media: Sentiment Analysis from June 2011 to April 2019
by Hilary Piedrahita-Valdés, Diego Piedrahita-Castillo, Javier Bermejo-Higuera, Patricia Guillem-Saiz, Juan Ramón Bermejo-Higuera, Javier Guillem-Saiz, Juan Antonio Sicilia-Montalvo and Francisco Machío-Regidor
Vaccines 2021, 9(1), 28; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9010028 - 07 Jan 2021
Cited by 85 | Viewed by 11389
Abstract
Vaccine hesitancy was one of the ten major threats to global health in 2019, according to the World Health Organisation. Nowadays, social media has an important role in the spread of information, misinformation, and disinformation about vaccines. Monitoring vaccine-related conversations on social media [...] Read more.
Vaccine hesitancy was one of the ten major threats to global health in 2019, according to the World Health Organisation. Nowadays, social media has an important role in the spread of information, misinformation, and disinformation about vaccines. Monitoring vaccine-related conversations on social media could help us to identify the factors that contribute to vaccine confidence in each historical period and geographical area. We used a hybrid approach to perform an opinion-mining analysis on 1,499,227 vaccine-related tweets published on Twitter from 1st June 2011 to 30th April 2019. Our algorithm classified 69.36% of the tweets as neutral, 21.78% as positive, and 8.86% as negative. The percentage of neutral tweets showed a decreasing tendency, while the proportion of positive and negative tweets increased over time. Peaks in positive tweets were observed every April. The proportion of positive tweets was significantly higher in the middle of the week and decreased during weekends. Negative tweets followed the opposite pattern. Among users with ≥2 tweets, 91.83% had a homogeneous polarised discourse. Positive tweets were more prevalent in Switzerland (71.43%). Negative tweets were most common in the Netherlands (15.53%), Canada (11.32%), Japan (10.74%), and the United States (10.49%). Opinion mining is potentially useful to monitor online vaccine-related concerns and adapt vaccine promotion strategies accordingly. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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11 pages, 523 KiB  
Article
Relationship between Citizens’ Health Engagement and Intention to Take the COVID-19 Vaccine in Italy: A Mediation Analysis
by Guendalina Graffigna, Lorenzo Palamenghi, Stefania Boccia and Serena Barello
Vaccines 2020, 8(4), 576; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8040576 - 01 Oct 2020
Cited by 127 | Viewed by 9229
Abstract
The actual effectiveness of the still-to-come vaccination against the coronavirus SARS-CoV-2 might be challenged by vaccine hesitancy, a rather common and known phenomenon whose psychological predictors are, nevertheless, still largely debated. Our study aims at understanding how adult citizens’ health engagement, perceived COVID-19 [...] Read more.
The actual effectiveness of the still-to-come vaccination against the coronavirus SARS-CoV-2 might be challenged by vaccine hesitancy, a rather common and known phenomenon whose psychological predictors are, nevertheless, still largely debated. Our study aims at understanding how adult citizens’ health engagement, perceived COVID-19 susceptibility and severity, and general vaccine-related attitudes affect the willingness to vaccinate against COVID-19. To that end, on a sample of Italian citizens, we implemented a path model to test the impact of health engagement on the willingness to vaccinate against SARS-CoV-2, and whether this relationship is direct or mediated by the general attitude towards vaccines and the risk perception. Moreover, we tested the configural and weak invariance of the model across gender and three age groups. Results show that health engagement is positively related to the intention to vaccinate and that this relationship is partially mediated by the general attitude towards vaccines. The model appears invariant across genders and partially invariant across age groups, showing some differences in the role of perceived susceptibility. These findings vouch for the implementation of educational campaigns aimed at sustaining future vaccination programs that also include health engagement promotion. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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Review

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21 pages, 1170 KiB  
Review
MMR Vaccine Attitude and Uptake Research in the United Kingdom: A Critical Review
by Louis Torracinta, Rachel Tanner and Samantha Vanderslott
Vaccines 2021, 9(4), 402; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9040402 - 19 Apr 2021
Cited by 14 | Viewed by 7854
Abstract
This review critically assesses the body of research about Measles-Mumps-and-Rubella (MMR) vaccine attitudes and uptake in the United Kingdom (UK) over the past 10 years. We searched PubMed and Scopus, with terms aimed at capturing relevant literature on attitudes about, and uptake of, [...] Read more.
This review critically assesses the body of research about Measles-Mumps-and-Rubella (MMR) vaccine attitudes and uptake in the United Kingdom (UK) over the past 10 years. We searched PubMed and Scopus, with terms aimed at capturing relevant literature on attitudes about, and uptake of, the MMR vaccine. Two researchers screened for abstract eligibility and after de-duplication 934 studies were selected. After screening, 40 references were included for full-text review and thematic synthesis by three researchers. We were interested in the methodologies employed and grouped findings by whether studies concerned: (1) Uptake and Demographics; (2) Beliefs and Attitudes; (3) Healthcare Worker Focus; (4) Experimental and Psychometric Intervention; and (5) Mixed Methods. We identified group and individual level determinants for attitudes, operating directly and indirectly, which influence vaccine uptake. We found that access issues, often ignored within the public “anti-vax” debate, remain highly pertinent. Finally, a consistent theme was the effect of misinformation or lack of knowledge and trust in healthcare, often stemming from the Wakefield controversy. Future immunisation campaigns for children, including for COVID-19, should consider both access and attitudinal aspects of vaccination, and incorporate a range of methodologies to assess progress, taking into account socio-economic variables and the needs of disadvantaged groups. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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14 pages, 1470 KiB  
Review
COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates
by Malik Sallam
Vaccines 2021, 9(2), 160; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020160 - 16 Feb 2021
Cited by 1250 | Viewed by 109477
Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim [...] Read more.
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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16 pages, 524 KiB  
Review
Ethics of Vaccination in Childhood—A Framework Based on the Four Principles of Biomedical Ethics
by Meta Rus and Urh Groselj
Vaccines 2021, 9(2), 113; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020113 - 02 Feb 2021
Cited by 15 | Viewed by 15809
Abstract
Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of [...] Read more.
Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of diseases now prevented with vaccines diminished the experience of their historical burdens. Increasing number of vaccine-hesitant people in recent years threatens, or even effectively disables, herd immunity levels of the population and results in outbreaks of previously already controlled diseases. We aimed to apply a framework for ethical analysis of vaccination in childhood based on the four principles of biomedical ethics (respect for autonomy, nonmaleficence, beneficence and justice) to provide a comprehensive and applicable model on how to address the ethical aspects of vaccination at both individual and societal levels. We suggest finding an “ethical equilibrium”, which means that the degree of respect for parents’ autonomy is not constant, but variable; it shall depend on the level of established herd immunity and it is specific for every society. When the moral obligation of individuals to contribute to herd immunity is not fulfilled, mandatory vaccination policies are ethically justified, because states bear responsibility to protect herd immunity as a common good. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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Other

9 pages, 241 KiB  
Brief Report
Impact of COVID-19 Pandemic on Flu and COVID-19 Vaccination Intentions among University Students
by Roberta Pastorino, Leonardo Villani, Marco Mariani, Walter Ricciardi, Guendalina Graffigna and Stefania Boccia
Vaccines 2021, 9(2), 70; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020070 - 20 Jan 2021
Cited by 70 | Viewed by 12368
Abstract
Flu vaccination for the general population, and specifically for vulnerable subgroups, brings the potential to reduce the impact of the COVID-19 pandemic in terms of mobility, mortality, and hospitalizations. In Italy, flu vaccination is recommended to all ≥6 months of age, even if [...] Read more.
Flu vaccination for the general population, and specifically for vulnerable subgroups, brings the potential to reduce the impact of the COVID-19 pandemic in terms of mobility, mortality, and hospitalizations. In Italy, flu vaccination is recommended to all ≥6 months of age, even if it is only free of charge for specific categories. We investigated the intentions towards flu and COVID-19 vaccinations from a sample of 436 Italian university students. Results of a web-based survey show that 77.52% of them were willing to get the flu vaccine and 94.73% were willing to be vaccinated against COVID-19 when available. We identified positive predictive factors to undertake flu vaccination as being a medical student, having undertaken a previous vaccination against flu, and having a high level of concern and perceived vulnerability to the COVID-19 pandemic. Reinforced public health activities might consider engaging university students a as possible “positive influencer” towards flu and COVID-19 vaccination programs. Full article
(This article belongs to the Special Issue Vaccine Hesitancy and Child Immunizations: Rationales, Issues and Knowledge Gaps)
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