BACKGROUND: Human papillomavirus (HPV) vaccination and Pap tests are recognized as effective preventive measures to reduce the incidence of HPV-related diseases among young adults. The objective of this study was to assess HPV vaccination and Pap test uptake, awareness, and barriers among young adults in the Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, the Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE).
METHODS: A comparative cross-sectional study was conducted from January to April 2024, involving 831 young adults aged 18-39 residing in GCC countries. The main outcome measures were HPV vaccination and Pap test uptake rates, awareness of the HPV vaccine and Pap testing, and barriers to vaccination. Data were collected using online platforms. The Chi-square test and Fisher\'s exact test were used for data analysis.
RESULTS: The UAE had the highest vaccination rate at 18.9% (50/264), followed by Qatar at 5.8% (6/104), and KSA at 4.6% (10/216), p < 0.001. Individuals with health insurance had higher vaccination rates than those without (11% vs. 5.4%, p = 0.006). Awareness of the HPV vaccine was highest in the UAE (49.6%) and KSA (58.8%), while awareness of Pap smear testing among females was similarly high in these countries (62.4% and 65.9%, respectively). However, actual Pap smear testing rates were highest in Bahrain (15.9%) and Qatar (13.4%). The main barriers to vaccination cited by participants were lack of knowledge (53.6%) and the absence of medical recommendations (13.2%).
CONCLUSIONS: The study\'s findings suggest the need of targeted educational campaigns to increase HPV vaccine uptake among both genders and Pap test participation among females. Additionally, incorporating HPV screening and vaccination into routine national programs in GCC countries and emphasising the crucial role of healthcare providers in influencing vaccination decisions are recommended strategies.

BACKGROUND: Pregnant women, fetuses, and neonates are particularly vulnerable to vaccine-preventable diseases (VPDs). These VPDs are associated with high morbidity and mortality among expectant mothers and their fetuses and neonates. Vaccination during pregnancy can protect the expectant mother from VPDs to which she may be especially vulnerable while pregnant. In addition, the passive transfer of maternal neutralizing immunoglobulin G (IgG) and secretory immunoglobulin A (IgA) also protects the fetus against congenital infections and may further protect the neonate from infection during the first few months of life. Despite this, coverage of recommended maternal vaccines remains suboptimal globally, especially in resource-constrained settings. Determinants of vaccine acceptance and uptake are frequently understudied in low- and middle-income countries (LMICs) and among specific groups such as pregnant and postpartum women. This proposed systematic review will assess the acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in LMICs.
METHODS: A Boolean search strategy employing common and medical subject heading (MeSH) terms for tetanus, influenza, pertussis, and COVID-19 vaccines, as well as vaccine acceptance, hesitancy, together with uptake, pregnancy, and postpartum, will be used to search electronic databases for relevant literature published between 2009 and 2024. Only studies conducted in LMICs that investigated determinants of acceptance, hesitancy, and uptake of tetanus, influenza, pertussis, and COVID-19 vaccines among pregnant and postpartum women will be eligible for inclusion in the review. The quality and the risk of bias of all eligible full-text articles will be assessed using the Joanna Briggs Institute\'s (JBI) critical appraisal tools.
CONCLUSIONS: This protocol proposes a systematic review and meta-analysis that aims to assess the uptake of maternal vaccines and to systematically appraise and quantify determinants of the acceptance and uptake of recommended vaccines during pregnancy and postpartum in LMICs. A better understanding of these factors and how they influence maternal vaccine decision-making will enable public health practitioners as well as global and national policymakers to design more effective interventions as we look towards expanding the scope and reach of maternal immunization programs.

BACKGROUND: Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination.
METHODS: Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted.
RESULTS: Findings indicate participants\' lack of confidence in the COVID-19 vaccine\'s efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial.
CONCLUSIONS: There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.

BACKGROUND: The demand for COVID-19 vaccines has diminished as the pandemic lingers. Understanding vaccine hesitancy among essential workers is important in reducing the impact of future pandemics by providing effective immunization programs delivered expeditiously.
METHODS: Two surveys exploring COVID-19 vaccine acceptance in 2021 and 2022 were conducted in cohorts of health care providers (HCP) and education workers participating in prospective studies of COVID-19 illnesses and vaccine uptake. Demographic factors and opinions about vaccines (monovalent and bivalent) and public health measures were collected in these self-reported surveys. Modified multivariable Poisson regression was used to determine factors associated with hesitancy.
RESULTS: In 2021, 3 % of 2061 HCP and 6 % of 3417 education workers reported hesitancy (p < 0.001). In December 2022, 21 % of 868 HCP and 24 % of 1457 education workers reported being hesitant to receive a bivalent vaccine (p = 0.09). Hesitance to be vaccinated with the monovalent vaccines was associated with earlier date of survey completion, later receipt of first COVID-19 vaccine dose, no influenza vaccination, and less worry about becoming ill with COVID-19. Factors associated with hesitance to be vaccinated with a bivalent vaccine that were common to both cohorts were receipt of two or fewer previous COVID-19 doses and lower certainty that the vaccines were safe and effective.
CONCLUSIONS: Education workers were somewhat more likely than HCP to report being hesitant to receive COVID-19 vaccines but reasons for hesitancy were similar. Hesitancy was associated with non-receipt of previous vaccines (i.e., previous behaviour), less concern about being infected with SARS-CoV-2, and concerns about the safety and effectiveness of vaccines for both cohorts. Maintaining inter-pandemic trust in vaccines, ensuring rapid data generation during pandemics regarding vaccine safety and effectiveness, and effective and transparent communication about these data are all needed to support pandemic vaccination programs.

Routine childhood vaccination is a crucial component of public health in Canada and worldwide. To facilitate catch-up from the global decline in routine vaccination caused by the COVID-19 pandemic, and toward the ongoing pursuit of coverage goals, vaccination programs must understand barriers to vaccine access imposed or exacerbated by the pandemic. We conducted a regionally representative online survey in January 2023 including 2036 Canadian parents with children under the age of 18. We used the COM-B model of behaviour to examine factors influencing vaccination timeliness during the pandemic. We assessed Capability with measures of vaccine understanding and decision difficulty, and Motivation with a measure of vaccine confidence. Opportunity was assessed through parents\' self-reported experience with barriers to vaccination. Twenty-four percent of surveyed parents reported having missed or delayed one of their children\'s scheduled routine vaccinations since the beginning of the pandemic, though most parents reported having either caught up or the intention to catch up soon. In the absence of opportunity barriers, motivation was associated with timely vaccination for children aged 0-4 years (aOR = 1.81, 95 % CI: 1.14-2.84). However, experience with one or more opportunity barriers, particularly clinic closures and difficulties getting an appointment, eliminated this relationship, suggesting perennial and new pandemic-associated barriers are a critical challenge to vaccine coverage goals in Canada.

BACKGROUND: COVID-19 vaccine uptake is cardinal in the control of COVID-19 pandemic. COVID-19 vaccine uptake is hindered by misinformation, conspiracy theory, and religious beliefs globally. This has posed a threat in curbing the spread of this highly infectious virus. Hence, knowledge of COVID-19 vaccine uptake predictors would help mitigate the burden of COVID-19 disease.
OBJECTIVE: To determine the predictors of COVID-19 vaccine uptake at the Federal Medical Centre, Makurdi.
METHODS: The study was a descriptive crosssectional study over 3 months from January to March 2022. The sample size was 384 at 50% prevalence. A self-administered questionnaire was employed using convenience sampling. Data analysis was done using SPSS version 23. The level of statistical significance was set at p<0.05.
RESULTS: The mean age of the participants was 39.97±5.56. The majority were aged 21-40 (52.9%, n=203). There were more males (57.6%, n=221). The proportion of COVID-19 uptake was 21.6%. There was a statistically significant relationship between taking the COVID-19 vaccine and age, marital status, education, occupation, job discipline, monthly income, type of family, place of residence, childhood vaccination, immunization as an adult, and family members/close contact with COVID-19. In addition, COVID-19 vaccine uptake was also significantly associated with the belief that the COVID-19 vaccine has not been thoroughly tested, that they could rely on the vaccine to stop severe disease and that pharmaceutical companies use COVID-19 to make money. The predictors of COVID-19 vaccine uptake were marital status (p-value= 0.001, aoR=0.286, 95% CI= 0.146-0.563), family type (p-value= 0.001, AoR=6.346, 95% CI= 2.700-14.912), those residing in an urban area (p-value= 0.024, AoR= 3.130, 95% CI= 1.164-8.416) and those who believe COVID 19 vaccine could stop the severe form of the disease (p-value= 0.001, AoR= 2.448, 95% CI= 1.560-3.841).
CONCLUSIONS: The COVID-19 vaccine uptake rate was low. The predictors of COVID-19 vaccine uptake were married respondents in a nuclear setting, residing in urban areas and believing that COVID 19 vaccine could stop the severe form of the disease.
BACKGROUND: L\'adoption du vaccin COVID-19 est essentielle pour contrôler la pandémie de COVID-19. L\'adoption du vaccin COVID-19 est entravée par la désinformation, les théories du complot et les croyances religieuses dans le monde entier. Cela constitue une menace pour endiguer la propagation de ce virus hautement infectieux. Par conséquent, la connaissance des prédicteurs de l\'adoption du vaccin COVID-19 aiderait à réduire le fardeau de la maladie COVID-19.
OBJECTIVE: Déterminer les prédicteurs de l\'adoption du vaccin COVID-19 au Centre Médical Fédéral de Makurdi.
UNASSIGNED: L\'étude était une étude descriptive transversale sur une période de 3 mois, réalisée de janvier à mars 2022. La taille de l\'échantillon était de 384 avec une prévalence de 50 %. Un questionnaire auto-administré a été utilisé en utilisant un échantillonnage de commodité. L\'analyse des données a été effectuée à l\'aide de SPSS version 23. Le niveau de signification statistique a été fixé à p<0.05.
UNASSIGNED: L\'âge moyen des participants était de 39,97±5,56 ans. La majorité avait entre 21 et 40 ans (52,9 %, n=203). Il y avait plus d\'hommes (57,6 %, n=221). La proportion d\'adoption du vaccin COVID-19 était de 21,6%. Il existait une relation statistiquement significative entre la prise du vaccin COVID-19 et l\'âge, l\'état matrimonial, le niveau d\'éducation, l\'occupation, la discipline professionnelle, le revenu mensuel, le type de famille, le lieu de résidence, la vaccination infantile, la vaccination à l\'âge adulte, les membres de la famille ou les contacts proches ayant contracté le COVID-19. De plus, l\'adoption du vaccin COVID-19 était également significativement associée à la croyance que le vaccin COVID-19 n\'a pas été suffisamment testé, qu\'ils pouvaient compter sur le vaccin pour éviter une forme grave de la maladie et que les compagnies pharmaceutiques utilisaient le COVID-19 pour gagner de l\'argent. Les prédicteurs de l\'adoption du vaccin COVID-19 étaient l\'état matrimonial (p-value=0,001, aoR=0,286, IC à 95 %=0,146-0,563), le type de famille (p-value=0,001, AoR=6,346, IC à 95 %=2,700-14,912), ceux résidant en zones urbaines (p-value=0,024, AoR=3,130, IC à 95 %=1,164-8,416) et ceux croyant que le vaccin COVID-19 pouvait éviter les formes graves de la maladie (p-value=0,001, AoR=2,448, IC à 95 %=1,560-3,841).
CONCLUSIONS: Le taux d\'adoption du vaccin COVID-19 était faible. Les prédicteurs de l\'adoption du vaccin COVID-19 étaient les répondants mariés vivant dans un cadre nucléaire, résidant en zones urbaines et croyant que le vaccin COVID-19 pouvait éviter les formes graves de la maladie.
UNASSIGNED: COVID-19, Prédicteurs, Hôpital tertiaire, Adoption du vaccin.

Influenza immunization includes a yearly repeated vaccine offered to every healthcare worker, including nursing students, with a high risk of contracting this viral disease. This study aimed to investigate the vaccination coverage, knowledge, attitudes, and practices of nursing students against influenza in Greece. A cross-sectional study was conducted in the Attica region between September 2022 and July 2023, with the use of an anonymous reference questionnaire. Data from 1261 nursing students were recorded (response rate: 68.6%). The study found that 23% of the sample were vaccinated against influenza for the flu season 2022-2023, and 42% were vaccinated for the previous flu season. Knowledge scores regarding influenza ranged from 0% to 100%, with a mean value of 55 (SD = 18.8%). A higher level of knowledge about influenza was associated with more appropriate attitudes and practices toward the disease (p < 0.001). Notably, participants in their second, third, or fourth year of study and beyond exhibited more suitable attitudes and practices towards the flu compared to those in their first year of study (p < 0.05). The emergence of low vaccination coverage identifies the need for departments of nursing studies to proceed with the design of educational and intervention programs on infection control.

The 2022 global outbreak of Mpox (formerly named Monkeypox) disproportionately impacted lesbian, gay, bisexual, transgender, and queer (LGBTQ+) populations, with a significant impact on sexual minority men. A cross-sectional survey was conducted among LGBTQ + adults living in New Jersey and New York to examine vaccination behaviors for Mpox. We sought out to understand the health experiences and behaviors of the population during the initial outbreak. This analysis included a subset of participants (n = 253) who completed the survey after the onset of the Mpox outbreak in May 2022. We examined awareness of and concerns about Mpox, willingness to vaccinate, as well as vaccination access and vaccination uptake. Our findings indicate that white, cisgender, gay men, as well as employed individuals, had the highest rates of vaccination for Mpox. Those with higher levels of concern about the virus were both more likely to be vaccinated and to report difficulty securing an appointment. Overall, our findings reinforce the health disparities in the population, demonstrating as with many other health conditions that white and economically stable individuals have advantages in accessing care.

OBJECTIVE: Childhood vaccine uptake in the United Kingdom (UK) is sub-optimal leading to outbreaks of preventable diseases. We aimed to explore UK parents\' perspectives on why some children are unvaccinated or vaccinated late.
METHODS: We undertook a mixed-methods, co-production study involving a survey using a questionnaire followed by focus groups. We partnered with The Mosaic Community Trust (Mosaic) who are based in a more deprived, ethnically diverse, low vaccine uptake area of London. Targeted recruitment to complete the questionnaire (either on paper or online) was done through Mosaic, community networks and social media promotion. We collected demographic data alongside parents\' views on routine childhood vaccination, their vaccine decisions, and experiences of accessing childhood vaccine appointments We report descriptive findings from the questionnaire and thematic analysis of free-text questionnaire answers and focus groups guided by the COM-B model of Capability, Opportunity, and Motivation.
RESULTS: Between June-October 2022, 518 parents were surveyed of whom 25% (n = 130), were from ethnic minorities (13%, n = 68-unknown ethnicity). In 2023 we held four focus groups with 22 parents (10 from ethnic minorities). Only 15% (n = 78) parents had delayed or refused a vaccine for their child. A quarter of parents felt they had not been given enough information nor an opportunity to ask questions before their children\'s vaccinations. Inconsistent reminders and difficulties booking or attending appointments impacted vaccine uptake with negative experiences influencing future vaccine decisions. Parents had mixed views on vaccinations being given in different locations and wanted trusted health professionals to vaccinate their children.
CONCLUSIONS: To reverse declining vaccine uptake and prevent future outbreaks it needs to be easier for UK parents to speak to health professionals to answer their childhood vaccine questions, alongside simplified booking systems and easier access to routine childhood vaccine appointments.

BACKGROUND: The Coronavirus disease-2019 (COVID-19) vaccines were rolled out in many countries; however, sub-optimal COVID-19 vaccine uptake remains a major public health concern globally. This study aimed at assessing the factors that affected the uptake, hesitancy, and resistance of the COVID-19 vaccine among university undergraduate students in Malawi, a least developed country in Africa.
METHODS: A descriptive cross-sectional study design was conducted using an online semi-structured questionnaire. A total of 343 University undergraduate students in Blantyre participated in this study after obtaining ethical clearance. Data was exported from Survey Monkey to Microsoft Excel version-21 for cleaning and was analysed using SPSS version-29. Descriptive statistics, including percentages, were performed to define the sample characteristics. Pearson Chi-square and Fisher\'s exact test were performed to identify significant relationships between vaccine uptake and demographics. A 95% confidence interval was set, and a p-value of < 0.05 was considered statistically significant.
RESULTS: Of the 343 participants, 43% were vaccinated. Among the vaccinated, the majority (47.3%, n = 69/146) received Johnson & Johnson vaccine followed by AstraZeneca (46.6%, n = 68/146). The commonly reported reason for vaccine acceptance was \'to protect me against getting COVID-19\' (49%); whereas vaccine hesitancy was attributed to \'lack of knowledge (34%), and concerns about vaccine safety (25%).
CONCLUSIONS: This study found that adequate knowledge about benefits and safety of COVID-19 vaccine could potentially increase uptake. Lack of credible information or misinformation contributed to vaccine hesitancy. The findings provide insights for design of strategies to increase future vaccine uptake and reduce determinants of vaccine hesitancy. To reduce vaccination hesitancy in any population with or without higher education, we recommend that institutions entrusted with vaccine management must optimise health messaging, and reduce mis-information and dis-information.