6 results found
de Figueiredo A, Simas C, Karafillakis E, et al., 2020, Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study, The Lancet, Vol: 396, Pages: 898-908, ISSN: 0140-6736
BackgroundThere is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019.MethodsIn this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty.FindingsBetween November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between i
Larson H, Hartigan-Go K, de Figueiredo A, 2018, Vaccine confidence plummets in the Philippines following dengue vaccine scare: why it matters to pandemic preparedness.", Human Vaccines & Immunotherapeutics
Larson HJ, de Figueiredo A, Xiahong Z, et al., 2016, The state of vaccine confidence 2016: global insights through a 67-country survey, EBioMedicine, Vol: 12, Pages: 295-301, ISSN: 2352-3964
BackgroundPublic trust in immunization is an increasingly important global health issue. Losses in confidence in vaccines and immunization programmes can lead to vaccine reluctance and refusal, risking disease outbreaks and challenging immunization goals in high- and low-income settings. National and international immunization stakeholders have called for better monitoring of vaccine confidence to identify emerging concerns before they evolve into vaccine confidence crises.MethodsWe perform a large-scale, data-driven study on worldwide attitudes to immunizations. This survey – which we believe represents the largest survey on confidence in immunization to date – examines perceptions of vaccine importance, safety, effectiveness, and religious compatibility among 65,819 individuals across 67 countries. Hierarchical models are employed to probe relationships between individual- and country-level socio-economic factors and vaccine attitudes obtained through the four-question, Likert-scale survey.FindingsOverall sentiment towards vaccinations is positive across all 67 countries, however there is wide variability between countries and across world regions. Vaccine-safety related sentiment is particularly negative in the European region, which has seven of the ten least confident countries, with 41% of respondents in France and 36% of respondents in Bosnia & Herzegovina reporting that they disagree that vaccines are safe (compared to a global average of 13%). The oldest age group (65 +) and Roman Catholics (amongst all faiths surveyed) are associated with positive views on vaccine sentiment, while the Western Pacific region reported the highest level of religious incompatibility with vaccines. Countries with high levels of schooling and good access to health services are associated with lower rates of positive sentiment, pointing to an emerging inverse relationship between vaccine sentiments and socio-economic status.ConclusionsRegular monitoring of vaccine
de Figueiredo A, Johnston IG, Smith DM, et al., 2016, Forecasted trends in vaccination coverage and correlations with socioeconomic factors: a global time-series analysis over 30 years., Lancet Global Health, Vol: 4, Pages: e726-e735, ISSN: 2214-109X
BACKGROUND: Incomplete immunisation coverage causes preventable illness and death in both developing and developed countries. Identification of factors that might modulate coverage could inform effective immunisation programmes and policies. We constructed a performance indicator that could quantitatively approximate measures of the susceptibility of immunisation programmes to coverage losses, with an aim to identify correlations between trends in vaccine coverage and socioeconomic factors. METHODS: We undertook a data-driven time-series analysis to examine trends in coverage of diphtheria, tetanus, and pertussis (DTP) vaccination across 190 countries over the past 30 years. We grouped countries into six world regions according to WHO classifications. We used Gaussian process regression to forecast future coverage rates and provide a vaccine performance index: a summary measure of the strength of immunisation coverage in a country. FINDINGS: Overall vaccine coverage increased in all six world regions between 1980 and 2010, with variation in volatility and trends. Our vaccine performance index identified that 53 countries had more than a 50% chance of missing the Global Vaccine Action Plan (GVAP) target of 90% worldwide coverage with three doses of DTP (DTP3) by 2015. These countries were mostly in sub-Saharan Africa and south Asia, but Austria and Ukraine also featured. Factors associated with DTP3 immunisation coverage varied by world region: personal income (Spearman's ρ=0·66, p=0·0011) and government health spending (0·66, p<0·0001) were informative of immunisation coverage in the Eastern Mediterranean between 1980 and 2010, whereas primary school completion was informative of coverage in Africa (0·56, p<0·0001) over the same period. The proportion of births attended by skilled health staff correlated significantly with immunisation coverage across many world regions. INTERPRETATION: Our vaccine performance inde
de Figueiredo A, Johnston IG, Smith DMD, et al., 2016, Forecasting time-series trends in vaccination coverage and their links with socio-economic factors: A global analysis over 30 years, Lancet Global Health, ISSN: 2214-109X
Background Incomplete immunisation coverage causes preventable illness and death in both the developing anddeveloped world. Identifying factors that may modulate coverage can inform effective immunisation programmes andpolicies.Methods We perform a data-driven analysis of unprecedented scale, examining time-varying trends in Diphtheriatetanus-pertussiscoverage across 190 countries over the past three decades. Gaussian process regression is employedto forecast future coverage rates and provide a Vaccine Performance Index: a summary measure of the strength ofimmunisation coverage in a country.Findings Overall vaccine coverage has increased in all five world regions between 1980 and 2010, with markedvariation in volatility and trends. Our Vaccine Performance Index identifies 53 countries with a less than 50% chanceof missing the Global Vaccine Action Plan (GVAP) target of 90% worldwide DTP3 coverage by 2015, in agreementwith recent immunisation data. These countries are mostly sub-Saharan and South Asian, but Austria and Ukraine inEurope also feature. Factors associated with DTP3 immunisation coverage vary by world-region: personal income(! = 0.66, ' < 0.001) and government health spending (! = 0.66, ' < 0.01) are particularly informative in theEastern Mediterranean between 1980 and 2010, whilst primary school completion is informative in Africa (! =0.56, ' < 0.001) over the same time. The fraction of births attended by skilled health staff is significantly informativeacross many world regionsInterpretation A Vaccine Performance Index can highlight countries at risk identifying the strength and resilience ofimmunisation programmes. Weakening correlations with socio-economic factors indicate a need to tackle vaccineconfidence whereas strengthening correlations points to clear factors to address.
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