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Article ; Online: How do mothers’ vaccine attitudes change over time?

Devon Greyson / Julie A. Bettinger

SSM: Qualitative Research in Health, Vol 2, Iss , Pp 100060- (2022)

2022

Abstract: Although many interventions aim to reduce parents' hesitancy about childhood vaccinations, parents' experiences of vaccine attitude change trajectories remain underexplored. This constructivist grounded theory study examines trajectories of change in ... ...

Abstract	Although many interventions aim to reduce parents' hesitancy about childhood vaccinations, parents' experiences of vaccine attitude change trajectories remain underexplored. This constructivist grounded theory study examines trajectories of change in vaccine confidence and uptake among mothers in the Greater Vancouver region of Canada. Specifically, we explored what mothers identified as causes and facilitators to these changes, the processes involved, and how they experienced these changes in the contexts of their parenting lives. The study population comprised 23 mothers (mean age 41.3 years), each with at least one child aged 6–12 years. Nine (39%) had become more confident in vaccines, 10 (43%) more hesitant, and four (17%) experienced multiple changes over time. Trajectories of growing vaccine confidence were portrayed by participants as cognitive journeys, moving toward facts and away from fear, and influenced by a participant's growing knowledge and experience. Trajectories of increased hesitancy about vaccination involved underlying concerns about vaccines that were augmented by negative peer attitudes or negative personal experiences with vaccination or health care. In both trajectories, a mother's growing confidence as a parent was perceived as empowering her to make decisions over time. Mothers with multiple changes in vaccine attitudes either had hesitations about specific vaccines, which were allayed over time, or experienced negative vaccine reactions that caused them to pause, then later resume, vaccination.
Keywords	Vaccination ; Vaccine hesitancy ; Vaccine confidence ; Vaccine attitudes ; Mothers ; Attitude change ; Public aspects of medicine ; RA1-1270
Subject code	300
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Proof-of-vaccination credentials for COVID-19 and considerations for future use of digital proof-of-immunization technologies

Devon Greyson / Wendy Pringle / Kumanan Wilson / Julie A. Bettinger

Digital Health, Vol

Results of an expert consultation

2023 Volume 9

Abstract: Objective As part of COVID-19 pandemic control efforts, digital proof-of-vaccination credentials were launched in Canada in 2021–2022 following widespread vaccine availability. Given the controversy over proof-of-vaccination credentials—often ... ...

Abstract	Objective As part of COVID-19 pandemic control efforts, digital proof-of-vaccination credentials were launched in Canada in 2021–2022 following widespread vaccine availability. Given the controversy over proof-of-vaccination credentials—often colloquially called vaccine or immunization “passports”—it is imperative to document successes, shortcomings, and recommendations for any future uses. Methods This expert consultation applied inductive qualitative content analysis to online video interviews with key informants whose expertise ranged from ethics to public health to computer science to identify what we can learn from this experience with proof-of-vaccination credentials, and what decision-makers must keep in mind for possible future use of such technologies. Results There remains a lack of consensus regarding appropriate language and scope for digital proof-of-vaccination technologies, the respective roles of the technology sector versus government in design and implementation, and parameters for future use. However, experts agree on many recommendations, including the importance of clear communication, evidence-based rationale for the use of proof-of-vaccination credentials, multidisciplinary consultation including academic experts and the public, and the importance of pan-Canadian standards for accessibility and interoperability. Identified risks of use that emerged, and should be minimized in the future, include risks of coercion and backlash; threats to access, equity and privacy; and impacts such as costs of the technology and workload burden of enforcement and fraud detection. Conclusions There is much to learn from this first major use of digital proof-of-vaccination credentials. A full scientific review of the impacts on health and equity should be combined with expert recommendations to create pan-Canadian guidelines for the future use of digital proof-of-vaccination solutions.
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	303
Language	English
Publishing date	2023-09-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: New mothers’ key questions about child vaccinations from pregnancy through toddlerhood

Marian Orhierhor / Clara Rubincam / Devon Greyson / Julie A. Bettinger

SSM: Qualitative Research in Health, Vol 3, Iss , Pp 100229- (2023)

Evidence from a qualitative longitudinal study in Victoria, British, Columbia

2023

Abstract: Canada's infant vaccination rate is suboptimal. British Columbia (BC) is below the targeted national coverage for infant vaccines, and vaccine hesitancy is a contributing factor in BC's low coverage rates. The literature suggests that many mothers are ... ...

Abstract	Canada's infant vaccination rate is suboptimal. British Columbia (BC) is below the targeted national coverage for infant vaccines, and vaccine hesitancy is a contributing factor in BC's low coverage rates. The literature suggests that many mothers are primary vaccine decision-makers and begin this decision process during pregnancy. This project examined mothers' vaccine concerns, vaccine information needs and preferences, and mother's trusted information sources regarding vaccines during early childhood.Using a qualitative, longitudinal design, interviews were conducted with women in four phases: during the third trimester of pregnancy, when the infant was 3–4 months, 9–12 months, and 15–18 months of age. Data analysis was thematic and both deductive and inductive coding techniques were utilized.Although most mothers in this study followed the BC infant vaccination schedule, many could be regarded as cautious acceptors. We identified five major themes. Three themes describe the questions mothers had about infant vaccination: 1) the vaccination schedule, 2) basic facts about vaccines, and 3) risks and benefits. Two themes described mothers’ information sources and preferences: 1) information sources, and 2) vaccine information delivery. Mothers indicated they wanted their concerns to be addressed in a safe, non-judgmental environment by health care providers.The questions and concerns identified by mothers in this study suggest that many mothers have unasked and unanswered questions about infant vaccines. Because health care providers are the favored source of vaccine information for pregnant people and new parents, they should receive continuous education on vaccines to raise their competency in addressing parental concerns.
Keywords	Vaccine hesitancy ; Childhood immunization ; Parental concern ; Health education ; Health promotion ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What do adolescents think about vaccines? Systematic review of qualitative studies.

Hana Mitchell / Rebecca Lim / Prubjot K Gill / Joban Dhanoa / Ève Dubé / Julie A Bettinger

PLOS Global Public Health, Vol 2, Iss 9, p e

2022 Volume 0001109

Abstract: Adolescence presents a key opportunity to build vaccine-related health literacy and promote vaccine confidence and uptake. Although adolescents are central to vaccination programs, their views around vaccines are frequently underrepresented in ... ...

Abstract	Adolescence presents a key opportunity to build vaccine-related health literacy and promote vaccine confidence and uptake. Although adolescents are central to vaccination programs, their views around vaccines are frequently underrepresented in qualitative literature. We reviewed qualitative studies to systematically identify and summarize existing evidence on adolescents' own understanding of vaccines and experiences with vaccine decision-making, including self-consent when applicable. CINAHL; Embase; Ovid Medline; and Psych Info database searches were last updated on May 28, 2022. Data pertaining to general study characteristics, participant demographics, and qualitative content were extracted independently by two reviewers and analyzed using textual narrative synthesis. Out of 3559 individual records, 59 studies were included. The majority of the studies were conducted in high-income countries and 75% focused on human papilloma virus vaccines, with the remaining studies looking at COVID-19, meningococcal, hepatitis B and influenza vaccines or adolescent experiences with vaccines in general. Adolescent self-consent was explored in 7 studies. Perspectives from sexual and gender minorities were lacking across studies. Adolescents often had limited understanding of different vaccines and commonly perceived vaccine information to be directed towards their parents rather than themselves. Many adolescents felt school-based vaccine education and information available through healthcare providers were insufficient to make informed decisions about vaccines. While adolescents described obtaining vaccine information from traditional and online media, face-to-face interactions and opinions from trusted adults remained important. Adolescents generally relied on their parents for vaccine-decision making, even when self-consent was an option. A notable exception to this included marginalized adolescents who could not rely on parents for health-related advice. Qualitative literature about adolescent vaccines would be enriched ...
Keywords	Public aspects of medicine ; RA1-1270
Subject code	370
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Is the pre-natal period a missed opportunity for communicating with parents about immunizations? Evidence from a longitudinal qualitative study in Victoria, British Columbia

Clara Rubincam / Devon Greyson / Constance Haselden / Robin Saunders / Julie A. Bettinger

BMC Public Health, Vol 22, Iss 1, Pp 1-

2022 Volume 10

Abstract: Abstract Background Growing evidence shows that many parents begin the decision-making process about infant vaccination during pregnancy and these decisions – once established – may be resistant to change. Despite this, many interventions targeting ... ...

Abstract	Abstract Background Growing evidence shows that many parents begin the decision-making process about infant vaccination during pregnancy and these decisions – once established – may be resistant to change. Despite this, many interventions targeting vaccination are focused on communicating with parents after their baby is born. This suggests that the prenatal period may constitute a missed opportunity for communicating with expectant parents about infant vaccination. Methods Using a longitudinal qualitative design, we conducted two interviews (prepartum and postpartum) with women (n = 19) to explore the optimal timing of vaccination information. The data were analyzed thematically, and examined across all sets of pre- and post-partum interviews as well as within each individual participant to draw out salient themes. Results Most participants formed their intentions to vaccinate before the baby was born and indicated that they would welcome information about vaccination from their maternity care providers. However, few individuals recalled their maternity care providers initiating vaccination-related conversations with them. Conclusion The prenatal period is an important time to begin conversations with expectant parents about vaccinating their infants, particularly if these conversations are initiated by trusted maternity care providers. More information is needed on how maternity care providers can be better supported to have these conversations with their patients.
Keywords	Vaccine ; Vaccination ; Parent ; Decision-making ; Interviews ; Health care provider ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: “If I'm a naturopath, It's because I trust nature above everything else”

Benjamin Malo / Samantha B. Meyer / Eric Filice / Janice E. Graham / Noni E. MacDonald / Julie A. Bettinger / Devon Greyson / Shannon E. MacDonald / S. Michelle Driedger / Gregory Kawchuk / Fabienne Labbé / Eve Dubé

SSM: Qualitative Research in Health, Vol 3, Iss , Pp 100203- (2023)

Canadian naturopaths' construction of vaccination as a risk object

2023

Abstract: Canadians and Quebecers increasingly consult complementary and alternative medicine (CAM) practitioners in parallel with biomedical providers. The close relationship between vaccine hesitancy and CAM use remains under explored in Western countries. We ... ...

Abstract	Canadians and Quebecers increasingly consult complementary and alternative medicine (CAM) practitioners in parallel with biomedical providers. The close relationship between vaccine hesitancy and CAM use remains under explored in Western countries. We present the results of a qualitative study conducted among one of Quebec's most used CAM approaches: naturopathy. Using Boholm and Corvellec's relational theory of risk to illustrate naturopaths' construction of vaccination as an “object of risk”, we describe how the health representations of 30 Quebec naturopath interviewees are associated with the ways they perceived the risks of infectious diseases and vaccination. Our findings illustrate how Quebec naturopaths' view the body as “at risk” from the possible harmful effects of vaccines. For these naturopaths, the body is a site, a “terrain”, where homeostasis must continually be preserved, and needs to be protected from risks such as vaccines—which were seen as far riskier than infectious diseases—through natural means. Such views are often perceived as unscientific or even irrational by public health researchers. Our study highlights that naturopaths' attitudes towards vaccination are perfectly aligned with the epistemological tenets of their risk representations and conceptions of health.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	300
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Canadian National Vaccine Safety Network

Gaston De Serres / Manish Sadarangani / Karina A Top / James D Kellner / Allison McGeer / Louis Valiquette / Julie A Bettinger / Otto G Vanderkooi / Matthew P Muller / Jennifer E Isenor / Kimberly Marty

BMJ Open, Vol 12, Iss

surveillance of adverse events following immunisation among individuals immunised with the COVID-19 vaccine, a cohort study in Canada

2022 Volume 1

Keywords	Medicine ; R
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID-19 Vaccine Intentions and Perceptions Among Public School Staff of the Greater Vancouver Metropolitan Area, British Columbia, Canada

Allison W. Watts / Sarah M. Hutchison / Julie A. Bettinger / Anne Gadermann / Eva Oberle / Tim F. Oberlander / David M. Goldfarb / Pascal M. Lavoie / Louise C. Mâsse

Frontiers in Public Health, Vol

2022 Volume 10

Abstract: BackgroundThe purpose of this study was to explore factors associated with COVID-19 vaccine intentions among school staff as high vaccine uptake is essential to ensure schools return to normal activities.MethodsStaff (e.g., teachers, administrators, ... ...

Abstract	BackgroundThe purpose of this study was to explore factors associated with COVID-19 vaccine intentions among school staff as high vaccine uptake is essential to ensure schools return to normal activities.MethodsStaff (e.g., teachers, administrators, student support workers) from three urban school districts in the Greater Vancouver Area of British Columbia, Canada completed a survey between February and June 2021 (n = 2,393) on COVID-19 vaccine intentions and perceptions (i.e., acceptance of routine vaccines, benefits and risks of vaccination, susceptibility to, and severity of COVID-19, recommendation by authority figures, information mistrust and conspiracy beliefs) as part of a COVID-19 seroprevalence study. Confirmatory factor analysis followed by multiple logistic regression models adjusting for relevant covariates were used to identify vaccine perceptions uniquely associated with (a) intention to get the COVID-19 vaccine (intention), and (b) intention to get vaccinated right away (urgency).ResultsIn total, 95.4% of participants of the seroprevalence study completed the vaccine questionnaire, corresponding to 17.7% of the target population. Vaccine intention was associated with staff who valued expert recommendations (AOR = 10.5, 95% CI = 7.39–14.90) accepted routine vaccines (AOR = 1.94, 95% CI = 1.26–2.98) and perceived higher benefits (AOR = 1.29, 95% CI = 1.01–1.65) and lower safety risks of vaccination (AOR = 0.40, 95% CI = 0.29–0.54). Comparable associations were found with vaccine urgency. Perceived susceptibility to the COVID-19 virus was uniquely associated with vaccine urgency (AOR = 1.30, 95% CI = 1.05–1.61). A significant interaction effect (p = 0.01) revealed that staff who expressed mistrust in COVID-19 information intended to get vaccinated only if they also perceived high benefits of vaccination.ConclusionsEducation about the risks and benefits of COVID-19 vaccines from a trusted source had the strongest relationship with vaccine intentions among this occupational group. Notably, those who ...
Keywords	COVID-19 ; vaccine hesitancy ; teachers ; schools ; vaccine intention ; Public aspects of medicine ; RA1-1270
Subject code	370
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Systematic review searches must be systematic, comprehensive, and transparent

Devon Greyson / Ellen Rafferty / Linda Slater / Noni MacDonald / Julie A. Bettinger / Ève Dubé / Shannon E. MacDonald

BMC Public Health, Vol 19, Iss 1, Pp 1-

a critique of Perman et al

2019 Volume 6

Abstract: Abstract A high quality systematic review search has three core attributes; it is systematic, comprehensive, and transparent. The current over-emphasis on the primacy of systematic reviews over other forms of literature review in health research, however, ...

Abstract	Abstract A high quality systematic review search has three core attributes; it is systematic, comprehensive, and transparent. The current over-emphasis on the primacy of systematic reviews over other forms of literature review in health research, however, runs the risk of encouraging publication of reviews whose searches do not meet these three criteria under the guise of being systematic reviews. This correspondence comes in response to Perman S, Turner S, Ramsay AIG, Baim-Lance A, Utley M, Fulop NJ. School-based vaccination programmes: a systematic review of the evidence on organization and delivery in high income countries. 2017; BMC Public Health 17:252, which we assert did not meet these three important quality criteria for systematic reviews, thereby leading to potentially unreliable conclusions. Our aims herein are to emphasize the importance of maintaining a high degree of rigour in the conduct and publication of systematic reviews that may be used by clinicians and policy-makers to guide or alter practice or policy, and to highlight and discuss key evidence omitted in the published review in order to contextualize the findings for readers. By consulting a research librarian, we identified limitations in the search terms, the number and type of databases, and the screening methods used by Perman et al. Using a revised Ovid MEDLINE search strategy, we identified an additional 1016 records in that source alone, and highlighted relevant literature on the organization and delivery of school-based immunization program that was omitted as a result. We argue that a number of the literature gaps noted by Perman et al. may well be addressed by existing literature found through a more systematic and comprehensive search and screening strategy. We commend both the journal and the authors, however, for their transparency in supplying information about the search strategy and providing open access to peer reviewer and editor’s comments, which enabled us to understand the reasons for the limitations of that review.
Keywords	Systematic review ; Narrative review ; Search methodology ; School ; Vaccination ; Immunization ; Public aspects of medicine ; RA1-1270
Subject code	302 ; 306
Language	English
Publishing date	2019-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Vaccination discourses among chiropractors, naturopaths and homeopaths

Eric Filice / Eve Dubé / Janice E Graham / Noni E MacDonald / Julie A Bettinger / Devon Greyson / Shannon MacDonald / S Michelle Driedger / Greg Kawchuk / Samantha B Meyer

PLoS ONE, Vol 15, Iss 8, p e

A qualitative content analysis of academic literature and Canadian organizational webpages.

2020 Volume 0236691

Abstract: Vaccine hesitancy-the reluctance to receive recommended vaccination because of concerns and doubts about vaccines-is recognized as a significant threat to the success of vaccination programs and has been associated with recent major outbreaks of vaccine- ... ...

Abstract	Vaccine hesitancy-the reluctance to receive recommended vaccination because of concerns and doubts about vaccines-is recognized as a significant threat to the success of vaccination programs and has been associated with recent major outbreaks of vaccine-preventable diseases. Moreover, the association between complementary and alternative medicine (CAM) use and vaccine hesitancy and/or refusal has been frequently reported in the literature. To date, significant gaps persist in our understanding of contemporary Canadian CAM providers' beliefs regarding vaccination and how socio-professional influences may shape their vaccine-related attitudes and behaviours. To address the latter gap, the current study aims to explore the content of professional guidelines, recommendations and other discourses among CAM providers as they concern vaccination by analyzing both academic, peer-reviewed literature and Canadian organizational webpages prepared by and/or for practicing chiropractors, naturopaths and homeopaths. In the academic literature, we identified a number of complex and diverging views on vaccination that spanned topics of effectiveness; safety; theoretical, empirical, and ethical soundness; political justifiability; and compatibility with CAM philosophy and professional boundaries. However, in its current state the CAM literature cannot be described in broad strokes as being either pro- or anti-vaccination without considering finer areas of disagreement. Compared to the academic literature, which focuses more on the conceptual and evidentiary basis of vaccination, a greater proportion of vaccine-related content on Canadian CAM organizations' webpages seems to be dedicated to offering specific directives and prescriptions to providers. Guidelines and standards of practice address a number of issues, including vaccine administration, counsel, education and marketing. As CAM organizations further evolve in Canada and elsewhere as part of a broader "professionalization" initiative, greater attention will need to be ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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