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Background Aceh, the westernmost province in Indonesia, was granted autonomous status, allowing the area to officially practice Sharia law, making the region religiously conservative. The province has the lowest measles vaccination rates in the country, with only 54% coverage. This study aims to quantify the contribution of concerns or structural barriers on non-vaccination. Methods In a 2022 cross-sectional population-based study, 899 parents reported religious vaccine concerns, concerns about side effects, and whether they encountered structural barriers. The degree to which religious concerns impact the first dose of measles-rubella (MR1) and pentavalent (Penta1) vaccination was quantified through population-attributable fractions (PAF). Results Among respondents, 62% reported their child had received MR1 and 63% Penta1. In total, 60% of parents expressed religious concerns about vaccination and 75% about vaccine side effects. The PAF for MR1 non-vaccination was 36% (95% CI: 21%, 52%) for religious concerns and 35% (95% CI: 16%, 51%) for concerns about side effects. For Penta1, the PAF was 42% (95% CI: 24%, 59%) for concerns about side effects and 28% (95% CI: 13%, 44%) for religious concerns. Structural barriers like stockouts, cost, or inconvenient clinic hours were less frequently cited and contributed minimally to non-vaccination. Conclusions While concerns can overlap, evidence suggests that religious concerns are distinct and influence vaccination rates more than structural barriers. Understanding barriers to vaccination is a precursor to developing tailored interventions, like encouraging religious leaders to act as a trusted source of vaccine guidelines or promoting the use of a halal vaccine, that can mitigate hesitancy.

Despite pediatric populations representing a smaller proportion of COVID-19 cases and having a less severe prognosis, those belonging to racial and ethnic minority groups are at an increased risk of developing more severe COVID-19-related outcomes. Vaccine coverage is crucial to pandemic mitigation efforts, yet since the start of the COVID-19 pandemic, vaccine hesitancy has increased and routine pediatric immunizations have decreased. Limited research exists on how vaccine hesitancy may contribute to low pediatric COVID-19 vaccine uptake among racial and ethnic minority populations. This study aimed to characterize COVID-19 vaccine-related discussion and sentiment among Twitter users, particularly among racial and ethnic minority users. We used the Twitter application programming interface to collect tweets and replies. Tweets were selected by filtering for keywords associated with COVID-19 vaccines and pediatric-related terms. From this corpus of tweets, we used the Biterm Topic Model to output topics and examined the top 200 retweeted tweets that were coded for pediatric COVID-19 vaccine relevance. Relevant tweets were analyzed using an inductive coding approach to characterize pediatric COVID-19 vaccine-related themes. Replies to relevant tweets were collected and coded. User metadata were assessed for self-reporting of race or ethnic group affiliation and verified account status. A total of 863,007 tweets were collected from October 2020 to October 2021. After outputting Biterm Topic Model topics and reviewing the 200 most retweeted tweets, 208,666 tweets and 3905 replies were identified as being pediatric COVID-19 vaccine related. The majority (150,262/208,666, 72.01%) of tweets expressed vaccine-related concerns. Among tweets discussing vaccine confidence, user replies expressing agreement were significantly outweighed by those expressing disagreement (1016/3106, 32.71% vs 2090/3106, 67.29%; P<.001). The main themes identified in the Twitter interactions were conversations regarding vaccine-related concerns including adverse side effects, concerns that the vaccine is experimental or needs more testing and should not be tested on pediatric populations, the perception that the vaccine is unnecessary given the perceived low risk of pediatric infection, and conversations associated with vaccine-related confidence (ie, the vaccine is protective). Among signal tweets and replies, we identified 418 users who self-identified as a racial minority individual and 40 who self-identified as an ethnic minority individual. Among the subcodes identified in this study, the vaccine being protective was the most discussed topic by racial and ethnic minority groups (305/444, 68.7%). Vaccine-related concerns can have negative consequences on vaccine uptake and participation in vaccine-related clinical trials. This can impact the uptake and development of safe and effective vaccines, especially among racial and ethnic minority populations.

Human Papillomavirus (HPV) is the most common sexually transmitted infection and is associated with cervical, anogenital, and oropharyngeal cancers. It is crucial to improve vaccination uptake in both genders as primary prevention for these conditions. Pediatricians play an active role in advocating for HPV vaccination and our study aims to assess the level of knowledge, attitudes, barriers, and practices among pediatric trainees and general pediatricians regarding HPV infection and vaccination. A survey‐questionnaire was administered to our target groups. It comprised 14 questions regarding demographics of the healthcare provider, knowledge of HPV infection and vaccination, practices and barriers of recommending HPV vaccination, and effective strategies for improving HPV vaccine uptake. Among survey respondents, majority did not recommend for HPV vaccination (66.7%) or receive any enquiry about it (80.6%) within the preceding 12 months. The most common perceived barrier was inadequate knowledge, which was consistent with the misconceptions regarding HPV infection and vaccination that were identified in this survey. Strategies which physicians felt would be most effective in increasing vaccine uptake include educating and providing resources for both physicians and caregivers as well as making the vaccine free. Our study revealed a low advocacy rate for HPV vaccination. Physicians need to be equipped with the knowledge, skills, and resources to better counsel caregivers as well as focus our efforts on vaccinating male patients in order to increase vaccine uptake in both genders. This study showed the human papillomavirus (HPV) vaccination advocacy trends, perceived barriers, and facilitators for pediatricians to initiate HPV vaccination regime. By identifying the barriers for vaccination, we aim to work toward improving vaccine uptake rates, especially among the young male population to improve herd immunity.

BackgroundThe Hajj pilgrimage poses significant public health challenges due to the risk of infectious disease transmission. Despite mandatory vaccination policies, barriers such as hesitancy, logistical issues, and vaccine availability persist.ObjectiveThis study assesses vaccine uptake, reasons for compliance or non-compliance, and barriers among Hajj pilgrims.MethodsA cross-sectional study was conducted during the 2024 Hajj season, with data collected via structured interviews from 5,355 participants. Descriptive statistics and logistic regression analyzed vaccination status and influencing factors.ResultsOf the participants, 4298 (80.3%) reported receiving mandatory or recommended vaccines, including influenza, COVID-19, and meningococcal. Primary motivators for vaccination were compliance to mandatory requirements 2240 (52.1%) and healthcare provider recommendations 2018 (46.9%). Among non-vaccinated respondents, the main reasons included belief in vaccine ineffectiveness 250(23.7%), reliance on natural immunity 243(23%), and lack of awareness 174(16.5%). Common barriers included long wait times 721(13.5%) and limited access to vaccination centers 543(10.1%). Women and individuals with higher education demonstrated greater vaccine uptake, while logistical barriers were more prevalent among self-employed and less-educated participants.ConclusionDespite high vaccine uptake, barriers remain. Addressing hesitancy, improving access, and aligning vaccine availability with Hajj timing are essential to enhance coverage and reduce disease transmission risks.Clinical Trial NumberNot applicable.

•Provider recommendations greatly influence decisions about vaccine acceptance.•We surveyed providers of high-risk patients about HPV vaccine.•Providers caring for high-risk patients are not routinely offering HPV vaccine.•Knowledge of factors that affect HPV vaccine utilization can guide interventions.•Time limitations and cost are reported as common barriers to offering HPV vaccine. Minority populations in the United States are disproportionally affected by human papillomavirus (HPV) infection and HPV-related cancer. We sought to understand physician practices, knowledge and beliefs that affect utilization of the HPV vaccine in primary care settings serving large minority populations in areas with increased rates of HPV-related cancer. Cross-sectional survey of randomly selected primary care providers, including pediatricians, family practice physicians and internists, serving large minority populations in Brooklyn, N.Y. and in areas with higher than average cervical cancer rates. Of 156 physicians randomly selected, 121 eligible providers responded to the survey; 64% were pediatricians, 19% were internists and 17% were family practitioners. Thirty-four percent of respondents reported that they routinely offered HPV vaccine to their eligible patients. Seventy percent of physicians reported that the lack of preventive care visits for patients in the eligible age group limited their ability to recommend the HPV vaccine and 70% of those who reported this barrier do not routinely recommend HPV vaccine. The lack of time to educate parents about the HPV vaccine and cost of the vaccine to their patients were two commonly reported barriers that affected whether providers offered the vaccine. Our study found that the majority of providers serving the highest risk populations for HPV infection and HPV-related cancers are not routinely recommending the HPV vaccine to their patients. Reasons for providers’ failure to recommend the HPV vaccine routinely are identified and possible areas for targeted interventions to increase HPV vaccination rates are discussed.

Background: Declining vaccination coverage (VC) and vaccine hesitancy among medical students are global challenges. These challenges reflect individual and logistical barriers to a sufficient adherence toward essential vaccines for healthcare professionals, as well as presenting a need for educational strategies during undergraduate training. Methods: This is a prospective study for evaluating VC rates, sociodemographic associations, and the vaccine confidence among medical students at a federal university in Brazil. The data collection included questionnaires and individual analyses of the participants’ vaccination records. Results: A total of 237 medical students from all six years of an undergraduate program participated, of whom 124 (52.3%) had a vaccination record. Although the majority considered the vaccines to be “Completely Safe” (86.9%), the VC rates for complete vaccination schedules were relatively low, ranging from 87.9% (hepatitis B vaccine) to 3.2% (meningococcal B vaccine), including the vaccines from the National Immunization Program (NIP) and the private sector. Higher VC rates were found to occur among students in the final years of their undergraduate studies, in those from families with higher monthly incomes, and those from private secondary schools. Conclusions: Given the low VC rates among medical students, other factors in addition to vaccine confidence may be determinants, thus highlighting the importance of reviewing policies for the inclusion of priority groups in the NIP and in implementing educational interventions during undergraduate training.

Objective: COVID-19 disproportionally affected Hispanic/Latinx populations exacerbating systemic health inequities. The pilot study aimed to explore barriers to COVID-19 vaccination across Hispanic/Latinx communities in Southern California. Methods: Cross-sectional survey of 200 participants to identify common barriers to vaccine hesitancy among Hispanics/Latinx individuals in Southern California utilizing a 14-item survey and questionnaire in English and Spanish. Results: Of the 200 participants that completed questionnaires, 37% identified a knowledge deficit, 8% identified misinformation, and 15% identified additional barriers such as awaiting appointments, immigration status, transportation issues, or religious reasons as barriers to not receiving the COVID-19 vaccine. Wald statistics denoted that household members with COVID-19 infection within the past 3 months saw a medical provider within the last year, wearing a mask in public often, and barriers to vaccination (not knowing enough about the vaccine) predicted vaccine. These variables indicated changes in the likelihood of obtaining vaccination. Conclusion: The most crucial factor for increasing vaccination rates was directly reaching out to the community and actively conducting surveys to address the barriers and concerns encountered by Hispanic/Latinx participants.

Background: There are limited studies that have assessed COVID-19 vaccine acceptance and side effects, both globally and in the western region of Saudi Arabia (SA). Objective: This study assessed the acceptance of vaccination against COVID-19, determined motivators and barriers for taking these vaccines, and assessed vaccine side effects in the western region of SA. Study design: The study was an online cross-sectional study conducted among the people who lived in the western region of SA during the period from December 2021 to March 2022. Participation was voluntary for participants who were above 18 and lived in the Western region of SA. Children and those living in other countries were excluded from the study. Methods: The study tool was a self-administered questionnaire which assessed COVID-19 vaccine acceptance, determined motivators and barriers for taking the vaccines, and assessed their side effects among 1136 participants in the western region of SA. Data gathered were analyzed by the SSPS version 22 software. Result: A total of 1136 individuals, aged 18 years and above, participated in the study, with 50.7% (n = 567) being males. Most of the participants were from Taif city (68.4%; n = 777), and 57.6% (n = 654) were unmarried. Pfizer was the most frequently administered vaccine (72.8%; n = 823). Most participants explained that their vaccine administration protected themselves and their families (70.5%; n = 835). The acceptance showed that 55% (n = 626) of the participants had either very high or high confidence in the efficacy of the COVID-19 vaccines, while 14.7% (n = 167) of them had low/very low confidence in its efficacy. The side effects showed that 80.8% (n = 918) of the participants showed that they did not have any difficulties attributed to COVID-19 vaccine administration. Positive attitudes and practices were apparent, and most of the participants (78.3%; n = 889) tended to be actors in the fight against COVID-19. Conclusions: The current study showed a high level of acceptance of COVID-19 vaccination among people living in the western region of SA. Health education and communication from authoritative sources will be important to alleviate public concerns about COVID-19 vaccine safety.

Background Vaccines are an essential public health strategy to curb viral infection spreading that hinge on vaccine uptake which may be threatened by vaccine hesitant individuals. This study aims to identify sociodemographic predictors of vaccine hesitancy, main reasons for vaccine hesitancy, and how these reasons are explained by sociodemographic characteristics during the COVID-19 pandemic. Methods A cross-sectional study ( N  = 5 442) was carried out in June 2021. A web-based survey was conducted among six eastern districts in Oslo with high infection pressure. Sociodemographic variables included gender, age, country of birth, education, and household income. Binary logistic regression models were used to explore predictors of both vaccine hesitancy and specific reasons for hesitancy. Results Vaccine hesitancy was low overall (5.8%). Findings indicate that participants with younger ages, lower education, and lower household income, and those born outside of Norway were prone to vaccine hesitancy. Over half of the vaccine hesitant sample cited barriers relating to confidence in the vaccines. Women and participants born in Norway were more likely hesitant due to fear of side effects and there being little experience with the vaccines. Otherwise, complacency barriers such as not feeling that they belonged to a risk group (46.1%), not needing the vaccines (39.1%), and wanting the body to develop natural immunity (29.3%) were frequently selected by participants. Conclusion Different determinants of vaccine hesitancy among population groups demonstrate the need for clear public health communication about the risks, benefits, and importance of vaccines. Future studies with a larger sample should verify current findings and further explore the role of convenience barriers in health literacy and language. Health authorities should take these results into account and develop different public health strategies targeted at vulnerable population groups during the current and future pandemics to increase vaccine uptake and reach sufficient immunization.