Collective Responsibility, Confidence in Immunizations Indicate Potential of Vaccine Refusal

Approximately 18% of individuals (N = 150) in a study refused a pneumococcal vaccine, with a sense of collective responsibility and lack of confidence significantly associated with vaccine refusal, according to the study authors. Vaccination can play a large role in the prevention of diseases, and there are many studies that support the efficacy of pneumococcal vaccines in preventing infection.¹

Pneumococcal Vaccine, Vaccine Hesitancy, Pneumonia, Immunization | Image Credit: © PRO Balance | stock.adobe.com

However, in a survey by the National Foundation for Infectious Diseases, investigators found that few adults in the United States intend to get vaccinated for respiratory diseases, including pneumococcal, for the 2024-2025 season. For pneumococcal, approximately 25% of individuals at high risk were already vaccinated, with 44% planning to get vaccinated. The top reasons for not wanting to receive a vaccination included safety concerns (41%), fear of getting sick (32%), and distrust (32%).²

In a recent study, investigators proposed strategies to increase pneumococcal vaccination uptake, which included many national-level initiatives to strengthen the reception of vaccination. These included equipping health care providers with adequate pneumococcal vaccine knowledge, public health education, and capitalizing on information transmission platforms. They stated that multi-pronged interventions should be introduced to increase uptake.³

In the current study, investigators aimed to determine the prevalence of vaccine refusal and the associated factors for older patients. The study, which was observational in nature, used a self-administered questionnaire that was provided at an outpatient clinic of the department of family medicine at Chaing Mai University in Thailand. Approximately 150 patients received the questionnaire, over 90% of whom were older with chronic diseases and met the qualifications for vaccination according to Thai vaccination guidelines.¹

Individuals were included between July and December 2023 and were 60 years and older who could communicate and make decisions independently. Those with dementia, mild cognitive impairment, depression, and contraindications for the pneumococcal vaccination were excluded. Approximately 60.7% were female, with an average of of 69.8 years. Approximately 72% lived with a partner, 43.3% finished primary school, and 36.7% had a maximum income ranging from 10,000 to 20,000 baht per month (approximately $300 to $585 USD). There were 27 individuals who refused the vaccine, with a significant difference of multiple comorbidities between the refusers and non-refusers at 14.1% and 85.9%, respectively.¹

Vaccine refusers had lower mean scores in confidence and collective responsibility but higher complacency compared with non-refusers, according to the study authors. Lower feelings of collective responsibility and confidence were significantly associated with vaccine refusal [(Odds ratio 0.22 (95% CI 0.06-0.74, P = .015); (Odds ratio 0.43 (95% CI 0.20-0.89, P = .024), respectively]. The study investigators stated that collective responsibility and confidence gained more attention globally due to the COVID-19 pandemic and growing vaccine hesitancy. Collective responsibility is associated as a predictor of vaccine acceptance and confidence in vaccine efficacy and safety were also crucial when considering uptake, the authors stated. Investigators hope the results of the study can support the development of guidelines for health promotion, specifically for prevention of pneumococcal infection, among older adults who are at risk.¹

REFERENCES

1. Chitaree W, Buawangpong N, Yotruangsri T, Jiraporncharoen W, Pinyopornpanish K. Vaccine Hesitancy Affecting Pneumococcal Vaccine Refusal in Older Adults with Morbidities. J Prim Care Community Health. 2024;15:21501319241303568. doi:10.1177/21501319241303568

2. Gallagher A. SURVEY: Few Adults Plan to Get Respiratory Vaccinations for 2024-2025 Season. Pharmacy Times. October 1, 2024. Accessed December 4, 2024. https://www.pharmacytimes.com/view/survey-few-adults-plan-to-get-respiratory-vaccinations-for-2024-2025-season

3. Halpern L. Decision to Receive Pneumococcal Vaccine Among Older Adults Is Multi-Factorial, Influenced by Multidimensional Interventions. Pharmacy Times. November 22, 2024. Accessed December 4, 2024. https://www.pharmacytimes.com/view/decision-to-receive-pneumococcal-vaccine-among-older-adults-is-multi-factorial-influenced-by-multidimensional-interventions