Influenza is a major concern across healthcare environments. Annual vaccination of healthcare workers (HCWs) remains essential for maintaining the health and availability of HCWs, as well as influenza prevention in healthcare environments. Yet, annual vaccination coverage among HCWs continues to be below recommended standards during pandemic (pH1N1) and non-pandemic (sINFLU) influenza seasons. The primary aim of this research is to inform the design and implementation of effective HCW targeted influenza vaccination campaigns via a 1) systematic review of the existing literature on HCW pH1N1 vaccination, 2) qualitative content analysis of motivators and barriers to HCW pH1N1 and sINFLU vaccination, as well as 3) quantitative regression analysis of modifiable factors predicting pH1N1 and sINFLU vaccination. The qualitative and quantitative analysis processes were applied to data collected from a large-scale multi-professional sample of HCWs. Findings from all analysis sections were found to be consistent. Most attitudes, beliefs, motivators, and barriers influencing HCW influenza vaccination were similar for pH1N1 and sINFLU vaccinations. Yet, a number of notable differences were also identified. HCWs were likely to accept vaccination if they perceived, 1) vaccination to be safe, 2) vaccination to be protective against influenza for self, loved ones, patients or communities, and 3) influenza to be a serious and severe infection to self and others. Additionally, encouragement from supervisors and colleagues, physicians, and loves ones also enhanced vaccine uptake. Most HCWs avoided vaccination because of 1) limited knowledge or misinformation about vaccination, 2) concern for vaccine induced side-effects and 3) assuming vaccination was not a requirement for healthy adults. With respect to pH1N1 vaccination, mass media communications, perceptions of novel vaccinations, and rapid vaccine development processes especially deterred HCW pH1N1 vaccination. Future vaccination programs targeting HCWs should look towards influencing HCWs’ vaccination attitudes and promoting pro-vaccination cultures in healthcare workplaces.

Influenza is a major concern across healthcare environments. Annual vaccination of healthcare workers (HCWs) remains essential for maintaining the health and availability of HCWs, as well as influenza prevention in healthcare environments. Yet, annual vaccination coverage among HCWs continues to be below recommended standards during pandemic (pH1N1) and non-pandemic (sINFLU) influenza seasons. The primary aim of this research is to inform the design and implementation of effective HCW targeted influenza vaccination campaigns via a 1) systematic review of the existing literature on HCW pH1N1 vaccination, 2) qualitative content analysis of motivators and barriers to HCW pH1N1 and sINFLU vaccination, as well as 3) quantitative regression analysis of modifiable factors predicting pH1N1 and sINFLU vaccination. The qualitative and quantitative analysis processes were applied to data collected from a large-scale multi-professional sample of HCWs. Findings from all analysis sections were found to be consistent. Most attitudes, beliefs, motivators, and barriers influencing HCW influenza vaccination were similar for pH1N1 and sINFLU vaccinations. Yet, a number of notable differences were also identified. HCWs were likely to accept vaccination if they perceived, 1) vaccination to be safe, 2) vaccination to be protective against influenza for self, loved ones, patients or communities, and 3) influenza to be a serious and severe infection to self and others. Additionally, encouragement from supervisors and colleagues, physicians, and loves ones also enhanced vaccine uptake. Most HCWs avoided vaccination because of 1) limited knowledge or misinformation about vaccination, 2) concern for vaccine induced side-effects and 3) assuming vaccination was not a requirement for healthy adults. With respect to pH1N1 vaccination, mass media communications, perceptions of novel vaccinations, and rapid vaccine development processes especially deterred HCW pH1N1 vaccination. Future vaccination programs targeting HCWs should look towards influencing HCWs’ vaccination attitudes and promoting pro-vaccination cultures in healthcare workplaces.

Introduction The discovery and continued development of vaccines is arguably one of the most important innovations in human history. Vaccination greatly reduces the worldwide incidence and transmission of diseases, preventing permanent injury and premature death. Mass vaccination campaigns have led to the eradication or partial eradication of severe infectious such as smallpox and polio, have reduced childhood mortality, and has led to an overall increase in average health in the human population globally. Despite the documented benefits of vaccination, vaccine hesitancy is increasing, and the uptake of some vaccines is low. Vaccines have been so successful at preventing disease that portions of the population are now more afraid of the possible side-effects of vaccines then they are of the serious symptoms and maladies that vaccines prevent. Vaccine hesitancy is a serious concern for the global medical community. The incidence of infectious disease is inversely proportional to vaccine uptake; as fewer people are vaccinated against preventable diseases, the frequency at which people get sick increases. A reduction in vaccination rates due to vaccine hesitancy reduces herd immunity, which increases the risk for the whole population, especially immunocompromised individuals who are unable to receive vaccines. Vaccines that protect against high-risk strains of Human Papillomavirus (HPV) have recently been developed and released to the worldwide population. High-risk HPV strains can cause persistent infection and various cancers. Although HPV vaccines have been extensively tested and are recommended by the Centers for Disease Control and Prevention and the World Health Organization, uptake among some demographics is low. Understanding what factors impact HPV vaccine hesitancy can guide the design of effective interventions which can increase vaccine uptake. High HPV uptake will lead to a reduction of HPV associated cancers and reduce the transmission of high-risk subtypes. Research Significance Vaccine hesitancy is a growing challenge for the medical community and could potentially put global health at risk by undermining 200 years of progress towards eliminating infectious diseases. A better understanding of what factors impact vaccine hesitancy allows public health professionals to design better policies and interventions policies and helps primary care providers better address concerns the concerns of their patients. Better understanding of the factors which cause vaccine hesitance can be used to tailor education about vaccines. This leads to higher vaccine uptake and better community health overall. Methodology Electronically distributed surveys and statistical analysis were the primary tools used in this research. Surveys were used to generate data from a sample population, including: demographic factors, attitudes towards vaccination, and intent to vaccinate against HPV. Barriers to HPV vaccine uptake and factors that impact HPV vaccine acceptance were identified through statistical analysis, including confirmatory factor analysis, structural equation modeling, regression and univariate analysis. Findings We found that general attitudes toward vaccination had the greatest impact on the intent of parents to vaccinate their children against HPV. Parents who view vaccination positively intend to vaccinate their children against HPV or have already vaccinated their children against HPV. Parents who are somewhat unsure about vaccines are more hesitant about vaccinating their children against HPV. Knowledge about HPV increases intent to vaccinate. We found that traditionally religious parents who felt that religious adherence provided some protection against HPV were more hesitant about HPV vaccinations. We found that both a religious-focused intervention and an education-focused interventions increased parental intent to vaccinate more than a control intervention. Our study of Utah residents confirmed our earlier findings that general attitudes toward vaccination had the greatest impact on the intent of parents to vaccinate their children against HPV. Our study also confirmed that knowledge about HPV increases intent to vaccinate. We found that high religious practice negatively impacts parental intent to vaccinate. Cautious sexual attitudes also negatively impact intent to vaccinate against HPV. High religious practice is correlated with cautious sexual attitudes which explains the negative impact of high religious practice on intent to vaccinate. The findings of this research work will be used to inform future religious and educational based interventions in Utah and beyond.

An emerging pattern of public doubt in scientific and political authorities has been seen during the COVID-19 pandemic, where numerous alternatives to vaccinations have gone viral. Ivermectin's growth from a relatively known specialist drug to a political controversy is a striking example of the amplification that social media can provide. Doubt in the dangers of illness has occurred in regard to previous diseases with limited impact, including the Zika virus, Ebola, and H1N1. However, the COVID-19 pandemic's impact in the United States is a much larger example of the gaps in current risk assessments and methods of public health authorities. Publicly available Twitter data was mined to identify tweets discussing ivermectin and vaccination during the first year of COVID-19, before public discussion of ivermectin took off. Those tweets were coded using textual analysis and examined through the use of statistical tools. I examine existing sociological studies about trust in medical authority, vaccine rejection, diffusion of new information, and risk analysis to provide context for my results. Attitudes towards vaccination influenced attitudes towards ivermectin inversely. Negative attitudes towards COVID-19 vaccination were associated with more positive attitudes towards ivermectin. Mentions of pharmaceuticals, deaths during the vaccine wait, or a vaccine conspiracy were additionally significant, all of which led to more positive attitudes towards ivermectin.