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Promoting Vaccination in the Post-COVID-19 Era

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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: 15 June 2025 | Viewed by 16561

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Special Issue Editor

Dr. Zoi Tsimtsiou

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Guest Editor

Associate Professor, Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: public health; primary health care; health promotion; vaccination hesitancy; quality of healthcare

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to a Special Issue on the factors to consider in the global effort to promote vaccination in the post-COVID-19 era.

Although vaccination is one of the most cost-effective ways of preventing disease, vaccine hesitancy has been included among the ten threats of global health, and vaccination coverage remains globally suboptimal, especially among adults. During the pandemic, numerous changes occurred that may contribute either positively or negatively to promoting vaccination in the era that follows. Although new challenges to vaccine acceptance have arisen following the introduction of the COVID-19 vaccines, the pandemic may have also acted as a golden opportunity for raising awareness on prevention issues in the population. In an effort to develop interventions that increase vaccination coverage in the post-pandemic era, investigating what people think and feel, as well as social influences and practical factors that may affect their motivation and ability to get vaccinated, is essential.

To achieve a more extensive understanding of the different factors that should be taken into consideration to deal effectively with suboptimal vaccination coverage in the post-COVID-19 era, this Special Issue is focused on the studies made in this field. Based on your extensive knowledge and experience, we invite you to contribute recent studies that present people’s attitudes, knowledge, fears, and expectations concerning vaccination, as well as social influences and practical factors that may affect vaccination uptake, in order to inform interventions effectively for the promotion of vaccination in the post-COVID-19 era globally.

Dr. Zoi Tsimtsiou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

vaccination
coverage
hesitancy
attitudes
behaviors
interventions
health promotion
public health
primary health care
barriers

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Published Papers (8 papers)

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Research

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13 pages, 603 KiB

Open AccessArticle

Vaccine Confidence and Coverage among Medical Students at a Federal University in Brazil

by Ricardo B. Feijó, Jordana V. H. Bertotto, Amanda C. Pinto, Maria Eduarda T. G. Leal, Víctor M. de Souza and Vitória F. Sakai

Vaccines 2024, 12(9), 993; https://doi.org/10.3390/vaccines12090993 - 30 Aug 2024

Viewed by 1371

Abstract

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. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

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12 pages, 257 KiB

Open AccessArticle

by Mei-Feng Huang, Yi-Chun Yeh, Tai-Ling Liu, Ray C. Hsiao, Cheng-Sheng Chen and Cheng-Fang Yen

Vaccines 2024, 12(6), 668; https://doi.org/10.3390/vaccines12060668 - 17 Jun 2024

Viewed by 1077

Abstract

Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers’ intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members’ attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers’ intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers’ perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers’ intention to vaccinate elderly family members with MNDs, whereas elderly family members’ age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members’ age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers’ intentions to vaccinate their elderly family members with MNDs against COVID-19. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

10 pages, 252 KiB

Open AccessArticle

Questionable Immunity to Mumps among Healthcare Workers in Italy—A Cross-Sectional Serological Study

by Cristiana Ferrari, Giuseppina Somma, Michele Treglia, Margherita Pallocci, Pierluigi Passalacqua, Luca Di Giampaolo and Luca Coppeta

Vaccines 2024, 12(5), 522; https://doi.org/10.3390/vaccines12050522 - 10 May 2024

Viewed by 1551

Abstract

Highly contagious diseases, such as mumps, are a global concern as new epidemics continue to emerge, even in highly vaccinated populations. The risk of transmission and spread of these viruses is even higher for individuals who are more likely to be exposed, including healthcare workers (HCWs). In healthcare settings, both HCWs and patients are at risk of infection during the care process, potentially leading to nosocomial epidemic outbreaks. Mumps is often underestimated compared with measles and rubella, despite being milder and less likely to spread. In fact, the risk of complications following mumps infection is extremely high, especially if the disease occurs in adulthood. The measles–mumps–rubella (MMR) vaccine has been shown to be an excellent preventive measure. Unfortunately, the mumps component appears to be less effective in inducing immunity than those for measles and rubella (two-dose effectiveness of 85%, 95% and 97%, respectively). The main aim of our study was to investigate the prevalence of detectable mumps antibodies (serum IgG antibodies) in a cohort of Italian and foreign HCWs in relation to personal and occupational factors. We included in the study 468 subjects who underwent health surveillance at the Occupational Medicine Unit of the Tor Vergata Polyclinic in Rome during the period from January 2021 to March 2023. In our study, the proportion of HCWs found to be unprotected against mumps was very high (8.3%), and those found to be immune are below the WHO threshold for herd immunity (95%). From our data, it seems essential that all occupational health services carry out an accurate screening with a dose of anti-mumps antibodies to assess serological protection before starting a job, regardless of an individual’s vaccination history. This approach is proving to be beneficial, accurate, as it allows all serologically non-immune individuals to be vaccinated in the workplace, including those who would be protected by their vaccination history but have lost the antibody response. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

15 pages, 2695 KiB

Open AccessArticle

Diphtheria and Tetanus Immunity Status among Greek Adults: Results from a Nationwide Seroprevalence Study

by Dimitrios Papagiannis, Eleftherios Thireos, Anargiros Mariolis, Antonios Katsioulis, Ioannis Ch. Lampropoulos, Ioanna Tsiaousi, Kostantina Gartzonika, Niki Malliaraki, Foteini Malli, Erasmia C. Rouka, Georgios Marinos, Emmanouil K. Symvoulakis, Georgios Rachiotis and Konstantinos I. Gourgoulianis

Vaccines 2024, 12(4), 378; https://doi.org/10.3390/vaccines12040378 - 2 Apr 2024

Viewed by 1878

Abstract

Diphtheria and tetanus could lead to serious morbidity. We aimed to evaluate immunity levels by measuring specific IgG antibodies for diphtheria and tetanus in serum samples from a nationally expanded sample of the Greek population. A geographically stratified sampling approach based on regional units (NUTS level 2) was applied by considering variables such as age group (30–80+) and sex. In total, 1201 persons (47.7% males and 52.3% females) participated in the survey. Bivariate analysis revealed a negative relationship between diphtheria and tetanus median antibody titers and age. The overall seropositivity rate for diphtheria IgG antibodies (≥0.10 IU/mL) was estimated at 31.5%. Regarding tetanus, the total seropositivity rate was estimated at 59.5% (tetanus IgG antibodies ≥0.10 IU/mL). Logistic regression analysis indicated that age groups <40 years and 40–59 years were independently associated with tetanus seropositivity. Logistic regression also revealed that male sex and being aged 60–69 years were independent risk factors for diphtheria-related seropositivity. Lastly, being resident of some regions was an independent risk factor for both diphtheria- and tetanus-related seropositivity. The present study shows that Greek adults are still not completely immune to diphtheria and tetanus. It is likely possible to achieve optimal immunization coverage by implementing serviceable public health initiatives after comprehending real community needs. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

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18 pages, 287 KiB

Open AccessArticle

Exploring Perceptions and Practices Regarding Adult Vaccination against Seasonal Influenza, Tetanus, Pneumococcal Disease, Herpes Zoster and COVID-19: A Mixed-Methods Study in Greece

by Iordanis Avramidis, Ilias Pagkozidis, Philippe-Richard J. Domeyer, Georgios Papazisis, Ilias Tirodimos, Theodoros Dardavesis and Zoi Tsimtsiou

Vaccines 2024, 12(1), 80; https://doi.org/10.3390/vaccines12010080 - 12 Jan 2024

Cited by 4 | Viewed by 2579

Abstract

We aimed to document vaccination coverage for five vaccines, predictors of each vaccine’s uptake and attitudes regarding adult vaccination. Adults visiting four pharmacies were randomly invited to participate during summer 2022. Among 395 participants (mean age 51.2 years, range 19–96), vaccination rates were 78.1% for influenza and 25.8% for herpes zoster (≥60 years old), 64.3% for pneumococcal disease (≥65 years old), 33.1% for tetanus, while 11.4% had received two and 74.8% ≥3 COVID-19 vaccine doses. Half of participants (50.1%) voiced some degree of hesitancy, and 1.3% were refusers. The strongest predictor of each vaccine’s uptake was doctor’s recommendation (OR range 11.33–37.66, p < 0.001) and pharmacist’s recommendation (4.01–19.52, p < 0.05), except for the COVID-19 vaccine, where the Attitude Towards Adult VACcination (ATAVAC) value of adult vaccination subscale’s score was the only predictor (OR: 5.75, p < 0.001). Regarding insufficient coverage, thematic content analysis revealed seven main themes. Insufficient knowledge, the absence of health professionals’ recommendation, perception of low susceptibility to disease, negligence and dispute of vaccine effectiveness were universal themes, whereas safety concerns and distrust in authorities were reported solely for COVID-19 vaccination. Designing public interventions aiming to increase trust in adult vaccination is essential in the aftermath of the COVID-19 pandemic. Health professionals’ role in recommending strongly adult vaccination is crucial. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

15 pages, 1298 KiB

Open AccessArticle

Psychological Factors of Vaccination Intent among Healthcare Providers, Parents, and Laypeople

by Kaja Damnjanović, Sandra Ilić, Marija Kušić, Milica Lazić and Dragoslav Popović

Vaccines 2023, 11(12), 1816; https://doi.org/10.3390/vaccines11121816 - 4 Dec 2023

Cited by 3 | Viewed by 2072

Abstract

The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from −0.128 to −0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

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Review

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13 pages, 687 KiB

Open AccessReview

Lessons from the COVID-19 Pandemic: Promoting Vaccination and Public Health Resilience, a Narrative Review

by Flavia Pennisi, Cristina Genovese and Vincenza Gianfredi

Vaccines 2024, 12(8), 891; https://doi.org/10.3390/vaccines12080891 - 7 Aug 2024

Cited by 3 | Viewed by 2402

Abstract

The COVID-19 pandemic has underscored the critical importance of adaptable and resilient public health systems capable of rapid response to emerging health crises. This paper synthesizes the lessons learned from the COVID-19 vaccination campaign and explores strategies to enhance vaccine uptake in the post-pandemic era. Key challenges identified include logistical, economic, sociocultural, and policy dimensions that impact vaccination efforts, particularly in low-resource settings. The analysis highlights the need for resilient supply chains, effective communication, community engagement, and equitable access to healthcare resources. The rapid development and deployment of mRNA vaccines exemplify the potential of innovative vaccine technologies, though public trust and acceptance remain crucial. Strategies such as partnerships with local leaders, tailored messaging, and integration of digital tools are essential for combating vaccine hesitancy. By applying these insights, future vaccination campaigns can be more efficient, equitable, and resilient, ultimately improving public health outcomes globally. This paper aims to inform policy and practice, ensuring that public health strategies are evidence based and context specific, thus better preparing for future health challenges. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

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Other

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11 pages, 838 KiB

Open AccessProject Report

Key Learnings from the Development and Early Use of Global Guidance on the Integration of COVID-19 Vaccination into Broader Health Systems

by Ibrahim Dadari, Alba Vilajeliu, Viorica Berdaga, Shalini Rozario, Phoebe Meyer, Laura Nic Lochlainn, Dirk Horemans, Nuria Toro, Gloria Lihemo, Sanjay Bhardwaj, Peter Cowley, Diana Chang Blanc, Florence Conteh-Nordman, Imran Mirza, Shahira Malm, Ida Marie Ameda and Ann Lindstrand

Vaccines 2024, 12(2), 196; https://doi.org/10.3390/vaccines12020196 - 14 Feb 2024

Viewed by 2430

Abstract

More than 13.5 billion COVID-19 vaccine doses were delivered between 2021 and 2023 through a mix of delivery platforms, with mass vaccination campaigns being the main approach. In 2022, with the continued circulation of SARS-CoV2 and the need for periodic boosters being most likely, countries were required to plan for more sustainable approaches to provide COVID-19 vaccinations. In this context of uncertainty, a global tool for integrating COVID-19 vaccines into immunization programs and as part of broader health systems was published jointly by the WHO and UNICEF to respond to country needs. This paper summarizes the approach to, and lessons learned during, the development of a global guidance document and describes some examples of its early use in low- and middle-income countries (LMICs). The guidance leveraged existing health system frameworks, proposed four steps for planning and implementing the COVID-19 vaccination integration journey, and identified investment areas. The development process maximized robust global stakeholder and country engagement, and the timeframe was aligned with donor funding windows to support countries with the integration of COVID-19 vaccination. The rapid dissemination of the guidance document allowed countries to ascertain their readiness for integrating COVID-19 vaccination and inform the development of national plans and funding applications. While progress has been made in specific areas (e.g., optimizing cold chain and logistics leveraging COVID-19 vaccination), in the context of decreasing demand for COVID-19 vaccines, reaching adult COVID-19 vaccine high-priority-use groups and engaging and coordinating with other health programs (beyond immunization) remain challenges, particularly in LMICs. We share the learning that despite the uncertainties of a pandemic, guidance documents can be developed and used within a short timeframe. Working in partnership with stakeholders within and beyond immunization towards a common objective is powerful and can allow progress to be made in terms of integrating health services and better preparing for future pandemics. Full article

(This article belongs to the Special Issue Promoting Vaccination in the Post-COVID-19 Era)

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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Exploring communication barriers and facilitators in school vaccination: A case study in South Eastern Sydney, Australia.
Author: Young
Highlights: • Barriers and facilitators exist to participation in the school vaccination program in Eastern Sydney • Accessible and targeted communication with parents promotes consent for school vaccination. • Students receive little information and education about vaccines and the vaccination process. • Opportunities exist to increase vaccine uptake by strengthening information and education for students and parents and creating greater awareness of catch-up vaccinations.

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