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SDG 3: Vaccines

Abstract

Background

Since February 2022, the start of the full-scale war in Ukraine, millions of women and children have fled the country. Vaccination of refugee children is important to protect this vulnerable population from disease.

Aim

We investigate the determinants of vaccination intention in refugee mothers from Ukraine residing in Poland and test the effect of three message frames.

Methods

Participants were randomised into either a control group or one of three intervention groups encouraging vaccination using a specific frame: (i) trust in the Polish health system, (ii) ease of access to vaccination or (iii) risk aversion. Primary outcomes were intention to vaccinate a child in Poland and clicking on a vaccination scheduling link.

Results

The study was completed by 1,910 Ukrainian refugee mothers. Compared with the control group, the risk aversion message significantly increased vaccination intention (adjusted odds ratio (AOR): 2.35, 95% confidence interval (CI): 1.25–4.42) and clicking on the vaccine scheduling link (AOR: 1.53, 95% CI: 1.12–2.09). Messages around trust and ease of access did not have an effect. Important determinants of vaccination intention were perceived importance of vaccination (AOR: 1.12 95% CI: 1.01–1.25) and trusting vaccination information official health institutes (AOR: 1.40 95% CI: 1.06–1.83) and social media (AOR: 2.09 95% CI: 1.33–3.27).

Discussion

Using a risk aversion frame highlighting the vulnerability to infection that refugees face resulted in increased vaccination intention and clicks on a vaccination scheduler. Health workers who interact with Ukrainian refugees could use this frame in their vaccination communication.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2024-09-26
2024-09-27
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.39.2400159
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References

  1. The United Nations refugee agency (UNHCR). Ukraine Situation Flash Update #56. UNHCR; 2023. Available from: https://data.unhcr.org/en/documents/details/103802
  2. The United Nations refugee agency (UNHCR). Ukraine refugee situation. UNHCR; 2023. Available from: https://data.unhcr.org/en/situations/ukraine/location
  3. The United Nations refugee agency (UNHCR). Regional intentions survey results (3rd & 4th round): intentions and perspectives of refugees from Ukraine. UNHCR; 2023. Available from: https://data.unhcr.org/en/dataviz/304?sv=54&geo=0
  4. UNICEF Refugee Response Office in Poland. Hope amid crisis: one year of UNICEF's response in Poland for children and families fleeing war in Ukraine. 2023. Available from: https://www.unicef.org/eca/media/27066/file/HOPE%20AMID%20CRISIS%20report.pdf
  5. Deal A, Halliday R, Crawshaw AF, Hayward SE, Burnard A, Rustage K, et al. Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review. Lancet Infect Dis. 2021;21(12):e387-98.  https://doi.org/10.1016/S1473-3099(21)00193-6  PMID: 34626552 
  6. Kadir A, Shenoda S, Goldhagen J, Pitterman S, Suchdev PS, Chan KJ, et al. The Effects of Armed Conflict on Children. Pediatrics. 2018;142(6):e20182586.  https://doi.org/10.1542/peds.2018-2586  PMID: 30397168 
  7. Semenza JC, Carrillo-Santisteve P, Zeller H, Sandgren A, van der Werf MJ, Severi E, et al. Public health needs of migrants, refugees and asylum seekers in Europe, 2015: Infectious disease aspects. Eur J Public Health. 2016;26(3):372-3.  https://doi.org/10.1093/eurpub/ckw023  PMID: 27053729 
  8. Bell S, Edelstein M, Zatoński M, Ramsay M, Mounier-Jack S. ‘I don’t think anybody explained to me how it works’: qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England. BMJ Open. 2019;9(7):e028228.  https://doi.org/10.1136/bmjopen-2018-028228  PMID: 31289079 
  9. Baauw A, Kist-van Holthe J, Slattery B, Heymans M, Chinapaw M, van Goudoever H. Health needs of refugee children identified on arrival in reception countries: a systematic review and meta-analysis. BMJ Paediatr Open. 2019;3(1):e000516.  https://doi.org/10.1136/bmjpo-2019-000516  PMID: 31646192 
  10. Crawshaw AF, Farah Y, Deal A, Rustage K, Hayward SE, Carter J, et al. Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review. Lancet Infect Dis. 2022;22(9):e254-66.  https://doi.org/10.1016/S1473-3099(22)00066-4  PMID: 35429463 
  11. Ganczak M, Bielecki K, Drozd-Dąbrowska M, Topczewska K, Biesiada D, Molas-Biesiada A, et al. Vaccination concerns, beliefs and practices among Ukrainian migrants in Poland: a qualitative study. BMC Public Health. 2021;21(1):93.  https://doi.org/10.1186/s12889-020-10105-9  PMID: 33413287 
  12. Mipatrini D, Stefanelli P, Severoni S, Rezza G. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence. Pathog Glob Health. 2017;111(2):59-68.  https://doi.org/10.1080/20477724.2017.1281374  PMID: 28165878 
  13. Lewtak K, Kanecki K, Tyszko P, Goryński P, Bogdan M, Nitsch-Osuch A. Ukraine war refugees - threats and new challenges for healthcare in Poland. J Hosp Infect. 2022;125:37-43.  https://doi.org/10.1016/j.jhin.2022.04.006  PMID: 35461902 
  14. Szezepienia info. Program Szczepień Ochronnych w 2024 roku. [Vaccination programme 2024]. [Accessed: 15 Jul 2024]. Polish. Available from: https://szczepienia.pzh.gov.pl/kalendarz-szczepien-2024/
  15. Hadjipanayis A, van Esso D, Del Torso S, Dornbusch HJ, Michailidou K, Minicuci N, et al. Vaccine confidence among parents: Large scale study in eighteen European countries. Vaccine. 2020;38(6):1505-12.  https://doi.org/10.1016/j.vaccine.2019.11.068  PMID: 31848051 
  16. Gallup. Wellcome Global Monitor 2018, Chapter 5: Attitudes to vaccines. 2019. Available from: https://wellcome.org/sites/default/files/wellcome-global-monitor-2018.pdf
  17. European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment: Outbreak of circulating vaccine-derived poliovirus type 1 (cVDPV1) in Ukraine. Stockholm: ECDC; 2015. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/Poliomyelitis-Ukraine-rapid-risk-assessment-September-2015.pdf
  18. Rzymski P, Falfushynska H, Fal A. Vaccination of Ukrainian refugees: Need for urgent action. Clin Infect Dis. 2022;75(6):1103-8.  https://doi.org/10.1093/cid/ciac276  PMID: 35435230 
  19. UNICEF. UNICEF Data Warehouse: Immunisation Ukraine 2023. [Accessed: 10 Jan 2024]. Available from: https://data.unicef.org/resources/data_explorer/unicef_f/?ag=UNICEF&df=GLOBAL_DATAFLOW&ver=1.0&dq=UKR.IMMUNISATION+IM_DTP3+IM_HEPBB+IM_HIB3+IM_IPV1+IM_MCV1+IM_MCV2+IM_PCV3+IM_POL3+IM_RCV1+IM_ROTAC+IM_YFV.&startPeriod=2010&endPeriod=2023
  20. World Health Organization (WHO). Behavioural and social drivers of vaccination: tools and practical guidance for achieving high uptake. Geneva: WHO; 2022. Available from: https://iris.who.int/bitstream/handle/10665/354459/9789240049680-eng.pdf?sequence=1
  21. World Health Organization (WHO). Understanding the behavioural and social drivers of vaccine uptake WHO position paper - May 2022. Wkly Epidemiol Rec. 2022;97:209-24.
  22. Malik AA, Ahmed N, Shafiq M, Elharake JA, James E, Nyhan K, et al. Behavioral interventions for vaccination uptake: A systematic review and meta-analysis. Health Policy. 2023;137:104894.  https://doi.org/10.1016/j.healthpol.2023.104894  PMID: 37714082 
  23. Powell-Jackson T, Fabbri C, Dutt V, Tougher S, Singh K. Effect and cost-effectiveness of educating mothers about childhood DPT vaccination on immunisation uptake, knowledge, and perceptions in Uttar Pradesh, India: A randomised controlled trial. PLoS Med. 2018;15(3):e1002519.  https://doi.org/10.1371/journal.pmed.1002519  PMID: 29509769 
  24. Yale Institute for Global Health. UNICEF, The Public Good Projects, Meta Platforms, Observatory VD. Vaccine Messaging Guide. 2021.New York: UNICEF. [Accessed: 20 Jul 2023]. Available from: https://www.unicef.org/coronavirus/vaccine-messaging-guide
  25. Gupta SK. Intention-to-treat concept: A review. Perspect Clin Res. 2011;2(3):109-12.  https://doi.org/10.4103/2229-3485.83221  PMID: 21897887 
  26. Covey J. The role of dispositional factors in moderating message framing effects. Health Psychol. 2014;33(1):52-65.  https://doi.org/10.1037/a0029305  PMID: 22924446 
  27. Böhm R, Betsch C. Prosocial vaccination. Curr Opin Psychol. 2022;43:307-11.  https://doi.org/10.1016/j.copsyc.2021.08.010  PMID: 34517200 
  28. Poland CM, Ratishvili T. Vaccine hesitancy and health care providers: Using the preferred cognitive styles and decision- making model and empathy tool to make progress. Vaccine X. 2022;11:100174.  https://doi.org/10.1016/j.jvacx.2022.100174  PMID: 35782719 
  29. Ozawa S, Stack ML. Public trust and vaccine acceptance--international perspectives. Hum Vaccin Immunother. 2013;9(8):1774-8.  https://doi.org/10.4161/hv.24961  PMID: 23733039 
  30. Lindholt MF, Jørgensen F, Bor A, Petersen MB. Public acceptance of COVID-19 vaccines: cross-national evidence on levels and individual-level predictors using observational data. BMJ Open. 2021;11(6):e048172.  https://doi.org/10.1136/bmjopen-2020-048172  PMID: 34130963 
  31. Larson HJ, Clarke RM, Jarrett C, Eckersberger E, Levine Z, Schulz WS, et al. Measuring trust in vaccination: A systematic review. Hum Vaccin Immunother. 2018;14(7):1599-609.  https://doi.org/10.1080/21645515.2018.1459252  PMID: 29617183 
  32. Hopfer S. Effects of a narrative HPV vaccination intervention aimed at reaching college women: a randomized controlled trial. Prev Sci. 2012;13(2):173-82.  https://doi.org/10.1007/s11121-011-0254-1  PMID: 21993613 
  33. Shen AK, Browne S, Srivastava T, Kornides ML, Tan ASL. Trusted messengers and trusted messages: The role for community-based organizations in promoting COVID-19 and routine immunizations. Vaccine. 2023;41(12):1994-2002.  https://doi.org/10.1016/j.vaccine.2023.02.045  PMID: 36803894 
  34. Viskupič F, Wiltse DL. The Messenger Matters: Religious Leaders and Overcoming COVID-19 Vaccine Hesitancy. PS Polit Sci Polit. 2022;55(3):504-9.  https://doi.org/10.1017/S104909652200004X 
  35. Winters M, Christie S, Lepage C, Malik AA, Bokemper S, Abeyesekera S, et al. Persuasive COVID-19 vaccination campaigns on Facebook and nationwide vaccination coverage in Ukraine, India, and Pakistan. PLOS Glob Public Health. 2023;3(9):e0002357.  https://doi.org/10.1371/journal.pgph.0002357  PMID: 37756298 
  36. Puri N, Coomes EA, Haghbayan H, Gunaratne K. Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases. Hum Vaccin Immunother. 2020;16(11):2586-93.  https://doi.org/10.1080/21645515.2020.1780846  PMID: 32693678 
  37. Cascini F, Pantovic A, Al-Ajlouni YA, Failla G, Puleo V, Melnyk A, et al. Social media and attitudes towards a COVID-19 vaccination: A systematic review of the literature. EClinicalMedicine. 2022;48:101454.  https://doi.org/10.1016/j.eclinm.2022.101454  PMID: 35611343 
 “Vaccinating your child during an emergency is more important than ever”: a randomised controlled trial on message framing among Ukrainian refugees in Poland, 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Maike+Winters&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Winters Maike</a>, <a href="/search?value1=Agnieszka+Socho%C5%84-Latuszek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sochoń-Latuszek Agnieszka</a>, <a href="/search?value1=Anastasiia+Nurzhynska&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nurzhynska Anastasiia</a>, <a href="/search?value1=Kseniia+Yoruk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Yoruk Kseniia</a>, <a href="/search?value1=Katarzyna+Kuku%C5%82a&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kukuła Katarzyna</a>, <a href="/search?value1=Mutribjon+Bahruddinov&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bahruddinov Mutribjon</a>, <a href="/search?value1=Aleksandra+Kusek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kusek Aleksandra</a>, <a href="/search?value1=Dorota+Kleszczewska&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kleszczewska Dorota</a>, <a href="/search?value1=Anna+Dzielska&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dzielska Anna</a>, <a href="/search?value1=Tomasz+Maciejewski&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maciejewski Tomasz</a>, <a href="/search?value1=Joanna+Mazur&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mazur Joanna</a>, <a href="/search?value1=Hannah+Melchinger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Melchinger Hannah</a>, <a href="/search?value1=John+Kinsman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kinsman John</a>, <a href="/search?value1=Piotr+Kramarz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kramarz Piotr</a>, <a href="/search?value1=Sarah+Christie&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Christie Sarah</a>, <a href="/search?value1=Saad+B+Omer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Omer Saad B</a></span>.  “Vaccinating your child during an emergency is more important than ever”: a randomised controlled trial on message framing among Ukrainian refugees in Poland, 2023. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(39):pii=2400159. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.39.2400159" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.39.2400159</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 14 Mar 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 05 Aug 2024 </span> </p>
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