Determinants of vaccine hesitancy and effectiveness of vaccination counseling interventions among a sample of the general population in Palermo, Italy

Abstract

Counteract vaccine hesitancy is a public health priority. Main objectives of the cross-sectional study conducted were to evaluate knowledge, attitudes, and behaviors regarding vaccination issues, to estimate the prevalence of vaccine hesitancy and to estimate the effectiveness of vaccination counseling on community advocacy in a sample of general population. An anonymous validated questionnaire was administered in April 2017 at the main shopping center of Palermo and was followed by tailored vaccination counseling interventions. To estimate the effectiveness of the interventions four main connection parameters to the vaccinarsi.org website were evaluated, in the two months before and after the intervention and in the two months before the intervention compared with the same period of previous and following years. Among the 299 subject enrolled 12.7% were hesitant about vaccinations, and 4.7% declared being against vaccinations. General practitioners (GPs) and pediatricians were the most affordable source of information about vaccinations. A higher probability of vaccination hesitancy/refusal was reported among subjects who considered "alternative strategies" the best way for the prevention of infectious diseases (adj-OR = 7.01, IC95% 2.88-17.09, p-value < 0.001). A considerable increase of all the vaccinarsi.org website indicators analyzed was observed, from the area in which survey participants lived. Prevalence of vaccine hesitancy among population surveyed is consistent with the literature data. HCWs, such as GPs and pediatricians, should play a key role in modifying personal convictions and choices about vaccinations. A proper vaccination counseling could improve attitudes regarding vaccination issues, such as quality of web-based research.

Keywords: Vaccine hesitancy; general population; health advocacy; internet traffic indicators; vaccination confidence; vaccination counseling; web search.

Figure 1.

Comparison of new unique visits, new website visitors (a), average webpages views in a single session and average duration of the website vaccinarsi.org visits in minutes (b), in the two months before (from 8th February 2017 to 7th April 2017) and after (from 8th April 2017 to 7th June 2017) vaccination counseling conducted at the principal shopping center of Palermo. (data limited to all the Sicilian cities in which survey participants lived)

Figure 2.

Average new unique visits to vaccinarsi.org in the two months after the interventions conducted (from 8th April 2017 to 7th June 2017), compared with the same period of the two previous (2015, 2016) and following (2018, 2019) years (data limited to all the Sicilian cities in which survey participants lived)