Aug 2026· Vaccines· Vol 14· 0 citations· 26 references
Medicine
TL;DR
Positive attitudes toward non-routine childhood vaccines among healthcare workers do not necessarily translate into consistent recommendation behaviors across all vaccine types, including rotavirus, meningococcal, human papillomavirus (HPV) and influenza vaccines.
Abstract
Background: Healthcare workers play a critical role in parental vaccine decision-making and the uptake of non-routine childhood vaccines. This study aimed to evaluate healthcare workers’ knowledge, attitudes and behaviors regarding non-routine childhood vaccines, including rotavirus, meningococcal, human papillomavirus (HPV) and influenza vaccines. Methods: This cross-sectional study was conducted between October 2025 and March 2026 among healthcare workers in Türkiye. Data were collected using a structured questionnaire and the Attitudes Towards Vaccine Scale (ATVS), distributed through convenience and snowball sampling methods. Results: A total of 345 healthcare workers participated in the study. Recommendation behaviors differed significantly according to vaccine type (p < 0.001). Rotavirus and meningococcal vaccines were more frequently recommended than HPV and influenza vaccines. Although influenza vaccine had the highest awareness rate, it demonstrated the lowest recommendation rate and the lowest support for inclusion in the national immunization schedule. Physicians had significantly higher knowledge levels and vaccination attitude scores than non-physician healthcare workers (p < 0.001). ATVS scores were positively correlated with recommendation behaviors (ρ = 0.35, p < 0.001) and self-vaccination tendency (ρ = 0.34, p < 0.001). In multivariable analyses, higher vaccination attitude scores independently predicted greater self-vaccination tendency (OR = 1.07, 95% CI: 1.04–1.11, p < 0.001). Cost was the most commonly reported barrier to vaccine implementation. Conclusions: Positive attitudes toward non-routine childhood vaccines among healthcare workers do not necessarily translate into consistent recommendation behaviors across all vaccine types. Strategies targeting healthcare worker education, equitable vaccine access and standardized vaccine counseling practices may improve uptake and recommendation of optional childhood vaccines in Türkiye.
Investigation of parents' knowledge, attitudes, and practices regarding childhood influenza vaccination in Jiangsu showed moderate knowledge and positive attitudes but low actual vaccination rates, suggesting targeted interventions are needed to reduce the cognition-practice gap and improve childhood influenza vaccination coverage.
Zhaohan Wei, Xiaolei Feng, Qin Sun et al.· Vaccine· 0 citations
Background: Human papillomavirus (HPV) is a major cause of cervical cancer, a largely preventable disease through vaccination. Despite the integration of the HPV vaccine into the Saudi National Immunization Schedule, uptake remains low, with vaccine hesitancy and provider-related factors contributing to suboptimal coverage. Physicians play a critical role in shaping vaccination decisions; however, evidence comparing HPV-related knowledge and practice recommendations across medical specialties in Saudi Arabia remains limited. This study aimed to evaluate physicians’ knowledge of HPV and the HPV vaccine and assess their recommendation practices across clinical specialties in Jeddah, Saudi Arabia.
Methods: A cross-sectional survey was conducted among physicians in the First and Second Health Clusters in Jeddah, Saudi Arabia, between December 2025 and March 2026 using a multistage sampling technique. Data were collected through a validated self-administered questionnaire. Knowledge was assessed using a 16-item scale, and recommendation behavior was dichotomized. Descriptive statistics, non-parametric tests, and multivariable regression analyses were performed.
Results: A total of 165 physicians were included. Awareness of the importance of HPV vaccination was high (95.2%). The median knowledge score was 68.75% (IQR: 25.00), with significant variation by age and specialty (p < 0.001). Pediatricians had significantly lower knowledge scores compared to family medicine physicians (β = -11.33, p = 0.034). Overall, 55.2% reported routinely recommending HPV vaccination. Knowledge was a significant predictor of recommendation behavior (OR = 1.05, 95% CI: 1.02–1.07, p < 0.001). Pediatricians were less likely to recommend vaccination (OR = 0.20, p = 0.012).
Conclusion: These findings highlight a gap between knowledge and practice and emphasize the need for targeted, specialty-specific interventions to improve HPV vaccination uptake in Saudi Arabia.
S. Alsalhi, Majed A Alghamdi· Saudi Journal of Public Heal...· 0 citations
Strengthening obstetricians’ guidance, promoting non-injectable influenza vaccines, and delivering targeted health education are important strategies to improve vaccination uptake in this population of women to inform evidence-based policy interventions.
Peipei Liu, Yanfang Min, Chunmei Cai et al.· Human Vaccines & Immunothera...· 0 citations
Background: In primary care settings, cervical cancer screening and prevention are highly dependent on healthcare provider initiatives, particularly in countries like Türkiye where the HPV vaccine is not yet integrated into the national routine immunization schedule. Since HPV vaccines provide over 90% protection against cervical cancer, the proactive guidance of primary care providers is critical. This study evaluated family physicians’ knowledge levels and awareness of HPV infection and human papillomavirus (HPV) vaccines in primary care settings in Türkiye. Methods: A total of 238 family physicians working in Türkiye participated in this descriptive cross-sectional study using a convenience sampling method. Data were collected through an online questionnaire administered via Google Forms. The survey included a sociodemographic information form and a 33-item HPV knowledge scale. Data were analyzed using descriptive statistics, normality assessment, chi-square test, Mann–Whitney U test, Kruskal–Wallis test, and hierarchical logistic regression analysis. Results: Overall, 81.1% of participants recommended the HPV vaccine, and 83.6% believed it should be included in the national schedule. Notably, only 15.1% of the participating physicians had received the HPV vaccine themselves, whereas 40.6% of the unvaccinated subgroup (82/202) stated they were considering personal vaccination. HPV knowledge levels were generally high, but lower when regarding the current national program. Vaccine recommenders and female participants had significantly higher knowledge scores, while out-of-pocket vaccine cost emerged as a major barrier to clinical recommendation. In multivariable hierarchical logistic regression, individual knowledge domains did not emerge as independent standalone predictors after controlling for demographics, with only knowledge of the current national program showing a borderline trend (p = 0.066), although the inclusion of the knowledge variables as a collective block significantly improved the overall model explanatory power (p = 0.003). Conclusions: Family physicians in Türkiye showed generally high HPV-related knowledge and a high rate of HPV vaccine recommendation. This study clarifies that primary care advocacy is shaped by the combined influence of professional knowledge and overriding structural factors, rather than individual knowledge domains acting as independent standalone predictors. While future strategies must focus on developing targeted continuous medical education to bridge specific knowledge gaps and optimize opportunistic counseling, achieving optimal immunization coverage ultimately relies on integrating the vaccine into national programs to mitigate out-of-pocket cost barriers.
F. Yurdakul, Ömer Acat, Latife Uzun· Healthcare· 0 citations
Background: Healthcare workers (HCWs) are at increased risk of exposure to vaccine-preventable diseases, including hepatitis B, tuberculosis (TB), and tetanus, due to their occupational environment. Despite the availability of safe and effective vaccines, vaccination coverage among HCWs remains suboptimal in many low- and middle-income countries. This study aimed to determine the vaccination coverage for hepatitis B, tuberculosis, and tetanus among HCWs in district hospitals in Yaounde, Cameroon, and to identify factors associated with incomplete vaccination. Methods: A cross-sectional analytical study was conducted from January to June 2024 across all seven district hospitals in Yaounde. A total of 406 HCWs were enrolled using a structured, self-administered questionnaire. Incomplete vaccination status was defined as nit having received three doses for hepatitis B, at least two doses for TB, and at least three doses for tetanus. Data were analyzed using R Statistics version 4.3.3. Bivariate and multivariate logistic regression models were used to identify predictors of incomplete vaccination, with statistical significance set at p < 0.05. Results: Most of participants were female (75.6%) and aged 30-44 years (65.5%). Full vaccination coverage was 36.2% for hepatitis B, 15.8% for tuberculosis, and 53.4% for tetanus. Unvaccinated proportions were 43.1% for hepatitis B, 0.5% for tuberculosis, and 17.2% for tetanus. Multivariate analysis revealed that HCWs aged 55-66 years were significantly less likely to be incompletely vaccinated against hepatitis B compared to those aged 19-29 years (aOR = 0.07; 95% CI: 0.01-0.39; p = 0.004). Nurses and laboratory technicians were more likely to be incompletely vaccinated than doctors (aOR = 7.06; 95% CI: 3.82-13.6; p < 0.001 and aOR = 3.78; 95% CI: 1.73-8.52; p = 0.001, respectively). Longer professional experience was protective against incomplete vaccination for all three vaccines (p < 0.05). The main barriers to vaccination included high cost, doubts about the need for vaccination, and concerns about side effects. Conclusions: Vaccination coverage for hepatitis B, tuberculosis, and tetanus among HCWs in Yaounde remains suboptimal, particularly for hepatitis B. Addressing financial barriers, improving access to vaccines, and implementing targeted educational interventions are essential to enhance vaccine uptake and protect both HCWs and their patients from preventable occupational infections.
A. Nouko, F. Z. Cheuyem, F. Nguefack et al.· medRxiv· 0 citations
Maternal influenza vaccination (MIV) is the most effective measure of preventing severe influenza-related complications in pregnant women. However, there is limited knowledge about MIV uptake in Kuwait. This study aimed to assess pregnant women’s knowledge, attitudes, and perceptions regarding MIV uptake and provision in Kuwait. A cross-sectional, hospital-based study using a self-administered electronic questionnaire adapted from the World Health Organization (WHO) Tailoring Immunization Programmes (TIP FLU) questionnaire was conducted among 272 pregnant and recently delivered women attending governmental maternity hospitals and antenatal clinics in Kuwait between October 2022 and January 2023. Only 22 participants (8.1%) reported receiving MIV during their current or most recent pregnancy. Although most participants recognised that influenza infection could have serious consequences during pregnancy, only 8% met the predefined threshold for adequate knowledge regarding MIV. Healthcare professionals demonstrated significantly higher knowledge of influenza infection than participants from other professions (
p
= 0.012), while younger participants had significantly greater knowledge of MIV (
p
= 0.023). No significant associations were identified between participant characteristics and MIV uptake. Participants recognised healthcare provider recommendation as an important factor influencing vaccination decisions, although many reported not receiving such a recommendation during pregnancy. Knowledge of maternal influenza vaccination and vaccine uptake were low among pregnant women in Kuwait. These findings highlight opportunities to strengthen antenatal education and encourage healthcare providers to consistently discuss and recommend maternal influenza vaccination during pregnancy. Further studies with larger samples are needed to identify independent predictors of vaccine uptake.
Fatemah Alhendyani, Louise Hayes, Laura Lindsey et al.· Scientific Reports· 0 citations
