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

Figures & data

Table 1. Socio-demographic and occupational characteristics of the surveyed population (n = 299)

	n	%
Gender
- Male	110	36.8
- Female	189	63.2
Age, mean ± DS	40 ± 14.2
Education
-Secondary or lower	67	22.4
-High School degree	232	77.6
Marital status
-Married/cohabitant	232	77.5
-Non married/single	67	21.5
Being parent
-Yes	235	78.6
-No	64	21.4
Working in health sector
-Yes	43	14.4
-No	256	85.6
Profession
-Housewife	77	25.8
-Unemployed	25	8.4
-Student	34	11.4
-Elderly	24	8
-Job holder/freelancer	139	46.4

Table 2. Attitudes and sources of information about vaccination of the surveyed population and their confidence on the Public Health authorities recommendation (n = 299)

	n	%
Best strategy for infectious disease prevention
- vaccination	269	90.0
- other (hygiene, physical activity, homeopathy, etc.)	30	10.0
Attitude toward vaccinations
- positive	247	82.6
- hesitant	38	12.7
- reluctant	14	4.7
Intention to get vaccinated in future
-Yes	247	82.6
-No	52	17.4
Intention to vaccinate your own children in future (n = 222)
-Yes, totally	186	83.8
-Yes, only with mandatory vaccinations	22	9.9
-No	14	6.3
Main information source on vaccinations (multiple answer)
- General practitioners or Pediatricians	243	81.3
- Vaccination Center Health Professionals	48	16.1
- Relatives and Friends	29	9.7
-Mass media and internet	72	24.0
- Institutional websites	45	15.1
Websites previously consulted about vaccination issues (n = 244)
- vaccinarsi.org	45	18.5
- focus.it	67	27.4
- Institutional websites (epicentro.iss.it e salute.gov)	122	50.0
- Anti–vaccination websites (mednat.org, comilva.org, disinformazione.it)	10	4.1
Reliable websites on vaccination issues (n = 224)
- vaccinarsi.org	49	21.9
- focus.it	44	19.6
- Institutional websites (epicentro.iss.it e salute.gov)	125	55.8
- Anti–vaccination websites (mednat.org, comilva.org, disinformazione.it)	6	2.7
Greater confidence in HCWs than in mass-media/internet on vaccination topics (n = 297)
- Yes	259	87.2
- No	38	12.8
HCWs failed to mention some vaccine-related adverse effects during counseling (n = 294)
- Yes	130	44.2
- No	164	55.8

Table 3. Univariate (crude OR) and Multivariate (adj-OR)* analysis between vaccination hesitancy or refusal (vs vaccination confidence) with different categorical variables considered in the study. (* multivariate analysis was performed only for variables with p ≤ .0.20 at the univariate).

	Vaccination hesitancy or refusal (vs confidence)
	crude OR (95% CIs)	p-value	adj-OR (95% CIs)	p-value
Gender
- Female	reference	0.48
- Male	1.82 (0.81–2.36)
Age classes
- ≤ 40 years	ref	0.15	ref	0.57
- ≥ 40 years	1.56 (0.85–2.56)		1.21 (0.61–2.37)
Education
- high school/university degree	ref	0.54
- primary/secondary school degree	0.79 (0.37–1.68)
Marital Status
- married/partner	ref	0.67
- single/widower/divorced	1.16 (0.58–2.33)
Being parent
- yes	ref	0.49
- no	1.28 (0.64–2.58)
Health-care workers
- yes	ref	0.14	ref	0.19
- no	2.25 (0.76–6.59)		2.14 (0.69–6.67)
Best strategy for infectious disease prevention
- vaccination	ref	<0.001	ref	<0.001
- other (hygiene, physical activity, homeopathy, etc.)	7.39 (3.32–16.44)		7.01 (2.88–17.09)
Main informative source on vaccination topics
- GPs, pediatricians, public health-care workers	ref	0.05	ref	0.19
- Mass media, social networks, friends/relatives	2.09 (1.01–4.41)		1.73 (0.77–3.89)
Confidence in HCWs regarding vaccination topics
- yes	ref	0.05	ref	0.98
- no	2.18 (1.02–4.75)		0.99 (0.38–2.54)
Healthcare Professionals failed to mention some vaccine-related events
- yes	ref	0.21
- no	1.47 (0.80–2.68)

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)