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Item COVID Vaccines in Adolescents and Young Adults(Elsevier, 2022) Holder, N.; Coyne-Beasely, T.; Zimet, G.; Eisenstein, E.; Skinner, R.; Galagali, P.; Kanbur, N.; Pediatrics, School of MedicineWorldwide, a number of COVID-19 vaccines have been approved or granted Emergency Use Authorization (EUA) or Emergency Use Listing for adolescents and young adults (AYA), which has brought hope to many across the globe. Extension of the EUA for a COVID-19 vaccine to children and adolescents aged 5 through 15 years is exciting news for children, adolescents, parents, and providers of AYA. Many countries around the globe have extended immunization against COVID-19 to younger age groups. At the same time, the COVID-19 pandemic has led to a decrease globally in administration of other adolescent vaccines. This highlights that vaccine recommendations do not necessarily lead to successful and equitable vaccine distribution, and overcoming barriers to vaccination is critical. Certain subpopulations of AYA, particularly those who are marginalized/underrepresented, do not receive appropriate health care. AYA should be offered protection against all vaccine-preventable illnesses at every opportunity. Creating innovative strategies to improve vaccine uptake among AYA should be encouraged.Item The effects of message framing and healthcare provider recommendation on adult hepatitis B vaccination: A randomized controlled trial(Elsevier, 2019-08-09) Kasting, Monica L.; Head, Katharine J.; Cox, Dena; Cox, Anthony D.; Zimet, Gregory D.; Pediatrics, School of MedicineMany adults in the U.S. do not receive recommended vaccines, and the research literature remains inconclusive on the best communication strategies for increasing this behavior. This study examined the association of message framing (gained-framed vs. loss-framed vs. control), and healthcare provider (HCP) recommendation (offered vs. recommended) on uptake of adult hepatitis B virus (HBV) vaccination in a high risk population using a 3×2 block design randomized controlled trial. Fear of shots, fear of vaccines, and perceived message framing were examined in secondary analyses. Of the 1,747 participants, 47.7% (n=833) received 0 doses of HBV vaccine, 27.8% (n=485) received 1 dose, 10.4% received 2 doses, and 14.1% received all 3 recommended doses. There was not a significant interaction between message framing and HCP recommendation (p =.59). Mean number of doses received by the gain-framed group (m=.96) was not significantly different from the loss-framed group (m=.97, RR=.99, 95% CI=.88–1.12). However, those receiving any framing message received significantly more doses (m= .96) than those in the control condition (m=.81, RR=1.17, 95%CI=1.06–1.31). Participants who received a HCP recommendation received significantly more vaccine doses (m=.95) than those in the vaccine-offered condition (mean=.82, RR=1.16, 95%CI=1.05–1.28). These results suggest there is no difference in vaccine uptake between gain-frame and loss-frame messages, but both are better than a control message. These results also support advising HCP to provide a strong recommendation for vaccinations beyond merely offering it to patients. This study has implications for vaccine uptake beyond HBV, and can inform future research on effective vaccine communication research.Item Human Papillomavirus Vaccination and School Entry Requirements: Politically Challenging, but Not Impossible(AMA, 2019-01) Daley, Ellen; Thompson, Erika; Zimet, Gregory; Pediatrics, School of MedicineItem Using an integrated conceptual framework to investigate parents' HPV vaccine decision for their daughters and sons(Elsevier, 2018-11) Shapiro, Gilla K.; Tatar, Ovidiu; Amsel, Rhonda; Prue, Gillian; Zimet, Gregory D.; Knauper, Barbel; Rosberger, Zeev; Pediatrics, School of MedicineDespite being an effective cancer prevention strategy, human papillomavirus (HPV) vaccination in Canada remain suboptimal. This study is the first to concurrently evaluate HPV vaccine knowledge, attitudes, and the decision-making stage of Canadian parents for their school-aged daughters and sons. Data were collected through an online survey from a nationally representative sample of Canadian parents of 9–16 year old children from August to September 2016. Measures included socio-demographics, validated scales to assess HPV vaccine knowledge and attitudes (using the Health Belief Model), and parents' HPV vaccination adoption stage using the Precaution Adoption Process Model (PAPM; six stages: unaware, unengaged, undecided, decided not, decided to, or vaccinated). 3779 parents' survey responses were analyzed (1826 parents of sons and 1953 parents of daughters). There was a significant association between child's gender and PAPM stage of decision-making, with parents of boys more likely to report being in earlier PAPM stages. In multinomial logistic regression analyses parents of daughters (compared to sons), parents of older children, and parents with a health care provider recommendation had decreased odds of being in any earlier PAPM stage as compared to the last PAPM stage (i.e. vaccinated). Parents who were in the ‘decided not to vaccinate’ stage had significantly greater odds of reporting perceived vaccine harms, lack of confidence, risks, and vaccine conspiracy beliefs. Future research could use these findings to investigate theoretically informed interventions to specifically target subsets of the population with particular attention towards addressing knowledge gaps, perceived barriers, and concerns of parents.