Ebola vaccine? Family first! Evidence from using a brief measure on Ebola vaccine demand in a national household survey during the outbreak in Sierra Leone.


Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
08 05 2020
Historique:
received: 22 01 2020
revised: 22 03 2020
accepted: 24 03 2020
pubmed: 16 4 2020
medline: 14 4 2021
entrez: 16 4 2020
Statut: ppublish

Résumé

Vaccination against Ebolavirus is an emerging public health tool during Ebola Virus Disease outbreaks. We examined demand issues related to deployment of Ebolavirus vaccine during the 2014-2015 outbreak in Sierra Leone. A cluster survey was administered to a population-based sample in December 2014 (N = 3540), before any Ebola vaccine was available to the general public in Sierra Leone. Ebola vaccine demand was captured in this survey by three Likert-scale items that were used to develop a composite score and dichotomized into a binary outcome to define high demand. A multilevel logistic regression model was fitted to assess the associations between perceptions of who should be first to receive an Ebola vaccine and the expression of high demand for an Ebola vaccine. The largest proportion of respondents reported that health workers (35.1%) or their own families (29.5%) should receive the vaccine first if it became available, rather than politicians (13.8%), vaccination teams (9.8%), or people in high risk areas (8.2%). High demand for an Ebola vaccine was expressed by 74.2% of respondents nationally. The odds of expressing high demand were 13 times greater among those who said they or their families should be the first to take the vaccine compared to those who said politicians should be the first recipients (adjusted odds ratio [aOR] 13.0 [95% confidence interval [CI] 7.8-21.6]). The ultra-brief measure of the Ebola vaccine demand demonstrated acceptable scale reliability (Cronbach's α = 0.79) and construct validity (single-factor loadings > 0.50). Perceptions of who should be the first to get the vaccine was associated with high demand for Ebola vaccine around the peak of the outbreak in Sierra Leone. Using an ultra-brief measure of Ebola vaccine demand is a feasible solution in outbreak settings and can help inform development of future rapid assessment tools.

Sections du résumé

BACKGROUND
Vaccination against Ebolavirus is an emerging public health tool during Ebola Virus Disease outbreaks. We examined demand issues related to deployment of Ebolavirus vaccine during the 2014-2015 outbreak in Sierra Leone.
METHODS
A cluster survey was administered to a population-based sample in December 2014 (N = 3540), before any Ebola vaccine was available to the general public in Sierra Leone. Ebola vaccine demand was captured in this survey by three Likert-scale items that were used to develop a composite score and dichotomized into a binary outcome to define high demand. A multilevel logistic regression model was fitted to assess the associations between perceptions of who should be first to receive an Ebola vaccine and the expression of high demand for an Ebola vaccine.
RESULTS
The largest proportion of respondents reported that health workers (35.1%) or their own families (29.5%) should receive the vaccine first if it became available, rather than politicians (13.8%), vaccination teams (9.8%), or people in high risk areas (8.2%). High demand for an Ebola vaccine was expressed by 74.2% of respondents nationally. The odds of expressing high demand were 13 times greater among those who said they or their families should be the first to take the vaccine compared to those who said politicians should be the first recipients (adjusted odds ratio [aOR] 13.0 [95% confidence interval [CI] 7.8-21.6]). The ultra-brief measure of the Ebola vaccine demand demonstrated acceptable scale reliability (Cronbach's α = 0.79) and construct validity (single-factor loadings > 0.50).
CONCLUSION
Perceptions of who should be the first to get the vaccine was associated with high demand for Ebola vaccine around the peak of the outbreak in Sierra Leone. Using an ultra-brief measure of Ebola vaccine demand is a feasible solution in outbreak settings and can help inform development of future rapid assessment tools.

Identifiants

pubmed: 32291102
pii: S0264-410X(20)30423-0
doi: 10.1016/j.vaccine.2020.03.044
pii:
doi:

Substances chimiques

Ebola Vaccines 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3854-3861

Informations de copyright

Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Mohamed F Jalloh (MF)

Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. Electronic address: mjalloh@cdc.gov.

Aaron S Wallace (AS)

Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA.

Rebecca E Bunnell (RE)

Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, USA.

Rosalind J Carter (RJ)

Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA.

John T Redd (JT)

Center for Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, USA.

Sophia A Nur (SA)

Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, USA.

Zangin Zeebari (Z)

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Jönköping International Business School, Jönköping, Sweden.

Anna Mia Ekström (AM)

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.

Helena Nordenstedt (H)

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

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