Keywords
Abstract
Introduction Dengue is a vector-borne viral disease that causes a million of cases every year (including deaths). It is available a tetravalent live-attenuated virus vaccine for this infection. The aim of our study was to analyze vaccine acceptance, attitudes and behaviors among travelers directed to areas with risk of dengue.
Methods We conducted a cross-sectional study in February – April 2024, at the Travel Medicine Clinic of Rozzano, Italy. We collected several information from adult travelers directed to areas at risk of Dengue. As well as, we registered the other vaccines that they accepted or refused and the antimalarial prophylaxis.
Results 58 travelers were included in our study: they chose 23 countries for their travel and the average length of stay was 16.98 days. Five (8.62%) refused dengue vaccination. 80% of these travelers, refused because considered the vaccination not necessary, 20% for its cost. No one refused for fear of side effects. There was no statistically significant difference between men and women in vaccination acceptance. Age and length of stay did not influence the percentage of refusal.
Conclusions Vaccine hesitancy among travelers could be an important problem and further efforts should be done to limit this phenomenon.
References
Roy, S.K. and S. Bhattacharjee, Dengue virus: epidemiology, biology, and disease aetiology. Can J Microbiol, 2021. 67(10): p. 687-702.
ISS. Febbre Dengue. 2024 05/04/2024]; Available from: https://www.epicentro.iss.it/febbre-dengue/.
EMA. Qdenga. 2022 05/04/2024]; Available from: https://www.ema.europa.eu/en/documents/assessment-report/qdenga-epar-public-assessment-report_en.pdf.
Patel, S.S., et al., Clinical Safety Experience of TAK-003 for Dengue Fever: A New Tetravalent Live Attenuated Vaccine Candidate. Clin Infect Dis, 2023. 76(3): p. e1350-e1359.
Kain, D., et al., Factors Affecting Pre-Travel Health Seeking Behaviour and Adherence to Pre-Travel Health Advice: A Systematic Review. J Travel Med, 2019. 26(6).
McGuinness, S.L., et al., Immediate recall of health issues discussed during a pre-travel consultation. J Travel Med, 2015. 22(3): p. 145-51.
Heywood, A.E. and N. Zwar, Improving access and provision of pre-travel healthcare for travellers visiting friends and relatives: a review of the evidence. J Travel Med, 2018. 25(1).
McGuinness, S.L., et al., Pre-travel vaccine information needs, attitudes, drivers of uptake and the role for decision aids in travel medicine. J Travel Med, 2023. 30(4).
CDC. Travelers' Health. 05/04/2024]; Available from: https://wwwnc.cdc.gov/travel/.
Bocci, G., et al., Malaria chemoprophylaxis' compliance in travelers. Ann Ig, 2018. 30(1): p. 71-72.
Arcilla, M.S., et al., Import and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae by international travellers (COMBAT study): a prospective, multicentre cohort study. Lancet Infect Dis, 2017. 17(1): p. 78-85.
Leong, W.Y., Measles cases hit record high in Europe in 2018. J Travel Med, 2018. 25(1).
Gautret, P., et al., The spread of vaccine-preventable diseases by international travellers: a public-health concern. Clin Microbiol Infect, 2012. 18 Suppl 5: p. 77-84.
ECDC. Dengue worldwide overview. 2024 09/04/2024]; Available from: https://www.ecdc.europa.eu/en/dengue-monthly.
Messina, J.P., et al., The current and future global distribution and population at risk of dengue. Nat Microbiol, 2019. 4(9): p. 1508-1515.
Lammert, S.M., et al., Refusal of recommended travel-related vaccines among U.S. international travellers in Global TravEpiNet. J Travel Med, 2016. 24(1).
Lopes, V.D.S., et al., Yellow fever vaccine hesitancy and its relationship with contextual, individual, or group influences and vaccine-specific issues: a scoping review. Cien Saude Colet, 2023. 28(6): p. 1717-1727.
Adongo, C.A., et al., Beyond fragmentary: A proposed measure for travel vaccination concerns. Tour Manag, 2021. 83: p. 104180.
Ishimaru, T., et al., Gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan. Hum Vaccin Immunother, 2021. 17(11): p. 3975-3981.
Troiano, G. and A. Nardi, Vaccine hesitancy in the era of COVID-19. Public Health, 2021. 194: p. 245-251.
Facciola, A., et al., Vaccine hesitancy: An overview on parents' opinions about vaccination and possible reasons of vaccine refusal. J Public Health Res, 2019. 8(1): p. 1436.
Ballalai, I., Dawson, R., Horn, M., Smith, V., Bekkat-Berkani, R., Soumahoro, L., & Vicic, N., Understanding barriers to vaccination against invasive meningococcal disease: a survey of the knowledge gap and potential solutions. . Expert Review of Vaccines, 22(1), 457–467. https://doi.org/10.1080/14760584.2023.2211163, 2023.
Kumar, D., et al., Vaccine hesitancy: understanding better to address better. Isr J Health Policy Res, 2016. 5: p. 2.