Concerns and Responses Toward Travel Vaccination Among International Tourists in Ghana

Abstract

People's concern toward vaccination is increasingly a major contributor to poor vaccine uptake, coverage and disease outbreaks. Despite poor vaccine uptake among international tourists attributed to concerns, research has rarely empirically investigated what constitutes travel vaccination concerns and its relationship with uptake among tourists. This study sought to propose a scale for measuring travel vaccination concerns; explore the underlying reasons of these concern s; examine the relationship between concerns and vaccine uptake and ; thus, propose a tourist typology based on their vaccination concerns. A mixed method approach was employed. Qualitative data were first collected through online data mining of 1,235 posts and field in-depth interviews of 20 respondents. This was followed by a survey of 1,032 inbound tourists in Ghana, using a questionnaire to collect quantitative data. The qualitative data were analysed thematically while structural equation modelling, ratio and logistic regression, and cluster analysis were used in the analysis of the quantitative data. A six-dimensional travel vaccination concern scale was identified with its facets being efficacy, safety, cost, time, access and ethical c ncerns. These concerns were influenced by respondents' socio-demographic characteristics, tripographics, vaccination information seeking behaviour and vaccination literacy. A significant relationship also existed between concerns and vaccine uptake. Consequently a typology of vaccination concerned tourists, which is made up of Crits. Passives and Fluiders, was identified. In view of this, travel medicine professionals, the World Health Organisation, governments and pharmaceutical companies need proper monitoring and understanding of tourists' travel vaccination concerns and targeted interventions to improve vaccine uptake.