147 lines
4.6 KiB
YAML
147 lines
4.6 KiB
YAML
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abstract: 'Extending the benefits of vaccination to everyone who is eligible
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requires an understanding of which populations current vaccination
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efforts have struggled to reach. A clear definition of
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``hard-to-reach{''''} populations - also known as high-risk or
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marginalized populations, or reaching the last mile - is essential for
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estimating the size of target groups, sharing lessons learned based on
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consistent definitions, and allocating resources appropriately. A
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literature review was conducted to determine what formal definitions of
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hard-to-reach populations exist and how they are being used, and to
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propose definitions to consider for future use. Overall, we found that
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(1) there is a need to distinguish populations that are hard to reach
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versus hard to vaccinate, and (2) the existing literature poorly defined
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these populations and clear criteria or thresholds for classifying them
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were missing. Based on this review, we propose that hard-to-reach
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populations be defined as those facing supply-side barriers to
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vaccination due to geography by distance or terrain, transient or
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nomadic movement, healthcare provider discrimination, lack of healthcare
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provider recommendations, inadequate vaccination systems, war and
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conflict, home births or other homebound mobility limitations, or legal
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restrictions. Although multiple mechanisms may apply to the same
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population, supply-side barriers should be distinguished from
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demand-side barriers. Hard-to-vaccinate populations are defined as those
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who are reachable but difficult to vaccinate due to distrust, religious
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beliefs, lack of awareness of vaccine benefits and recommendations,
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poverty or low socioeconomic status, lack of time to access available
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vaccination services, or gender-based discrimination. Further work is
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needed to better define hard-to-reach populations and delineate them
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from populations that may be hard to vaccinate due to complex refusal
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reasons, improve measurement of the size and importance of their impact,
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and examine interventions related to overcoming barriers for each
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mechanism. This will enable policy makers, governments, donors, and the
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vaccine community to better plan interventions and allocate necessary
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resources to remove existing barriers to vaccination. (C) 2019 Elsevier
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Ltd. All rights reserved.'
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affiliation: 'Ozawa, S (Corresponding Author), UNC Eshelman Sch Pharm, CB 7574,Beard
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Hall 115H, Chapel Hill, NC 27599 USA.
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Ozawa, Sachiko; Yemeke, Tatenda T., Univ N Carolina, UNC Eshelman Sch Pharm, Div
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Practice Adv \& Clin Educ, Chapel Hill, NC 27515 USA.
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Ozawa, Sachiko, Univ N Carolina, UNC Eshelman Sch Pharm, Dept Maternal \& Child
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Hlth, Chapel Hill, NC 27515 USA.
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Evans, Daniel R., Duke Univ, Sch Med, Durham, NC USA.
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Pallas, Sarah E.; Wallace, Aaron S., CDC, US Ctr Dis Control \& Prevent, Global
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Immunizat Div, Atlanta, GA USA.
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Lee, Bruce Y., Johns Hopkins Bloomberg Sch Publ Hlth, Publ Hlth Computat \& Operat
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Res PHICOR, Baltimore, MD USA.
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Lee, Bruce Y., Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore,
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MD USA.
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Lee, Bruce Y., Johns Hopkins Univ, GOPC, Baltimore, MD USA.'
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author: Ozawa, Sachiko and Yemeke, Tatenda T. and Evans, Daniel R. and Pallas, Sarah
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E. and Wallace, Aaron S. and Lee, Bruce Y.
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author-email: ozawa@unc.edu
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author_list:
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- family: Ozawa
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given: Sachiko
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- family: Yemeke
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given: Tatenda T.
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- family: Evans
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given: Daniel R.
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- family: Pallas
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given: Sarah E.
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- family: Wallace
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given: Aaron S.
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- family: Lee
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given: Bruce Y.
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da: '2023-09-28'
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doi: 10.1016/j.vaccine.2019.06.081
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eissn: 1873-2518
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files: []
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issn: 0264-410X
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journal: VACCINE
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keywords: Hard-to-reach; Definition; Vaccination; Immunization; Unvaccinated
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keywords-plus: 'HUMAN-PAPILLOMAVIRUS VACCINATION; ROUTINE IMMUNIZATION COVERAGE;
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MIDDLE-INCOME COUNTRIES; HEALTH-CARE; INFLUENZA VACCINATION; CHILDREN;
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BARRIERS; RECOMMENDATIONS; INCREASE; SERVICES'
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language: English
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month: SEP 3
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number: '37'
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number-of-cited-references: '106'
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orcid-numbers: 'Ozawa, Sachiko/0000-0001-7608-9038
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Evans, Daniel/0000-0002-9818-5001
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Wallace, Aaron/0000-0003-2264-3229
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Pallas, Sarah/0000-0002-9719-6278
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Yemeke, Tatenda/0000-0002-1489-627X'
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pages: 5525-5534
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papis_id: 91faa1a429daf4ac7e6bfc12c827df4e
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ref: Ozawa2019defininghardtoreach
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researcherid-numbers: 'Ozawa, Sachiko/Z-4944-2019
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'
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tags:
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- review
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times-cited: '36'
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title: Defining hard-to-reach populations for vaccination
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type: Review
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unique-id: WOS:000485212400005
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usage-count-last-180-days: '3'
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usage-count-since-2013: '16'
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volume: '37'
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web-of-science-categories: Immunology; Medicine, Research \& Experimental
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year: '2019'
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