Introduction: Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale.

Methodology: In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents’ attitudes towards vaccination of their children.

Results: Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p< 0.05 for all).

Conclusions: Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.

Background

Patients who underwent thoracic surgery procedures were usually subjected to daily chest X-rays until discharge, exposing patients to ionizing radiation and requiring patient movement with chest drains, difficult positioning, and time-consuming. Unlike chest ultrasound, which is a good alternative because it is bedside and accurate in the detection of pulmonary complications. We hypothesize that a thoracic surgery resident with a short training program in chest ultrasound can achieve comparable results to a chest X-ray. Our study aims to analyze the agreement between the two techniques.

Results

This is an observational prospective study. Eighty-six adult patients who underwent thoracic surgery were included. Every patient had a chest X-ray and chest ultrasound follow-up on day 0, day 3, and day 5 post-operative. Chest ultrasound examinations were performed by the same resident, and the results were revised by an expert sonographer for the detection of pneumothorax, pleural effusion, pulmonary consolidation, and interstitial pattern. Both diagnostic procedures showed substantial agreement for pneumothorax (K = 0.661). For pleural effusion, they showed moderate agreement (K = 0.448, P < 0.001), and no cases developed an interstitial pattern. Overall, both diagnostic procedures showed perfect agreement (K = 0.838, P < 0.001). The time lag to perform a chest ultrasound was statistically lower than that to perform. chest X-ray, with a median of 7 min versus 80 min, respectively.

Conclusions

Performing chest ultrasound by a thoracic surgery resident is a less time-consuming and easy bedside diagnostic tool. Compared chest ultrasound to the postoperative X-ray showed a perfect diagnostic agreement for pulmonary consolidation and moderate agreement for pleural effusion and pneumothorax.