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Xie H, Zhou Y, Li M, Chen Z, Zheng Y. Attitude, knowledge, and barriers of Chinese clinical and nursing students in implementing complementary and alternative medicine for COVID-19:a cross-sectional study. Heliyon 2024; 10:e30915. [PMID: 38778948 PMCID: PMC11108821 DOI: 10.1016/j.heliyon.2024.e30915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
Background Complementary and alternative medicine (CAM) has emerged to combat the global COVID-19 pandemic. However, no studies have been conducted to evaluate the attitudes, knowledge, and barriers of Chinese clinical and nursing students in implementing CAM during this period. Objective The aim of this study was to investigate the attitude, knowledge, and barriers of Chinese clinical and nursing students in using CAM in the context of COVID-19. Methods An online-based cross-sectional survey was carried out among Chinese medical students, majoring in clinical medicine or nursing, in Nanjing, Jiangsu Province, and Zhengzhou, Henan Province from May to July 2022. A total of 402 clinical and 644 nursing students responded to a self-administered questionnaire through the Questionnaire Star and WeChat APPs. SPSS 25 (version 25) was used for data analysis. Proportions were compared by Chi-square test. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test. Results The average score of attitude was 46.63 (SD: 7.38) in clinical students and 49.84 (SD: 6.76) in nursing students. The top four most commonly used CAM treatments in China were proprietary Chinese medicine, diet therapy, decoction, and acupuncture and moxibustion (59.66 %, 22.28 %, 11.66 %, 9.85 %). The students had a good mastery of knowledge about CAM-based prevention and control of COVID-19 (mean score 7.36). The score of CAM knowledge in nursing students was significantly higher than that in clinical students (7.56 VS 7.04, P = 0.000). Gender, grade, previous use, age, and knowledge score could affect students' attitude towards CAM. The main barriers in spreading CAM use included time-consumption, bad taste, and fear of treatment-related pain (24.5 %). Compared with clinical students, nursing students were more likely to recommend CAM to patients in the future (P = 0.002). Conclusions During the COVID-19 pandemic, nursing students were more positive towards CAM use, had a better mastery of CAM knowledge than clinical students. CAM is expected to provide better outcomes in COVID-19 patients. Future studies should focus on the changes in students' attitudes over time and exploration of influencing factors on CAM use.
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Affiliation(s)
- Hui Xie
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, 450000, China
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Yaqiu Zhou
- Department of Geriatrics, The Fourth People's Hospital of Taizhou, Taizhou, 225300, China
| | - Muhan Li
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Zhaoqi Chen
- Henan Provincial People's Hospital, Zhengzhou, 450000, China
| | - Yuling Zheng
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, 450000, China
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
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Spector S, Shah S, ul Rasool MH, Hilt E, Goldstein H, Meade J, Korn E, Lipetskaia L. Attitudes toward COVID-19 vaccination among urogynecology patients. Heliyon 2024; 10:e30092. [PMID: 38778988 PMCID: PMC11108857 DOI: 10.1016/j.heliyon.2024.e30092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 04/01/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Objective Urogynecology patients skew older and often require intimate exams to treat non-life-threatening conditions, thus making care particularly susceptible to the effects of COVID-19. We aim to understand COVID-19 vaccination attitudes amongst urogynecology patients during the pandemic, which has adversely affected healthcare delivery, to identify measures that can be undertaken to improve care going forward. Study design Cross-sectional surveys of urogynecology patients were conducted in three different states (Delaware, New Jersey, and Pennsylvania) between March and August 2021. Demographics, vaccination status, and COVID-19 attitudes were analyzed. Chi-square tests investigated group differences between vaccine-hesitant and unhesitant subjects. Results Out of 158 surveys, eighty-three percent of respondents were vaccinated or planning to get vaccinated. Older age and regular flu vaccination predicted COVID-19 vaccination. Ninety-three percent of subjects were comfortable attending in-person visits. However, vaccine-hesitant individuals were less comfortable attending in-person and were significantly less likely to be comforted by clinic interventions, such as masking. Hesitant and unhesitant groups trusted doctors or medical professionals most for their source of COVID-19 information. Conclusions Urogynecology patients mirror the general older population's COVID-19 vaccination attitudes, with distinct differences between hesitant and unhesitant groups. Vaccine-hesitant subjects appear less comfortable coming to in-person visits and less comforted by possible interventions, posing a difficult obstacle for clinics to overcome. High levels of patient trust suggest healthcare providers can play a crucial role in encouraging COVID-19 vaccination and combating misinformation.
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Affiliation(s)
- Sean Spector
- Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA
| | - Shanaya Shah
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Elizabeth Hilt
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Howard Goldstein
- Center for Urogynecology and Pelvic Surgery, Christiana Care Health System, Newark, DE, USA
| | - Jason Meade
- UroGynecology Specialty Center, Fresno, CA, USA
| | | | - Lioudmila Lipetskaia
- Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
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Zhao W, Russell CM, Jankovsky A, Cannon TD, Pittenger C, Pushkarskaya H. Information processing style and institutional trust as factors of COVID vaccine hesitancy. Sci Rep 2024; 14:10416. [PMID: 38710827 PMCID: PMC11074285 DOI: 10.1038/s41598-024-60788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
This study investigates the factors contributing to COVID vaccine hesitancy. Vaccine hesitancy has commonly been attributed to susceptibility to misinformation and linked to particular socio-demographic factors and personality traits. We present a new perspective, emphasizing the interplay between individual cognitive styles and perceptions of public health institutions. In January 2020, before the COVID-19 pandemic, 318 participants underwent a comprehensive assessment, including self-report measures of personality and clinical characteristics, as well as a behavioral task that assessed information processing styles. During 2021, attitudes towards vaccines, scientists, and the CDC were measured at three time points (February-October). Panel data analysis and structural equation modeling revealed nuanced relationships between these measures and information processing styles over time. Trust in public health institutions, authoritarian submission, and lower information processing capabilities together contribute to vaccine acceptance. Information processing capacities influenced vaccination decisions independently from the trust level, but their impact was partially mediated by authoritarian tendencies. These findings underscore the multifactorial nature of vaccine hesitancy, which emerges as a product of interactions between individual cognitive styles and perceptions of public health institutions. This novel perspective provides valuable insights into the underlying mechanisms that drive this complex phenomenon.
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Affiliation(s)
- Wanchen Zhao
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA.
| | - Catherine Maya Russell
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Christopher Pittenger
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, CT, USA
| | - Helen Pushkarskaya
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA.
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Topçu S, Emlek Sert Z. Intern nursing students' experiences in the COVID-19 vaccination unit and views on the COVID-19 vaccine: A phenomenological qualitative study. Work 2024:WOR220655. [PMID: 38701167 DOI: 10.3233/wor-220655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Improving acceptance of the COVID-19 vaccine among nursing students is an important strategy for both preventing infection and building public confidence in the vaccine. OBJECTIVE The aim of this study was to describe the views of intern nursing students on the COVID-19 vaccine and to evaluate their experiences in the COVID-19 vaccination unit. METHODS This was a phenomenological qualitative study with a descriptive design. The 46 intern nursing students included in this study were all trained in the COVID-19 vaccination unit. The data was collected at focus group interviews conducted during June 2021 and October 2021. RESULTS The mean age of intern nursing students was 22.78±0.91. From the focus group interviews, two themes were identified regarding the views of intern nursing students on the COVID-19 vaccine and their experiences in the COVID-19 vaccination unit: Theme 1. Positive views; Theme 2. Negative views. Intern nursing students described that they trust the COVID-19 vaccine and believe in its protection. Intern nursing students who performed their clinical practices in COVID-19 vaccination unit stated that they realized their responsibilities toward patients and the community. CONCLUSIONS From the INSs' point of view, confidence in the vaccine, responsibility towards patients, their families and the community, and VU practice experience, the health risk associated with COVID-19 positively affected their decision to be vaccinated against COVID-19. The participation of intern nursing students in clinical practice during the pandemic influenced both intern nursing students and population in terms of the uptake of COVID-19 vaccines.
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Thompson ESJ, Howe E, Kenworthy LaMarca T, Natale R, Jent JF. Diverse Parents Decision-Making to Vaccinate Their Child under Five Attending Childcare Programs. J Clin Med 2024; 13:2299. [PMID: 38673572 PMCID: PMC11051460 DOI: 10.3390/jcm13082299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/29/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: On 18 June 2022, Moderna and Pfizer-BioNTech COVID-19 vaccines were authorized under an Emergency Use Authorization by the United States Food and Drug Administration to prevent severe coronavirus disease in children six months to four years of age. Despite approval of the COVID-19 vaccinations for young children, there remain ongoing challenges reaching widespread coverage due to parental decision-making. Parental decision-making plays a pivotal, yet understudied, role governing vaccine adoption among this priority demographic. Methods: This cross-sectional analysis examined COVID-19 vaccine intentions for 320 predominately Hispanic parents of two to five-year-olds attending Miami-Dade County childcare programs in Florida USA, several months following the June 2022 emergency authorization. Parent's self-reported survey data encompassed vaccine choices and rationales, social determinants of health, and parent immigrant status. Data analyses illustrate the associations between parent decision-making and these variables. Regression modeling and tests of independence identified predicting factors for parental vaccine decision-making. Results: Only 25% of parents intended to vaccinate their young child, while 34% resisted and 41% felt unsure, despite 70% personal vaccination rates. Household income under $25,000, identifying as a migrant, or testing COVID-19-positive significantly predicted unsure decision-making. The majority of hesitant groups expressed concerns around side effects (20%), safety (2.9%), and sufficiency of vaccine knowledge (3.3%). Conclusions: In this sample, the predominance of parents were unsure and resistant rather than accepting of having their child vaccinated despite emergency approval of the pediatric vaccine. Associations and predictive factors are examined.
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Affiliation(s)
| | | | | | | | - Jason F. Jent
- Mailman Center for Child Development, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA (T.K.L.)
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Kuo CT, Yu RR. Association of National Identity and Trust in Government with COVID-19 Vaccination and Brand Choice in Taiwan. J Community Health 2024:10.1007/s10900-024-01347-4. [PMID: 38522040 DOI: 10.1007/s10900-024-01347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/25/2024]
Abstract
In Taiwan, hesitancy regarding COVID-19 vaccination centered more on the choice of vaccine brand than on the decision to vaccinate. However, there is limited research exploring the factors influencing COVID-19 vaccine brand preferences from a sociopolitical perspective. Thus, we aimed to examine how Taiwanese national identity and trust in government influence vaccination status and vaccine brand choice, using longitudinal data from 2020, 2021, and 2023. This study utilized data from the Taiwan Panel Study of Family Dynamics 2020 survey, and combined it with data from two self-administered surveys conducted in 2021 and 2023. We focused on four vaccines commonly administered in Taiwan: AstraZeneca, Moderna, Pfizer-BioNTech, and the domestically-developed Medigen. Using Poisson regression models with robust standard errors, we assessed the effects of national identity and trust in government on the choice of COVID-19 vaccine brand. By analyzing data from 2361 participants, we found that national identity and trust in government were associated with the likelihood of COVID-19 vaccination, the number of vaccine doses received, and the brand of vaccine taken. Those who identified themselves as Taiwanese were more inclined to receive the Medigen and AstraZeneca vaccines, but less willing to receive Pfizer-BioNTech vaccine. Those who trusted the government were more likely to prefer and receive the Medigen vaccine. Conversely, those who didn't trust the government were less likely to prefer Medigen and AstraZeneca vaccines, but were willing to receive Pfizer-BioNTech vaccine. Vaccine brand preferences and uptake in Taiwan were affected by individuals' national identity and their trust in government. This highlights the critical role of sociopolitical factors in shaping public health strategies.
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Affiliation(s)
- Chun-Tung Kuo
- Center for Survey Research, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Ruoh-Rong Yu
- Center for Survey Research, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
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Blazek ES, Bucher A. Barriers to COVID-19 Vaccination in a Troop of Fleet Antiterrorism Security Team Marines: Observational Study. JMIR Form Res 2024; 8:e50181. [PMID: 38502179 PMCID: PMC10988372 DOI: 10.2196/50181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/21/2023] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND In 2019, the World Health Organization declared the reluctance to vaccinate despite the availability of vaccination services as one of the top 10 threats to global health. In early 2021, self-reported reluctance to vaccinate among military personnel might have been considered a significant threat to national security. Having a choice architecture that made COVID-19 vaccination optional rather than required for military personnel could have inadvertently undermined military readiness if vaccination uptake did not reach an acceptable threshold. OBJECTIVE The purpose of this observational study was to examine Marines' self-reported reasons for planning to decline the COVID-19 vaccine to understand their barriers to vaccination. METHODS As the vaccination became available to 1 company of Fleet Antiterrorism Security Team (FAST) Marines in early 2021, company command required those planning to decline vaccination to write an essay with up to 5 reasons for their choice. These essays provided the data for this study. Qualitative descriptive analysis with elements from grounded theory was used to thematically categorize FAST Marines' written reasons for planning to decline the COVID-19 vaccine into a codebook describing 8 key behavioral determinants. Interrater agreement among 2 qualitatively trained researchers was very good (κ=0.81). RESULTS A troop of 47 Marines provided 235 reasons why they planned to decline the COVID-19 vaccine. The most frequent reasons were difficulty understanding health information (105/235, 45%), low estimates of risk (33/235, 14%), and fear of physical discomfort (29/235, 12%). Resulting interventions directly targeted Marines' self-reported reasons by reducing barriers (eg, normalized getting the vaccine), increasing vaccine benefits (eg, improved access to base gyms and recreational facilities), and increasing nonvaccine friction (eg, required in writing 5 reasons for declining the vaccine). CONCLUSIONS Understanding the barriers military personnel experience toward COVID-19 vaccination remains critical as vaccine acquisition and availability continue to protect military personnel. Insights from subpopulations like FAST Marines can enhance our ability to identify barriers and appropriate intervention techniques to influence COVID-19 vaccination behaviors.
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Affiliation(s)
- E Susanne Blazek
- Behavioral Reinforcement Learning Lab (BReLL), Lirio, Knoxville, TN, United States
| | - Amy Bucher
- Behavioral Reinforcement Learning Lab (BReLL), Lirio, Knoxville, TN, United States
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8
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Mundo Ortiz A, Nasri B. Socio-demographic determinants of COVID-19 vaccine uptake in Ontario: Exploring differences across the Health Region model. Vaccine 2024; 42:2106-2114. [PMID: 38413281 DOI: 10.1016/j.vaccine.2024.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
The COVID-19 pandemic continues to be a worldwide public health concern. Although vaccines against this disease were rapidly developed, vaccination uptake has not been equal across all the segments of the population, particularly in the case of underrepresented groups. However, there are also differences in vaccination across geographical areas, which might be important to consider in the development of future public health vaccination policies. In this study, we examined the relationship between vaccination status (having received the first dose of a COVID-19 vaccine), socio-economic strata, and the Health Regions for individuals in Ontario, Canada. Our results show that between October of 2021 and January of 2022, individuals from underrepresented communities were three times less likely to be vaccinated than White/Caucasian individuals across the province of Ontario, and that in some cases, within these groups, individuals in low-income brackets had significantly higher odds of vaccination when compared to their peers in high income brackets. Finally, we identified significantly lower odds of vaccination in the Central, East and West Health Regions of Ontario within certain underrepresented groups. This study shows that there is an ongoing need to better understand and address differences in vaccination uptake across diverse segments of the population of Ontario that the pandemic has largely impacted.
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Affiliation(s)
- Ariel Mundo Ortiz
- Centre de Recherches Mathématiques, Université de Montréal. 2920 Ch de la Tour, Montréal, QC H3T 1N8, Canada; Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche en santé publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada
| | - Bouchra Nasri
- Centre de Recherches Mathématiques, Université de Montréal. 2920 Ch de la Tour, Montréal, QC H3T 1N8, Canada; Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche en santé publique, Université de Montréal. 7101 Av du Parc, Montréal, QC H3N 1X9, Canada.
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9
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Sohail SS, Madsen DØ, Farhat F, Alam MA. ChatGPT and Vaccines: Can AI Chatbots Boost Awareness and Uptake? Ann Biomed Eng 2024; 52:446-450. [PMID: 37428336 DOI: 10.1007/s10439-023-03305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
The global COVID-19 pandemic has affected all spheres of human life, resulting in millions of deaths and overwhelming medical facilities. Moreover, the world has witnessed great financial hardship because of job losses resulting in economic havoc. Many sections of society have contributed in different ways to slow the spread of the virus and protect public health. For example, medical scientists are praised for their efforts to develop COVID-19 vaccines. Clinical trials have shown that the COVID-19 vaccines are highly effective in preventing symptomatic COVID-19 infections. However, many people around the world have been hesitant to get vaccinated. Vaccine misconceptions have emerged and increased due to a combination of factors, including the availability of information on the Internet and the influence of celebrities and opinion leaders. In this context, we have analyzed ChatGPT responses to relevant queries on vaccine misconceptions. The positive responses and supportive opinions provided by the AI chatbot could be instrumental in shaping people's perceptions of vaccines and in encouraging users to get vaccinated and reduce misconceptions.
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Affiliation(s)
- Shahab Saquib Sohail
- Department of Computer Science and Engineering, School of Engineering Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India
| | - Dag Øivind Madsen
- USN School of Business, University of South-Eastern Norway, 3511, Hønefoss, Norway.
| | - Faiza Farhat
- Department of Zoology, Aligarh Muslim University, Aligarh, U.P., 202002, India
| | - M Afshar Alam
- Department of Computer Science and Engineering, School of Engineering Sciences and Technology, Jamia Hamdard, New Delhi, 110062, India
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10
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Zeinab D, Shahin N, Fateme M, Saeed BF. Economic evaluation of vaccination against COVID-19: A systematic review. Health Sci Rep 2024; 7:e1871. [PMID: 38332928 PMCID: PMC10850437 DOI: 10.1002/hsr2.1871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024] Open
Abstract
Background and Aims Coronavirus has burdened considerable expenditures on the different health systems. Vaccination programs, the critical solution against pandemic diseases, are known as safe and effective interventions to prevent and control epidemics. We aimed to perform a systematic review to provide economic evidence of the value of different types of vaccines available to combat the Covid-19 to all health policymakers worldwide. Methods Electronic searches conducted on Medline/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and other economic evaluation databases. Related and published articles searched up to March 2022 by using keywords such as "Vaccination," "Covid-19," "Cost-benefit," "Cost-utility," "Cost-effectiveness," "Economic Assessment," and "Economic evaluation." Followed by choosing the most suitable articles according to inclusion and exclusion criteria, data captured and the results extracted. The quality assessment of the articles performed by the checklist of CHEERS 2022. Finally, 13 articles included in the review. Results All messenger RNA vaccines were dominant with approximately 70% coverage against no vaccination in the primary vaccination program except in one study that looked at booster effects. From a payer's perspective, a dollar invested in a vaccine would be less profitable than from a societal perspective. Therefore, primary mass vaccination can be considered a cost-effective intervention in primary vaccination to save more lives and produce more positive externalities. However, the cost-benefit ratio for all vaccines increases when statistical lifetime value and global economic and educational disadvantages are considered. Conclusion The COVID-19 primary vaccination programs in regional outbreaks, from a long-term perspective, will demonstrate substantial cost-effectiveness. It is suggested that due to the positive externalities of vaccination, primary mass vaccination, with the help of COVAX-19TM, could be considered a reliable way to combat viral epidemics compared to the loss of individual lives and economic and educational disturbances around the world.
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Affiliation(s)
- Dolatshahi Zeinab
- Department of Health Policy, School of Health Management and Information SciencesIran University of Medical SciencesTehranIran
| | - Nargesi Shahin
- Department of Health Management and Economics, Faculty of HealthIlam University of Medical SciencesIlamIran
| | - Mezginejad Fateme
- Department of Hematology, School of Allied Medicine, Cellular and Molecular Research CenterBirjand University of Medical SciencesBirjanIran
| | - Bagheri Faradonbeh Saeed
- Department of Health Services Management, School of HealthAhvaz Jundishapur University of Medical ScienceAhvazIran
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11
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AlMuammar S, Alshora W, Sadik Gari A, Bahaj RK, Alansari BA. Parental Willingness and Factors Influencing COVID-19 Vaccination for Children in Saudi Arabia. Pediatric Health Med Ther 2024; 15:29-48. [PMID: 38260725 PMCID: PMC10800286 DOI: 10.2147/phmt.s443272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Purpose The study aimed to examine the parents' willingness and its association with demographic factors, attitudes, and practices to vaccinate their child against COVID-19. Patients and Methods The study involved 2500 participants from various regions of Saudi Arabia and was conducted between July 1, 2021, and August 31, 2021. Information was gathered via an online questionnaire comprising 26 questions, distributed across social media platforms. Informed consent was obtained from all participants before the commencement of the study. A chi-square test was applied to analyze the association among variables, utilizing a subset of 2127 participants based on study inclusion criteria. A chi-square test was applied to observe the association. Results The willingness of parents to vaccinae their children against COVID-19 was found 61%. The main reason for taking was "Protect the child" by 1094 (51.4%%) and the main reason for refusing was "Side effects/safety concerns" by 477 (22.4%). 1846 (86.8%) participants, received the COVID-19 vaccine or were planning to receive it. Conclusion Our study concluded that parent's willingness to vaccinate their children against COVID-19 was relatively high in our sample as about two-thirds of them accept the vaccine for their child once it is available. The use of the health belief model demonstrated the urgent requirement for awareness and education campaigns in the private and public sectors to increase awareness of parents not only related to COVID-19 but also to cater to any unexpected or suspected pandemic of infectious disease in the future full capacity.
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Affiliation(s)
- Sarah AlMuammar
- Family Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Weam Alshora
- Family Medicine Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Atheer Sadik Gari
- Family Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem Khalid Bahaj
- Family Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
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12
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Yuan J, Xu Y, Wong IOL, Lam WWT, Ni MY, Cowling BJ, Liao Q. Dynamic predictors of COVID-19 vaccination uptake and their interconnections over two years in Hong Kong. Nat Commun 2024; 15:290. [PMID: 38177142 PMCID: PMC10767005 DOI: 10.1038/s41467-023-44650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
The global rollout of COVID-19 vaccines faces a significant barrier in the form of vaccine hesitancy. This study adopts a dynamic and network perspective to explore the determinants of COVID-19 vaccine uptake in Hong Kong, focusing on multi-level determinants and their interconnections. Following the framework proposed by the Strategic Advisory Group of Experts (SAGE), the study used repeated cross-sectional surveys to map these determinants at multiple levels and investigates their interconnections simultaneously in a sample of 15,179 over two years. The results highlight the dynamic nature of COVID-19 vaccine hesitancy in an evolving pandemic. The findings suggest that vaccine confidence attitudes play crucial roles in vaccination uptake, with their importance shifting over time. The initial emphasis on vaccine safety gradually transitioned to heightened consideration of vaccine effectiveness at a later stage. The study also highlights the impact of chronic condition, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviours on vaccine uptake. Higher educational attainment and being married were associated with primary and booster vaccine uptake and it may be possible to leverage these groups as early innovation adopters. Trust in government acts as a crucial bridging factor linking various variables in the networks with vaccine confidence attitudes, which subsequently closely linked to vaccine uptake. This study provides insights for designing future effective vaccination programmes for changing circumstances.
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Affiliation(s)
- Jiehu Yuan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yucan Xu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Irene Oi Ling Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Li Ka Shing Faculty of Medicine, Jocky Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China.
| | - Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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13
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Moradi Hasan-Abad A, Arbabi M, Gilasi H, Motedayyen H. Immunogenicity and adverse events of the COVID-19 vaccines in healthy and individuals with autoimmune diseases in an Iranian population. Int J Immunopathol Pharmacol 2024; 38:3946320241239202. [PMID: 38494849 PMCID: PMC10946076 DOI: 10.1177/03946320241239202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Introduction: Recent studies have proposed various COVID-19 vaccines to control the disease and protect susceptible individuals. However, immunogenicity and safety of COVID-19 vaccines in various populations are not well identified yet. Therefore, this study aimed to elucidate the efficacy and safety of the BBIBP-CorV (Sinopharm) and ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccines in healthy subjects and patients with autoimmune diseases.Methods: Study population included 121 healthy subjects and 100 patients with autoimmune diseases. Immunization was performed based on the national vaccination protocols. Of the 221 volunteers, 201 subjects received Sinopharm and 20 cases were vaccinated with Oxford-AstraZeneca. During a 1-year follow-up, the immunogenicity was measured by ELISA before primary vaccination and 1 to 3 months after secondary immunization. Side effects were studied before entering the study and 1 week after the second dose.Results: Vaccination had a positive impact on the induction of immunogenic response (p < .0001). The rates of seropositive vaccine responses were 80% and 75% in subjects vaccinated with the Sinopharm and Oxford-AstraZeneca, respectively. The neutralizing antibody values were significantly higher in subjects with autoimmune diseases than those without autoimmunity (p < .05). The rate of adverse events were 38% and 42% in subjects vaccinated with the Sinopharm and Oxford-AstraZeneca, respectively. The rates of immunogenic responses induced with the Sinopharm and Oxford-AstraZeneca were, respectively, 76% and 81.5% in seropositive subjects, while they were 63.8% and 79.1% in seronegative subjects vaccinated with the Sinopharm and Oxford-AstraZeneca, respectively. Individuals previously infected with SARS-CoV-2 showed a significant reduction in the value of SARS-CoV-2 neutralizing antibodies compared with seronegative subjects (p < .01-.05). Seropositive individuals vaccinated with the Sinopharm had significantly higher the percentages of vaccine-related adverse events than seronegative persons (p < .05). There was no significant difference between seronegative and seropositive individuals vaccinated with the Oxford-AstraZeneca.Conclusion: Our findings revealed that the Sinopharm and Oxford-AstraZeneca vaccines are effective in the production of neutralizing antibodies in healthy subjects and patients with autoimmune disorders undergoing immunosuppressive therapies without considerable reactogenicity.
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Affiliation(s)
- Amin Moradi Hasan-Abad
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Arbabi
- Department of Medical Parasitology And Mycology, Kashan University Of Medical Sciences, Kashan, Iran
| | - Hamidreza Gilasi
- Department of Epidemiology & Biostatistics, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
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14
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Isiguzo GC, Stefanovics E, Unamba NN, Mbam TT, Anyaehie UG, Chukwu CC, Anyaehie UB, Osy-Eneze C, Ibezim EO, Okoro UG, Njoku PO, Adimekwe AI, Ibediro K, Stefanovics G, Iheanacho T. Perceptions of the COVID-19 Vaccine and Willingness to Receive Vaccination among Health Workers in Nigeria: A Cross-sectional Study. Niger J Clin Pract 2024; 27:102-108. [PMID: 38317042 DOI: 10.4103/njcp.njcp_537_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/01/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND COVID-19 vaccine hesitancy is a major barrier to vaccine uptake, and the achievement of herd immunity is required to reduce morbidity and mortality and protect the most vulnerable populations. In Nigeria, COVID-19 vaccine hesitancy has been high, and uptake remains very low. Healthcare workers (HCWs) in Nigeria can help support public health efforts to increase vaccine uptake. AIM This study evaluates Nigerian HCWs' acceptance and intent to recommend the COVID-19 vaccine. SUBJECTS AND METHODS Cross-sectional survey among 1,852 HCWs in primary, secondary, and tertiary care settings across Nigeria. Respondents included doctors, nurses, pharmacy workers, and clinical laboratory professionals who have direct clinical contact with patients in various healthcare settings. A 33-item questionnaire was used in the study, with two of the questions focused on the COVID-19 vaccine. The responses to the two questions were analyzed using Chi-square (c2) tests and independent t-tests to determine the acceptance of the vaccine. RESULTS The majority of respondents were younger than 34 years (n = 1,227; 69.2%) and primarily worked in hospitals (n = 1,278; 72.0%). Among the respondents, 79.2% (n = 1,467) endorsed the COVID-19 vaccine as a critical tool in reducing the impact of the disease, and 76.2% (n = 1,412) will accept and recommend the vaccine to their patients. The younger HCWs were more likely to endorse and recommend the vaccine to their patients. CONCLUSION There is a moderately high COVID-19 vaccine acceptance rate among HCWs surveyed in our study. The confidence of HCWs in its use and their willingness to recommend it to their patients can provide a potentially useful element in increasing acceptance by the larger population in Nigeria.
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Affiliation(s)
- G C Isiguzo
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital/Ebonyi State University Abakaliki, Ebonyi State, Nigeria
| | - E Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
| | - N N Unamba
- Division of Cardiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - T T Mbam
- Department of Otorhinolaryngology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - U G Anyaehie
- National Orthopedic Hospital Enugu, Enugu State, Nigeria
| | - C C Chukwu
- Department of Radiology, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - U B Anyaehie
- Department of Physiology, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - C Osy-Eneze
- Colchester GP Vocational Training Scheme, NHS, England, UK
| | - E O Ibezim
- College of Medicine, Imo State University, Owerri, Imo State, Nigeria
| | - U G Okoro
- Family Practice Department, Franciscan Physician Network, Crown Point, Indiana, United States
| | - P O Njoku
- Department of Internal Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - A I Adimekwe
- Northallerton GP Vocational Training Scheme, NHS, England, UK
| | - K Ibediro
- Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - G Stefanovics
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
| | - T Iheanacho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
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15
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Purvis RS, Moore R, Rojo MO, Riklon S, Alik E, Alik D, Maddison BK, McElfish PA. COVID-19 vaccine hesitancy among Marshallese in Northwest Arkansas (USA). J Public Health Res 2024; 13:22799036241231549. [PMID: 38440055 PMCID: PMC10910884 DOI: 10.1177/22799036241231549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
Background COVID-19 has disproportionately affected Pacific Islander communities, with disparities in the prevalence of infection, serious illness, and death compared to non-Hispanic whites in the US. Marshallese Pacific Islanders face significant COVID-19 disparities. Design and methods This exploratory study aimed to understand Marshallese community attitudes about the COVID-19 vaccine to identify and implement culturally relevant strategies to encourage vaccine uptake. Data were collected from 17 participants in three focus groups. Results Using content analysis, researchers identified two global themes: (1) barriers to vaccination and (2) facilitators of COVID-19 vaccine uptake. Within these themes, participants described fear, lack of knowledge about vaccines, negative perceptions of the COVID-19 vaccine, health concerns, and transportation as barriers to vaccination. Participants described several factors influencing vaccine behavior, including location of and personnel at vaccine clinics, vaccine experiences, the need for trusted information, positive perceptions, cultural leaders, and mandates. Conclusions The qualitative study makes a significant contribution as the first to report community perceptions and experiences related to the COVID-19 vaccine in Marshallese participants' own words. Findings show that cultural influencers and brokers are crucial bridges for public health messaging related to COVID-19 vaccination targeted to this vulnerable and underserved population. Culturally appropriate and effective public health messaging can help achieve vaccine equity and improve COVID-19-related health disparities in the Marshallese community.
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Affiliation(s)
- Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Martha O Rojo
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Eldon Alik
- Republic of the Marshall Islands Consulate, Springdale, AR, USA
| | - Derek Alik
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | | | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
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16
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Small NN, Busogi BU, Nguyen N, Chen M, Carrier CC, Buzcu-Guven B, McNeill LH. COVID-19 Knowledge, Beliefs, and Intention to Get Vaccinated: A Brief Educational Intervention Among Black and Hispanic Populations. Am J Public Health 2024; 114:S82-S86. [PMID: 38207268 PMCID: PMC10785169 DOI: 10.2105/ajph.2023.307501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 01/13/2024]
Abstract
We aimed to determine the effect of a brief educational intervention on COVID-19 vaccine knowledge, beliefs, and vaccination intention in Black and Hispanic communities in Houston, Texas. As part of the Community Engagement Alliance (CEAL) Against COVID-19 Disparities study (2020-2022), 1606 Black and Hispanic adults completed Web-based surveys before and after viewing COVID-19 educational materials. The intervention significantly improved health beliefs and vaccination intention. Disseminating short and ethnically appropriate educational materials is an effective strategy to decrease vaccine hesitancy in minority populations. (Am J Public Health. 2024;114(S1):S82-S86. https://doi.org/10.2105/AJPH.2023.307501).
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Affiliation(s)
- Nicole N Small
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Belinda U Busogi
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Nga Nguyen
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Minxing Chen
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Chelsea C Carrier
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Birnur Buzcu-Guven
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Lorna H McNeill
- Nicole N. Small and Belinda U. Busogi are with the McGovern Medical School, University of Texas Health Science Center at Houston. Nga Nguyen and Minxing Chen are with the Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston. Chelsea C. Carrier, Birnur Buzcu-Guven, and Lorna H. McNeill are with the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
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17
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Amalo CG, Ekaristy EA, Wattileo M, Pakpahan M, Silitonga E. Factors affecting the community's attitude toward COVID-19 vaccination: cross-sectional study. Rev Bras Enferm 2023; 76Suppl 1:e20220597. [PMID: 38055428 DOI: 10.1590/0034-7167-2022-0597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/14/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE The study aimed to analyze the factors that affect the community's attitude towards COVID-19 vaccination in Tangerang District. METHODS A cross-sectional study was used. Convenience sampling was used to select 400 respondents. Inclusion criteria are living in Tangerang District, aged between 18 and 55, and earning a living. An online questionnaire was used and passed validity and reliability tests. This study received ethical approval. RESULTS Most respondents had a high level of education (48.50%), low income (72.50%), high knowledge (78%), and a positive attitude (76.50%) regarding vaccination against COVID-19. The Chi-square test revealed a correlation between knowledge and attitudes towards COVID-19 vaccination (p=0.001), as well as education levels (p=0.001), but there was no correlation between income and attitudes (p=0.094). CONCLUSIONS Health professionals should engage in extensive socialization and face-to-face visits with people with limited access to information to promote a positive attitude and expand the scope of COVID-19 vaccination.
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Affiliation(s)
| | | | - Maretty Wattileo
- Universitas Pelita Harapan, Faculty of Nursing. Tangerang, Indonesia
| | - Martina Pakpahan
- Universitas Pelita Harapan, Faculty of Nursing. Tangerang, Indonesia
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18
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Caycho-Rodríguez T, Tomás JM, Vilca LW, Carbajal-León C, Gallegos M, Reyes-Bossio M, Oré-Kovacs N, Muñoz-Del-Carpio-Toia Á, Torales J, Barria-Asenjo NA, Garcia-Cadena CH. Relationship Between Fear of Monkeypox and Intention to be Vaccinated Against Monkeypox in a Peruvian Sample. The Mediating Role of Conspiracy Beliefs About Monkeypox. Eval Health Prof 2023; 46:353-361. [PMID: 37246714 DOI: 10.1177/01632787231180195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The present study evaluated the predictive capacity of fear of Monkeypox (MPX) on the intention to be vaccinated against MPX and the influence of conspiracy beliefs as a mediating variable in this relationship in 516 Peruvian sample with an average age of 27.10 years participated. Monkeypox Fear Scale, MPX Conspiracy Beliefs Scale and a single item of intention to be vaccinated against MPX were used. Statistical analyses have included estimation of descriptive statistics for all variables in the model tested and Structural Equation Modeling to predict intention to be vaccinated against monkeypox. It has been found that fear has a positive impact on conspiracy beliefs about MPX and intention to be vaccinated against MPX. Finally, conspiracy beliefs are negatively related to intention to be vaccinated. As for indirect effects, both are statistically significant. The model explains 11.4% of the variance in beliefs and 19.1% in intention to be vaccinated. It is concluded that fear of MPX played an important role, both directly and indirectly, in the intention to be vaccinated against MPX, having conspiratorial beliefs about MPX as a mediating variable. The results have important implications for public health practices aimed at combating doubts about MPX vaccination.
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Affiliation(s)
| | - José M Tomás
- Department of Methodology for the Behavioral Sciences, Universidad de Valencia, Valencia, España
| | - Lindsey W Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Carlos Carbajal-León
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Miguel Gallegos
- Programa de Pós-graduação em Psicologia, Universidade Católica de Minas Gerais, Belo Horizonte, Brasil
- Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento, Consejo Nacional de Investigaciones Científicas y Técnicas, Entre Ríos, Argentina
| | - Mario Reyes-Bossio
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Nicole Oré-Kovacs
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Julio Torales
- Departamento de Psiquiatría, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
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19
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Miao Y, Zhang W, Li Y, Wu J, Shen Z, Bai J, Zhu D, Ren R, Zhang J, Guo D, Tarimo CS, Li C, Dong W. Quantifying the benefits of healthy lifestyle behaviors and emotional expressivity in lowering the risk of COVID-19 infection: a national survey of Chinese population. BMC Public Health 2023; 23:2374. [PMID: 38037040 PMCID: PMC10687789 DOI: 10.1186/s12889-023-17158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND COVID-19 is still prevalent in most countries around the world at the low level. Residents' lifestyle behaviors and emotions are critical to prevent COVID-19 and keep healthy, but there is lacking of confirmative evidence on how residents' lifestyle behaviors and emotional expressivity affected COVID-19 infection. METHODS Baseline study was conducted in August 2022 and follow-up study was conducted in February 2023. Baseline survey collected information on residents' basic information, as well as their lifestyle behaviors and emotions. Follow-up study was carried out to gather data on COVID-19 infection condition. Binary logistic regression was utilized to identify factors that may influence COVID-19 infection. Attributable risk (AR) was computed to determine the proportion of unhealthy lifestyle behaviors and emotional factors that could be attributed to COVID-19 infection. Sensitivity analysis was performed to test the robustness of the results. RESULTS A total of 5776 participants (46.57% males) were included in this study, yielding an overall COVID-19 infection rate of 54.8% (95%CI: 53.5 - 56.0%). The findings revealed that higher stress levels [aOR = 1.027 (95%CI; 1.005-1.050)] and lower frequency in wearing masks, washing hands, and keeping distance [aOR = 1.615 (95%CI; 1.087-2.401)], were positively associated with an increased likelihood of COVID-19 infection (all P < 0.05). If these associations were causal, 8.1% of COVID-19 infection would have been prevented if all participants had normal stress levels [Attributable Risk Percentage: 8.1% (95%CI: 5.9-10.3%)]. A significant interaction effect between stress and the frequency in wearing masks, washing hands, and keeping distance on COVID-19 infection was observed (β = 0.006, P < 0.001), which also was independent factor of COVID-19 infection. CONCLUSIONS The overall COVID-19 infection rate among residents is at a medium level. Residents' increasing stress and decreasing frequency in wearing masks and washing hands and keeping distance contribute to increasing risk of infection, residents should increase the frequency of mask-wearing, practice hand hygiene, keep safe distance from others, ensure stable emotional state, minimize psychological stress, providing evidence support for future responses to emerging infectious diseases.
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Affiliation(s)
- Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Dan Guo
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Clifford Silver Tarimo
- Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Chengpeng Li
- Department of Human Resources, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China.
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Silva MEP, Skeva R, House T, Jay C. Tracking the structure and sentiment of vaccination discussions on Mumsnet. SOCIAL NETWORK ANALYSIS AND MINING 2023; 13:152. [PMID: 38026264 PMCID: PMC10657328 DOI: 10.1007/s13278-023-01155-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
Vaccination is one of the most impactful healthcare interventions in terms of lives saved at a given cost, leading the anti-vaccination movement to be identified as one of the top 10 threats to global health in 2019 by the World Health Organization. This issue increased in importance during the COVID-19 pandemic where, despite good overall adherence to vaccination, specific communities still showed high rates of refusal. Online social media has been identified as a breeding ground for anti-vaccination discussions. In this work, we study how vaccination discussions are conducted in the discussion forum of Mumsnet, a UK-based website aimed at parents. By representing vaccination discussions as networks of social interactions, we can apply techniques from network analysis to characterize these discussions, namely network comparison, a task aimed at quantifying similarities and differences between networks. Using network comparison based on graphlets-small connected network subgraphs-we show how the topological structure of vaccination discussions on Mumsnet differs over time, in particular before and after COVID-19. We also perform sentiment analysis on the content of the discussions and show how the sentiment toward vaccinations changes over time. Our results highlight an association between differences in network structure and changes to sentiment, demonstrating how network comparison can be used as a tool to guide and enhance the conclusions from sentiment analysis.
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Affiliation(s)
- Miguel E. P. Silva
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
- LIAAD, INESC-TEC, Porto, Portugal
| | - Rigina Skeva
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
| | - Caroline Jay
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PY England UK
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21
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Burman J, Roy Choudhury N, Chattopadhyay A, Sembiah S, Karmakar A, Shukla M. Psychological Impact of COVID-19 and Its Influence on Parental Willingness to Vaccinate Children: A Cross-Sectional Study at a Tertiary Care Hospital in Kolkata. Cureus 2023; 15:e49585. [PMID: 38156120 PMCID: PMC10754491 DOI: 10.7759/cureus.49585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Background COVID-19 has affected the physical and mental health of people globally, and vaccination is seen as a crucial tool in controlling the pandemic. However, the readiness to vaccinate children remains a concern, particularly in India. Aim The study aimed to investigate the association between the psychological impact of COVID-19 and willingness to vaccinate their children among attendees of the COVID-19 vaccination clinic at Nil Ratan Sircar Medical College, Kolkata. Method The study used an observational, cross-sectional design and collected data from 356 participants between August and September 2022. The COVID-19 Perceived Stress Scale-10 was used to assess participants' psychological impact, and willingness to vaccinate was determined using a survey. Results Approximately 64% (n=227) and 71% (n=253) of the participants exhibited a high level of perceived stress and willingness to vaccinate their children. The vaccine acceptance was significantly associated with perceived stress level and other factors such as family type, presence of chronic illness, and history of acquaintances suffering from COVID-19. Conclusion The study highlights the importance of addressing parental stress and anxiety to enhance vaccination rates among children. To achieve this, population-level awareness of vaccine safety measures and benefits should be raised to alleviate stress and increase vaccine uptake.
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Affiliation(s)
- Jayeeta Burman
- Community Medicine, Sarat Chandra Chattopadhyay Government Medical College & Hospital, Uluberia, IND
| | | | | | - Sembagamuthu Sembiah
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
| | - Anubrata Karmakar
- Community Medicine, North Bengal Medical College and Hospital, Siliguri, IND
| | - Mukesh Shukla
- Community and Family Medicine, All India Institute of Medical Sciences, Rae Bareli, Raebareli, IND
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22
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Vahdani B, Mohammadi M, Thevenin S, Gendreau M, Dolgui A, Meyer P. Fair-split distribution of multi-dose vaccines with prioritized age groups and dynamic demand: The case study of COVID-19. EUROPEAN JOURNAL OF OPERATIONAL RESEARCH 2023; 310:1249-1272. [PMID: 37284206 PMCID: PMC10116158 DOI: 10.1016/j.ejor.2023.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 03/25/2023] [Indexed: 06/08/2023]
Abstract
The emergence of the SARS-CoV-2 virus and new viral variations with higher transmission and mortality rates have highlighted the urgency to accelerate vaccination to mitigate the morbidity and mortality of the COVID-19 pandemic. For this purpose, this paper formulates a new multi-vaccine, multi-depot location-inventory-routing problem for vaccine distribution. The proposed model addresses a wide variety of vaccination concerns: prioritizing age groups, fair distribution, multi-dose injection, dynamic demand, etc. To solve large-size instances of the model, we employ a Benders decomposition algorithm with a number of acceleration techniques. To monitor the dynamic demand of vaccines, we propose a new adjusted susceptible-infectious-recovered (SIR) epidemiological model, where infected individuals are tested and quarantined. The solution to the optimal control problem dynamically allocates the vaccine demand to reach the endemic equilibrium point. Finally, to illustrate the applicability and performance of the proposed model and solution approach, the paper reports extensive numerical experiments on a real case study of the vaccination campaign in France. The computational results show that the proposed Benders decomposition algorithm is 12 times faster, and its solutions are, on average, 16% better in terms of quality than the Gurobi solver under a limited CPU time. In terms of vaccination strategies, our results suggest that delaying the recommended time interval between doses of injection by a factor of 1.5 reduces the unmet demand up to 50%. Furthermore, we observed that the mortality is a convex function of fairness and an appropriate level of fairness should be adapted through the vaccination.
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Affiliation(s)
- Behnam Vahdani
- IMT Atlantique, Lab-STICC, UMR CNRS 6285, Brest F-29238, France
| | - Mehrdad Mohammadi
- IMT Atlantique, Lab-STICC, UMR CNRS 6285, Brest F-29238, France
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven 5600MB, the Netherlands
| | - Simon Thevenin
- IMT Atlantique, LS2N-CNRS, La Chantrerie, 4, rue Alfred Kastler, Nantes cedex 3, F-44307, France
| | - Michel Gendreau
- CIRRELT and Département de Mathématiques et Génie Industriel, Polytechnique Montréal, P.O. Box 6079, Station Centre-Ville, Montréal H3C 3A7, Canada
| | - Alexandre Dolgui
- IMT Atlantique, LS2N-CNRS, La Chantrerie, 4, rue Alfred Kastler, Nantes cedex 3, F-44307, France
| | - Patrick Meyer
- IMT Atlantique, Lab-STICC, UMR CNRS 6285, Brest F-29238, France
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Zeladita-Huaman JA, Esteban-Espinoza D, Lozada-Urbano M, Franco Chalco E, Costa MF, Castillo-Parra H. Association between the risk perception of contracting COVID-19 and sociodemographic characteristics in a Peruvian population. F1000Res 2023; 12:919. [PMID: 38264263 PMCID: PMC10804047 DOI: 10.12688/f1000research.138838.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/25/2024] Open
Abstract
Background: The perception of risk regarding coronavirus disease 2019 (COVID-19) has been widely researched due to its association with the adoption of preventive measures. In addition, since the onset of vaccination, it has been reported that the population perceives a lower risk of getting infected. However, few studies have analyzed the factors associated with risk perception in low- and middle-income countries. The aim of this study was to determine the association between the risk perception of contracting COVID-19 and sociodemographic characteristics in Peruvian population. Methods: An analytical and cross-sectional study was conducted in four cities in Peru from October to December, 2021. The sample consisted of 821 individuals aged 18 years and older. A virtual questionnaire was used to collect sociodemographic data and assess the risk perception of contracting coronavirus based on the Health Belief Model. The process of back-translation, expert judgment, and reliability analysis using split-half correlation was conducted. Student's t-tests, analysis of variance with post hoc Tukey's test, and Spearman's correlation were employed. Results: Of the participants, 53.71% were women and 73.3% had a higher education level, 45.55% are self-employed, and 40.44% did not have a family member infected with COVID-19. The risk perception of COVID-19 infection was associated with participants' family antecedent of COVID-19 (p < 0.05). Regarding the factors analyzed, perceived susceptibility to COVID-19 was associated with age (p=0.002), occupation (p<0.05), and a history of COVID-19 (p<0.05), while the perceived benefits of adopting preventive measures against this disease were associated with educational level (p < 0.001). Conclusions: The risk perception of contracting COVID-19 was higher among whose had multiple infected relatives.. Furthermore, the perception of susceptibility and the perceived benefits of using preventive measures were associated with sociodemographic characteristics.
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Affiliation(s)
- Jhon Alex Zeladita-Huaman
- Nursing Academic Department, Universidad Nacional Mayor de San Marcos, Lima District, Lima Region, Peru
| | - David Esteban-Espinoza
- Departamento de Ciencias, Universidad Ricardo Palma, Santiago de Surco, Lima, Peru, Peru
| | - Michelle Lozada-Urbano
- South American Center fo Education and Research in Public Health, Universidad Norbert Wiener, Lima District, Lima Region, Peru
| | - Eduardo Franco Chalco
- Research Department, Universidad Maria Auxiliadora, Lima District, Lima Region, Peru
| | - Marcelo Fernandes Costa
- Departamento de Psicologia Experimental, Universidade de Sao Paulo, São Paulo, State of São Paulo, Brazil
| | - Henry Castillo-Parra
- Facultad de Ciencias de la Salud, Universidad Maria Auxiliadora, Lima District, Lima Region, Peru
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Kokabisaghi F, Akhtar F, Taghipour A, Javan-Noughabi J, Moghri J, Tabatabaee SS. Why healthcare providers are not vaccinated? A qualitative study during the COVID-19 pandemic in Iran. BMC PRIMARY CARE 2023; 24:208. [PMID: 37828425 PMCID: PMC10571274 DOI: 10.1186/s12875-023-02166-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Vaccination has been effective in controlling contagious diseases, especially among high-risk groups such as medical staff. Their unwillingness to be vaccinated might adversely affect individual and public health. This study aimed to explore the factors related to the refusal of COVID-19 vaccines among health service providers. METHODS A qualitative study was conducted on 28 healthcare providers in Mashhad, Northeast of Iran from March to June 2022. The method of data collection was face-to-face interviews. The purposive method was used for sampling. Data collection continued until the saturation was reached. To analyze the data, the content analysis method was applied, and Maxqda (version 10) software was used. RESULTS By analyzing interview transcripts, six themes and ten sub-themes were extracted. Factors that explained employees' reluctance to be vaccinated against COVID-19 were the opinion of peers, lack of trust in vaccines, fear of vaccination, mistrust to the government and health authorities, low perceived risk of coronavirus disease, and the contradictions of traditional and modern medicine in their approach to controlling the disease. CONCLUSIONS Among healthcare workers, concerns about the side effects of vaccines were the most influential factors in refusing vaccination. Providing reliable information about vaccines and their safety is key to increasing the trust of health workers in vaccination and facilitating its acceptance.
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Affiliation(s)
- Fatemeh Kokabisaghi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Akhtar
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Department of Epidemiology & Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Javan-Noughabi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Moghri
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Saeed Tabatabaee
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Lun P, Ning K, Wang Y, Ma TSW, Flores FP, Xiao X, Subramaniam M, Abdin E, Tian L, Tsang TK, Leung K, Wu JT, Cowling BJ, Leung GM, Ni MY. COVID-19 Vaccination Willingness and Reasons for Vaccine Refusal. JAMA Netw Open 2023; 6:e2337909. [PMID: 37856125 PMCID: PMC10587797 DOI: 10.1001/jamanetworkopen.2023.37909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/22/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Hong Kong was held as an exemplar for pandemic response until it recorded the world's highest daily COVID-19 mortality, which was likely due to vaccine refusal. To prevent this high mortality in future pandemics, information on underlying reasons for vaccine refusal is necessary. Objectives To track the evolution of COVID-19 vaccination willingness and uptake from before vaccine rollout to mass vaccination, to examine factors associated with COVID-19 vaccine refusal and compare with data from Singapore, and to assess the population attributable fraction for vaccine refusal. Design, Setting, and Participants This cohort study used data from randomly sampled participants from 14 waves of population-based studies in Hong Kong (February 2020 to May 2022) and 2 waves of population-based studies in Singapore (May 2020 to June 2021 and October 2021 to January 2022), and a population-wide registry of COVID-19 vaccination appointments. Data were analyzed from February 23, 2021, to May 30, 2022. Exposures Trust in COVID-19 vaccine information sources (ie, health authorities, physicians, traditional media, and social media); COVID-19 vaccine confidence on effectiveness, safety, and importance; COVID-19 vaccine misconceptions on safety and high-risk groups; political views; and COVID-19 policies (ie, workplace vaccine mandates and vaccine pass). Main Outcomes and Measures Primary outcomes were the weighted prevalence of COVID-19 vaccination willingness over the pandemic, adjusted incidence rate ratios, and population attributable fractions of COVID-19 vaccine refusal. A secondary outcome was change in daily COVID-19 vaccination appointments. Results The study included 28 007 interviews from 20 waves of longitudinal data, with 1114 participants in the most recent wave (median [range] age, 54.2 years [20-92] years; 571 [51.3%] female). Four factors-mistrust in health authorities, low vaccine confidence, vaccine misconceptions, and political views-could jointly account for 82.2% (95% CI, 62.3%-100.0%) of vaccine refusal in adults aged 18 to 59 years and 69.3% (95% CI, 47.2%-91.4%) of vaccine refusal in adults aged 60 years and older. Workplace vaccine mandates were associated with 62.2% (95% CI, 9.9%-139.2%) increases in daily COVID-19 vaccination appointments, and the Hong Kong vaccine pass was associated with 124.8% (95% CI, 65.9%-204.6%) increases in daily COVID-19 vaccination appointments. Conclusions and Relevance These findings suggest that trust in health authorities was fundamental to overcoming vaccine hesitancy. As such, engendering trust in health care professionals, experts, and public health agencies should be incorporated into pandemic preparedness and response.
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Affiliation(s)
- Phyllis Lun
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ke Ning
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yishan Wang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tiffany S. W. Ma
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Francis P. Flores
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Xiao
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Linwei Tian
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tim K. Tsang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Kathy Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Joseph T. Wu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Benjamin J. Cowling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Urban System Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Mengato D, Mazzitelli M, Francavilla A, Bettio M, Sasset L, Presa N, Pivato L, Lo Menzo S, Trevenzoli M, Venturini F, Gregori D, Cattelan AM. Changing patterns and clinical outcomes of hospitalized patients with COVID-19 severe pneumonia treated with remdesivir according to vaccination status: results from a real-world retrospective study. Clin Exp Med 2023; 23:2749-2756. [PMID: 36961678 PMCID: PMC10037380 DOI: 10.1007/s10238-023-01036-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 03/01/2023] [Indexed: 03/25/2023]
Abstract
Since the beginning of Coronavirus Disease 2019 (COVID-19) pandemic, many drugs have been purposed for the treatment of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Remdesivir emerged as an encouraging antiviral drug for patients with documented severe COVID-19-related pneumonia. Although several studies about remdesivir effectiveness exist, no study investigated the effect of the combination of remdesivir with the vaccination status. The aim of this study was to assess whether the administration of remdesivir could show some differences in terms of clinical outcomes in patients vaccinated against SARS-CoV-2 versus those who were not. The primary outcome was the in-hospital mortality. The secondary outcomes were 30-days mortality, the need for ICU admission and for oxygen supplementation. This is a retrospective cohort study including all consecutive adult patients hospitalized for severe COVID-19 at the Padua University Hospital (Italy), between September 1st, 2020, and January 31st, 2022, and who received a 5-days course of remdesivir. A total of 708 patients were included, 467 (66%) were male, and the median age was 67 (IQR: 56-79) years. To better estimate the outcomes of interest, a propensity score weighted approach was implemented for vaccination status. A total of 605/708 patients (85.4%) did not complete the vaccination schedule. In-hospital mortality rate was 5.1% (n = 36), with no statistically significant difference between the unvaccinated (n=29, 4.8%) and vaccinated (n=7, 6.8%; p=0.4) patients. After propensity score matching, mortality between the two groups remained similar. However, both the need for ICU and oxygen supplementation were significantly lower in the vaccinated group. Our finding suggests that a complete vaccination course could have an impact in reducing the need for transfer in ICU and for high-flow therapy in moderate-to-severe COVID-19 patients treated with remdesivir.
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Affiliation(s)
- Daniele Mengato
- University of Padua, Padua, Italy.
- Padova University Hospital, Hospital Pharmacy Unit, Padua, Italy.
| | - Maria Mazzitelli
- Padova University Hospital, Infectious and Tropical Diseases Unit, Padua, Italy
| | - Andrea Francavilla
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Monica Bettio
- Padova University Hospital, Hospital Pharmacy Unit, Padua, Italy
| | - Lolita Sasset
- Padova University Hospital, Infectious and Tropical Diseases Unit, Padua, Italy
| | - Nicolò Presa
- Padova University Hospital, Infectious and Tropical Diseases Unit, Padua, Italy
| | - Lisa Pivato
- Padova University Hospital, Hospital Pharmacy Unit, Padua, Italy
| | - Sara Lo Menzo
- Padova University Hospital, Infectious and Tropical Diseases Unit, Padua, Italy
| | - Marco Trevenzoli
- Padova University Hospital, Infectious and Tropical Diseases Unit, Padua, Italy
| | | | - Dario Gregori
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Anna Maria Cattelan
- Padova University Hospital, Infectious and Tropical Diseases Unit, Padua, Italy
- Department of Molecular Medicine, University of Padua, Padua, Italy
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27
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Willis DE, Moore R, Andersen JA, Li J, Selig JP, McKinnon JC, Gurel-Headley M, Reece S, McElfish PA. Correlates of COVID-19 vaccine coverage in Arkansas: Results from a weighted random sample survey. Vaccine 2023; 41:6120-6126. [PMID: 37661536 PMCID: PMC10574122 DOI: 10.1016/j.vaccine.2023.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/16/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
We assessed COVID-19 vaccination (≥1 dose) status as influenced by sociodemographic factors (i.e., age, gender, race/ethnicity, education, income, and parent or guardian status), healthcare provider recommendation, and personal vaccine hesitancy among Arkansas residents in October 2022. We asked: did the likelihood of vaccination differ across sociodemographic groups of Arkansas during this period of the pandemic? Is COVID-19 vaccination associated with recommendations from healthcare providers and/or COVID-19 vaccine hesitancy? We analyzed data from a random sample survey of adults in Arkansas (N = 2,201). Three in four adults self-reported vaccination against COVID-19 in October 2022. We found both positive and negative association between COVID-19 vaccination and age, gender, race/ethnicity, education, income, healthcare provider recommendation, and vaccine hesitancy. We highlight racial differences in COVID-19 coverage and the higher odds of COVID-19 vaccination among Black adults compared to White adults in particular, which has broad implications for the study of vaccine coverage and hesitancy. We also discuss implications of our findings regarding healthcare provider recommendations to be vaccinated against COVID-19.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Joshua C McKinnon
- College of Nursing, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Morgan Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA.
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Al-Abdulla O, Kallström A. Community engagement and adherence to COVID-19 prevention measures in Northwest Syria: a systematic review. Med Confl Surviv 2023; 39:229-246. [PMID: 37122087 DOI: 10.1080/13623699.2023.2198894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 03/31/2023] [Indexed: 05/02/2023]
Abstract
The COVID-19 pandemic has increased the burden on the collapsing health system in northwest Syria. The situation was exacerbated by the low rates of adherence to preventive measures and acceptance of the COVID-19 vaccine. In this study, we systematically analysed studies related to Risk Communication and Community Engagement programs, and community awareness in northwest Syria in order to determine the most widespread prevention methods, the community's perspectives and knowledge of epidemic prevention, and the factors that prevent effective community engagement and uptake of COVID-19 prevention precautions in an area that has been suffering from the scourge of conflict for more than ten years. Based on the research findings, low adherence to COVID-19 prevention measures is mainly due to external factors related to socioeconomic status, scarcity of resources, and poor living conditions. Therefore, this study suggested that integrated multi-sectoral humanitarian programs that address these factors holistically are more effective than solely public health interventions in involving the community to become an active part of the Risk Communication and Community Engagement programs and ensuring their effectiveness.
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Affiliation(s)
- Orwa Al-Abdulla
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Strategic Research Center ÖZ SRC, Gaziantep, Turkey
| | - Agneta Kallström
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Strategic Research Center ÖZ SRC, Gaziantep, Turkey
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Reichmuth ML, Heron L, Riou J, Moser A, Hauser A, Low N, Althaus CL. Socio-demographic characteristics associated with COVID-19 vaccination uptake in Switzerland: longitudinal analysis of the CoMix study. BMC Public Health 2023; 23:1523. [PMID: 37563550 PMCID: PMC10413773 DOI: 10.1186/s12889-023-16405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Vaccination is an effective strategy to reduce morbidity and mortality from coronavirus disease 2019 (COVID-19). However, the uptake of COVID-19 vaccination has varied across and within countries. Switzerland has had lower levels of COVID-19 vaccination uptake in the general population than many other high-income countries. Understanding the socio-demographic factors associated with vaccination uptake can help to inform future vaccination strategies to increase uptake. METHODS We conducted a longitudinal online survey in the Swiss population, consisting of six survey waves from June to September 2021. Participants provided information on socio-demographic characteristics, history of testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), social contacts, willingness to be vaccinated, and vaccination status. We used a multivariable Poisson regression model to estimate the adjusted rate ratio (aRR) and 95% confidence intervals (CI) of COVID-19 vaccine uptake. RESULTS We recorded 6,758 observations from 1,884 adults. For the regression analysis, we included 3,513 observations from 1,883 participants. By September 2021, 600 (75%) of 806 study participants had received at least one vaccine dose. Participants who were older, male, and students, had a higher educational level, household income, and number of social contacts, and lived in a household with a medically vulnerable person were more likely to have received at least one vaccine dose. Female participants, those who lived in rural areas and smaller households, and people who perceived COVID-19 measures as being too strict were less likely to be vaccinated. We found no significant association between previous SARS-CoV-2 infections and vaccination uptake. CONCLUSIONS Our results suggest that socio-demographic factors as well as individual behaviours and attitudes played an important role in COVID-19 vaccination uptake in Switzerland. Therefore, appropriate communication with the public is needed to ensure that public health interventions are accepted and implemented by the population. Tailored COVID-19 vaccination strategies in Switzerland that aim to improve uptake should target specific subgroups such as women, people from rural areas or people with lower socio-demographic status.
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Affiliation(s)
- Martina L Reichmuth
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
| | - Leonie Heron
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Julien Riou
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland
| | - André Moser
- CTU Bern, University of Bern, Bern, Switzerland
| | - Anthony Hauser
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Christian L Althaus
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland
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30
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Jiesisibieke ZL, Liu WY, Yang YP, Chien CW, Tung TH. Effectiveness and Safety of COVID-19 Vaccinations: An Umbrella Meta-Analysis. Int J Public Health 2023; 68:1605526. [PMID: 37485047 PMCID: PMC10361396 DOI: 10.3389/ijph.2023.1605526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives: This umbrella meta-analysis aims to provide comprehensive and synthesized evidence regarding the effectiveness and safety of COVID-19 vaccinations based on current studies. Methods: Studies from the Cochrane Library, PubMed, and EMBASE, published before 10 December 2021, were included in the analysis. The pooled results of effectiveness and safety were estimated and shown in forest plots. Results: We included nineteen studies (fifteen studies regarding safety and nine regarding effectiveness) in the analysis. The mRNA vaccines, adenovirus vector vaccines, subunit vaccines, and inactivated vaccines were found to be effective; however, mRNA vaccines, adenovirus vector vaccines and subunit vaccines were associated with local adverse events and systemic events when compared with inactivated vaccines. Conclusion: Our study suggested that till date, COVID-19 vaccination is still a preferred pharmaceutical way to control the widespread pandemic. However, all reported adverse events should be revisited to provide further evidence for mass vaccinations.
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Affiliation(s)
- Zhu Liduzi Jiesisibieke
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Wen-Yi Liu
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Shanghai Bluecross Medical Science Institute, Shanghai, China
| | - Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
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Guan M, Li Y, Scoles JD, Zhu Y. COVID-19 Message Fatigue: How Does It Predict Preventive Behavioral Intentions and What Types of Information are People Tired of Hearing About? HEALTH COMMUNICATION 2023; 38:1631-1640. [PMID: 34984940 DOI: 10.1080/10410236.2021.2023385] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examines the impact of message fatigue and what makes people fatigued in the context of the COVID-19 pandemic. Data collected with a Qualtrics panel (N = 744) showed that both active (i.e., reactance) and passive (i.e., inattention) resistance in message processing mediated the relationships between message fatigue and intentions to follow three types of preventive behaviors against COVID-19 (i.e., wearing masks, social distancing, and washing hands). The indirect effect of message fatigue on intention to seek COVID-19 information was explained by inattention but not reactance. Analyses of open-ended responses identified 18 types of COVID-related information that individuals were tired of hearing about. About 73.38% of participants (n = 546) reported that they were tired of hearing about at least one type of information about COVID-19, with mask-wearing being the most frequently mentioned (21.91%). The results extend existing research on message fatigue-evoked resistance to persuasion and provide practical implications for public health message design.
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Affiliation(s)
- Mengfei Guan
- Department of Communication, University of Arkansas
| | - Yachao Li
- Department of Communication Studies and Department of Public Health, The College of New Jersey
| | | | - Yaguang Zhu
- Department of Communication, University of Arkansas
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Li J, Tang Z, Gong Z. Does the Message Frame Promote People's Willingness to Vaccinate when they Worry about Side Effects from the COVID-19 Vaccine? Evidence from an Online Survey Experiment in China. HEALTH COMMUNICATION 2023; 38:1688-1696. [PMID: 35057686 DOI: 10.1080/10410236.2022.2028469] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Vaccination is an effective strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. However, worrying about side effects (WSE) from the COVID-19 vaccine is the leading concern making people hesitant to get vaccinated. Regrettably, there are few studies on alleviating the negative impacts of WSE on COVID-19 vaccination. This study aimed to assess whether message framing (gain- and loss-framed) can moderate the impacts of WSE on the willingness to vaccinate. We conducted an online self-administered survey experiment with three groups: control group (non-framed group), gain-framed groups, and loss-framed groups. In total, 981 participants were randomly assigned to one of the three groups, and their willingness to vaccinate themselves, their children, and elderly members was recorded. People with a higher level of WSE exhibited a lower willingness to vaccinate against COVID-19. However, the gain- and loss-framed messages increased people's willingness to vaccinate themselves, their children, and the elderly. Compared to the gain-framed messages, the loss-framed messages had a greater impact on enhancing people's willingness to self-vaccinate, but not on vaccinating their children and the elderly. Although the gain- and loss-framed messages weakened the negative impacts of WSE on the willingness to be vaccinated, their buffer effect was non-significantly different. The findings in this study suggest that a loss-framed messaging strategy could be a valuable tool in disseminating information on vaccination against COVID-19.
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Affiliation(s)
- Jie Li
- School of Public Affairs and Administration, University of Electronic Science and Technology of China
| | - Zhiwei Tang
- School of Public Affairs and Administration, University of Electronic Science and Technology of China
- Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China
| | - Zepeng Gong
- School of Public Affairs and Administration, University of Electronic Science and Technology of China
- Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China
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Fernández-Basanta S, López-Villasenín S, Freijomil-Vázquez C, Movilla-Fernández MJ, Coronado C. COVID-19 Vaccination and Community Management: A Qualitative Study. J Nurs Educ 2023; 62:343-350. [PMID: 37279977 DOI: 10.3928/01484834-20230404-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Nurses play key roles as vaccination agents and frontline workers who deal with prejudice and misinformation. This study examined the attitudes and perceptions of nursing students regarding corona-virus disease 2019 (COVID-19) vaccination and its social and institutional management. METHOD This qualitative study consisted of an exploratory phase involving first- and fourth-year nursing students and a second phase using the PhotoVoice tool SHOWED mnemonic method followed by discussion groups with second-year nursing students. RESULTS Three themes emerged: (1) hope tinged with fear; (2) too much information generating fear, uncertainty, and mistrust; and (3) leaders without recognition or voice. CONCLUSION The results inform the body of knowledge in nursing science and enhance changes in clinical practice by providing new insights regarding the perceptions of nursing students on vaccination and its management, highlighting the need to train future nurses in health literacy and new ways to interact with community members. [J Nurs Educ. 2023;62(6):343-350.].
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Asriadi, Mutiarin D. Comparison of Achievements in the Implementation of COVID-19 Vaccination in Five Provinces to Establish Herd Immunity in Indonesia in the Perspective of the New Public Service. Viral Immunol 2023; 36:318-330. [PMID: 37204316 DOI: 10.1089/vim.2022.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
This study aims to analyze the achievements of coronavirus disease-2019 (COVID-19) vaccination in five provinces in Indonesia, North Maluku, West Sulawesi, Maluku, West Papua, and Papua. Furthermore, to establish herd immunity in the new normal perspective. Vaccination is important because it is an effective way to build immunity. This method uses qualitative research with a Qualitative Data Analysis Software (QDAS) approach. The source of data was obtained from the official website of the government, the ministry of health, in the category of areas with low vaccination achievement, and data were also obtained by capturing news in credible official media to find the cause of the low vaccination rate in the community. The data analyst uses NVivo12 software to code and visualizes data in graphs, images, and word clouds. The findings of this study indicate that in five provinces in Indonesia, North Maluku (68%), West Sulawesi (76%), Maluku (66%), West Papua (62%), and Papua (41%), the achievement of vaccination implementation is still relatively low. Due to doubts in the community about the status of the vaccine, information and communication education from the government have not been optimal; the environment and geography vary, so it becomes an obstacle in carrying out vaccination.
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Affiliation(s)
- Asriadi
- Government Affairs and Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Dyah Mutiarin
- Government Affairs and Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
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Vernon-Wilson E, Tetui M, Nanyonjo A, Adil M, Bala A, Nelson D, Sayers E, Waite N, Grindrod K. Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada. BMC Public Health 2023; 23:932. [PMID: 37221519 DOI: 10.1186/s12889-023-15861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. METHODS Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. RESULTS Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. CONCLUSIONS Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.
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Affiliation(s)
- Elizabeth Vernon-Wilson
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, Lincolnshire, UK
| | - Maisha Adil
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Arthi Bala
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, Lincolnshire, UK
| | - Emma Sayers
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, Lincolnshire, UK
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
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Amick III BC, Allen JL, Brown CC, Goudie A, Tilford M, Williams M. Racial differences in COVID-19 vaccine acceptance in Arkansas. PLoS One 2023; 18:e0268876. [PMID: 37200371 PMCID: PMC10194941 DOI: 10.1371/journal.pone.0268876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 04/29/2023] [Indexed: 05/20/2023] Open
Abstract
Vaccines are one of the most successful tools for protecting the public's health. However, widespread vaccine hesitancy in the Southern United States is preventing effective mitigation of the current COVID-19 pandemic. The purpose of this study was to assess COVID-19 vaccine acceptance among adults living in a largely rural Southern state. This cross-sectional study collected data from 1,164 Arkansas residents between October 3 and October 17, 2020 using random digit dialing. The primary outcome was a multidimensional COVID-19 vaccine acceptance measure with scores between -3 to +3. The full COVID-19 vaccine acceptance scale was measured along with perceived vaccine safety, effectiveness, acceptance, value, and legitimacy subscales. Statistical analyses were conducted using multivariable linear regression. Results indicated Black participants had the lowest overall vaccine acceptance (0.5) compared to White participants (1.2). Hispanic participants had the highest scores (1.4). In adjusted models, Black participants had 0.81 points lower acceptance than White participants, and Hispanic participants had 0.35 points higher acceptance. Hispanic participants had the highest scores for all five vaccine acceptance subscales, relatively equivalent to White participants. Black participants had consistently lower scores, especially perceived vaccine safety (mean -0.2, SD 0.1). In conclusion, the lowest vaccine acceptance rates were among Black participants particularly on perceived vaccine safety. While Black participants had the lowest acceptance scores, Hispanic participants had the highest. This variability shows the value of a multidimensional vaccine acceptance measure to inform COVID-19 vaccination campaign strategies.
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Affiliation(s)
- Benjamin C. Amick III
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Jaimi L. Allen
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Clare C. Brown
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Anthony Goudie
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Mick Tilford
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Mark Williams
- Department of Health Education and Health Behavior, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
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McCarthy RNE, Donkoh ET, Arthur DD, Dassah ET, Boadu KO, Otoo JE, Boadu IWO, Gyasi SF. Public relations strategies employed by the Ghana Health Service to address COVID-19 vaccine hesitancy: a qualitative inquiry. Trop Med Health 2023; 51:26. [PMID: 37170342 PMCID: PMC10175053 DOI: 10.1186/s41182-023-00519-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Strategies for developing and advancing good public relations can be recognized in nearly all fields of life without making an exception for the healthcare industry. In the wake of the COVID-19 pandemic, matters of public health have gathered more force. The importance of effective public relations for improving healthcare is highlighted by the position that immediate access to reliable health information should be the hallmark of a just society. However, the strategies available for addressing major threats to the uptake of public health services such as mass vaccination campaigns are not properly studied and documented in the Ghanaian context. This organizational case study explored strategies used by healthcare professionals working with the Ghana Health Service (GHS) to address COVID-19-related vaccine hesitancy in the country. METHODS We performed a qualitative inquiry with semi-structured in-depth interviews conducted with 25 public health officials of the GHS. The interviews were timed to coincide with the mass deployment of COVID-19 vaccines in four Regions. Participants were recruited through purposive sampling. Data collected included demographic characteristics, perspectives on public relations strategies used in the past year to improve COVID-19 vaccine uptake as well as successes and pitfalls. Thematic analysis was performed with NVIVO software to generate themes from interview transcripts. RESULTS Four main themes emerged from the data analysis and these are presented. Healthcare workers perceived vaccine hesitancy to be a threat with the potential to undermine an important strategic organizational goal related to COVID-19 illness. In terms of PR strategies, we determined that a combination of informative, motivational, persuasive and coercive public relations strategies was employed by the Ghana Health Service to address the challenge of vaccine hesitancy. We further found that PR strategies were deployed across both traditional (print, radio, TV) and emerging/social media networks. Officials were optimistic that the strategies would produce results, but were uncertain whether they could attribute current successes or failures to the PR strategies used. CONCLUSION Since the onset of the COVID-19 pandemic, public relations strategies which have been employed by the Ghana Health Service to address vaccine hesitancy are characterized and catalogued. The nature of the audience and PR strategies employed suggests that the effect of these strategies may be short-lived unless they are constantly reinforced by the GHS. These findings show that effective PR strategies exist for addressing vaccine hesitancy in public health practice.
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Affiliation(s)
- Ruth Nana Efua McCarthy
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Timmy Donkoh
- Screen and Treat Research Group, Center for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, UENR, P. O. Box 214, Sunyani, Ghana.
| | - Dominic DeGraft Arthur
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Tieru Dassah
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - John Ekow Otoo
- Eastern Regional Health Directorate, Ghana Health Service, Koforidua, Ghana
| | - Ivy Wina Ofori Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Fosu Gyasi
- Center for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, UENR, P. O. Box 214, Sunyani, Ghana
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Roubenoff E, Feehan D, Mahmud AS. Evaluating primary and booster vaccination prioritization strategies for COVID-19 by age and high-contact employment status using data from contact surveys. Epidemics 2023; 43:100686. [PMID: 37167836 PMCID: PMC10155422 DOI: 10.1016/j.epidem.2023.100686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/08/2023] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
The debate around vaccine prioritization for COVID-19 has revolved around balancing the benefits from: (1) the direct protection conferred by the vaccine amongst those at highest risk of severe disease outcomes, and (2) the indirect protection through vaccinating those that are at highest risk of being infected and of transmitting the virus. While adults aged 65+ are at highest risk for severe disease and death from COVID-19, essential service and other in-person workers with greater rates of contact may be at higher risk of acquiring and transmitting SARS-CoV-2. Unfortunately, there have been relatively little data available to understand heterogeneity in contact rates and risk across these demographic groups. Here, we retrospectively analyze and evaluate vaccination prioritization strategies by age and worker status. We use a mathematical model of SARS-CoV-2 transmission and uniquely detailed contact data collected as part of the Berkeley Interpersonal Contact Survey to evaluate five vaccination prioritization strategies: (1) prioritizing only adults over age 65, (2) prioritizing only high-contact workers, (3) splitting prioritization between adults 65+ and high-contact workers, (4) tiered prioritization of adults over age 65 followed by high-contact workers, and (5) tiered prioritization of high-contact workers followed by adults 65+. We find that for the primary two-dose vaccination schedule, assuming 70% uptake, a tiered roll-out that first prioritizes adults 65+ averts the most deaths (31% fewer deaths compared to a no-vaccination scenario) while a tiered roll-out that prioritizes high contact workers averts the most number of clinical infections (14% fewer clinical infections compared to a no-vaccination scenario). We also consider prioritization strategies for booster doses during a subsequent outbreak of a hypothetical new SARS-CoV-2 variant. We find that a tiered roll-out that prioritizes adults 65+ for booster doses consistently averts the most deaths, and it may also avert the most number of clinical cases depending on the epidemiology of the SARS-CoV-2 variant and the vaccine efficacy.
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Affiliation(s)
- Ethan Roubenoff
- Department of Demography, University of California, Berkeley, United States of America.
| | - Dennis Feehan
- Department of Demography, University of California, Berkeley, United States of America
| | - Ayesha S Mahmud
- Department of Demography, University of California, Berkeley, United States of America
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Muridzo NG, Simbine SL, Simango TG, Matanga AA. Reflections on the Social Determinants of the COVID-19 Vaccination Programme in Zimbabwe. JOURNAL OF HUMAN RIGHTS AND SOCIAL WORK 2023; 8:1-7. [PMID: 37360668 PMCID: PMC10140699 DOI: 10.1007/s41134-023-00240-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 06/28/2023]
Abstract
Zimbabwe has not been spared by the coronavirus disease COVID-19 which has wreaked havoc throughout the world. The country is currently grappling with the pandemic against a background of multiple complex socio-economic conditions. Unfortunately, COVID-19 has escalated prevalent human rights concerns and challenges, including health disparities, poverty, child sexual abuse, access to education, and freedom of speech. Although vaccines are an important tool for reducing the incidence of life-threatening diseases, social determinants of health contribute to vaccine hesitancy. This paper is based on scoping literature review of various relevant materials on the social determinants of health that are inhibiting Zimbabwe's COVID-19 vaccination programme. This paper aims to contribute to the ongoing discourses on COVID-19. Four main themes are highlighted as social determinants of COVID-19 vaccination: (i) vaccination priority groups; (ii) vaccination hesitancy due to myths; (iii) social exclusion; and (iv) corruption. Findings are discussed in light of the implications to the right to health and other related rights. We recommend that governments of developing countries and stakeholders intensify myth-busting campaigns if vaccination programmes are to gain currency. We further call for the inclusion of priority groups such as persons with disabilities and the elderly on the vaccination priority list.
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Liu J, Lu S, Zheng H. Analysis of Differences in User Groups and Post Sentiment of COVID-19 Vaccine Hesitators in Chinese Social-Media Platforms. Healthcare (Basel) 2023; 11:healthcare11091207. [PMID: 37174749 PMCID: PMC10177948 DOI: 10.3390/healthcare11091207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: The COVID-19 epidemic is still global and no specific drug has been developed for COVID-19. Vaccination can both prevent infection and limit the spread of the epidemic. Eliminating hesitation to the COVID-19 vaccine and achieving early herd immunity is a common goal for all countries. However, efforts in this area have not been significant and there is still a long way to go to eliminate vaccine hesitancy. (2) Objective: This study aimed to uncover differences in the characteristics and sentiments of COVID-19 vaccine hesitators on Chinese social-media platforms and to achieve a classification of vaccine-hesitant groups. (3) Methods: COVID-19-vaccine-hesitation posts and user characteristics were collected on the Sina Microblog platform for posting times spanning one year, and posts were identified for hesitation types. Logistic regression was used to conduct user-group analysis. The differences in user characteristics between the various types of COVID-19 vaccine posts were analysed according to four user characteristics: gender, address type, degree of personal-information disclosure, and whether they followed health topics. Sentiment analysis was conducted using sentiment analysis tools to calculate the sentiment scores and sentiment polarity of various COVID-19 vaccine posts, and the K-W test was used to uncover the sentiment differences between various types of COVID-19-vaccine-hesitation posts. (4) Results: There are differences in the types of COVID-19-vaccine-hesitation posts posted by users with different characteristics, and different types of COVID-19-vaccine-hesitation posts differ in terms of sentiment. Differences in user attributes and user behaviors are found across the different COVID-19-vaccine-hesitation types. Ultimately, two COVID-19-vaccine-hesitant user groups were identified: Body-related and Non-bodily-related. Users who posted body-related vaccine-hesitation posts are more often female, disclose more personal information and follow health topics on social-media platforms. Users who posted non-bodily-related posts are more often male, disclose less personal information, and do not follow health topics. The average sentiment score for all COVID-19-vaccine-hesitant-type posts is less than 0.45, with negative-sentiment posts outweighing positive- and neutral-sentiment posts in each type, among which the "Individual rights" type is the most negative. (5) Conclusions: This paper complements the application of user groups in the field of vaccine hesitation, and the results of the analysis of group characteristics and post sentiment can help to provide an in-depth and comprehensive analysis of the concerns and needs of COVID-19 vaccine hesitators. This will help public-health agencies to implement more targeted strategies to eliminate vaccine hesitancy and improve their work related to the COVID-19 vaccine, with far-reaching implications for COVID-19-vaccine promotion and vaccination.
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Affiliation(s)
- Jingfang Liu
- School of Management, Shanghai University, No. 20, Chengzhong Road, Jiading District, Shanghai 201899, China
| | - Shuangjinhua Lu
- School of Management, Shanghai University, No. 20, Chengzhong Road, Jiading District, Shanghai 201899, China
| | - Huiqin Zheng
- School of Management, Shanghai University, No. 20, Chengzhong Road, Jiading District, Shanghai 201899, China
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Kreps SE, Kriner DL. Resistance to COVID-19 vaccination and the social contract: evidence from Italy. NPJ Vaccines 2023; 8:60. [PMID: 37087511 PMCID: PMC10122449 DOI: 10.1038/s41541-023-00660-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/11/2023] [Indexed: 04/24/2023] Open
Abstract
Confronted with stalled vaccination efforts against COVID-19, many governments embraced mandates and other measures to incentivize vaccination that excluded the unvaccinated from aspects of social and economic life. Even still, many citizens remained unvaccinated. We advance a social contract framework for understanding who remains unvaccinated and why. We leverage both observational and individual-level survey evidence from Italy to study the relationship between vaccination status and social context, social trust, political partisanship, and adherence to core institutional structures such as the rule of law and collective commitments. We find that attitudes toward the rule of law and collective commitments outside the domain of vaccination are strongly associated with compliance with vaccine mandates and incentives. Partisanship also corresponds with vaccine behaviors, as supporters of parties whose leaders criticized aggressive policies to incentivize or mandate vaccination and emphasized individual liberty are least likely to comply. Our findings suggest appeals emphasizing individual benefits may be more effective than appeals emphasizing collective responsibility.
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Affiliation(s)
- Sarah E Kreps
- Department of Government, Cornell University, Ithaca, NY, USA
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Thakur S, Cervantes JD, Thakur A. Understanding Factors Impacting Coronavirus Disease 2019 Vaccine Hesitancy in a Rural Surgical Clinic. Surg Infect (Larchmt) 2023. [PMID: 37083508 DOI: 10.1089/sur.2022.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Objective: Evaluate patient hesitancy about the coronavirus disease 2019 (COVID-19) vaccine. Patients and Methods: English and Spanish pre-and post-video surveys were completed by patients at rural surgery clinics. The surveys consisted of 25 or 21 five-point Likert statements, respectively. Paired difference t-tests and independent sample t-tests were performed. Results: Ninety-four patients completed the surveys: 137 females (73%) and 51 (27%) males; 113 patients were Hispanic (64%); 63 patients were white (36%). The pre-video survey showed that the top two factors influencing patients were: preference for wearing masks over vaccination (n = 185; x¯ = 3.55) and not trusting the effectiveness of the vaccine (n = 186; x¯ = 3.01). Patients agreed that the video made them want to talk to their family about getting vaccinated (n = 176; x¯ = 3.14) and made them appreciate that they can get really sick from COVID-19 (n = 177; x¯ = 3.14). After watching the video, women of childbearing age (WCBA; n = 65; x¯ = 3.20) agreed more that the video made them want to get the COVID-19 vaccine than non-WCBA (n = 59; x¯ = 2.37; p = 0.0123). Women of childbearing age (n = 66; x¯ = 3.32) also agreed more that the video made them appreciate that they can get really sick from the COVID virus than non-WCBA (n = 60; x¯ = 2.58; p = 0.0254). Post-video statements showed that patients agreed that the video was easy to understand, they liked the video, and the video was helpful. Conclusions: There is room to better inform patients in a rural setting, especially WCBA, about COVID-19 illness and vaccination through video testimonies. Surgeons are uniquely positioned to offer effective recommendations, to increase vaccination rates, and address vaccine hesitancy.
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Affiliation(s)
- Shivani Thakur
- Georgetown University School of Medicine, Washington, DC, USA
- Valley Vein Health Center (VVHC), Turlock, California, USA
| | - Jasmin Dominguez Cervantes
- Valley Vein Health Center (VVHC), Turlock, California, USA
- California State University at Stanislaus (CSUS), Turlock, California, USA
| | - Anjani Thakur
- Valley Vein Health Center (VVHC), Turlock, California, USA
- Touro University, Vallejo, California, USA
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Wu X, Li Z, Xu L, Li P, Liu M, Huang C. COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis. J Med Internet Res 2023; 25:e45051. [PMID: 37058349 PMCID: PMC10132036 DOI: 10.2196/45051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/04/2023] [Accepted: 03/23/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The COVID-19 vaccine is an effective tool in the fight against the COVID-19 outbreak. As the main channel of information dissemination in the context of the epidemic, social media influences public trust and acceptance of the vaccine. The rational application of health behavior theory is a guarantee of effective public health information dissemination. However, little is known about the application of health behavior theory in web-based COVID-19 vaccine messages, especially from Chinese social media posts. OBJECTIVE This study aimed to understand the main topics and communication characteristics of hot papers related to COVID-19 vaccine on the WeChat platform and assess the health behavior theory application with the aid of health belief model (HBM). METHODS A systematic search was conducted on the Chinese social media platform WeChat to identify COVID-19 vaccine-related papers. A coding scheme was established based on the HBM, and the sample was managed and coded using NVivo 12 (QSR International) to assess the application of health behavior theory. The main topics of the papers were extracted through the Latent Dirichlet Allocation algorithm. Finally, temporal analysis was used to explore trends in the evolution of themes and health belief structures in the papers. RESULTS A total of 757 papers were analyzed. Almost all (671/757, 89%) of the papers did not have an original logo. By topic modeling, 5 topics were identified, which were vaccine development and effectiveness (267/757, 35%), disease infection and protection (197/757, 26%), vaccine safety and adverse reactions (52/757, 7%), vaccine access (136/757, 18%), and vaccination science popularization (105/757, 14%). All papers identified at least one structure in the extended HBM, but only 29 papers included all of the structures. Descriptions of solutions to obstacles (585/757, 77%) and benefit (468/757, 62%) were the most emphasized components in all samples. Relatively few elements of susceptibility (208/757, 27%) and the least were descriptions of severity (135/757, 18%). Heat map visualization revealed the change in health belief structure before and after vaccine entry into the market. CONCLUSIONS To the best of our knowledge, this is the first study to assess the structural expression of health beliefs in information related to the COVID-19 vaccine on the WeChat public platform based on an HBM. The study also identified topics and communication characteristics before and after the market entry of vaccines. Our findings can inform customized education and communication strategies to promote vaccination not only in this pandemic but also in future pandemics.
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Affiliation(s)
- Xiaoqian Wu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Ziyu Li
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- Department of Information, Xiaoqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Pengfei Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - Ming Liu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
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Kaim A, Saban M. Dynamic Trends in Sociodemographic Disparities and COVID-19 Morbidity and Mortality—A Nationwide Study during Two Years of a Pandemic. Healthcare (Basel) 2023; 11:healthcare11070933. [PMID: 37046860 PMCID: PMC10094509 DOI: 10.3390/healthcare11070933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Social epidemiological research has documented that health outcomes, such as the risk of becoming diseased or dying, are closely tied to socioeconomic status. The aim of the current study was to investigate the impact of socioeconomic status on morbidity, hospitalization, and mortality outcomes throughout five waves of the pandemic amongst the Israeli population. A retrospective archive study was conducted in Israel from March 2020 to February 2022 in which data were obtained from the Israeli Ministry of Health’s (MOH) open COVID-19 database. Our findings, though requiring careful and cautious interpretation, indicate that the socioeconomic gradient patterns established in previous COVID-19 literature are not applicable to Israel throughout the five waves of the pandemic. The conclusions of this study indicate a much more dynamic and complex picture, where there is no single group that dominates the realm of improved outcomes or bears the burden of disease with respect to morbidity, hospitalization, and mortality. We show that health trends cannot necessarily be generalized to all countries and are very much dynamic and contingent on the socio-geographical context and must be thoroughly examined throughout distinct communities with consideration of the specific characteristics of the disease. Furthermore, the implications of this study include the importance of identifying the dynamic interplay and interactions of sociodemographic characteristics and health behavior in order to enhance efforts toward achieving improved health outcomes by policymakers and researchers.
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45
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Emami A, Javanmardi F, Bakhtiari H, Rezaei T, Hemmati A, Akbari A, Pirbonyeh N. Death Reporting in Breakthrough and Unvaccinated SARS-CoV-2 Infection Cases. Disaster Med Public Health Prep 2023; 17:e359. [PMID: 36938906 PMCID: PMC10063864 DOI: 10.1017/dmp.2023.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Vaccines are undeniably an important tool for controlling infectious disease outbreaks, and they are the most certain way to end the epidemic risk. This brief report describes the characteristics of coronavirus disease 2019 (COVID-19) deaths among breakthrough and unvaccinated cases hospitalized in Fars province in the south of Iran. This cross-sectional study was performed to compare breakthrough and unvaccinated death cases in Fars, Iran (February 2, to August 19, 2021). Among 444,728 fully vaccinated people, 60,800 breakthrough cases were detected. Thus, 501 died, of which 297 (297/501) cases were hospitalized and compared with the unvaccinated dead group. The median age for breakthrough and unvaccinated cases was estimated 79 and 65 y, respectively. All signs and symptoms of COVID-19 were more frequent in the unvaccinated group. Decreasing O2 saturation (less than 93%) happened more often in the unvaccinated group significantly. Unvaccinated dead patients had significantly shorter hospital stays. These patients received 66.63% Sinopharm, 0.67% Sputnik, 0.67% COVIran Barekat, and 31.99% AstraZeneca vaccines. None of them were health-care staff. Equitable access to safe and effective vaccines is critical to ending the COVID-19 pandemic. As vaccine uptake increases, we observed a decrease in mortality and protection from severe forms of the disease.
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Affiliation(s)
- Amir Emami
- Microbiology Department, Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Javanmardi
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Bakhtiari
- Vice Chancellor for Health Affairs Center of Disease Control (CDC), Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Ali Akbari
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Pirbonyeh
- Microbiology Department, Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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46
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Boragno P, Fiabane E, Taino I, Maffoni M, Sommovigo V, Setti I, Gabanelli P. Perceptions of COVID-19 Vaccines: Protective Shields or Threatening Risks? A Descriptive Exploratory Study among the Italian Population. Vaccines (Basel) 2023; 11:642. [PMID: 36992226 PMCID: PMC10054618 DOI: 10.3390/vaccines11030642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Although several quantitative studies have explored vaccine hesitancy, qualitative research on the factors underlying attitudes toward vaccination is still lacking. To fill this gap, this study aimed to investigate the general perceptions of COVID-19 vaccines among the Italian population with a qualitative approach. The sample included 700 Italian participants who completed an online survey. Open questions underwent a descriptive analysis for unveiling meaning categories, while differences in the prevalence of categories were calculated using chi-square or Fisher's exact tests. Vaccination was associated with the following seven main themes: 'safety', 'healthcare', 'vaccine delivery', 'progress', 'ambivalence', 'mistrust', and 'ethics'. Vaccinated individuals more frequently reported words related to the safety theme (χ2 = 46.7, p < 0.001), while unvaccinated individuals more frequently reported words related to mistrust (χ2 = 123, p < 0.001) and ambivalence (χ2 = 48.3, p < 0.001) themes. Working in the healthcare sector and being younger than 40 years affected the general perceptions of vaccination in terms of pro-vaccine attitudes. Unvaccinated individuals were more affected by the negative experiences of their acquaintances and manifested more distrust of scientific researchers, doctors, and pharmaceutical companies than vaccinated individuals. These findings suggest promoting collaborative efforts of governments, health policymakers, and media sources, including social media companies, in order to deal with cognitions and emotions supporting vaccine hesitancy.
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Affiliation(s)
- Paola Boragno
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Elena Fiabane
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Irene Taino
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, 27040 Montescano, Italy
| | - Valentina Sommovigo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Ilaria Setti
- Unit of Applied Psychology, Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, 27100 Pavia, Italy
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47
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Timilsina SS, Durr N, Jolly P, Ingber DE. Rapid quantitation of SARS-CoV-2 antibodies in clinical samples with an electrochemical sensor. Biosens Bioelectron 2023; 223:115037. [PMID: 36584477 PMCID: PMC9788850 DOI: 10.1016/j.bios.2022.115037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
The current coronavirus disease 2019 (COVID-19) pandemic is caused by several variants of severe acute respiratory syndrome coronavirus-2 virus (SARS-CoV-2). With the roll-out of vaccines and development of new therapeutics that may be targeted to distinct viral molecules, there is a need to screen populations for viral antigen-specific SARS-CoV-2 antibodies. Here, we report a rapid, multiplexed, electrochemical (EC) device with on-chip control that enables detection of SARS-CoV-2 antibodies in less than 10 min using 1.5 μL of a patient sample. The EC biosensor demonstrated 100% sensitivity and specificity, and an area under the receiver operating characteristic curve of 1, when evaluated using 93 clinical samples, including plasma and dried blood spot samples from 54 SARS-CoV-2 positive and 39 negative patients. This EC biosensor platform enables simple, cost-effective, sensitive, and rapid detection of anti-SARS-CoV-2 antibodies in complex clinical samples, which is convenient for evaluating humoral-responses to vaccination or infection in population-wide testing, including applications in point-of-care settings. We also demonstrate the feasibility of using dried blood spot samples that can be collected locally and transported to distant clinical laboratories at ambient temperature for detection of anti-SARS-CoV-2 antibodies which may be utilized for serological surveillance and demonstrate the utility of remote sampling.
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Affiliation(s)
- Sanjay S Timilsina
- Wyss Institute for Biologically Inspired Engineering, Harvard University, 02115, USA
| | - Nolan Durr
- Wyss Institute for Biologically Inspired Engineering, Harvard University, 02115, USA
| | - Pawan Jolly
- Wyss Institute for Biologically Inspired Engineering, Harvard University, 02115, USA
| | - Donald E Ingber
- Wyss Institute for Biologically Inspired Engineering, Harvard University, 02115, USA; Vascular Biology Program, Boston Children's Hospital, And Harvard Medical School, 02115, USA; Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, 02115, USA.
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48
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Wu J, Shen Z, Li Q, Tarimo CS, Wang M, Gu J, Wei W, Zhang X, Huang Y, Ma M, Xu D, Ojangba T, Miao Y. How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study. Soc Sci Med 2023; 320:115695. [PMID: 36736053 PMCID: PMC9846885 DOI: 10.1016/j.socscimed.2023.115695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/08/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
RATIONALE Although urban-rural residency has been shown to influence individual COVID-19 vaccine hesitancy, the differences between urban and rural China have yet to be uncovered. OBJECTIVE This study aims to assess the current prevalence and factors associated with COVID-19 vaccine hesitancy in urban and rural areas and explore whether the rural versus urban residency is associated with COVID-19 vaccine hesitancy. METHODS A national, cross-sectional, online survey among Chinese urban and rural adults (≥18 years old) was conducted from 6th to August 9, 2021. A questionnaire was used to collect data on sociodemographic factors, perceptions of the COVID-19 pandemic and vaccination status. A multivariable logistic regression model was used to identify the factors that influence COVID-19 vaccine hesitancy. Propensity score matching (PSM) analysis was performed to explore the association between urban versus rural residency and COVID-19 vaccine hesitancy. RESULTS In total, 29,925 participants (80.56% urban participants) were recruited. Urban participants had a higher COVID-19 vaccine hesitancy than their rural counterparts (9.39% vs. 4.26%). After adjusting for potential confounders, we found that COVID-19 vaccine hesitancy among females was lower than that in males in both urban (aOR = 0.78, 95% CI [0.69-0.88]) and rural areas (aOR = 0.54, 95% CI [0.39-0.75]). The lack of trust towards vaccine producers was found to be associated with vaccine hesitancy among the urban participants (aOR = 2.76, 95% CI [2.22-3.43]). The rural floating population had a lower COVID-19 vaccine hesitancy than the rural permanent residents (aOR = 0.58, 95% CI [0.42-0.80]). PSM analysis revealed a 2.38% difference in COVID-19 vaccine hesitancy between urban and rural participants. CONCLUSIONS Urban participants were more hesitant to receive the COVID-19 vaccine than rural participants. Priority should be placed on boosting confidence in the healthcare system to reduce COVID-19 vaccine hesitancy among urban residents. Furthermore, we advocate for extra incentives and vaccination education for rural permanent residents.
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Affiliation(s)
- Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China; Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Meiyun Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, People's Republic of China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Guangdong, People's Republic of China
| | - Wei Wei
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, People's Republic of China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yanli Huang
- Manage and service Center of Wuhou Medical Institutes, Sichuan, People's Republic of China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Dongyang Xu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Theodora Ojangba
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China; Henan Province Engineering, Research Center of Health Economy & Health Technology Assessment, Zhengzhou, Henan, People's Republic of China.
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49
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Stevens G, Johnson LC, Saunders CH, Schmidt P, Sierpe A, Thomeer RP, Little NR, Cantrell M, Yen RW, Pogue JA, Holahan T, Schubbe DC, Forcino RC, Fillbrook B, Sheppard R, Wooten C, Goldmann D, O’Malley AJ, Dubé E, Durand MA, Elwyn G. The CONFIDENT study protocol: a randomized controlled trial comparing two methods to increase long-term care worker confidence in the COVID-19 vaccines. BMC Public Health 2023; 23:384. [PMID: 36823559 PMCID: PMC9948785 DOI: 10.1186/s12889-023-15266-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Clinical and real-world effectiveness data for the COVID-19 vaccines have shown that they are the best defense in preventing severe illness and death throughout the pandemic. However, in the US, some groups remain more hesitant than others about receiving COVID-19 vaccines. One important group is long-term care workers (LTCWs), especially because they risk infecting the vulnerable and clinically complex populations they serve. There is a lack of research about how best to increase vaccine confidence, especially in frontline LTCWs and healthcare staff. Our aims are to: (1) compare the impact of two interventions delivered online to enhanced usual practice on LTCW COVID-19 vaccine confidence and other pre-specified secondary outcomes, (2) determine if LTCWs' characteristics and other factors mediate and moderate the interventions' effect on study outcomes, and (3) explore the implementation characteristics, contexts, and processes needed to sustain a wider use of the interventions. METHODS We will conduct a three-arm randomized controlled effectiveness-implementation hybrid (type 2) trial, with randomization at the participant level. Arm 1 is a dialogue-based webinar intervention facilitated by a LTCW and a medical expert and guided by an evidence-based COVID-19 vaccine decision tool. Arm 2 is a curated social media web application intervention featuring interactive, dynamic content about COVID-19 and relevant vaccines. Arm 3 is enhanced usual practice, which directs participants to online public health information about COVID-19 vaccines. Participants will be recruited via online posts and advertisements, email invitations, and in-person visits to care settings. Trial data will be collected at four time points using online surveys. The primary outcome is COVID-19 vaccine confidence. Secondary outcomes include vaccine uptake, vaccine and booster intent for those unvaccinated, likelihood of recommending vaccination (both initial series and booster), feeling informed about the vaccines, identification of vaccine information and misinformation, and trust in COVID-19 vaccine information provided by different people and organizations. Exploration of intervention implementation will involve interviews with study participants and other stakeholders, an in-depth process evaluation, and testing during a subsequent sustainability phase. DISCUSSION Study findings will contribute new knowledge about how to increase COVID-19 vaccine confidence and effective informational modalities for LTCWs. TRIAL REGISTRATION NCT05168800 at ClinicalTrials.gov, registered December 23, 2021.
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Affiliation(s)
- Gabrielle Stevens
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, US.
| | - Lisa C. Johnson
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Catherine H. Saunders
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Peter Schmidt
- grid.137628.90000 0004 1936 8753Department of Neurology, Grossman School of Medicine, New York University, New York, NY US
| | - Ailyn Sierpe
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Rachael P. Thomeer
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - N. Ruth Little
- grid.255364.30000 0001 2191 0423Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC US
| | - Matthew Cantrell
- National Association of Health Care Assistants, Carl Junction, MO US
| | - Renata W. Yen
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Jacqueline A. Pogue
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Timothy Holahan
- grid.16416.340000 0004 1936 9174Department of Geriatric Medicine, University of Rochester, Rochester, NY US
| | - Danielle C. Schubbe
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Rachel C. Forcino
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | | | | | | | - Don Goldmann
- grid.418700.a0000 0004 0614 6393Institute for Healthcare Improvement, Boston, MA US
| | - A. James O’Malley
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
| | - Eve Dubé
- grid.23856.3a0000 0004 1936 8390Department of Anthropology, Faculty of Social Sciences, Laval University, Quebec City, QC Canada
| | - Marie-Anne Durand
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US ,grid.511931.e0000 0004 8513 0292Unisanté, Centre universitaire de médecine générale et santé publique, Rue du Bugnon 44, Lausanne Switzerland ,CERPOP, Université de Toulouse, Inserm, Toulouse, UPS France
| | - Glyn Elwyn
- grid.254880.30000 0001 2179 2404The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH US
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50
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Zhao Y, Du J, Li Z, Xu Z, Wu Y, Duan W, Wang W, Zhang T, Xu J, Wu H, Huang X. It is time to improve the acceptance of COVID-19 vaccines among people with chronic diseases: A systematic review and meta-analysis. J Med Virol 2023; 95:e28509. [PMID: 36655758 DOI: 10.1002/jmv.28509] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/19/2022] [Accepted: 01/14/2023] [Indexed: 01/20/2023]
Abstract
This study aims to investigated COVID-19 vaccine acceptance among people with chronic diseases and the factors correlating with their vaccination hesitancy. The articles were searched in PubMed, Ovid, EMBASE, and web of science databases between December 2019 and October 2022. Cross-sectional studies, including the acceptance of the COVID-19 vaccine by patients with chronic diseases (≥18 years old), were included in this study. The outcomes included the proportion and 95% confidence interval (95% CI) of chronic disease patients willing to be vaccinated and the odds ratio (OR) and 95% CI of correlating factors. The source of heterogeneity was analyzed through meta-regression and subgroup analysis. We included 31 studies involving 57 875 patients with chronic disease. The overall COVID-19 vaccine acceptance among patients with chronic disease was 0.65 (95% CI, 0.59-0.72). The acceptance among the elderly patients was 0.53 (95% CI, 0.26-0.80). South America had the highest COVID-19 vaccine acceptance rate and Asia the lowest, while on a country level, the United Kingdom had the highest acceptance rate among patients with chronic diseases. People with rheumatic immune diseases had the lowest rate of COVID-19 vaccine acceptance. Concerns about vaccine safety had a statistically different effect on acceptance. Overall, the health systems ought to focus on educating specific groups of individuals on the benefits of COVID-19 vaccination and addressing safety concerns.
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Affiliation(s)
- Yang Zhao
- Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Juan Du
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zhen Li
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zhe Xu
- Department of Dermatology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yaxin Wu
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wenshan Duan
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wenjing Wang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- Department of Dermatology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | - Hao Wu
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiaojie Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
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