Using the 5C model to understand COVID-19 vaccine hesitancy across a National and South Carolina sample

Mental health and psychosocial factors predicting concerns about the COVID-19 vaccine among refugee background and Australian-born women

BACKGROUND

Hesitancy about the COVID-19 vaccine in high-income countries can be caused by diverse psychological and social factors. Few studies on vaccine concerns have examined the interplay of the effects of mental disorders, social and economic factors, gender and refugee status. To investigate these issues, this article reports findings from the 2023 wave of a longitudinal study involving 709 women who are mothers of young children in Australia, both refugees and Australian-born.

METHODS

Respondents were asked if they had any worries or fears about receiving the COVID-19 vaccine. In previous waves they completed standardized assessments of mental health and sociodemographic factors. An open-ended question provided insights into the reasons for self-reported vaccine concerns. Descriptive statistics and binary logistic regression analyses were conducted, and demographic adjusted logistic regression undertaken separately for Australian-born and refugee women. Formal comparisons of effect sizes between Australian-born and refugee women were performed, with Cohen's d quantifying the magnitude of these differences. Qualitative responses were coded by topic and ranked by frequency.

FINDINGS

More than half of the respondents reported worries about receiving a COVID-19 vaccine. Concerns were significantly higher for younger age women, those with a lower educational level and those with a history of mood disorder, panic disorder or separation anxiety disorder. Vaccine hesitancy was associated with poorer quality of life, living difficulties and disability among refugee women only. Separation anxiety disorder and a younger age were associated with an increased odds among Australian-born women only. The newness of the vaccine and concern about side effects were the greatest concerns among respondents who reported hesitancy.

CONCLUSIONS

Young mothers with mental health problems and lower education need to be sensitively targeted to improve COVID-19 vaccine uptake. Mental health and public health professionals need to be aware of differences reported for women from refugee background. Improved quality of life and economic status will increase vaccine uptake among socioeconomically challenged communities.

Development and validation of COVID-19 vaccination perception (CoVaP) instrument among healthcare workers in Malaysia

Background

Healthcare workers (HCWs) play an essential role in facilitating coronavirus disease 2019 (COVID-19) vaccination, and their confidence in vaccination is crucial. Nevertheless, valid instruments for assessing the HCWs' perceptions of COVID-19 vaccination were lacking. This study aims to develop and validate the COVID-19 Vaccination Perceptions (CoVaP) instrument among HCWs in Malaysia.

Methods

A literature review and discussion with research teams were conducted to identify the content to be considered. The instrument was developed in Malay language and underwent back-to-back translations to the English version. The initial CoVaP instrument was unidimensional with 12 items. The Malay and English versions underwent a content validation process by seven expert panels. However, only the Malay version underwent face and construct validation. Face validity was assessed using 30 HCWs. The construct validation was conducted in a two-step process using data from two cross-sectional study samples, including 125 and 300 HCWs for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. It was a self-administered questionnaire, and the data were collected using both face-to-face and online platforms. The data were analysed using Analysis of Moment Structure version 28.0 and Statistical Packages for the Social Sciences version 26.

Results

The analysis showed excellent content (item content validity index (I-CVI) = 0.83 to 1.0, average content validity index (S-CVI/Ave) = 0.97) and face (item face validity index (I-FVI) = 0.87 to 1.0, average face validity index (S-FVI/Ave) = 1.02) validity. The EFA analysis revealed seven items with two domains. Subsequent analysis using CFA demonstrated a two-factor model of seven items with an acceptable level of goodness of fit indexes (comparative fit index = 0.999, Tucker-Lewis index = 0.999, incremental fit index = 0.987, chi-squared/degree of freedom = 1.039, and root mean square error of approximation = 0.011). Finally, the Cronbach's alpha was satisfactory for both domains (0.899 and 0.815).

Conclusion

The CoVaP instrument is a valid and reliable tool for measuring perceptions of COVID-19 vaccination among HCWs. The high validity and reliability of the CoVaP instrument underscore its utility in capturing the unique cultural and contextual factors influencing vaccine perceptions among Malaysian HCWs. Understanding these factors is essential for designing effective public health interventions to address vaccine hesitancy and improve vaccination rates.

Vaccine hesitancy as indecision: Creation and evaluation of the Unidimensional Vaccine Hesitancy Scale

BACKGROUND

Several authors have argued that vaccine hesitancy should be conceptualized as indecision in the vaccination decision-making process, but no established measure with support for its psychometric properties and validity has been created from this operational definition.

AIMS

To resolve this tension, this article undergoes a four-study scale development process to create the 4-item Unidimensional Vaccine Hesitancy Scale (UVHS).

MATERIALS AND METHODS

We conduct four survey studies utilizing a total sample size of 884.

RESULTS

In Studies 1 (n = 297) and 2 (n = 298), we provide psychometric support for the measure via exploratory and confirmatory factor analysis. In Studies 3 (n = 193) and 4 (n = 106), we support the concurrent and discriminant validity of the measure by assessing its relations with relevant constructs, such as vaccination readiness and acceptance, and we also provide initial indicators of the scale's possible predictive qualities by testing its time-separated effects with vaccination willingness, receipt and word-of-mouth.

DISCUSSION

We leverage these results to provide a number of theoretical insights and suggestions for future practice. Of note, we highlight that different conceptualizations and operationalizations for the same construct can produce notably differing empirical findings, and vaccine hesitancy is no different.

CONCLUSION

Our cumulative efforts indicate that the UVHS is an appropriate measure to assess vaccine hesitancy as indecision.

Exploring healthcare workers' immunisation behaviour towards COVID-19 vaccines through psychological patterns

BACKGROUND

 The psychological approach can provide valuable insights into vaccination behaviour, especially in high-risk contexts. It offers new perspectives for effective interventions to improve vaccination behaviour.

AIM

 To investigate key factors influencing stress related to vaccination in emergency situations among healthcare professionals.

SETTING

 Eastern region of Morocco.

METHODS

 We conducted a descriptive and analytical cross-sectional study involving 221 healthcare professionals in the Eastern region of Morocco. A snowball sampling method was used to select the participants who were administered a questionnaire. Logistic regression analysis was performed with p  0.05 being the level of statistical significance.

RESULTS

 The participants had a median age of 25.5 years (30-34.5) and were predominantly females (68.3%). Vaccination coverage stood at 84.6%, with a positive perception of 77.8%. The analysis of the Perceived Stress Scale (PSS) revealed that 51.6% (n = 114) of healthcare professionals experienced stress towards vaccination. Females were almost two times more susceptible to experiencing vaccination stress (p = 0.03). Furthermore, the analysis showed that vaccination profile (p = 0.02), accepting the vaccine for any reason other than its accessibility (p = 0.03) and having a previous coronavirus disease 2019 infection (p = 0.03), were significantly associated with stress. In contrast, healthcare professionals based at the university hospital had a significantly lower stress level (p = 0.01).

CONCLUSION

 Moroccan healthcare professionals exhibited high vaccine acceptance and positive perceptions, particularly among vaccinated individuals despite notable stress around immunisation.Contribution: These insights can guide governments and policymakers in developing strategies to enhance healthcare workers' awareness and understanding of vaccination.

Using the 5C Vaccine Hesitancy Framework to Elucidate and Measure Contraceptive Acceptability in sub-Saharan Africa

We draw lessons from immunization research by assessing the applicability of the 5C framework of vaccine hesitancy to contraceptive acceptability in sub-Saharan Africa.

An exploration of the role of trust and rapport in enhancing vaccine uptake among Anishinaabe in rural northern Ontario

This article examines the complicated terrain of immunization acceptance and access among Indigenous peoples in northern Ontario by drawing on conversations held prior to 2019 that explored knowledge about Haemophilus influenzae type a (Hia) infection specifically and attitudes toward vaccines more broadly. In the decade preceding COVID-19, Hia emerged as a leading cause of morbidity and mortality in Indigenous communities in northern Canada. Before developing new vaccines, it is imperative to hold conversations with the communities most affected and to learn more about Indigenous peoples' perceptions of and knowledge about vaccines, both generally and Hia specifically. We conducted focus groups and one-on-one conversations with Anishinaabe Peoples in northwestern Ontario. Our findings illustrate that decisions to vaccinate are informed by a host of social, institutional, and ideological factors and historical and contemporary relationships with government institutions and health practitioners. In particular, Indigenous community members perceived their relationships with social and health services and education institutions as coercive. Thus, public health approaches cannot continue to operate in ways that prioritize interventions for Indigenous peoples and communities so that they "do the right thing." More emphasis is needed on health service and social service provider knowledge, skills, attitudes and practices-redirecting the onus onto those within the health care system. Solutions must respect Indigenous nationhood and the right of self-determination. Finally, we suggest the term vaccine hesitancy may not entirely capture the breadth of experiences that many Indigenous Peoples and communities have and continue to have within the health care system in Canada.

Promoters and Barriers of Vaccine Hesitancy

This systematic review explores the psychological antecedents of Vaccine Hesitancy, a significant determinant of vaccination behavior. Following PRISMA guidelines, an extensive search was conducted starting from 1673 papers and resulting in 48 publications from various databases. The review identifies psychological factors, specifically cognitive, personality, experiential, and social factors contributing to hesitancy. Cognitive factors include health literacy, conspiracy beliefs, trust, and perceived risk. Personality traits such as extraversion, openness, and psychological capital impact hesitancy, while psychopathy increases it. Personal experiences, like perceived stress and racial discrimination, indirectly affect hesitancy. Social factors, including social relationships and norms, play a significant role in reducing hesitancy. Tailored interventions addressing these factors can enhance vaccine acceptance.

A scoping review of COVID-19 vaccine hesitancy: refusal rate, associated factors, and strategies to reduce

Objective

This study aimed to investigate the evidence regarding vaccine hesitancy including refusal rate, associated factors, and potential strategies to reduce it.

Methods

This is a scoping review. Three main databases such as PubMed, Scopus, and Web of Science were searched from 1 January 2020 to 1 January 2023. All original studies in the English language that investigated one of our domains (vaccine hesitancy rate, factors associated with vaccine hesitancy, and the ways/interventions to overcome or decrease vaccine hesitancy) among the general population were included in this study. The data were charted using tables and figures. In addition, a content analysis was conducted using the 3C model of vaccine hesitancy (Confidence, Complacency, and Convenience) that was previously introduced by the WHO.

Results

Finally, 184 studies were included in this review. Of these, 165, 181, and 124 studies reported the vaccine hesitancy rate, associated factors, and interventions to reduce or overcome vaccine hesitancy, respectively. Factors affecting the hesitancy rate were categorized into 4 themes and 18 sub-themes (contextual factors, confidence barriers, complacency barriers, and convenience barriers).

Conclusion

Vaccine hesitancy (VH) rate and the factors affecting it are different according to different populations, contexts, and data collection tools that need to be investigated in specific populations and contexts. The need to conduct studies at the national and international levels regarding the reasons for vaccine refusal, the factors affecting it, and ways to deal with it still remains. Designing a comprehensive tool will facilitate comparisons between different populations and different locations.

A Comprehensive Model for Understanding Breast Cancer Screening Hesitancy: Integrating the Health Belief Model and the Confidence, Convenience, Complacency, Constraints, and Risk and Responsibility Calculations (5C) Model

Breast cancer screening (BCS) is a critical preventive measure that can significantly reduce mortality rates. Despite its importance, screening hesitancy remains a global issue. This paper showcases the combination of the Health Belief Model (HBM) and the 5C Model and how it provides a more holistic understanding of BCS hesitancy. The first model, HBM, is a well-regarded tool that collects data based on individual beliefs such as perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy. The second model, the 5C Model, stands for confidence, convenience, complacency, constraints, and risk and responsibility calculations. This model adds a layer of environmental considerations that HBM lacks. By combining these models, we can identify the key psychological, social, and structural barriers that contribute to BCS hesitancy. Furthermore, analysis of the literature suggests that enhancing trust in healthcare systems, increasing accessibility and affordability of screening, addressing cultural and social stigmas, and promoting a sense of collective responsibility can significantly improve screening participation rates, which are reflected in the models.

Understanding COVID-19 Vaccine Hesitancy in the United States: A Systematic Review

The COVID-19 pandemic has presented the importance of vaccination as a pivotal strategy for controlling its spread. However, vaccine hesitancy poses a significant barrier to achieving widespread immunization in the United States. This systematic review utilizes the 5C model to examine the factors contributing to hesitancy, which include confidence in vaccines, complacency about disease risk, calculations of individual benefit, convenience of vaccination, and collective responsibility for the protection of others.

METHODS

We conducted a comprehensive search across several relevant databases and the gray literature, identifying 544 studies that used quantitative and qualitative methods to explore COVID-19 vaccine hesitancy in the general U.S.

POPULATION

RESULTS

This review identifies a complex interplay of factors affecting hesitancy, such as concerns over vaccine safety and efficacy, misinformation and conspiracy theories, demographic variables, and socioeconomic conditions. Key strategies for increasing vaccine uptake include transparent and effective communication along with proactive community engagement.

CONCLUSIONS

To effectively mitigate vaccine hesitancy, it is crucial to understand its multifaceted causes. Tailored interventions that consider socioeconomic and cultural contexts and prioritize clear communication, community involvement, and specific strategies to address unique concerns can enhance vaccine acceptance.

Motivators and Demotivators for COVID-19 Vaccination Based on Co-Occurrence Networks of Verbal Reasons for Vaccination Acceptance and Resistance: Repetitive Cross-Sectional Surveys and Network Analysis

BACKGROUND

Vaccine hesitancy is complex and multifaced. People may accept or reject a vaccine due to multiple and interconnected reasons, with some reasons being more salient in influencing vaccine acceptance or resistance and hence the most important intervention targets for addressing vaccine hesitancy.

OBJECTIVE

This study was aimed at assessing the connections and relative importance of motivators and demotivators for COVID-19 vaccination in Hong Kong based on co-occurrence networks of verbal reasons for vaccination acceptance and resistance from repetitive cross-sectional surveys.

METHODS

We conducted a series of random digit dialing telephone surveys to examine COVID-19 vaccine hesitancy among general Hong Kong adults between March 2021 and July 2022. A total of 5559 and 982 participants provided verbal reasons for accepting and resisting (rejecting or hesitating) a COVID-19 vaccine, respectively. The verbal reasons were initially coded to generate categories of motivators and demotivators for COVID-19 vaccination using a bottom-up approach. Then, all the generated codes were mapped onto the 5C model of vaccine hesitancy. On the basis of the identified reasons, we conducted a co-occurrence network analysis to understand how motivating or demotivating reasons were comentioned to shape people's vaccination decisions. Each reason's eigenvector centrality was calculated to quantify their relative importance in the network. Analyses were also stratified by age group.

RESULTS

The co-occurrence network analysis found that the perception of personal risk to the disease (egicentrality=0.80) and the social responsibility to protect others (egicentrality=0.58) were the most important comentioned reasons that motivate COVID-19 vaccination, while lack of vaccine confidence (egicentrality=0.89) and complacency (perceived low disease risk and low importance of vaccination; egicentrality=0.45) were the most important comentioned reasons that demotivate COVID-19 vaccination. For older people aged ≥65 years, protecting others was a more important motivator (egicentrality=0.57), while the concern about poor health status was a more important demotivator (egicentrality=0.42); for young people aged 18 to 24 years, recovering life normalcy (egicentrality=0.20) and vaccine mandates (egicentrality=0.26) were the more important motivators, while complacency (egicentrality=0.77) was a more important demotivator for COVID-19 vaccination uptake.

CONCLUSIONS

When disease risk is perceived to be high, promoting social responsibility to protect others is more important for boosting vaccination acceptance. However, when disease risk is perceived to be low and complacency exists, fostering confidence in vaccines to address vaccine hesitancy becomes more important. Interventions for promoting vaccination acceptance and reducing vaccine hesitancy should be tailored by age.

Assessing COVID-19 Vaccine Hesitancy and Trust in Home Health Workers in New York City: A Pilot Study

OBJECTIVE

This study aimed to identify characteristics surrounding COVID-19 vaccine hesitancy and trust in home health workers (HHWs) in New York City.

METHODS

Data were collected from HHWs through focus group sessions conducted via Zoom. We developed a facilitator guide using the 5C Scale, a validated psychometric tool for assessing vaccine hesitancy. We performed qualitative thematic analysis using a combined inductive and deductive approach.

RESULTS

Major themes that emerged included the following: conflicting information decreased vaccine confidence; individualized outreach is valued when information gathering; mandates and financial incentives may increase skepticism; low health literacy and conflict in personal relationships are barriers to acceptance; and experiencing a severe infection and fear of exposure at work increase acceptance.

CONCLUSIONS

Based on our study, personalized yet consistent messaging may be key to reaching hesitant HHWs.

Vaccine Hesitancy Affecting Pneumococcal Vaccine Refusal in Older Adults with Morbidities

INTRODUCTION

Pneumonia is a leading cause of mortality worldwide, with Streptococcus pneumoniae being the most common cause. Older adults are particularly at risk. However, vaccination rates in Thailand remain low.

OBJECTIVE

This study aims to examine the prevalence of vaccine refusal and its association with factors outlined in the 5C model (Confidence, Complacency, Constraints, Calculation, and Collective Responsibility) among older patients with morbidities.

SETTING

Study was conducted at outpatient clinic of the Department of Family Medicine, Chiang Mai University.

METHODS

An observational cross-sectional study. The data was collected via a self-administered questionnaire including demographic data, questionnaire in 5C model, and intention to received pneumococcal vaccine. Comparison of characteristic between vaccine refuser and non-refuser was performed by using Chi-square or a T-test. To explore the association between factors in 5C model and vaccine refusal, multiple logistic regression was performed with an adjustment for confounders.

RESULTS

From a total of 150 participants, the mean age was 69.8 ± 5.6 years old. Most of the patients were female (60.7%). The study found that 18% of the participants refused the pneumococcal vaccine. After adjusted for the confounders, the lower collective responsibility and confidence were significantly associated with vaccine refusal (Odds ratio 0.22 (95% confidence interval [CI] 0.06-0.74, P = .015) and Odds ratio 0.43 (95% CI 0.20-0.89, P = .024), respectively.

CONCLUSION

Strategies to enhance confidence and address complacency about vaccines are essential for improving pneumococcal vaccination coverage. This insight can be used as a guideline and policies can be formulated which are aimed at reducing pneumococcal vaccine refusal in the older adults by enhancing communication about the benefits, efficacy, and risks of vaccines.

Extracting factors associated with vaccination from Twitter data and mapping to behavioral models

Social media platform, particularly Twitter, is a rich data source that allows monitoring of public opinions and attitudes toward vaccines.Established behavioral models like the 5C psychological antecedents model and the Health Belief Model (HBM) provide a well-structured framework for analyzing shifts in vaccine-related behavior. This study examines if the extracted data from Twitter contains valuable insights regarding public attitudes toward vaccines and can be mapped to two behavioral models. This study focuses on the Arab population, and a search was carried out on Twitter using: ' تلقيحي OR تطعيم OR تطعيمات OR لقاح OR لقاحات' for two years from January 2020 to January 2022. Then, BERTopicmodeling was applied, and several topics were extracted. Finally, the topics were manually mapped to the factors of the 5C model and HBM. 1,068,466 unique users posted 3,368,258 vaccine-related tweets in Arabic. Topic modeling generated 25 topics, which were mapped to the 15 factors of the 5C model and HBM. Among the users, 32.87%were male, and 18.06% were female. A significant 55.77% of the users were from the MENA (Middle East and North Africa) region. Twitter users were more inclined to accept vaccines when they trusted vaccine safety and effectiveness, but vaccine hesitancy increased due to conspiracy theories and misinformation. The association of topics with these theoretical frameworks reveals the availability and diversity of Twitter data that can predict behavioral change toward vaccines. It allows the preparation of timely and effective interventions for vaccination programs compared to traditional methods.

Role of leadership and incentive-based programs in addressing vaccine hesitancy in India

The current study goes beyond the popular 5Cs model of vaccine hesitancy to explore perceived social norms, role of leadership and the role of incentive-based intervention for improving the likelihood of vaccination, in a population-representative sample of adults in India (N = 1129). We investigated differences in socio-demographic status, perceived descriptive norms like vaccine behaviours, beliefs, experience and perceived injunctive norms like community and political leadership within the context of the COVID-19 pandemic are related to vaccination. Further, we examined the role of incentive-based intervention as a potentially salient predictor of adults' vaccine uptake. The study is based on a cross-sectional survey conducted in July-November 2021, which included questions about impacts of pandemic collected by phone call interview from adults' beneficiaries of Government free food schemes, across 11 states in India. The data include 81 % vaccinated and 19 % vaccine hesitant participants, with a higher proportion of business or self-employed (53.1 %) as vaccine hesitant. We performed the t-test to assess the variation between vaccinated and vaccine hesitant adults, and Exploratory Factor Analysis to uncover the underlying dimension of vaccine hesitancy. Subsequently, Binary Logistic Regression model probed the factors associated with likelihood of vaccination uptake. In contrast to the prevailing evidence, results demonstrated community and political leadership has significant negative impact on vaccination (p-value < 0.06, 95 % CI, 0.57-1.01). Incentive-based intervention offer a vital leverage to enhance positive attitude towards vaccination (p-value < 0.05, 95 % CI, 1.01-1.80). The results thus broadly highlight the limited role of political and community leaders in leveraging their influence on vaccination, the role of timely, accurate information, applications of telemedicine as an important tool to provide healthcare and the need for optimal design of incentive-based vaccination programs recommended by trusted sources.

Maternal pertussis vaccination behavior: Psychosocial, attitudinal and organizational factors

BACKGROUND

In December 2019, the maternal pertussis vaccination (MPV) became part of the Dutch National Immunization Program. This study aims to study MPV behavior and associated psychosocial, attitudinal and organizational factors of pertussis vaccination behavior during pregnancy in the Netherlands.

METHODS

We conducted a cross-sectional survey among pregnant women and recent mothers, up to six months post-partum. The primary outcome measure of this study was MPV behavior. Associations between psychosocial, attitudinal and organizational factors and MPV behavior were assessed using univariate and multivariate binary logistic regression analysis.

RESULTS

In total 1348 participants filled out the questionnaire, including 1282 (95.1%) MPV acceptors and 66 (4.9%) MPV refusers. The most important factors associated with MPV behavior were: attitude (aOR: 10.19; 95%CI: 4.30-24.16), outcome expectations (aOR: 8.94; 95%CI: 3.60-22.21), omission bias (aOR: 0.11; 95%CI: 0.02-0.59) and physical accessibility (aOR: 7.44; 95%CI: 3.37-16.46).

CONCLUSION

Pregnant women make their decision about the MPV primarily based on attitudinal and psychosocial factors, such as outcome expectations and attitude. A combination and variation of different messages, about the advantages (effectiveness) and disadvantages (side effects) of maternal vaccination, can be used in reaching pregnant women with a positive and negative attitude about the MPV. In addition, strategies to increase MPV uptake should not only focus on providing information, but also decrease experienced practical barriers, such as poor physical accessibility, in people that are intended to receive the MPV but are not getting vaccinated.

Utilizing the theory of planned behavior to predict COVID-19 vaccination intention: A structural equational modeling approach

It is essential to achieve herd immunity in order to control the COVID-19 pandemic, and this requires a high level of vaccination rate. Despite the importance of vaccination, hesitancy and unwillingness in receiving the COVID-19 vaccine still exists. It is therefore crucial to comprehend the intentions of adults regarding COVID-19 vaccination, which is beneficial for establishing community immunity and an efficient future pandemic response. An online survey was administered to 2722 adults in Vietnam. Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were used to test the reliability and validity of the developed scales. Then, structural equational modeling (SEM) was employed to test correlations. This study found that favorable attitudes toward COVID-19 vaccines played the most important role in shaping adults' intention to receive these vaccines, followed by perceived behavioral control, perceived benefits of COVID-19 vaccines, and subjective norms. Concurrently, all three core dimensions of the theory of planned behavior mediated the link between the perceived benefits of COVID-19 vaccines and the intention to receive them. Also, there were significant differences between males and females in the way they formed this intention. The findings of this study offer valuable guidance for practitioners on how to encourage adults to receive COVID-19 vaccinations, as well as how to limit the transmission of the COVID-19 virus.

The Prevalence of COVID-19 Vaccine Hesitancy Among the Black Asian Ethnic Minority in New South Wales, Australia

INTRODUCTION

Vaccination provides a cost-effective approach to controlling the COVID-19 pandemic. The success of vaccination depends on global preparedness and acceptance of the new vaccines, and this is threatened by vaccine hesitancy worldwide. This study aimed to measure the prevalence of COVID-19 vaccine hesitancy, attitudes, and contributing factors in the Black Asian Ethnic Minority (BAME) of New South Wales (NSW), Australia.  Aim: This study aimed to measure the prevalence of COVID-19 vaccine hesitancy and identify contributing factors leading to vaccine hesitancy in the Black Asian and Ethnic Minority (BAME) in NSW.

METHOD

A cross-sectional study was conducted among the BAME community in NSW; over 12 weeks, from January 3^rd, 2022, to March 28^th, 2022. The study used the pre-existing previously known 5Cs model (confidence, constraints, complacency, calculation, and collective responsibility) to assess reasons for hesitancy. The questionnaire was distributed in English using social media platforms: Facebook and WhatsApp.

RESULTS

The study received 101 respondents over 18 years from all states in Australia from BAME communities, males and females, with different educational levels, employment sectors, marital statuses, co-existing chronic medical conditions, previous COVID-19 infection status, and COVID-19 vaccine received. Of these, 56 respondents were from NSW. Our findings revealed a high prevalence of COVID-19 vaccine hesitancy among the BAME community in NSW, with 72.8% of respondents demonstrating hesitancy/reluctance due to various attitudes identified by the 5Cs model. Despite this high hesitancy, 98.2% of the participants had received at least one to three vaccine doses.

CONCLUSION

 Even in populations with high vaccine uptake, it is still essential to address vaccine hesitancy and provide ongoing education about the importance of vaccination, particularly as new variants of COVID-19 continue to emerge and the need for booster shots may arise. This can help ensure continued protection against the virus and prevent future outbreaks.