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Steinmayr A, Rossi M. Vaccine-skeptic physicians and patient vaccination decisions. HEALTH ECONOMICS 2024; 33:509-525. [PMID: 38015034 DOI: 10.1002/hec.4781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/12/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
What is the role of general practitioners (GPs) in supporting or hindering public health efforts? We investigate the influence of vaccine-skeptic GPs on their patients' decisions to get a COVID-19 vaccination. We identify vaccine-skeptic GPs from the signatories of an open letter in which 199 Austrian physicians expressed their skepticism about COVID-19 vaccines. We examine small rural municipalities where patients choose a GP primarily based on geographic proximity. These vaccine-skeptic GPs reduced the vaccination rate by 5.6 percentage points. This estimate implies that they discouraged 7.9% of the vaccinable population. The effect appears to stem from discouragement rather than rationing vaccine access.
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Wojczewski S, Leitner KM, Hoffmann K, Kutalek R, Jirovsky-Platter E. Vaccine hesitancy among physicians: a qualitative study with general practitioners and paediatricians in Austria and Germany. BMJ Open 2024; 14:e077411. [PMID: 38262649 PMCID: PMC10806645 DOI: 10.1136/bmjopen-2023-077411] [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] [Received: 07/04/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE This study aims to understand reasons for vaccine hesitancy (VH) among general practioners (GPs) and paediatricians. We aim to analyse how and when the healthcare workers (HCWs) developed vaccine-hesitant views and how they transfer these to patients. DESIGN AND SETTING Semistructured interviews with vaccine-hesitant GPs and paediatricians were conducted in Austria and Germany using an explorative qualitative research design. PARTICIPANTS We contacted 41 physicians through letters and emails and 10 agreed to participate, five were male and five female. DATA COLLECTION AND ANALYSIS Ten interviews were recorded, transcribed verbatim and anonymised. The material was analysed inductively following a grounded theory approach with open coding using the software atlas.ti. RESULTS Key themes that were identified were education and career path, understanding of medicine and medical profession, experiences with vaccines, doctor-patient interactions and continuous education activities and the link to VH. GPs and paediatricians' vaccine-hesitant attitudes developed during their medical training and, in particular, during extracurricular training in homeopathy, which most of the participants completed. Most participants work in private practices rather than with contracts with social insurance because they are not satisfied with the health system. Furthermore, they are critical of biomedicine. Most of the interview partners do not consider themselves antivaccination, but are sceptical towards vaccines and especially point out the side effects. Most do not vaccinate in their practices and some do only occasionally. Their vaccine-hesitant views are often fostered through respective online communities of vaccine-hesitant HCWs. CONCLUSIONS More studies on a connection between complementary medicine and vaccine-hesitant views of HCWs are needed. Education about vaccines and infectious diseases among healthworkers must increase especially tailored towards the use of internet and social media. Physicians should be made aware that through time and empathy towards their patients they could have a positive impact on undecided patients and parents regarding vaccine decisions.
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Affiliation(s)
- Silvia Wojczewski
- Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | - Kathryn Hoffmann
- Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Elena Jirovsky-Platter
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Dinga JN, Kabakama S, Njimoh DL, Chia JE, Morhason-Bello I, Lumu I. Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries. Vaccines (Basel) 2023; 12:34. [PMID: 38250847 PMCID: PMC10818751 DOI: 10.3390/vaccines12010034] [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: 12/03/2023] [Revised: 12/18/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72-67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05-35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = -0.11, p < 0.164) or vaccine hesitancy (r = -0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67-212.8), rural setting (OR = 2.53, 95% CI; 0.29-119.33), older (OR = 1.98, 95% CI; 0.99-4.07), higher education (OR = 1.76, 95% CI; 0.85-3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45-30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03-1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92-8.24), complacency (OR = 2.86, 95% CI; 1.02-8.83), pregnancy (OR = 2.3, 95% CI; 0.12-141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52-10.42), being female (OR = 1.53, 95% CI; 0.78-3.01), and safety concerns (OR = 1.29, 95% CI; 0.67-2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19.
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Affiliation(s)
- Jerome Nyhalah Dinga
- Michael Gahnyam Gbeugvat Foundation, Buea P.O. Box 63, Cameroon
- Biotechnology Unit, University of Buea, Buea P.O. Box 63, Cameroon
| | - Severin Kabakama
- Humanitarian and Public Health Consultant, Mwanza P.O. Box 511, Tanzania
| | - Dieudonne Lemuh Njimoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea P.O. Box 63, Cameroon
| | - Julius Ebua Chia
- World Health Organization-Regional Office for Africa, Brazaville P.O. Box 06, Congo
| | | | - Ivan Lumu
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
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Kotronia E, Rosinska M, Stepien M, Czerwinski M, Sadkowska-Todys M. Willingness to vaccinate among adults, and factors associated with vaccine acceptance of COVID-19 vaccines in a nationwide study in Poland between March 2021 and April 2022. Front Public Health 2023; 11:1235585. [PMID: 38111477 PMCID: PMC10726053 DOI: 10.3389/fpubh.2023.1235585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023] Open
Abstract
Introduction Despite the availability, safety and effectiveness of COVID-19 vaccines, Poland remains one of the six countries of the European Union with the lowest cumulative uptake of the vaccine's primary course in the general population. This study examined willingness to vaccinate and the associated factors in samples of unvaccinated and vaccinated adults between March 2021 and April 2022. Methods Data were collected using OBSER-CO, a nationwide, repeated cross-sectional study, conducted at four different time points (rounds). Data on willingness to vaccinate among the unvaccinated (at all rounds) and willingness to receive another dose in the vaccinated (at 2 rounds-after booster introduction), reasons for reluctance, sociodemographic, health, and behavioral factors were collected using a uniform questionnaire via computer-assisted telephone interviewing. In each round, more than 20,000 respondents were interviewed. To assess associations between factors and willingness to vaccinate, separate multivariable logistic regression models were fitted for each factor at each round and adjusted for confounders. Results Between rounds 1 and 4 (March 2021-April 2022), in the unvaccinated, willingness to vaccinate declined from 73 to 12%, whereas in the vaccinated, willingness to receive another dose declined from 90 to 53%. The highest magnitude of decline between subsequent rounds occurred during the Omicron wave. Overall, concerns about side effects, effectiveness, and vaccine adverse effects were common but decreased over time. Age, gender, employment, place of residence, COVID-19 diagnosis or exposure, hospitalization, and participation in social activities were among the factors associated with willingness. However, associations changed over rounds highlighting the influence of different pandemic waves and variants. Conclusion We observed a declining and multifactorial willingness to vaccinate in Poland, with vaccine attitudes dynamically changing across subsequent rounds. To address vaccine concerns, sustained health communication about COVID-19 vaccines is essential, especially after the emergence of new variants.
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Affiliation(s)
- Eftychia Kotronia
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Magdalena Rosinska
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Malgorzata Stepien
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
| | - Michal Czerwinski
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
| | - Malgorzata Sadkowska-Todys
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
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Jiao L, Wachinger J, Dasch S, Bärnighausen T, McMahon SA, Chen S. Calculation, knowledge, and identity: Dimensions of trust when making COVID-19 vaccination choices in China. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 4:100288. [PMID: 37334196 PMCID: PMC10232919 DOI: 10.1016/j.ssmqr.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023]
Abstract
Vaccine hesitancy threatens the response to the COVID-19 pandemic and to other infectious disease outbreaks globally. Fostering trust has been highlighted as a critical factor in addressing vaccine hesitancy and expanding vaccine coverage, but qualitative exploration of trust in the context of vaccination remains limited. We contribute to filling this gap by providing a comprehensive qualitative analysis of trust in the context of COVID-19 vaccination in China. We conducted 40 in-depth interviews with Chinese adults in December 2020. During data collection, trust emerged as a highly salient topic. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed with a combination of inductive and deductive coding. Following established trust literature, we differentiate between three types of trust - calculation-based trust, knowledge-based trust, and identity-based trust - which we grouped across components of the health system, as informed by the WHO's building blocks. Our results highlight how participants attributed their level of trust in COVID-19 vaccines to their trust in the medical technology itself (based on assessing risks and benefits or previous vaccination experiences), the service delivery and health workforce (informed by past experiences with health providers and their role throughout the pandemic), and leadership and governance (drawing on notions of government performance and patriotism). Reducing negative impact from past vaccine controversies, increasing the credibility of pharmaceutical companies, and fostering clear communication are identified as important channels for facilitating trust. Our findings emphasize a strong need for comprehensive information on COVID-19 vaccines and increased promotion of vaccination by credible figures.
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Affiliation(s)
- Lirui Jiao
- Columbia University Mailman School of Public Health, New York, USA
| | - Jonas Wachinger
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - Selina Dasch
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- Department of Global Health and Population, Harvard School of Public Health, Massachusetts, USA
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shannon A McMahon
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Simiao Chen
- Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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6
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Lenart C, Prager M, Sachs M, Steininger C, Fernandes C, Thannesberger J. Tackling Vaccine Hesitancy and Increasing Vaccine Willingness Among Parents of Unvaccinated Children in Austria. Int J Public Health 2023; 68:1606042. [PMID: 37701049 PMCID: PMC10493290 DOI: 10.3389/ijph.2023.1606042] [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: 03/29/2023] [Accepted: 08/09/2023] [Indexed: 09/14/2023] Open
Abstract
Objectives: In autumn 2021, there was a surge of COVID-19 infections in Austria, and vaccination coverage stagnated at a below-average level compared to the rest of Europe. Surveys showed that both children and adolescents were the main drivers of the rising infection rates and that vaccination numbers were particularly low in this age group. This was due to widespread vaccination skepticism and hesitancy among parents of unvaccinated children and adolescents. Methods: Here, we describe a novel intervention concept that allowed us to efficiently tackle parental vaccine hesitancy. We designed an intervention series that followed a reproducible format based on online face-to-face seminars in groups of a maximum of twenty people. Each seminar included an anonymous online questionnaire for internal quality control. Moreover, we assessed the motives of parental vaccine hesitancy and asked participants to rate subjective vaccine willingness for their children on a scale of zero to ten. Results: Within 8 weeks, more than 580 people participated in the seminar series. We found that concerns about the side effects of the vaccine were the predominant motive of vaccination hesitancy among the study population. Overall, the intervention could successfully increase the median parental vaccination willingness of participants from a score of five to eight. We identified tree hesitancy motives (distrust towards the pharmaceutical industry, the government, or feelings of restriction from personal freedom) that were associated with below-average vaccination willingness and significant lower increase. Conclusion: With this study we analyzed motives driving COVID-19 vaccination hesitancy among parents of unvaccinated children and reasons of parents to restrain their children from getting vaccinated. The intervention method described here, could effectively address individual concerns on a personal level while at the same time reach a large number of people across geographical and language barriers. Thereby we could significantly increase subjective vaccination willingness of the participants. Our approach is easy to apply, highly cost-effective, and can be used to tackle any kind of medical misinformation.
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Affiliation(s)
- Christian Lenart
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
- Department of Emergency Medicine, Clinic Hietzing, Vienna, Austria
| | - Marlene Prager
- Department of Emergency Medicine, Clinic Donaustadt, Vienna, Austria
| | - Marlene Sachs
- Department of Emergency Medicine, Clinic Donaustadt, Vienna, Austria
| | - Christoph Steininger
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
| | | | - Jakob Thannesberger
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
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7
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Zhang X, Lane T. The backfiring effects of monetary and gift incentives on Covid-19 vaccination intentions. CHINA ECONOMIC REVIEW 2023; 80:102009. [PMID: 37351337 PMCID: PMC10270730 DOI: 10.1016/j.chieco.2023.102009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
We provide evidence that material inducements for Covid-19 vaccination may backfire. Results from a hypothetical survey experiment in China (N = 1365) show incentives of 8-125 USD reduce vaccine uptake intentions compared to simply offering vaccination for free. Ours is the first Covid-19 vaccine study to separately consider and directly compare the effects of monetary and goods-based incentives, both of which have been widely employed by countries seeking to increase uptake; we demonstrate that both types backfire equally. Results are compared against the burgeoning literature on Covid-19 vaccine incentives.
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Affiliation(s)
- Xinrui Zhang
- School of Economics, University of Nottingham Ningbo China, China
| | - Tom Lane
- School of Economics, University of Nottingham Ningbo China, China
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Sabatini S, Kaufmann M, Fadda M, Tancredi S, Noor N, Van Der Linden BWA, Cullati S, Frank I, Michel G, Harju E, Luedi C, Frei A, Ballouz T, Menges D, Fehr J, Kohler P, Kahlert CR, Scheu V, Ortega N, Chocano-Bedoya P, Rodondi N, Stringhini S, Baysson H, Lorthe E, Zufferey MC, Suggs LS, Albanese E, Vincentini J, Bochud M, D’Acremont V, Nusslé SG, Imboden M, Keidel D, Witzig M, Probst-Hensch N, von Wyl V. Factors Associated With COVID-19 Non-Vaccination in Switzerland: A Nationwide Study. Int J Public Health 2023; 68:1605852. [PMID: 37284510 PMCID: PMC10239801 DOI: 10.3389/ijph.2023.1605852] [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: 02/06/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives: We compared socio-demographic characteristics, health-related variables, vaccination-related beliefs and attitudes, vaccination acceptance, and personality traits of individuals who vaccinated against COVID-19 and who did not vaccinate by December 2021. Methods: This cross-sectional study used data of 10,642 adult participants from the Corona Immunitas eCohort, an age-stratified random sample of the population of several cantons in Switzerland. We used multivariable logistic regression models to explore associations of vaccination status with socio-demographic, health, and behavioral factors. Results: Non-vaccinated individuals represented 12.4% of the sample. Compared to vaccinated individuals, non-vaccinated individuals were more likely to be younger, healthier, employed, have lower income, not worried about their health, have previously tested positive for SARS-CoV-2 infection, express lower vaccination acceptance, and/or report higher conscientiousness. Among non-vaccinated individuals, 19.9% and 21.3% had low confidence in the safety and effectiveness of SARS-CoV-2 vaccine, respectively. However, 29.1% and 26.7% of individuals with concerns about vaccine effectiveness and side effects at baseline, respectively vaccinated during the study period. Conclusion: In addition to known socio-demographic and health-related factors, non-vaccination was associated with concerns regarding vaccine safety and effectiveness.
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Affiliation(s)
- Serena Sabatini
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marta Fadda
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Nazihah Noor
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | | | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Irene Frank
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- ZHAW Zurich University of Applied Sciences, School of Health Sciences, Winterthur, Switzerland
| | - Chantal Luedi
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Philipp Kohler
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Christian R. Kahlert
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
- Children’s Hospital of Eastern Switzerland, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Victor Scheu
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Natalia Ortega
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Patricia Chocano-Bedoya
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Center for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Hélène Baysson
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Maria Caiata Zufferey
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - L. Suzanne Suggs
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
- Institute of Communication and Public Policy, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Julia Vincentini
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Valérie D’Acremont
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Samira Gonseth Nusslé
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Melissa Witzig
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
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9
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Stamm TA, Partheymüller J, Mosor E, Ritschl V, Kritzinger S, Alunno A, Eberl JM. Determinants of COVID-19 vaccine fatigue. Nat Med 2023; 29:1164-1171. [PMID: 36973410 DOI: 10.1038/s41591-023-02282-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
There is growing concern that Coronavirus Disease 2019 (COVID-19) vaccine fatigue will be a major obstacle in maintaining immunity in the general population. In this study, we assessed vaccine acceptance in future scenarios in two conjoint experiments, investigating determinants such as new vaccines, communication, costs/incentives and legal rules. The experiments were embedded in an online survey (n = 6,357 participants) conducted in two European countries (Austria and Italy). Our results suggest that vaccination campaigns should be tailored to subgroups based on their vaccination status. Among the unvaccinated, campaign messages conveying community spirit had a positive effect (0.343, confidence interval (CI) 0.019-0.666), whereas offering positive incentives, such as a cash reward (0.722, CI 0.429-1.014) or voucher (0.670, CI 0.373-0.967), was pivotal to the decision-making of those vaccinated once or twice. Among the triple vaccinated, vaccination readiness increased when adapted vaccines were offered (0.279, CI 0.182-0.377), but costs (-0.795, CI -0.935 to -0.654) and medical dissensus (-0.161, CI -0.293 to -0.030) reduced their likelihood to get vaccinated. We conclude that failing to mobilize the triple vaccinated is likely to result in booster vaccination rates falling short of expectations. For long-term success, measures fostering institutional trust should be considered. These results provide guidance to those responsible for future COVID-19 vaccination campaigns.
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Affiliation(s)
- Tanja A Stamm
- Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria.
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria.
| | | | - Erika Mosor
- Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Valentin Ritschl
- Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | | | - Alessia Alunno
- Department of Life, Health & Environmental Sciences, University of L'Aquila and Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
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10
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Mamani-Benito O, Farfán-Solís R, Huayta-Meza M, Tito-Betancur M, Morales-García WC, Tarqui EEA. Effect of religious fatalism and concern about new variants on the acceptance of COVID-19 vaccines. Front Psychiatry 2023; 14:1071543. [PMID: 36937730 PMCID: PMC10017722 DOI: 10.3389/fpsyt.2023.1071543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction To protect public health, it is important that the population be vaccinated against COVID-19; however, certain factors can affect vaccine acceptance. Objective The objective of this study was to determine whether religious fatalism and concern about new variants have a significant effect on the acceptance of COVID-19 vaccines. Methodology An explanatory study was conducted with 403 adults of legal age captured through non-probabilistic convenience sampling in vaccination centers in the 13 health networks of the Regional Health Directorate of Puno, Peru. Data were collected through a brief scale of religious fatalism, a scale of acceptance of vaccines against COVID-19 and a scale of concern about a new variant of COVID-19. Results The proposed model obtained an adequate fit. There was a negative effect of religious fatalism on vaccine acceptance, a positive effect of fatalism on vaccine rejection, a positive effect of concern about new variants on the acceptance of vaccines, and a positive effect of concern about new variants on vaccine rejection. Conclusion These findings provide evidence for the usefulness of considering both religious fatalism and concern about new variants affect the intention to receive the COVID-19 vaccine in adults in southern Peru.
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Affiliation(s)
- Oscar Mamani-Benito
- Facultad de Derecho y Humanidades, Universidad Señor de Sipán, Chiclayo, Peru
| | - Rosa Farfán-Solís
- Facultad de Enfermería, Universidad Nacional del Altiplano, Puno, Peru
| | - Mariné Huayta-Meza
- Facultad de Ciencias Empresariales, Universidad Peruana Unión, Juliaca, Peru
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Oniszczenko W, Turek A. The relationship between fear of COVID-19 infection, fear of COVID-19 vaccination and Big Five personality traits: a mediation model. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2022; 11:1-10. [PMID: 38013827 PMCID: PMC10654332 DOI: 10.5114/cipp/155944] [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: 03/09/2022] [Revised: 07/07/2022] [Accepted: 10/20/2022] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The primary objective of our correlational, cross-sectional study was to determine the relationship between fear of COVID-19 infection and fear of COVID-19 vaccination and the role of the Big Five personality traits in this relationship. PARTICIPANTS AND PROCEDURE The study sample consisted of 462 participants, including 286 women and 176 men, aged 18 to 75, recruited from the general population. The Big Five personality traits were diagnosed using the Polish version of the Ten-Item Personality Inventory. We used an 11-point numerical rating scale to measure the intensity of fear of COVID-19 infection as well as fear of COVID-19 vaccination. RESULTS The results indicate that fear of infection has a weak positive correlation with fear of vaccination. Both types of fear have a weak negative correlation with emotional stability and openness to experience. People diagnosed with COVID-19 have significantly higher levels of fear of vaccination and lower levels of emotional stability compared to those without a COVID-19 diagnosis. Fear of infection proves a good predictor of fear of vaccination and a likely mediator between emotional stability and fear of vaccination against COVID-19. CONCLUSIONS The results may increase our understanding of the role of personality traits, such as emotional stability, in the fear of infection and COVID-19 vaccination hesitancy.
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Affiliation(s)
| | - Anna Turek
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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12
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Schirwani N, Pateisky P, Koren T, Farr A, Kiss H, Bancher-Todesca D. Written Briefing and Oral Counseling Increase the Willingness to Receive the SARS-CoV-2 Vaccination among Women in Puerperium: A Qualitative Prospective Cohort Study. Vaccines (Basel) 2022; 10:vaccines10091505. [PMID: 36146582 PMCID: PMC9501465 DOI: 10.3390/vaccines10091505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/28/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Vaccination rates for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) are low in Austria. International obstetric societies recommend the SARS-CoV-2 mRNA vaccination for women in puerperium. (2) Methods: A prospective two-stage cohort study was conducted at the Medical University of Vienna between October 2022 and December 2022. Firstly, women in puerperium were assigned to the evaluation group (step 1), and secondly, another cohort of unvaccinated women were randomly assigned to study group A (written briefing) or B (written and oral briefing) (step 2). We evaluated the vaccination status among women in the evaluation group and the willingness to receive the vaccination in all three cohorts. (3) Results: We included 217 women in puerperium (evaluation: n = 69, A: n = 68; B: n = 80). In the evaluation group, 66.7% (n = 46/69) of the women were unvaccinated. A total of 45.7% (21/46) of the unvaccinated women categorically declined the SARS-CoV-2 vaccination. A total of 26.5% (n = 18/68) of women in study group A, and 43.8% (n = 35/80) of women in study group B expressed their willingness to receive the vaccination (p = 0.029). There were no differences in willingness to receive the vaccination between different age strata of women in study groups A and B. (D) Conclusion: Our qualitative data demonstrate a benefit from oral counseling in addition to written briefing in order to increase the willingness to receive the vaccination among women in puerperium.
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Calabrese C, Annunziata A, Mariniello DF, Coppola A, Mirizzi AI, Simioli F, Pelaia C, Atripaldi L, Pugliese G, Guarino S, Fiorentino G. Evolution of the Clinical Profile and Outcomes of Unvaccinated Patients Affected by Critical COVID-19 Pneumonia from the Pre-Vaccination to the Post-Vaccination Waves in Italy. Pathogens 2022; 11:pathogens11070793. [PMID: 35890037 PMCID: PMC9323253 DOI: 10.3390/pathogens11070793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/04/2023] Open
Abstract
The vaccination campaign and the new SARS-CoV-2 variants may have changed the clinical profile and outcomes of patients admitted to sub-intensive unit care. We conducted a retrospective study aimed to compare the clinical and radiological features of unvaccinated critical COVID-19 patients hospitalized during the last pandemic wave (December 2021−February 2022, No-Vax group) and before starting the vaccination campaign (March−December 2020, Pre-Vax group). The No-Vax group was also compared with vaccinated patients of the same pandemic wave (Vax group). With respect to the Pre-Vax group, the No-Vax group contained a higher percentage of smokers (p = 0.0007) and a lower prevalence of males (p = 0.0003). At admission, the No-Vax patients showed both a higher CT score of pneumonia and a worse severe respiratory failure (p < 0.0001). In the No-Vax group, a higher percentage of deaths occurred, though this was not significant. In comparison with the No-Vax group, the Vax patients were older (p = 0.0097), with a higher Charlson comorbidity index (p < 0.0001) and a significantly lower HRCT score (p = 0.0015). The percentage of deaths was not different between the two groups. The No-Vax patients showed a more severe disease in comparison with the Pre-Vax patients, and were younger and had fewer comorbidities than the Vax patients.
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Affiliation(s)
- Cecilia Calabrese
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
- Correspondence:
| | - Anna Annunziata
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Domenica Francesca Mariniello
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
| | - Antonietta Coppola
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Angela Irene Mirizzi
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Francesca Simioli
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Corrado Pelaia
- Respiratory Medicine Unit, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Lidia Atripaldi
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
| | - Gaia Pugliese
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
| | - Salvatore Guarino
- Department of Radiology, Monaldi Hospital, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy;
| | - Giuseppe Fiorentino
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
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14
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Till B, Niederkrotenthaler T. Predictors of vaccine hesitancy during the COVID-19 pandemic in Austria : A population-based cross-sectional study. Wien Klin Wochenschr 2022; 134:822-827. [PMID: 35947223 PMCID: PMC9364912 DOI: 10.1007/s00508-022-02061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/07/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Unwillingness to get vaccinated against the coronavirus disease 2019 (COVID-19) is a major barrier in managing the pandemic. Previous studies have explored predictors of hesitancy to be vaccinated against COVID-19, but evidence on these predictors was partly mixed, and the number of assessed predictors was often limited. This study aimed to explore a wide range of potential predictors of vaccine hesitancy in a population-based cross-sectional study. METHODS We assessed associations of vaccine hesitancy with individuals' fears about the future, social media use, and sociodemographics in a hierarchical multiple regression analysis. Data were collected via online questionnaires in a population-based cross-sectional study with 4018 respondents representative of the Austrian adult population between October and December 2020. RESULTS Vaccine hesitancy was predicted by freedom-related fears (i.e., fears regarding the political situation, particularly loss of personal freedoms), but were negatively associated with health-related fears (i.e., fears about physical or mental health) and society-related fears (i.e., fears regarding societal issues such as solidarity, distance learning, and isolation). Social media use as well as female gender, younger age, lower education, lower income, and living in rural regions were further predictors of vaccine hesitancy. CONCLUSION The study confirms that public health efforts targeting unvaccinated persons need to address freedom-related fears and social media discourse in order to improve vaccine uptake in the population. Particularly individuals in socially and economically disadvantaged groups and social media users need to be targeted to reduce vaccine hesitancy.
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Affiliation(s)
- Benedikt Till
- grid.22937.3d0000 0000 9259 8492Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria ,Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Thomas Niederkrotenthaler
- grid.22937.3d0000 0000 9259 8492Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria ,Wiener Werkstaette for Suicide Research, Vienna, Austria
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