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Miao Y, Bai J, Shen Z, Li Y, Zhang W, Zhu D, Ren R, Zhang J, Guo D, Tarimo CS, Dong W, Liu R, Zhao Q, Hu J, Li M, Wei W. How urban versus rural population relates to COVID-19 booster vaccine hesitancy: A propensity score matching design study. Hum Vaccin Immunother 2024; 20:2297490. [PMID: 38214317 DOI: 10.1080/21645515.2023.2297490] [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: 08/29/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
During the COVID-19 pandemic, the vaccine hesitancy has significantly affected the vaccination. To evaluate the booster vaccine hesitancy and its influencing factors among urban and rural residents, as well as to estimate the net difference of booster vaccine hesitancy between urban and rural residents. We conducted a nationwide, cross-sectional Internet survey on 1-8 February 2023, and employed stratified random sampling technique to select participants (≥18 years old) from urban and rural areas. Multivariate logistic regression was used to determine the factors impacting booster vaccine hesitancy. Propensity Score Matching was used to estimate the net difference of COVID-19 booster vaccine hesitancy between urban and rural residents. The overall COVID-19 booster vaccine hesitancy rate of residents was 28.43%. The COVID-19 booster vaccine hesitancy rate among urban residents was found to be 34.70%, among rural residents was 20.25%. Chronic diseases, infection status, vaccination benefits, and trust in vaccine developers were associated with booster vaccine hesitancy among urban residents. Barriers of vaccination were associated with booster vaccine hesitancy among rural residents. PSM analysis showed that the urban residents have a higher booster vaccine hesitancy rate than rural residents, with a net difference of 6.20%. The vaccine hesitancy rate increased significantly, and the urban residents have a higher COVID-19 booster vaccine hesitancy than rural residents. It becomes crucial to enhance the dissemination of information regarding the advantages of vaccination and foster greater trust among urban residents toward the healthcare system.
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Affiliation(s)
- Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Institute for Hospital Management of Henan Province, Henan, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dan Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Rongmei Liu
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiuping Zhao
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianping Hu
- Henan Engineering technology Research Center for Health Big Data Governance, Henan Medical Communication and Project Forward Center, Zhengzhou, Henan, China
| | - Miaojun Li
- Henan Engineering technology Research Center for Health Big Data Governance, Henan Medical Communication and Project Forward Center, Zhengzhou, Henan, China
| | - Wei Wei
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Limbu YB, McKinley C. Communication Strategies to Promote COVID-19 Vaccination Intention: How Effective are Source, Appeal, Framing, and Evidence Type Approaches? HEALTH COMMUNICATION 2024:1-16. [PMID: 38706043 DOI: 10.1080/10410236.2024.2346959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
This systematic review analyzed the effectiveness of key persuasive strategies - source, appeal, framing, and evidence (SAFE) - on COVID-19 vaccination intention. Quantitative studies were searched in Web of Science, Scopus, and PubMed following the PRISMA guidelines. From the 61 studies that met inclusion criteria, source and framing are the most commonly applied SAFE strategies. However, source characteristics are a more consistent influence on vaccine intentions than message framing strategies, with expert sources and general practitioners emerging as the key sources contributing to greater vaccine intentions. In addition, a range of mediators and moderators influence the process through which SAFE message strategies impact vaccine intentions. Framing effects, in particular, are moderated by political identity, source characteristics, and vaccine perceptions. Tests of mediating processes highlight how health behavior judgments (e.g. perceived vaccine benefits, risks, trust in vaccination, perceived severity) and message response/perceptions (e.g. counterarguing, perceived similarity/empathy) operate as key intervening factors between SAFE message strategies and vaccine intentions. Overall, when practitioners apply various structural approaches (narrative elements, fear appeals, framing cues) to vaccine promotion campaigns, they should be cognizant of who is providing that appeal. Targeted populations may benefit most from different structural elements if they are integrated with sources that resonate with the audience.
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Affiliation(s)
- Yam B Limbu
- Department of Marketing, Feliciano School of Business, Montclair State University
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Szászi ÁJ, Bíró-Nagy A. Controversies of COVID-19 vaccine promotion: lessons of three randomised survey experiments from Hungary. Public Health 2024; 229:192-200. [PMID: 38457939 DOI: 10.1016/j.puhe.2024.01.030] [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: 07/11/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This study aimed to investigate vaccine promotion messages, examine the heterogeneous effects of these messages and provide experimental evidence to help evaluate the efficiency of COVID-19 vaccine promotion campaigns in Hungary. STUDY DESIGN This study presents the results of three randomised survey experiments that were embedded in cross-sectional, representative, public opinion studies of Hungarian adults based on in-person interviews. Simple randomisation and blinding were applied to assign participants into the control group (no message) or treatment groups (vaccine promotion messages). METHODS The first experiment (March 2021) aimed to test vaccination promotion messages from politicians (N = 331) and medical experts (N = 342) by comparing experimental groups' trust in vaccines and conspiratorial beliefs with the control group (N = 327). The second experiment (September 2022) tested the impact of two communication strategies ([1] highlighting the safety and effectiveness of vaccines, N = 104; and [2] highlighting the wide variety of vaccines available, N = 110) on increasing vaccine uptake among those who were still unvaccinated (control group, N = 89). The third experiment (September 2022) tested one message aiming to increase COVID-19 booster uptake among those who received only the first round of vaccination (N = 172; control group, N = 169). The outcome variable in the second and third experiments was intent to get vaccinated. Robust regressions, logit models, Mann-Whitney U-tests and model-based recursive partitioning were run. The inference criteria (p < 0.05) was set in pre-registration of the experiments. RESULTS All treatment effects were insignificant, but exploratory research found significant conditional treatment effects. Exposure to vaccine promotion by medical professionals was associated with a higher level of trust in Russian and Chinese COVID-19 vaccines in older age cohorts (weighted robust regressions, 50-59 years old, Russian vaccine: +0.769, interaction term [i.t.] p = 0.010; Chinese vaccine: +0.326, i.t. p = 0.044; and ≥60 years old, Russian vaccine +0.183, i.t. p = 0.040; Chinese vaccine +0.559, i.t. p = 0.010) and with a lower level of trust in these vaccines among younger adults (<30 years old, Russian vaccine: -1.236, i.t. p = 0.023; Chinese vaccine: -1.281, i.t. p = 0.022). Receiving a vaccine promotion message from politicians led to a higher level of trust in Chinese vaccines among the oldest respondents (≥60 years: +0.634, i.t. p = 0.035). CONCLUSIONS Short-term persuasion attempts that aimed to convince respondents about COVID-19 vaccination were ineffective. Booster hesitancy, similar to primary vaccine hesitancy, was resistant to vaccine promotion messages. Significant conditional effects suggest that COVID-19 vaccine promotion by medical experts and politicians may have had adverse effects for some demographic groups in Hungary.
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Affiliation(s)
- Á J Szászi
- HUN-REN Centre for Social Sciences, Institute for Political Science, Budapest, 1097, Tóth Kálmán u. 4., Hungary.
| | - A Bíró-Nagy
- HUN-REN Centre for Social Sciences, Institute for Political Science, Budapest, 1097, Tóth Kálmán u. 4., Hungary.
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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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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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6
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Fleischmann KR. The Sociotechnical Construction of Distrust during the Covid-19 Pandemic. Hastings Cent Rep 2023; 53 Suppl 2:S16-S21. [PMID: 37963040 DOI: 10.1002/hast.1519] [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: 11/16/2023]
Abstract
What were the impacts of the Covid-19 pandemic on trust in public health information, and what can be done to rebuild trust in public health authorities? This essay synthesizes insights from science and technology studies, information studies, and bioethics to explore sociotechnical factors that may have contributed to the breakdown of trust in public health information during the Covid-19 pandemic. The field of science and technology studies lays out the dynamic nature of facts, helping to explain rapid shifts in public health messaging during Covid-19 and reasons they produced a lack of trust in public health authorities. The information field looks at how facts are sociotechnically constructed through systems of classification, illustrating how extrascientific factors influence public health authorities. Putting these perspectives alongside bioethics principles raises additional factors to consider. The goal of this essay is to learn from past failures to point toward a brighter future where trust in public health authorities can be rebuilt, not on faith, but rather through striving for calibrated trust within which, through a virtuous circle, trust is validated.
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Takagi MA, Hess S, Gawronski K, Haddad N, Noveloso B, Zyzanski S, Ragina N. COVID-19 Virus and Vaccination Attitudes among Healthcare Workers in Michigan: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1105. [PMID: 37376494 DOI: 10.3390/vaccines11061105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Defining the characteristics of healthcare worker (HCW) attitudes toward the coronavirus disease 2019 (COVID-19) vaccine can provide insights into vaccine hesitancy. This study's goal is to determine HCWs' attitudes regarding the COVID-19 vaccination and reasons for vaccine hesitancy. METHODS This cross-sectional study surveyed HCWs working in institutions in Saginaw, Sanilac, and Wayne counties in Michigan (N = 120) using tipping-scale questions. Analysis of variance and t-test were used to measure HCWs' attitudes toward the COVID-19 virus and vaccines. RESULTS Most HCWs received (95.9%) and recommended (98.3%) a COVID-19 vaccine. The top three factors that HCWs cited for recommending a COVID-19 vaccine were: (1) efficacy of the vaccine, (2) current exposure to patients with active COVID-19 infection and risk of virus spread, and (3) safety of vaccine and long-term follow-up. Female HCWs or HCWs aged 25-54 years were more concerned about contracting COVID-19. Physicians or HCWs aged 55-64 were less concerned regarding the effectiveness and side effects of the vaccine. CONCLUSIONS Gender, age, ethnicity, provider type, and medical specialty showed statistically significant differences among COVID-19 attitudes. Focusing educational efforts on HCW demographics who are more likely to have negative attitudes can potentially decrease vaccine hesitancy.
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Affiliation(s)
- Maya Asami Takagi
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Samantha Hess
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Karissa Gawronski
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Nicholas Haddad
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Bernard Noveloso
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
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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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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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10
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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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11
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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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12
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Lohiniva AL, Hussein I, Lehtinen JM, Sivelä J, Hyökki S, Nohynek H, Nuorti P, Lyytikäinen O. Qualitative Insights into Vaccine Uptake of Nursing Staff in Long-Term Care Facilities in Finland. Vaccines (Basel) 2023; 11:530. [PMID: 36992113 PMCID: PMC10056830 DOI: 10.3390/vaccines11030530] [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: 01/29/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in Finland. Methodology: The study was based on the Theoretical Domains Framework. Data were collected through qualitative in-depth interviews among nursing staff and managers of LTCFs. The analysis was based on thematic analysis. We identified seven behavioral domains, with several themes, that reduced the staff's intention to get vaccinated: knowledge (information overload, inability to identify trustworthy information sources, lack of vaccine-specific and understandable scientific information), beliefs about consequences (incorrect perceptions about the vaccine effectiveness, and lack of trust in the safety of the vaccine), social influences (influence of family and friends), reinforcement (limited abilities of the management to encourage vaccination), beliefs about capabilities (pregnancy or desire to get pregnant), psychological factors (coping with changing opinion), and emotions (confusion, suspicion, disappointment, and fatigue). We also identified three behavioral domains that encouraged vaccine uptake: social influences (trust in health authorities), environmental context and resources (vaccination logistics), and work and professional role (professional pride). The study findings can help authorities to develop tailored vaccine promotion strategies for healthcare workers in LTCFs.
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Affiliation(s)
- Anna-Leena Lohiniva
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Idil Hussein
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Jaana-Marija Lehtinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Jonas Sivelä
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Suvi Hyökki
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
| | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Kalevankatu 4, 33520 Tampere, Finland
| | - Outi Lyytikäinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland
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13
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Koskan AM, Teeter BS, Daniel CL, LoCoco IE, Jensen UT, Ayers SL. U.S. adults' reasons for changing their degree of willingness to vaccinate against COVID-19. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-13. [PMID: 36694558 PMCID: PMC9852802 DOI: 10.1007/s10389-023-01819-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023]
Abstract
Introduction COVID-19 vaccines significantly reduce the risk of complications and hospitalizations due to this virus. When COVID-19 vaccines first became commercially available, roughly 30% of U.S. adults reported being hesitant to receive these newly developed vaccines, and 15% said they would not receive the vaccine. However, by May 2021, 19% of adults were vaccine-hesitant, and 13% refused to vaccinate against COVID-19. It is critical to understand why adults' degree of willingness to vaccinate against COVID-19 changed over time to plan for future pandemics and vaccination campaigns. Methods We conducted two waves of survey research over five months (January and May 2021) with a panel of 890 U.S. adults. One survey question assessed willingness to vaccinate against COVID-19. The response option included a slider scale ranging from 0 (signifying complete unwillingness) to 10 (complete willingness). We asked participants whose willingness score changed by more than one point to report their rationale for their change in perceptions. We conducted a conventional content analysis on all qualitative responses. Results We analyzed qualitative responses for 289 participants, 54.7% of whom had not been vaccinated against COVID-19 by May 2021. Among those who remained unvaccinated, 36.1% reported increased willingness to vaccinate. The most commonly cited reasons for becoming more willing to receive the vaccine include believing that COVID-19 vaccines are safe and effective, protecting against the pandemic, and desiring to return to pre-pandemic life. Reasons for increased COVID-19 vaccine hesitancy include vaccine safety concerns, the low perceived need for the vaccine, distrust in how COVID-19 vaccines are made and of larger institutions such as the government and pharmaceutical companies, and concerns about vaccine effectiveness. Conclusion Findings illuminate the rationale behind individuals' changes in their degree of willingness to vaccinate against COVID-19. It is critical to incorporate these considerations in future vaccine rollout initiatives to increase the public's vaccine confidence.
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Affiliation(s)
- Alexis M. Koskan
- College of Health Solutions, Arizona State University, 425 N. 5th Street, Phoenix, AZ USA
| | - Benjamin S. Teeter
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR USA
| | - Casey L. Daniel
- Department of Family Medicine, University of South Alabama Health Whiddon College of Medicine, 5795 USA North Drive, Mobile, AL USA
| | - Iris E. LoCoco
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ USA
| | - Ulrich T. Jensen
- School of Public Affairs, Arizona State University, 411 N Central Ave Suite 400, Phoenix, AZ USA
| | - Stephanie L. Ayers
- School of Public Affairs, Arizona State University, 411 N Central Ave Suite 400, Phoenix, AZ USA
- Southwest Interdisciplinary Research Center (SIRC), Arizona State University, 400 E Van Buren St, Phoenix, AZ USA
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14
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Serrano-Alarcón M, Wang Y, Kentikelenis A, Mckee M, Stuckler D. The far-right and anti-vaccine attitudes: lessons from Spain's mass COVID-19 vaccine roll-out. Eur J Public Health 2023; 33:215-221. [PMID: 36655519 PMCID: PMC10066477 DOI: 10.1093/eurpub/ckac173] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Far-right politicians in several countries have been vocal opponents of COVID-19 vaccination. But can this threaten vaccine roll-out? METHODS We take advantage of repeated cross-sectional surveys with samples of around 3800 individuals across Spain conducted monthly from December 2020 to January 2022 (n = 51 294) to examine any association between far-right politics and vaccine hesitancy through the whole vaccine roll-out. RESULTS Consistent with prior data, we found that far-right supporters were almost twice as likely to be vaccine-hesitant than the overall population in December 2020, before vaccines became available. However, with a successful vaccine roll out, this difference shrank, reaching non-significance by September 2021. From October 2021, however, vaccine hesitancy rebounded among this group at a time when the leadership of the far-right promoted a 'freedom of choice' discourse common among anti-vax supporters. By the latest month analysed (January 2022), far-right voters had returned to being twice as likely to be vaccine-hesitant and 7 percentage points less likely to be vaccinated than the general population. CONCLUSIONS Our results are consistent with evidence that far-right politicians can encourage vaccine hesitancy. Nonetheless, we show that public attitudes towards vaccination are not immutable. Whereas a rapid and effective vaccine rollout can help to overcome the resistance of far-right voters to get vaccinated, they also seem to be susceptible to their party leader's discourse on vaccines.
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Affiliation(s)
- Manuel Serrano-Alarcón
- DONDENA Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Yuxi Wang
- DONDENA Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Alexander Kentikelenis
- Department of Social & Political Sciences, Bocconi University, Milan, Italy.,Centre for Business Research, University of Cambridge, Cambridge, UK
| | - Martin Mckee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - David Stuckler
- DONDENA Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy.,Department of Social & Political Sciences, Bocconi University, Milan, Italy
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15
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Woodard L, Gilbert L, King B, Adepoju OE, Bruce MA, McDougle L, Moultry AM, Beech BM. Examining Black and Hispanic physicians and other healthcare providers' attitudes toward the COVID-19 vaccine. J Natl Med Assoc 2023; 115:53-65. [PMID: 36610827 PMCID: PMC9815487 DOI: 10.1016/j.jnma.2022.12.001] [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: 07/22/2022] [Revised: 10/11/2022] [Accepted: 12/07/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Recognizing that the voice delivering the message is as important as the information being shared, we examined vaccine perceptions and willingness to encourage patients to obtain COVID-19 vaccinations among Black and Hispanic healthcare providers. METHODS We conducted a cross-sectional, online survey of Black and Hispanic healthcare providers who were members of the National Medical Association (NMA), National Hispanic Medical Association (NHMA), and National Pharmaceutical Association (NPhA) between January 11 - March 3, 2021, shortly after emergency use authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines. Three multivariable logistic regression models were used to determine factors associated with the willingness to encourage COVID-19 vaccination. RESULTS The analytic sample consisted of 542 fully completed surveys. Pharmacists reported intent to take the vaccine (75.0% "as soon as you can" vs 91.4% for MD/DOs; p<0.001) and encouraged patients to get vaccinated (78.6% vs 91.0% for MD/DOs; p = 0.01). Providers in a suburban practice location were less likely to recommend vaccines to patients (OR=0.43, 95%CI: 0.22-0.87) and personal family (OR=0.45, 95%CI: 0.22-0.92) compared to those practicing in urban areas. Providers over age 45 were also more likely to report intent to take the vaccine themselves as soon as it was available (OR=3.72, 95%CI: 1.30-10.64). CONCLUSIONS This is likely the first cross-sectional study in the United States demonstrating the substantial vaccine confidence among Black and Hispanic healthcare providers who serve minoritized communities that have borne the greatest risk of adverse COVID-related outcomes.
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Affiliation(s)
- LeChauncy Woodard
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Lauren Gilbert
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US.
| | - Ben King
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Omolola E Adepoju
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US; Humana Integrated Health System Sciences Institute, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Marino A Bruce
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
| | - Leon McDougle
- The Ohio State University Wexner Medical Center, 410W. 10th Ave., Columbus, Ohio 43210 US
| | | | - Bettina M Beech
- Tilman J. Fertitta Family College of Medicine, University of Houston, Health 2 Building, 4849 Martin Luther King Blvd, Houston, TX 77004 US
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16
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Persistent drop in confidence following US recommended pause of Ad26.COV2.S vaccine administration. Vaccine 2023; 41:5-9. [PMID: 36443155 PMCID: PMC9692206 DOI: 10.1016/j.vaccine.2022.11.035] [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: 08/30/2021] [Revised: 05/11/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
The Janssen COVID-19 vaccine came to market in February 2021 as the first non-mRNA and first single-dose formula approved for use in the US. In April 2021, a temporary pause was recommended for the vaccine after the discovery of rare but serious post-vaccination side-effects. We fielded a large-scale nationally representative survey (n = 401,398) on individual confidence in each of the COVID-19 vaccine formulas available in the US before, during, and after this pause. We find widespread loss of confidence in the Janssen vaccine across gender, age, and other demographics, which persisted over time and after lifting of the halt. Despite this drop, overall reasons for remaining unvaccinated were stable and there was a concurrent minor bump in confidence towards other vaccine formulas. This contrast between the persistent reduction in confidence in the Janssen vaccine and the apparent maintenance of the broader campaign's integrity, highlights the complex dynamics and downstream effects of the pause.
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17
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Chiang CF, Kuo J, Liu JT. Cueing quality: Unpacking country-of-origin effects on intentions to vaccinate against COVID-19 in Taiwan. Soc Sci Med 2022; 314:115403. [PMID: 36244227 PMCID: PMC9534538 DOI: 10.1016/j.socscimed.2022.115403] [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: 03/11/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022]
Abstract
While existing studies have reported and recognized country-of-origin effects on the intentions to vaccinate against COVID-19 among individual citizens in some countries, the causal mechanism behind such effects to inform public health policymakers remain unexplored. Adding up a quality cue explanation for such effects to the existing literature, the authors argue that individual consumers are less willing to get a vaccine designed and manufactured by a country with a significantly lower quality perception than other countries. A survey experiment that recruited a nationally representative sample of Taiwanese adults (n = 1951) between December 13, 2020 and January 11, 2021 was designed and conducted to test the argument. We find that all else equal, Taiwanese respondents were on average less likely to express stronger willingness to take a vaccine from China than from the US, Germany, and Taiwan. Furthermore, even when the intrinsic quality of the vaccine was held constant by the experimental design, respondents still had a significantly lower quality perception of the vaccine from China, both in terms of perceived protection and severe side effects. Further evidence from casual mediation analyses shows that about 33% and 11% of the total average causal effects of the "China" country-of-origin label on vaccine uptake intention were respectively mediated through the perceived efficacy of protection and perceived risk of experiencing severe side effects. We conclude that quality cue constitutes one of many casual mechanisms behind widely reported country-of-origin effects on intention to vaccinate against COVID-19.
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Affiliation(s)
| | - Jason Kuo
- Department of Political Science, National Taiwan University, Taiwan,Corresponding author
| | - Jin-Tan Liu
- Department of Economics, National Taiwan University, Taiwan
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18
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Moore R, Purvis RS, Willis DE, Worley KC, Hervey D, Reece S, Yeates A, McElfish PA. The vaccine hesitancy continuum among hesitant adopters of the COVID-19 vaccine. Clin Transl Sci 2022; 15:2844-2857. [PMID: 36330587 PMCID: PMC9747130 DOI: 10.1111/cts.13385] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
Vaccination is a strategy for mitigating the impact of coronavirus disease 2019 (COVID-19) at both the individual and population levels. Vaccine hesitancy is identified as a significant threat to global health by the World Health Organization (WHO). Vaccine hesitancy has been theorized as a continuum encompassing a range of attitudes, beliefs, emotional orientations, ideologies, and health-seeking behaviors. Individuals who received the COVID-19 vaccine but also indicated some level of hesitancy about vaccination, or "hesitant adopters," remain an understudied group. This study uses a qualitative descriptive design to understand motivations to receive the COVID-19 vaccine among hesitant adopters at various self-reported levels of hesitancy. We conducted interviews with hesitant adopters (n = 49) to analyze the elements of vaccine hesitancy corresponding to reported levels of COVID-19 vaccine hesitancy (i.e., "little hesitant," "somewhat hesitant," and "very hesitant"). Concerns about side effects are shared across the continuum but are articulated differently at each level of hesitancy. The "little hesitant" relate fears of side effects to their health and a lack of clear information to inform their health decision making, whereas the "very hesitant" articulate the risks of side effects within the frame of conspiracies related to the development, approval, and economics of the COVID-19 vaccine. Additionally, conspiracy theories generally increase in salience across the continuum, with the "very hesitant" reporting conspiracy theories as the most salient element of vaccine hesitancy. This research presents opportunities for developing targeted interventions for different levels of vaccine hesitancy.
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Affiliation(s)
- Ramey Moore
- College of MedicineUniversity of Arkansas for Medical Sciences NorthwestFayettevilleArkansasUSA
| | - Rachel S. Purvis
- College of MedicineUniversity of Arkansas for Medical Sciences NorthwestFayettevilleArkansasUSA
| | - Don E. Willis
- College of MedicineUniversity of Arkansas for Medical Sciences NorthwestFayettevilleArkansasUSA
| | | | | | - Sharon Reece
- College of MedicineUniversity of Arkansas for Medical Sciences NorthwestFayettevilleArkansasUSA
| | - Aimee Yeates
- College of MedicineUniversity of Arkansas for Medical Sciences NorthwestFayettevilleArkansasUSA
| | - Pearl A. McElfish
- College of MedicineUniversity of Arkansas for Medical Sciences NorthwestFayettevilleArkansasUSA
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19
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Mühlbacher AC, Sadler A, Jordan Y. Population preferences for non-pharmaceutical interventions to control the SARS-CoV-2 pandemic: trade-offs among public health, individual rights, and economics. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:1483-1496. [PMID: 35138495 PMCID: PMC9468277 DOI: 10.1007/s10198-022-01438-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/13/2022] [Indexed: 05/25/2023]
Abstract
PROBLEM Policymakers must decide on interventions to control the pandemic. These decisions are driven by weighing the risks and benefits of various non-pharmaceutical intervention alternatives. Due to the nature of the pandemic, these decisions are not based on sufficient evidence regarding the effects, nor are decision-makers informed about the willingness of populations to accept the economic and health risks associated with different policy options. This empirical study seeks to reduce uncertainty by measuring population preferences for non-pharmaceutical interventions. METHODS An online-based discrete choice experiment (DCE) was conducted to elicit population preferences. Respondents were asked to choose between three pandemic scenarios with different interventions and impacts of the Corona pandemic. In addition, Best-worst scaling (BWS) was used to analyze the impact of the duration of individual interventions on people's acceptance. The marginal rate of substitution was applied to estimate willingness-to-accept (WTA) for each intervention and effect by risk of infection. RESULTS Data from 3006 respondents were included in the analysis. The DCE showed, economic effect of non-pharmaceutical measures had a large impact on choice decisions for or against specific lockdown scenarios. Individual income decreases had the most impact. Excess mortality and individual risk of infection were also important factors influencing choice decisions. Curfews, contact restrictions, facility closures, personal data transmissions, and mandatory masking in public had a lesser impact. However, significant standard deviations in the random parameter logit model (RPL) indicated heterogeneities in the study population. The BWS results showed that short-term restrictions were more likely to be accepted than long-term restrictions. According to WTA estimates, people would be willing to accept a greater risk of infection to avoid loss of income. DISCUSSION The results can be used to determine which consequences of pandemic measures would be more severe for the population. For example, the results show that citizens want to limit the decline in individual income during pandemic measures. Participation in preference studies can also inform citizens about potential tradeoffs that decision-makers face in current and future decisions during a pandemic. Knowledge of the population's preferences will help inform decisions that consider people's perspectives and expectations for the future. Survey results can inform decision-makers about the extent to which the population is willing to accept certain lockdown measures, such as curfews, contact restrictions, lockdowns, or mandatory masks.
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Affiliation(s)
- Axel C Mühlbacher
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany.
- Gesellschaft Für Empirische Beratung GmbH, Freiburg, Germany.
- Duke Department of Population Health Sciences and Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Andrew Sadler
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany
| | - Yvonne Jordan
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany
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20
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Olatunji BO, Cox RC, Cole DA. Longitudinal trajectories of coronavirus anxiety and health behavior use before and after the U.S. 2020 presidential election: The effects of political orientation. J Anxiety Disord 2022; 92:102643. [PMID: 36283183 PMCID: PMC9575577 DOI: 10.1016/j.janxdis.2022.102643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/28/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022]
Abstract
Although heightened anxiety and health behavior use (i.e., masking, hand washing) may be viewed as an adaptive response to the coronavirus (COVID-19) pandemic, it is unclear how the politicization of the pandemic has influenced the trajectory of such responses. Accordingly, the present study examined differences between those that identify as more conservative or liberal in the trajectory of anxiety and health behaviors during the pandemic. This study also examines shifts in this trajectory before and after the presidential election. As part of a larger study, participants (N = 374) completed a symptom survey starting on May 27, 2020 every 2 weeks for a total of 15 timepoints over 30 weeks. The findings showed that more conservative participants reported lower levels of COVID-19 anxiety and less health behavior use compared to more liberal participants. In fact, anxiety levels increased slightly for more liberal participants and decreased slightly for more conservative participants during the pre-election time frame. Health behavior use also decreased more rapidly for conservative participants than for liberal participants during the pre-election time frame. However, COVID-19 anxiety and health behavior use rose sharply and similarly for both liberal and conservative individuals after the election. Importantly, these patterns were independent of state level variability in COVID-19 positivity and death rates. Subsequent analysis also revealed significant relations between COVID-19 anxiety and health behavior use that was slightly stronger among conservatives. Implications of these findings for navigating the influence of political ideology on anxiety-related responses during a public health emergency like the COVID-19 pandemic are discussed.
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Affiliation(s)
- Bunmi O. Olatunji
- Vanderbilt University, USA,Correspondence to: Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA
| | - Rebecca C. Cox
- Vanderbilt University, USA,University of Colorado-Boulder, USA
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21
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Purvis RS, Moore R, Willis DE, Hallgren E, McElfish PA. Factors influencing COVID-19 vaccine decision-making among hesitant adopters in the United States. Hum Vaccin Immunother 2022; 18:2114701. [PMID: 36070518 PMCID: PMC9746519 DOI: 10.1080/21645515.2022.2114701] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Increasing COVID-19 vaccine uptake is crucial to managing the endemic. In this qualitative study, we examine factors influencing the decision-making process of COVID-19 hesitant adopters - those who reported some level of hesitancy and are vaccinated. Using interviews with 49 participants, we documented multiple factors influencing the decision-making process to get the COVID-19 vaccine among a racially and ethnically diverse sample of hesitant adopters in the US. Participants described influences related to sociocultural context and personal and group influences, which affected their decision to get the COVID-19 vaccine despite being hesitant. We find politics, culture, healthcare professionals, employment, vaccine attitudes and beliefs, social networks, and the media influence the decision to get vaccinated. Our findings provide nuanced and in-depth information in their own words. This study expands on prior literature on COVID-19 vaccine hesitancy, especially among hesitant adopters. These findings can inform future interventions and research targeting vaccine-hesitant populations to increase vaccine uptake.
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Affiliation(s)
- Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Emily Hallgren
- 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, Fayetteville, AR, USA,CONTACT Pearl A. McElfish College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR72703, USA
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22
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Bam NE. Strategies to address conspiracy beliefs and misinformation on COVID-19 in South Africa: A narrative literature review. Health SA 2022; 27:1851. [PMID: 36483504 PMCID: PMC9723965 DOI: 10.4102/hsag.v27i0.1851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 07/11/2022] [Indexed: 10/08/2023] Open
Abstract
UNLABELLED Conspiracy theories and misinformation have been explored extensively however, strategies to minimise their impact in the context of coronavirus disease 2019 (COVID-19) vaccines are limited. This study aimed to explore strategies that can be used to reduce the negative effects of conspiracies and misinformation about SARS-CoV-2. This review was carried out based on accessed literature on beliefs in misinformation about the COVID-19 pandemic. A comprehensive search of databases, such as Google Scholar, EBSCOhost and African Journals between 2019 and 2022 yielded qualitative and quantitative studies. Two themes emerged, namely underlying motives for conspiracy theories and belief in misinformation about the pandemic and ways to overcome them. The latter included: (1) strengthening critical scanning of information, (2) critical review to address misinformation and (3) establishing approaches for managing conspiracy theories. A proposal is made to address conspiracy beliefs about COVID-19 infection. CONTRIBUTION This is believed to be the first review that describes strategies to mitigate belief in conspiracies and misinformation to promote vaccination.
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Affiliation(s)
- Nokwanda E Bam
- School of Nursing, Faculty of Health Sciences, North-West University, Mahikeng, South Africa
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Lun P, Gao J, Tang B, Yu CC, Jabbar KA, Low JA, George PP. A social ecological approach to identify the barriers and facilitators to COVID-19 vaccination acceptance: A scoping review. PLoS One 2022; 17:e0272642. [PMID: 36191018 PMCID: PMC9529136 DOI: 10.1371/journal.pone.0272642] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that has caused substantial impact on population health, healthcare, and social and economic systems around the world. Several vaccines have been developed to control the pandemic with varying effectiveness and safety profiles. One of the biggest obstacles to implementing successful vaccination programmes is vaccine hesitancy stemming from concerns about effectiveness and safety. This review aims to identify the factors influencing COVID-19 vaccine hesitancy and acceptance and to organize the factors using the social ecological framework. METHODS We adopted the five-stage methodological framework developed by Arksey and O'Malley to guide this scoping review. Selection criteria was based on the PICo (Population, Phenomenon of interest and Context) framework. Factors associated with acceptance and hesitancy were grouped into the following: intrapersonal, interpersonal, institutional, community, and public policy factors using the social ecological framework. RESULTS Fifty-one studies fulfilled this review's inclusion criteria. Most studies were conducted in Europe and North America, followed by Asia and the Middle East. COVID-19 vaccine acceptance and hesitancy rates varied across countries. Some common demographic factors associated with hesitancy were younger age, being female, having lower than college education, and having a lower income level. Most of the barriers and facilitators to acceptance of the COVID-19 vaccines were intrapersonal factors, such as personal characteristics and preferences, concerns with COVID-19 vaccines, history/perception of general vaccination, and knowledge of COVID-19 and health. The remaining interpersonal, institution, community, and public policy factors were grouped into factors identified as barriers and facilitators. CONCLUSION Our review identified barriers and facilitators of vaccine acceptance and hesitancy and organised them using the social ecological framework. While some barriers and facilitators such as vaccine safety are universal, differentiated barriers might exist for different target groups, which need to be understood if they are to be addressed to maximize vaccine acceptance.
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Affiliation(s)
- Penny Lun
- Geriatric Education and Research Institute Limited, Singapore, Singapore
- * E-mail:
| | - Jonathan Gao
- Geriatric Education and Research Institute Limited, Singapore, Singapore
| | - Bernard Tang
- Geriatric Education and Research Institute Limited, Singapore, Singapore
| | - Chou Chuen Yu
- Geriatric Education and Research Institute Limited, Singapore, Singapore
| | | | - James Alvin Low
- Geriatric Education and Research Institute Limited, Singapore, Singapore
- Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Pradeep Paul George
- Geriatric Education and Research Institute Limited, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
- Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
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Abdul Aziz NI, Flanders S, Nungsari M. Social expectations and government incentives in Malaysia’s COVID-19 vaccine uptake. PLoS One 2022; 17:e0275010. [PMID: 36156604 PMCID: PMC9512221 DOI: 10.1371/journal.pone.0275010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
High vaccination rates are integral to reducing infection and severity rates of COVID-19 infections within a community. We examine the role of social expectations in COVID-19 vaccination take-ups and its interaction with potential government actions in Malaysia. We find that individuals’ expectations of others in their social groups towards vaccination predicts those individuals’ vaccination registrations. Using a vignette experiment, we examine the extent of normative expectations in normalizing pro-vaccination behavior beyond an individual’s reference group. We find that unless moderated by a high level of public trust, individuals prefer punitive policies as a way to increase vaccination rates in their communities.
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Affiliation(s)
- N. Izzatina Abdul Aziz
- Institute of Malaysian and International Studies (IKMAS), National University of Malaysia, Bangi, Selangor, Malaysia
- ASEAN Research Center, Asia School of Business, Kuala Lumpur, Malaysia
- * E-mail:
| | - Sam Flanders
- ASEAN Research Center, Asia School of Business, Kuala Lumpur, Malaysia
- Asia School of Business, Kuala Lumpur, Malaysia
- MIT Sloan School of Management, Cambridge, MA, United States of America
| | - Melati Nungsari
- ASEAN Research Center, Asia School of Business, Kuala Lumpur, Malaysia
- Asia School of Business, Kuala Lumpur, Malaysia
- MIT Sloan School of Management, Cambridge, MA, United States of America
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“Before Dawn,” Listening to the Voices of Social Media: A Study on the Public’s Response to the COVID-19 Vaccine. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:7308084. [PMID: 36159760 PMCID: PMC9507649 DOI: 10.1155/2022/7308084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic is a worldwide catastrophe. In the absence of an effective drug, one effective measure to pull the pandemic to the end is herd immunity by taking vaccines, while the hesitation and anti-attitude from social media affect the vaccination. This makes it crucial to evaluate the text data about the COVID-19 vaccine from tweets. The period for data used in this study is 1 Aug to 31 Oct, 2020, since it is just before promoting the use when public reactions to the COVID-19 vaccine can influence their subsequent vaccination behavior. In this study, we used the latent Dirichlet allocation (LDA) topic model and sentiment analysis to explore public reactions to the COVID-19 vaccine. The results indicate that the public discussion could be divided into 11 topics, which could be further summarized into four different themes: (1) concerns about COVID-19; (2) concerns about vaccine development, production, and distribution; (3) how to control the COVID-19 before obtaining the vaccine; and (4) concerns about information of vaccine safety and efficacy. It can be concluded that to a large extent, public reactions to vaccines are dominated by positive sentiment. Specifically, the politicization of the vaccine approval process, suspension of vaccine trials, and measures to control COVID-19 tend to trigger negative public sentiment; whereas information related to successful vaccine development and availability enhances positive public sentiment. These findings help us understand public reactions to the COVID-19 vaccine, uncover potential factors that may influence vaccination behavior, and help policymakers understand public opinion about the COVID-19 vaccine and develop rational and effective policies.
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Trust is the common denominator for COVID-19 vaccine acceptance: a literature review. Vaccine X 2022; 12:100213. [PMID: 36217424 PMCID: PMC9536059 DOI: 10.1016/j.jvacx.2022.100213] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Vaccine hesitancy is a central barrier to ending the COVID-19 pandemic. Trust in the quality and safety of vaccines and the institutions dispensing the vaccines is critical for the willingness to be vaccinated. Trust in vaccines and institutions are subject to individual and societal perceptions built over time, and vary by social, cultural and historical context. Preconceived perceptions of COVID-19 vaccines played a more important role in decision-making than science-based information. Targeted and tailored approaches are essential to build trust in COVID-19 vaccines.
Vaccine hesitancy and refusal to be vaccinated are major reasons why mass vaccination strategies do not reach the intended coverage, even if adequate vaccine supply has been achieved. The main objective of this study is to explore the role and contribution of trust in public willingness to accept COVID-19 vaccinations. The study utilised a qualitative synthesis of literature around hesitancy, willingness to accept vaccination, and the role of trust. Data were extracted from the literature and first categorised using a deductive approach, and later analysed in QSR NVivo using a mix of deductive and inductive approaches. The impact of trust was mostly borne out in the willingness to accept a vaccine, but details on what trust is, how and why it affects willingness or lack of it, was not frequently reported. Three types of trust were identified: 1) Trust in the quality and safety of vaccines; 2) Institutional trust; and 3) Interpersonal trust in the professionals who communicate about and administer the vaccine. Trust in the vaccines’ quality and safety, and institutional affiliation significantly contributed towards willingness to be vaccinated. The bulk of the literature focused on how interpersonal trust and personal attributes of potential vaccinees affected the willingness to accept the vaccine. This complex relationship included a fragility of beliefs and perceptions at an individual level, with a bidirectional relationship to societal perceptions. Perceptions of vaccines had a predominant role in decision-making, in contrast to more science-based decision-making. Although globally, the perceptions and beliefs contributing to trust had commonalities and relevance, trust was often found to be dependent on factors embedded in local social, cultural, institutional, and individual attributes and experiences. Understanding different types of trust offers potential approaches to motivate undecided people to receive vaccine; and vaccine refusers to revisit their decisions.
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Atinga RA, Koduah A, Abiiro GA. Understanding the policy dynamics of COVID-19 vaccination in Ghana through the lens of a policy analytical framework. Health Res Policy Syst 2022; 20:94. [PMID: 36050739 PMCID: PMC9434511 DOI: 10.1186/s12961-022-00896-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ghana became the first African country to take delivery of the first wave of the AstraZeneca/Oxford vaccine from the COVAX facility. But why has this promising start of the vaccination rollout not translated into an accelerated full vaccination of the population? To answer this question, we drew on the tenets of a policy analytical framework and analysed the diverse interpretations, issue characteristics, actor power dynamics and political context of the COVID-19 vaccination process in Ghana. Methods We conducted a rapid online review of media reports, journal articles and other documents on debates and discussions of issues related to framing of the vaccination rollout, social constructions generated around vaccines, stakeholder power dynamics and political contentions linked to the vaccination rollout. These were complemented by desk reviews of parliamentary reports. Results The COVID-19 vaccination was mainly framed along the lines of public health, gender-centredness and universal health coverage. Vaccine acquisition and procurement were riddled with politics between the ruling government and the largest main opposition party. While the latter persistently blamed the former for engaging in political rhetoric rather than a tactical response to vaccine supply issues, the former attributed vaccine shortages to vaccine nationalism that crowded out fair distribution. The government’s efforts to increase vaccination coverage to target levels were stifled when a deal with a private supplier to procure 3.4 million doses of the Sputnik V vaccine collapsed due to procurement breaches. Amidst the vaccine scarcity, the government developed a working proposal to produce vaccines locally which attracted considerable interest among pharmaceutical manufacturers, political constituents and donor partners. Regarding issue characteristics of the vaccination, hesitancy for vaccination linked to misperceptions of vaccine safety provoked politically led vaccination campaigns to induce vaccine acceptance. Conclusions Scaling up vaccination requires political unity, cohesive frames, management of stakeholder interests and influence, and tackling contextual factors promoting vaccination hesitancy.
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Affiliation(s)
- Roger A Atinga
- Department of Public Administration and Health Services Management, University of Ghana Business School, P.O. Box LG 78, Legon, Accra, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Accra, Ghana
| | - Gilbert Abotisem Abiiro
- Department of Health Services, Policy, Planning, Management and Economics, School of Public Health, University for Development Studies, P.O. Box 1883, Tamale, Ghana. .,Department of Population and Reproductive Health, School of Public Health, University for Development Studies, P. O. Box 1883, Tamale, Ghana.
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Andreas M, Iannizzi C, Bohndorf E, Monsef I, Piechotta V, Meerpohl JJ, Skoetz N. Interventions to increase COVID-19 vaccine uptake: a scoping review. Cochrane Database Syst Rev 2022; 8:CD015270. [PMID: 35920693 PMCID: PMC9347311 DOI: 10.1002/14651858.cd015270] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Vaccines are effective in preventing severe COVID-19, a disease for which few treatments are available and which can lead to disability or death. Widespread vaccination against COVID-19 may help protect those not yet able to get vaccinated. In addition, new and vaccine-resistant mutations of SARS-CoV-2 may be less likely to develop if the spread of COVID-19 is limited. Different vaccines are now widely available in many settings. However, vaccine hesitancy is a serious threat to the goal of nationwide vaccination in many countries and poses a substantial threat to population health. This scoping review maps interventions aimed at increasing COVID-19 vaccine uptake and decreasing COVID-19 vaccine hesitancy. OBJECTIVES To scope the existing research landscape on interventions to enhance the willingness of different populations to be vaccinated against COVID-19, increase COVID-19 vaccine uptake, or decrease COVID-19 vaccine hesitancy, and to map the evidence according to addressed populations and intervention categories. SEARCH METHODS We searched Cochrane COVID-19 Study Register, Web of Science (Science Citation Index Expanded and Emerging Sources Citation Index), WHO COVID-19 Global literature on coronavirus disease, PsycINFO, and CINAHL to 11 October 2021. SELECTION CRITERIA We included studies that assess the impact of interventions implemented to enhance the willingness of different populations to be vaccinated against COVID-19, increase vaccine uptake, or decrease COVID-19 vaccine hesitancy. We included randomised controlled trials (RCTs), non-randomised studies of intervention (NRSIs), observational studies and case studies with more than 100 participants. Furthermore, we included systematic reviews and meta-analyses. We did not limit the scope of the review to a specific population or to specific outcomes assessed. We excluded interventions addressing hesitancy towards vaccines for diseases other than COVID-19. DATA COLLECTION AND ANALYSIS Data were analysed according to a protocol uploaded to the Open Science Framework. We used an interactive scoping map to visualise the results of our scoping review. We mapped the identified interventions according to pre-specified intervention categories, that were adapted to better fit the evidence. The intervention categories were: communication interventions, policy interventions, educational interventions, incentives (both financial and non-financial), interventions to improve access, and multidimensional interventions. The study outcomes were also included in the mapping. Furthermore, we mapped the country in which the study was conducted, the addressed population, and whether the design was randomised-controlled or not. MAIN RESULTS We included 96 studies in the scoping review, 35 of which are ongoing and 61 studies with published results. We did not identify any relevant systematic reviews. For an overview, please see the interactive scoping map (https://tinyurl.com/2p9jmx24) STUDIES WITH PUBLISHED RESULTS Of the 61 studies with published results, 46 studies were RCTs and 15 NRSIs. The interventions investigated in the studies were heterogeneous with most studies testing communication strategies to enhance COVID-19 vaccine uptake. Most studies assessed the willingness to get vaccinated as an outcome. The majority of studies were conducted in English-speaking high-income countries. Moreover, most studies investigated digital interventions in an online setting. Populations that were addressed were diverse. For example, studies targeted healthcare workers, ethnic minorities in the USA, students, soldiers, at-risk patients, or the general population. ONGOING STUDIES Of the 35 ongoing studies, 29 studies are RCTs and six NRSIs. Educational and communication interventions were the most used types of interventions. The majority of ongoing studies plan to assess vaccine uptake as an outcome. Again, the majority of studies are being conducted in English-speaking high-income countries. In contrast to the studies with published results, most ongoing studies will not be conducted online. Addressed populations range from minority populations in the USA to healthcare workers or students. Eleven ongoing studies have estimated completion dates in 2022. AUTHORS' CONCLUSIONS: We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake. A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research. AUTHORS CONCLUSIONS We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake. A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research.
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Affiliation(s)
- Marike Andreas
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Bohndorf
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, Cologne, Germany
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Strengthened belief in vaccine effectiveness predicted increased COVID-19 vaccination intention and behaviour: Results from a nationally representative longitudinal survey of U.S. adults from July 2020 to April/May 2021. Vaccine 2022; 40:6035-6041. [PMID: 36088194 PMCID: PMC9449782 DOI: 10.1016/j.vaccine.2022.08.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 11/23/2022]
Abstract
Vaccine hesitancy remains a major barrier to ending the COVID-19 pandemic in the United States (U.S.) and an important target for communication interventions. Using longitudinal survey data, we examined whether baseline levels and changes in beliefs about the COVID-19 vaccines predicted change in vaccination intention/behaviour. Repeated measures were collected from a nationally representative sample of U.S. adults (n = 665) in July 2020 and April/June 2021. Linear regressions associated change in COVID-19 vaccination intention/behaviour with changes in beliefs about the COVID-19 vaccines’ safety, effectiveness in protecting others from infection, and effectiveness in protecting oneself from infection. Changes in beliefs from T1 to T2 were significantly associated with change in vaccination outcomes for all belief types (safety B = 0.39, SE = 0.07; effectiveness for self B = 0.38, SE = 0.09; effectiveness for others B = 0.43, SE = 0.07). Cross-lagged models suggested a reciprocal causal relationship between pro-vaccine beliefs and vaccination intention/behaviour: Intention to get vaccinated at T1 predicted strengthened safety and effectiveness beliefs at T2. T1 effectiveness beliefs predicted T2 vaccination intention/behaviour, though T1 safety beliefs did not. Communication interventions highlighting the protective benefits of COVID-19 vaccines may be particularly successful in reducing vaccine hesitancy.
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Reddinger JL, Levine D, Charness G. Can targeted messages reduce COVID-19 vaccination hesitancy? A randomized trial. Prev Med Rep 2022; 29:101903. [PMID: 35844628 PMCID: PMC9272666 DOI: 10.1016/j.pmedr.2022.101903] [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: 11/11/2021] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 12/05/2022] Open
Abstract
We find no evidence that tailoring public health communication regarding COVID-19 vaccination for broad demographic groups would increase its effectiveness. A post hoc analysis finds that a vaccine endorsement from Dr. Fauci reduces stated intent to vaccinate among conservatives. We recommend further research on communicators and endorsers, as well as incentives.
Background Widespread vaccination is certainly a critical element in successfully fighting the COVID-19 pandemic. We apply theories of social identity to design targeted messaging to reduce vaccine hesitancy among groups with low vaccine uptake, such as African Americans and political conservatives. Methods Participants. We conducted an online experiment from April 7 to 27, 2021, that oversampled Black, Latinx, conservative, and religious U.S. residents. We first solicited the vaccination status of over 10,000 individuals. Of the 4,609 individuals who reported being unvaccinated, 4,190 enrolled in our covariate-adaptive randomized trial. Interventions. We provided participants messages that presented the health risks of COVID-19 to oneself and others; they also received messages about the benefits of a COVID-19 vaccine and an endorsement by a celebrity. Messages were randomly tailored to each participant’s identities—Black, Latinx, conservative, religious, or being a parent. Outcomes. Respondents reported their intent to obtain the vaccine for oneself and, if a parent, for one’s child. Results We report results for the 2,621 unvaccinated respondents who passed an incentivized manipulation check. We find no support for the hypothesis that customized messages or endorsers reduce vaccine hesitancy among our segments. A post hoc analysis finds evidence that a vaccine endorsement from Dr. Fauci reduces stated intent to vaccinate among conservatives. Conclusions We find no evidence that tailoring public-health communication regarding COVID-19 vaccination for broad demographic groups would increase its effectiveness. We recommend further research on communicators and endorsers, as well as incentives.
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Affiliation(s)
- J Lucas Reddinger
- 1725 State St., 339C Wimberly Hall, La Crosse, WI 54601.,Department of Economics, University of California, Santa Barbara, 93106.,Menard Family Initiative, College of Business Administration, University of Wisconsin, La Crosse, 54601
| | - David Levine
- Haas School of Business, University of California, Berkeley, 94720
| | - Gary Charness
- Department of Economics, University of California, Santa Barbara, 93106
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Peters MD. Addressing vaccine hesitancy and resistance for COVID-19 vaccines. Int J Nurs Stud 2022; 131:104241. [PMID: 35489108 PMCID: PMC8972969 DOI: 10.1016/j.ijnurstu.2022.104241] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 01/12/2023]
Abstract
The COVID-19 vaccine rollout has had various degrees of success in different countries. Achieving high levels of vaccine coverage is key to responding to and mitigating the impact of the pandemic on health and aged care systems and the community. In many countries, vaccine hesitancy, resistance, and refusal are emerging as significant barriers to immunisation uptake and the relaxation of policies that limit everyday life. Vaccine hesitancy/ resistance/ refusal is complex and multi-faceted. Individuals and groups have diverse and often multiple reasons for delaying or refusing vaccination. These reasons include: social determinants of health, convenience, ease of availability and access, health literacy understandability and clarity of information, judgements around risk versus benefit, notions of collective versus individual responsibility, trust or mistrust of authority or healthcare, and personal or group beliefs, customs, or ideologies. Published evidence suggests that targeting and adapting interventions to particular population groups, contexts, and specific reasons for vaccine hesitancy/ resistance may enhance the effectiveness of interventions. While evidence regarding the effectiveness of interventions to address vaccine hesitancy and improve uptake is limited and generally unable to underpin any specific strategy, multi-pronged interventions are promising. In many settings, mandating vaccination, particularly for those working in health or high risk/ transmission industries, has been implemented or debated by Governments, decision-makers, and health authorities. While mandatory vaccination is effective for seasonal influenza uptake amongst healthcare workers, this evidence may not be appropriately transferred to the context of COVID-19. Financial or other incentives for addressing vaccine hesitancy may have limited effectiveness with much evidence for benefit appearing to have been translated across from other public/preventive health issues such as smoking cessation. Multicomponent, dialogue-based (i.e., communication) interventions are effective in addressing vaccine hesitancy/resistance. Multicomponent interventions that encompasses the following might be effective: (i) targeting specific groups such as unvaccinated/under-vaccinated groups or healthcare workers, (ii) increasing vaccine knowledge and awareness, (iii) enhanced access and convenience of vaccination, (iv) mandating vaccination or implementing sanctions against non-vaccination, (v) engaging religious and community leaders, (vi) embedding new vaccine knowledge and evidence in routine health practices and procedures, and (vii) addressing mistrust and improving trust in healthcare providers and institutions via genuine engagement and dialogue. It is universally important that healthcare professionals and representative groups, as often highly trusted sources of health guidance, should be closely involved in policymaker and health authority decisions regarding the establishment and implementation of vaccine recommendations and interventions to address vaccine hesitancy.
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Affiliation(s)
- Micah D.J. Peters
- University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre, City East Campus
- Centenary Building P4-32 North Terrace, Adelaide, SA 5000, Australia,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Nursing School, Adelaide, SA, Australia,The Centre for Evidence-based Practice South Australia (CEPSA): A Joanna Briggs Institute Centre of Excellence, Australia,Australian Nursing and Midwifery Federation (ANMF) Federal Office, Australia,Correspondence to: University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre, City East Campus
- Centenary Building P4-32 North Terrace, Adelaide, SA 5000, Australia
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Ajana B, Engstler E, Ismail A, Kousta M. Perceptions and attitudes towards Covid-19 vaccines: narratives from members of the UK public. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-17. [PMID: 35789880 PMCID: PMC9244123 DOI: 10.1007/s10389-022-01728-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/17/2022] [Indexed: 12/03/2022]
Abstract
Aim The aim of the paper is to enhance understanding of how members of the public make sense of the Covid-19 vaccines and to understand the factors influencing their attitudes towards such artefacts of pandemic governance. Methods The paper draws on 23 online in-depth interviews with members of the UK public and builds on relevant literature to examine participants' perceptions of the benefits and risks of Covid-19 vaccines, the sources that have shaped their attitudes, and the level of trust they have towards the government's handling of the pandemic through vaccines. Results The findings indicate that participants generally felt that the benefits of having the vaccine outweigh the risks and that Covid-19 vaccines are a crucial mechanism for enabling society to return to normal. Vaccine acceptance was, for some, strongly linked to a sense of social responsibility and the duty to protect others. However, some participants expressed concerns with regard to the side-effects of Covid-19 vaccines and their perceived potential impact on fertility and DNA makeup. Participants used various sources of information to learn about Covid-19 vaccines and understand their function, benefits, and risks. The majority of participants criticised the government's response during the early stages of the pandemic yet felt positive about the vaccine rollout. Conclusion Just as with any other vaccination programme, the success of the Covid-19 immunisation campaigns does not only depend on the efficacy of the vaccines themselves or the ability to secure access to them, but also on a myriad of other factors which include public compliance and trust in governments and health authorities. To support an effective immunisation campaign that is capable of bringing the pandemic to an end, governments need to understand public concerns, garner trust, and devise adequate strategies for engaging the public and building more resilient societies.
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Affiliation(s)
- Btihaj Ajana
- Department of Digital Humanities, King’s College London, Strand Campus, London, WC2R 2LS UK
| | - Elena Engstler
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, 5 Cutcombe Road, London, Brixton SE5 9RT UK
| | - Anas Ismail
- Department of Population Health and Environmental Sciences, King’s College London, Guy’s Campus, London, SE1 1UL UK
| | - Marina Kousta
- Department of Global Health & Social Medicine, King’s College London, Bush House, North East Wing, 40 Aldwych, London, WC2B 4BG UK
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Mann S, Christini K, Chai Y, Chang CP, Hashibe M, Kepka D. "Vaccine hesitancy and COVID-19 immunization among rural young adults". Prev Med Rep 2022; 28:101845. [PMID: 35669235 PMCID: PMC9159780 DOI: 10.1016/j.pmedr.2022.101845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 11/18/2022] Open
Abstract
Rural young adults may be more averse to receiving a COVID-19 immunization than urban young adults. We aimed to assess differences in COVID-19 vaccine hesitancy for rural, compared with urban, young adults and characterize modifiable factors. This cross-sectional online survey collected demographic data, vaccination attitudes, and COVID-19 impacts from 2937 young adults, ages 18-26 years, across the western U.S. from October 2020 to April 2021. Rurality was determined by participants' zip code and classified using the rural and urban continuum codes (RUCC). Multivariable logistic regression described adjusted (age, gender, race and ethnicity, being a current student, and month of survey) odds of self-reported intent to receive the COVID-19 vaccination by rurality. Mediation analysis was used to decompose total effects into average direct effects and average causal mediation (indirect) effects. Rural participants had 40% lower odds than urban participants of intending to receive the COVID-19 vaccine after adjustments (adjusted odds ratio, 0.62 [95% CI, 0.50-0.76]). The direct effect remained (P<0.001), but was mediated by both education (8.3%, P<0.001) and month in which the survey was taken (23.5%, P<0.001). We observed a divergence after December 2020 in vaccination intent between rural and urban young adults that widened over time. Hesitancy to receive the COVID-19 vaccine was greater among rural, compared with urban young adults, and grew disproportionally after December 2020. Mediation by whether one was a current student or not suggests differences in sources of information for vaccination decision-making, and highlights areas for addressing vaccine hesitancy.
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Affiliation(s)
- Sara Mann
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kaila Christini
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Corresponding author at: 2000 Circle of Hope, Rm 4144, Salt Lake City, UT 84112, USA.
| | - Yan Chai
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Chun-Pin Chang
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Mia Hashibe
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Deanna Kepka
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- University of Utah College of Nursing, Salt Lake City, UT, USA
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Asri A, Asri V, Renerte B, Föllmi-Heusi F, Leuppi JD, Muser J, Nüesch R, Schuler D, Fischbacher U. Which hospital workers do (not) want the jab? Behavioral correlates of COVID-19 vaccine willingness among employees of Swiss hospitals. PLoS One 2022; 17:e0268775. [PMID: 35617200 PMCID: PMC9135270 DOI: 10.1371/journal.pone.0268775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/07/2022] [Indexed: 11/20/2022] Open
Abstract
In many countries, the current vaccination rates are stagnating, to the extent that vaccine hesitancy—the delay or refusal to take recommended vaccinations—forms a major obstacle to ending the COVID-19 pandemic. This tendency is particularly concerning when observed among healthcare workers who are opinion leaders on medical matters for their patients and peers. Our study surveys 965 employees of two large Swiss hospitals and profiles vaccine-hesitant hospital employees using not only socio-demographic characteristics, but also a comprehensive set of standard behavioral preference measures: (i) Big-5 personality traits, (ii) risk-, time- and social preferences, and (iii) perceived prevailing social norms. Using multinomial probit models and linear probability models, we find that vaccine-hesitant hospital employees are less patient and less likely to perceive vaccination as the prevailing social norm—in addition to replicating previously published socio-demographic results. Our findings are robust to a range of model specifications, as well as individual and situational covariates. Our study thus offers actionable policy implications for tailoring public-health communications to vaccine-hesitant hospital employees.
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Affiliation(s)
- Ankush Asri
- University of Konstanz, Konstanz, Germany
- Thurgau Institute of Economics, Kreuzlingen, Switzerland
| | - Viola Asri
- University of Konstanz, Konstanz, Germany
- Thurgau Institute of Economics, Kreuzlingen, Switzerland
| | - Baiba Renerte
- University of Konstanz, Konstanz, Germany
- Thurgau Institute of Economics, Kreuzlingen, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Franziska Föllmi-Heusi
- Spital Schwyz, Schwyz, Switzerland
- Swiss Institute for International Economics and Applied Economic Research, University of St.Gallen, St.Gallen, Switzerland
| | - Joerg D. Leuppi
- Kantonsspital Baselland, Liestal, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Reto Nüesch
- Spital Schwyz, Schwyz, Switzerland
- University of Basel, Basel, Switzerland
| | - Dominik Schuler
- Spital Schwyz, Schwyz, Switzerland
- University of Basel, Basel, Switzerland
| | - Urs Fischbacher
- University of Konstanz, Konstanz, Germany
- Thurgau Institute of Economics, Kreuzlingen, Switzerland
- * E-mail:
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Alsharawy A, Dwibedi E, Aimone J, Ball S. Vaccine Hesitancy and Betrayal Aversion. Ann Biomed Eng 2022; 50:794-804. [PMID: 35581511 PMCID: PMC9113375 DOI: 10.1007/s10439-022-02975-4] [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: 04/11/2022] [Accepted: 05/06/2022] [Indexed: 01/10/2023]
Abstract
The determinants of vaccine hesitancy remain complex and context specific. Betrayal aversion occurs when an individual is hesitant to risk being betrayed in an environment involving trust. In this pre-registered vignette experiment, we show that betrayal aversion is not captured by current vaccine hesitancy measures despite representing a significant source of unwillingness to be vaccinated. Our survey instrument was administered to 888 United States residents via Amazon Mechanical Turk in March 2021. We find that over a third of participants have betrayal averse preferences, resulting in an 8–26% decline in vaccine acceptance, depending on the betrayal source. Interestingly, attributing betrayal risk to scientists or government results in the greatest declines in vaccine acceptance. We explore an exogenous message intervention and show that an otherwise effective message acts narrowly and fails to reduce betrayal aversion. Our results demonstrate the importance of betrayal aversion as a preference construct in the decision to vaccinate.
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Affiliation(s)
- Abdelaziz Alsharawy
- School of Public and International Affairs, Princeton University, Princeton, NJ, 08544, USA.,Department of Economics, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Esha Dwibedi
- Department of Economics, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Jason Aimone
- Department of Economics, Baylor University, Waco, TX, 76798, USA
| | - Sheryl Ball
- Department of Economics, Virginia Tech, Blacksburg, VA, 24061, USA. .,School of Neuroscience, Virginia Tech, Blacksburg, VA, 24061, USA. .,, 3016 Pamplin Hall, Mail Code 0316, 880 West Campus Drive, Blacksburg, VA, 24061, USA.
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Lau BHP, Yuen SWH, Yue RPH, Grépin KA. Understanding the societal factors of vaccine acceptance and hesitancy: evidence from Hong Kong. Public Health 2022; 207:39-45. [PMID: 35486982 PMCID: PMC9040517 DOI: 10.1016/j.puhe.2022.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/13/2022] [Accepted: 03/18/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Vaccination is considered to be an important public health strategy for controlling the COVID-19 pandemic. Besides subjective evaluations of the vaccine and the health threat, societal factors have been seen as crucial to vaccination decisions. Based on a socioecological perspective, this study examines the role of societal factors in COVID-19 vaccine hesitancy in Hong Kong. STUDY DESIGN AND METHOD An online survey was fielded between 25 and 28 June 2021, collecting 2753 complete responses. Multinomial logistic regression was conducted to examine how subjective evaluations of the vaccine (summarised by the 5C model - Confidence, Collective responsibility, Constraints, Complacency and Calculation), threat perception, interpersonal influences and institutional trust contribute to explaining three types of decision - acceptant (vaccinated, scheduled or indicated 'Yes'), hesitant (unvaccinated and indicated 'Maybe' on intention) and resistant (unvaccinated and indicated 'No'). RESULTS A total of 43.2%, 21.7% and 35.1% of respondents were acceptant, hesitant and resistant. Although the 5C model remained useful in explaining vaccination decisions, respondents were heavily influenced by the decisions of their family, although they were less influenced by friends. Second, respondents tended to accept the vaccine when they had a weaker perception that the act is supportive of the government and were less resistant if they had stronger institutional trust. CONCLUSION Under the low-incidence and low-trust environment such as Hong Kong, vaccination decisions are heavily influenced by family's decision and the perception of vaccination as socially and politically desirable. Our findings highlight the importance of a nuanced conception of interpersonal and political influence towards vaccine acceptance/hesitancy.
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Affiliation(s)
- Bobo Hi Po Lau
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong, Hong Kong; Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-based Practice & Research, Hong Kong Shue Yan University, Hong Kong, Hong Kong, Hong Kong.
| | - Samson Wai Hei Yuen
- Department of Government and International Studies, Baptist University of Hong Kong, Hong Kong, Hong Kong, Hong Kong.
| | - Ricci Pak Hong Yue
- Department of Geography and Planning, University of Liverpool, Liverpool, United Kingdom
| | - Karen A Grépin
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, Hong Kong
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Toro-Ascuy D, Cifuentes-Muñoz N, Avaria A, Pereira-Montecinos C, Cruzat G, Peralta-Arancibia K, Zorondo-Rodríguez F, Fuenzalida LF. Factors Influencing the Acceptance of COVID-19 Vaccines in a Country with a High Vaccination Rate. Vaccines (Basel) 2022; 10:vaccines10050681. [PMID: 35632437 PMCID: PMC9145438 DOI: 10.3390/vaccines10050681] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 12/13/2022] Open
Abstract
Control of the COVID-19 pandemic largely depends on the effectiveness of the vaccination process. An understanding of the factors that underlie the willingness to accept vaccination contributes pivotal information to controlling the pandemic. We analyzed the association between the willingness to accept the available COVID-19 vaccines and vaccine determinants amidst the Chilean vaccination process. Individual-level survey data was collected from 744 nationally representative respondents and multivariate regression models were used to estimate the association between outcome and explanatory variables. We found that trust in COVID-19 vaccines, scientists, and medical professionals significantly increased the willingness to: accept the vaccines and booster doses, as well as annual vaccinations and the vaccination of children. Our results are critical to understanding the acceptance of COVID-19 vaccines in the context of a country with one of the world’s highest vaccination rates. We provide useful information for decision-making and policy design, in addition to establishing guidelines regarding how to effectively explain vaccination programs to citizens.
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Affiliation(s)
- Daniela Toro-Ascuy
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago 8910060, Chile; (D.T.-A.); (N.C.-M.); (C.P.-M.); (G.C.); (K.P.-A.)
| | - Nicolás Cifuentes-Muñoz
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago 8910060, Chile; (D.T.-A.); (N.C.-M.); (C.P.-M.); (G.C.); (K.P.-A.)
| | - Andrea Avaria
- Facultad de Ciencias Sociales y Humanidades, Universidad Autónoma de Chile, Santiago 8910132, Chile;
| | - Camila Pereira-Montecinos
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago 8910060, Chile; (D.T.-A.); (N.C.-M.); (C.P.-M.); (G.C.); (K.P.-A.)
| | - Gilena Cruzat
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago 8910060, Chile; (D.T.-A.); (N.C.-M.); (C.P.-M.); (G.C.); (K.P.-A.)
| | - Katherine Peralta-Arancibia
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago 8910060, Chile; (D.T.-A.); (N.C.-M.); (C.P.-M.); (G.C.); (K.P.-A.)
| | - Francisco Zorondo-Rodríguez
- Departamento de Gestión Agraria, Facultad Tecnológica, Universidad de Santiago de Chile, Santiago 9170125, Chile
- Correspondence: (F.Z.-R.); (L.F.F.); Tel.: +56-2-27180565 (F.Z.-R.); +56-2-23036662 (L.F.F.)
| | - Loreto F. Fuenzalida
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago 8910060, Chile; (D.T.-A.); (N.C.-M.); (C.P.-M.); (G.C.); (K.P.-A.)
- Correspondence: (F.Z.-R.); (L.F.F.); Tel.: +56-2-27180565 (F.Z.-R.); +56-2-23036662 (L.F.F.)
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Acceptance and side effects of COVID-19 vaccination among private dental practitioners and their staffs in Belagavi city. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns2.6145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: In January 2021, India launched its largest COVID-19 vaccination campaign. Vaccines were distributed at 3,006 locations across India. The health-care workers were given first preference for vaccination. Vaccines are intended to provide immunity without the risk of disease transmission. Methods: A survey was conducted among private dental practitioners and their staff to inquire about their vaccination status, symptoms experienced, post-vaccination dental practice, and out-patient care. A complete list of registered dentists was compiled. A total of 315 participants were interviewed, including both private dental practitioners and their staffs, and data collected via phone call. Results: A total of 315 participants from 120 Dental Clinics in Belgaum City were included in the current study. 84.1% of the population were immunized. The majority of them (80.38%) were vaccinated with Covishield, and (69.06%) received two doses. In addition, 90.57% of participants experienced one or more symptoms following vaccination. The main symptoms reported were Fever/Chills (50.19%), Fatigue (27.12%), Headache (22.26%). Only 0.75% had diarrhea. None of the symptoms were life-threatening or necessitated hospitalization. Conclusion: The vaccine acceptance rate was 84.1% in the study. Mild and short post-vaccination symptoms was reported in more than two-thirds of healthcare professionals.
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Thorpe A, Fagerlin A, Drews FA, Butler J, Stevens V, Riddoch MS, Scherer LD. Communications to Promote Interest and Confidence in COVID-19 Vaccines. Am J Health Promot 2022; 36:976-986. [PMID: 35411819 PMCID: PMC9008475 DOI: 10.1177/08901171221082904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Communicating about COVID-19 vaccine side effects and efficacy is crucial for promoting transparency and informed decision-making, but there is limited evidence on how to do so effectively. DESIGN A within-subjects experiment. SETTING Online survey from January 21 to February 6, 2021. SUBJECTS 596 US Veterans and 447 non-Veterans. INTERVENTION 5 messages about COVID-19 vaccine side effects and 4 messages about COVID-19 vaccine efficacy. MEASURES COVID-19 vaccine interest (1 = "I definitely do NOT want the vaccine" to 7 = "I definitely WANT the vaccine" with the midpoint 4 = "Unsure"). Confidence about COVID-19 vaccine efficacy (1= "Not at all confident," 2 = "Slightly confident," 3 = "Somewhat confident," 4 = "Moderately confident," 5 = "Extremely confident"). RESULTS Compared to providing information about side effects alone (M = 5.62 [1.87]), messages with additional information on the benefits of vaccination (M = 5.77 [1.82], P < .001, dz = .25), reframing the likelihood of side effects (M = 5.74 [1.84], P < .001, dz = .23), and emphasizing that post-vaccine symptoms indicate the vaccine is working (M = 5.72 [1.84], P < .001, dz = .17) increased vaccine interest. Compared to a vaccine efficacy message containing verbal uncertainty and an efficacy range (M = 3.97 [1.25]), messages conveying verbal certainty with an efficacy range (M = 4.00 [1.24], P = .042, dz=.08), verbal uncertainty focused on the upper efficacy limit (M = 4.03 [1.26], P < .001, dz = .13), and communicating the point estimate with certainty (M = 4.02 [1.25], P < .001, dz = .11) increased confidence. Overall, Veteran respondents were more interested (MVeterans = 5.87 [1.72] vs MNonVeterans = 5.45 [2.00], P < .001, d = .22) and confident (MVeterans = 4.13 [1.19] vs MNonVeterans = 3.84 [1.32], P < .001, d = .23) about COVID-19 vaccines than non-Veterans. CONCLUSIONS These strategies can be implemented in large-scale communications (e.g., webpages, social media, and leaflets/posters) and can help guide healthcare professionals when discussing vaccinations in clinics to promote interest and confidence in COVID-19 vaccines.
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Affiliation(s)
- Alistair Thorpe
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
| | - Angela Fagerlin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Frank A Drews
- Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA.,University of Utah College of Social and Behavioral Science, Salt Lake City, UT, USA
| | - Jorie Butler
- University of Colorado School of Medicine, Aurora, CO, USA.,VA Denver Center for Innovation, Denver, CO, USA
| | - Vanessa Stevens
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Marian S Riddoch
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
| | - Laura D Scherer
- University of Colorado School of Medicine, Aurora, CO, USA.,VA Denver Center for Innovation, Denver, CO, USA
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Zhu XM, Yan W, Sun J, Liu L, Zhao YM, Zheng YB, Que JY, Sun SW, Gong YM, Zeng N, Yuan K, Shi L, Sun YK, Guo SH, Lu Y, Ran MS, Wong SYS, Shi J, Jiang ZD, Bao YP, Lu L. Patterns and influencing factors of COVID-19 vaccination willingness among college students in China. Vaccine 2022; 40:3046-3054. [PMID: 35450782 PMCID: PMC8995203 DOI: 10.1016/j.vaccine.2022.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022]
Abstract
Background Vaccination is an important preventive measure against the coronavirus disease 19 (COVID-19) pandemic. We aimed to examine the willingness to vaccination and influencing factors among college students in China. Methods From March 18 to April 26, 2021, we conducted a cross-sectional online survey among college students from 30 universities in Wuhan, Hubei Province, China. The survey was composed of the sociodemographic information, psychological status, experience during pandemic, the willingness of vaccination and related information. Students’ attitudes towards vaccination were classified as ‘vaccine acceptance’, ‘vaccine hesitancy’, and ‘vaccine resistance’. Multinomial logistic regression analyses were performed to identify the influencing factors associated with vaccine hesitancy and resistance. Results Among 23,143 students who completed the survey, a total of 22,660 participants were included in the final analysis with an effective rate of 97.9% after excluding invalid questionnaires. A total of 60.6% of participants would be willing to receive COVID-19 vaccine, 33.4% were hesitant to vaccination, and 6.0% were resistant to vaccination. Social media platforms and government agencies were the main sources of information vaccination. Worry about the efficacy and adverse effects of vaccine were the top two common reason of vaccine hesitancy and resistance. Multiple multinomial logistic regression analysis identified that participants who worried about the adverse effects of vaccination were more likely to be vaccine hesitancy (aOR = 2.44, 95% CI = 2.30, 2.58) and resistance (aOR = 2.71, 95% CI = 2.40, 3.05). Conclusion More than half of college students are willing to receive the COVID-19 vaccine, whereas nearly one-third college students are still hesitant or resistant. It is crucial to provide sufficient and scientific information on the efficacy and safety of vaccine through social media and government agencies platforms to promote vaccine progress against COVID-19 and control the pandemic in China.
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Affiliation(s)
- Xi-Mei Zhu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Wei Yan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Jie Sun
- Center for Pain Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Yong-Bo Zheng
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Jian-Yu Que
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Si-Wei Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Yi-Miao Gong
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Le Shi
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Yan-Kun Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Sui-Huai Guo
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Yu Lu
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Zheng-Dong Jiang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China.
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Kreps S, Kriner DL. Communication about vaccine efficacy and COVID-19 vaccine choice: Evidence from a survey experiment in the United States. PLoS One 2022; 17:e0265011. [PMID: 35353846 PMCID: PMC8967042 DOI: 10.1371/journal.pone.0265011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/18/2022] [Indexed: 11/18/2022] Open
Abstract
While mass vaccination campaigns against COVID-19 have inoculated almost 200 million Americans and billions more worldwide, significant pockets of vaccine hesitancy remain. Research has firmly established that vaccine efficacy is an important driver of public vaccine acceptance and choice. However, current vaccines offer widely varying levels of protection against different adverse health outcomes of COVID-19. This study employs an experiment embedded on a survey of 1,194 US adults in June 2021 to examine how communications about vaccine efficacy affect vaccine choice. The experiment manipulated how vaccine efficacy was defined across four treatments: (1) protection against symptomatic infection; (2) protection against severe illness; (3) protection against hospitalization/death; (4) efficacy data on all three metrics. The control group received no efficacy information. Subjects were asked to choose between a pair of vaccines-a one-dose viral vector vaccine or two-dose mRNA vaccine-whose efficacy data varied across the four experimental treatment groups. Efficacy data for each vaccine on each dimension were adapted from clinical trial data on the Johnson & Johnson/Janssen and Pfizer/BioNTech vaccines. Among all respondents, only modest preference gaps between the two vaccines emerged in the control group and when the two vaccines' roughly equivalent efficacy data against hospitalization and death were reported. Strong preferences for a two-dose mRNA vaccine emerged in treatments where its higher efficacy against symptomatic or severe illness was reported, as well as in the treatment where data on all three efficacy criteria were reported. Unvaccinated respondents preferred a one-dose viral vector vaccine when only efficacy data against hospitalization or death was presented. Black and Latino respondents were significantly more likely to choose the one-shot viral vector vaccine in the combined efficacy treatment than were whites. Results speak to the importance of understanding how communications about vaccine efficacy affect public preferences in an era of increasing uncertainty about efficacy against variants.
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Affiliation(s)
- Sarah Kreps
- Department of Government, Cornell University, Ithaca, NY, United States of America
| | - Douglas L. Kriner
- Department of Government, Cornell University, Ithaca, NY, United States of America
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GADARIAN SHANAKUSHNER, GOODMAN SARAWALLACE, MICHENER JAMILA, NYHAN BRENDAN, PEPINSKY THOMASB. Information From Same‐Race/Ethnicity Experts Online Does Not Increase Vaccine Interest or Intention to Vaccinate. Milbank Q 2022; 100:492-503. [PMID: 35315950 PMCID: PMC9111148 DOI: 10.1111/1468-0009.12561] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Callaghan T, Washburn D, Goidel K, Nuzhath T, Spiegelman A, Scobee J, Moghtaderi A, Motta M. Imperfect messengers? An analysis of vaccine confidence among primary care physicians. Vaccine 2022; 40:2588-2603. [PMID: 35315324 PMCID: PMC8931689 DOI: 10.1016/j.vaccine.2022.03.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Timothy Callaghan
- Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States.
| | - David Washburn
- Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Kirby Goidel
- Department of Political Science, Texas A&M University, 2935 Research Pkwy, College Station, TX, United States
| | - Tasmiah Nuzhath
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Abigail Spiegelman
- USA Center for Rural Public Health Preparedness, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Julia Scobee
- Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Ali Moghtaderi
- Department of Health Policy and Management, Milken School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, United States
| | - Matthew Motta
- Department of Political Science, Oklahoma State University, 210 Social Sciences and Humanities Hall, Stillwater, OK, United States
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Fowler EF, Nagler RH, Banka D, Gollust SE. Effects of politicized media coverage: Experimental evidence from the HPV vaccine and COVID-19. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 188:101-134. [PMID: 35168740 PMCID: PMC8839809 DOI: 10.1016/bs.pmbts.2021.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although concerns about politicization of health and science are not new, the COVID-19 pandemic has amplified attention to how political disagreement over scientific guidelines and recommendations might influence attitudes and behaviors about the health topics in question and might even spill or carry over to affect other attitudes important to public health. The literature employs differing definitions of politicization—at times referring to controversy in the public sphere, at others referring to the exploitation of the uncertainty inherent in science, and at still others referring to whether the issue enters political discourse—all of which are viewed as distinct dimensions by the public. What is not known is how these different aspects of politicization influence public attitudes about the health topics and or broader attitudes about scientific guidelines, and—assuming adverse effects—what strategies might be effective at mitigating the consequences. This paper draws on a survey experiment of 3012 U.S. respondents fielded in summer 2020 that was designed as a pilot study to assess the effects of different dimensions of politicization. Findings do not suggest that one type of politicization is necessarily more pernicious than the others. In fact, all types of politicization increased negative emotional responses and confusion, both with respect to the health topic in question (HPV vaccine and COVID-19) but also on other domains, although opinions about policy were unaffected. The findings also suggest that inoculation may have potential as a messaging strategy for blunting the adverse effects of exposure to politicization.
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Bolsen T, Palm R. Politicization and COVID-19 vaccine resistance in the U.S. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 188:81-100. [PMID: 35168748 PMCID: PMC8577882 DOI: 10.1016/bs.pmbts.2021.10.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Science is frequently used and distorted to advance political, economic, or cultural agendas. The politicization of science can limit the positive impacts that scientific advances can offer when people reject sound and beneficial scientific advice. Politicization has undoubtedly contributed to hesitancy toward uptake of the COVID-19 vaccine. It is urgent for scientists and clinicians to better understand: (1) the roots of politicization as related to COVID-19 vaccines; (2) the factors that influence people's receptivity to scientific misinformation in politicized contexts; and (3) how to combat the politicization of science to increase the use of life-saving vaccines. This chapter explores these issues in the context of COVID-19 vaccine resistance in the United States. After briefly describing the development of the vaccines, we describe the ways in which the disease itself became politicized because of statements by political leaders and also by media accounts including social media. We then review the politicization of the vaccine at both national and international scales, variability in public acceptance of the vaccines in the United States, and response to the emergence of variants. The next section summarizes social science findings on overcoming vaccine resistance, and the concluding section outlines some of the lessons of the politicization of the disease and the vaccine for health practitioners and life scientists.
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Affiliation(s)
- Toby Bolsen
- Department of Political Science, Georgia State University, Atlanta, GA, United States.
| | - Risa Palm
- Urban Studies Institute, Georgia State University, Atlanta, GA, United States
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Honora A, Wang KY, Chih WH. How does information overload about COVID-19 vaccines influence individuals' vaccination intentions? The roles of cyberchondria, perceived risk, and vaccine skepticism. COMPUTERS IN HUMAN BEHAVIOR 2022; 130:107176. [PMID: 35013641 PMCID: PMC8730468 DOI: 10.1016/j.chb.2021.107176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 01/18/2023]
Abstract
This research proposes and tests an integrated model to explain how information overload influence vaccine skepticism and vaccination intention. In addition, this research investigates the effectiveness of using a celebrity endorsement strategy in promoting vaccination and compares its effectiveness with other endorsement types. A survey study (Study 1) was conducted to examine the mechanism underlying the impact of the COVID-19 vaccine information overload on vaccine skepticism that, subsequently, affects vaccination intention. It also examined the moderating role of celebrity endorsement trustworthiness. The results indicate that information overload positively influenced vaccine skepticism through cyberchondria and perceived risk of the vaccine, which subsequently reduces vaccination intention. The negative effect of vaccine skepticism on vaccination intention was weakened by the celebrity endorsement that was considered trustworthy. A follow-up experimental study (Study 2) was performed to compare the effectiveness of celebrity endorsement with other endorsement types (i.e., government official and medical expert endorsements). The results showed that the celebrity endorsement was more effective in mitigating the negative effect of vaccine skepticism on vaccination intention compared to government official and medical expert. The findings provide practical insights into how governments can minimize people's vaccine skeptical views and increase their vaccination intentions.
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Affiliation(s)
- Andreawan Honora
- Department of Business Administration, National Dong Hwa University, No. 1, Sec. 2, Da Hsueh Rd, Shoufeng, Hualien, 97401, Taiwan, ROC
| | - Kai-Yu Wang
- Department of Marketing, International Business and Strategy, Goodman School of Business, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S3A1, Canada
| | - Wen-Hai Chih
- Department of Business Administration, National Dong Hwa University, No. 1, Sec. 2, Da Hsueh Rd, Shoufeng, Hualien, 97401, Taiwan, ROC
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Luo H, Qu H, Basu R, Rafferty AP, Patil SP, Cummings DM. Willingness to Get a COVID-19 Vaccine and Reasons for Hesitancy Among Medicare Beneficiaries: Results From a National Survey. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:70-76. [PMID: 34081668 DOI: 10.1097/phh.0000000000001394] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess (1) the willingness to get a COVID-19 vaccine among Medicare beneficiaries, (2) the associated factors, and (3) the reasons for vaccine hesitancy. METHODS Data were taken from the Medicare Current Beneficiary Survey (MCBS) 2020 Fall COVID-19 Supplement, conducted October-November 2020. Willingness to get a COVID-19 vaccine was measured by respondents' answer to whether they would get a COVID-19 vaccine when available. We classified responses of "definitely" and "probably" as "willing to get," and responses "probably not," "definitely not," and "not sure" as "vaccine hesitancy." Reasons for vaccine hesitancy were assessed by a series of yes/no questions focusing on 10 potential reasons. The analytical sample included 6715 adults 65 years and older. We conducted a logistic regression model to assess demographic factors and other factors associated with the willingness to get a COVID-19 vaccine. All analyses were conducted in Stata 14 and accounted for the complex survey design of MCBS. RESULTS Overall, 61.0% (95% confidence interval [CI], 59.1-63.0) of Medicare beneficiaries would be willing to get a vaccine when available. Among those who were hesitant, more than 40% reported that mistrust of the government and side effects as the main reasons. Logistic regression model results showed that non-Hispanic Blacks (adjusted odds ratio [AOR] = 0.33; 95% CI, 0.24-0.44) and Hispanics (AOR = 0.60; 95% CI, 0.47-0.77) were less willing to get a vaccine than non-Hispanic Whites; beneficiaries with an income of less than $25 000 (AOR = 0.71; 95% CI, 0.62-0.81) were less willing to get the vaccine than those with an income of $25 000 or more; those who did not think that the COVID-19 virus was more contagious (AOR = 0.53; 95% CI, 0.41-0.69) or more deadly (AOR = 0.51; 95% CI, 0.41-0.65) were also less willing to get the vaccine than those who thought that the virus was more contagious or more deadly than the influenza virus. CONCLUSIONS The 2020 MCBS survey data showed that close to 40% of Medicare beneficiaries were hesitant about getting a COVID-19 vaccine, and the hesitancy was greater in racial/ethnic minorities. Medicare beneficiaries were concerned about the safety of the vaccine, and some appeared to be misinformed. Evidence-based educational and policy-level interventions need to be implemented to further promote COVID-19 vaccination.
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Affiliation(s)
- Huabin Luo
- Departments of Public Health (Drs Luo, Basu, and Rafferty) and Family Medicine (Drs Patil and Cummings), Brody School of Medicine, East Carolina University, Greenville, North Carolina; and Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama (Dr Qu)
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Persuasive messaging to increase COVID-19 vaccine uptake intentions. Vaccine 2021; 39:7158-7165. [PMID: 34774363 PMCID: PMC8531257 DOI: 10.1016/j.vaccine.2021.10.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
Widespread vaccination remains the best option for controlling the spread of COVID-19 and ending the pandemic. Despite the considerable disruption the virus has caused to people’s lives, many people are still hesitant to receive a vaccine. Without high rates of uptake, however, the pandemic is likely to be prolonged. Here we use two survey experiments to study how persuasive messaging affects COVID-19 vaccine uptake intentions. In the first experiment, we test a large number of treatment messages. One subgroup of messages draws on the idea that mass vaccination is a collective action problem and highlighting the prosocial benefit of vaccination or the reputational costs that one might incur if one chooses not to vaccinate. Another subgroup of messages built on contemporary concerns about the pandemic, like issues of restricting personal freedom or economic security. We find that persuasive messaging that invokes prosocial vaccination and social image concerns is effective at increasing intended uptake and also the willingness to persuade others and judgments of non-vaccinators. We replicate this result on a nationally representative sample of Americans and observe that prosocial messaging is robust across subgroups, including those who are most hesitant about vaccines generally. The experiments demonstrate how persuasive messaging can induce individuals to be more likely to vaccinate and also create spillover effects to persuade others to do so as well. The first experiment in this study was registered at clinicaltrials.gov and can be found under the ID number NCT04460703. This study was registered at Open Science Framework (OSF) at: https://osf.io/qu8nb/?view_only=82f06ecad77f4e54b02e8581a65047d7.
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Xu B, Zhang Y, Chen L, Yu L, Li L, Wang Q. The influence of social network on COVID-19 vaccine hesitancy among healthcare workers: a cross-sectional survey in Chongqing, China. Hum Vaccin Immunother 2021; 17:5048-5062. [PMID: 34982646 PMCID: PMC8903998 DOI: 10.1080/21645515.2021.2004837] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The factors that lead to coronavirus disease 2019 (COVID-19) vaccine hesitancy among health-care workers (HCWs) are unclear. We aimed to identify the factors that influence HCWs' hesitancy, especially the influence of their social network. Using an online platform, we surveyed HCWs in Chongqing, China, in January 2021 to understand the factors that influence the COVID-19 vaccine hesitancy among HCWs. Proportional allocation stratified sampling method was used to recruit respondents. Multivariable logistic regression and social network analysis (SNA) were used to analyze the influence factors. A total of 5247 HCWs were included and 23.3% of them were vaccine-hesitant. Participants were more hesitant if they had chronic diseases (OR = 1.411, 95% CI: 1.146-1.738), worked in tertiary hospitals (OR = 1.546, 95% CI: 1.231-1.942), and reported a history of vaccine hesitancy (OR = 1.637, 95% CI: 1.395-1.920) and refusal toward other vaccines (OR = 2.433, 95% CI: 2.067-2.863). The participants with a social network to communicate COVID-19 immunization were less hesitant (OR = 0.850, 95% CI: 0.728-0.993). Several influential members with social networks were found in SNA. Most of these influential members in the networks were department leaders who were willing to get COVID-19 vaccines (P < .05). Hesitant subgroups among Chinese HCWs were linked to the lack of a social network to communicate COVID-19 immunization. Our findings may lead to tailored interventions to enhance COVID-19 vaccine uptake among HCWs by targeting key members in social network.
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Affiliation(s)
- Binyue Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China,EPI Department, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yi Zhang
- School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Chen
- EPI Department, Yuzhong Distinct Center for Disease Control and Prevention, Chongqing, China
| | - Linling Yu
- EPI Department, Yubei Distinct Center for Disease Control and Prevention, Chongqing, China
| | - Lanxin Li
- EPI Department, Shapingba Distinct Center for Disease Control and Prevention, Chongqing, China
| | - Qing Wang
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China,CONTACT Qing Wang EPI Department, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
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Allen JD, Feng W, Corlin L, Porteny T, Acevedo A, Schildkraut D, King E, Ladin K, Fu Q, Stopka TJ. Why are some people reluctant to be vaccinated for COVID-19? A cross-sectional survey among U.S. Adults in May-June 2020. Prev Med Rep 2021; 24:101494. [PMID: 34277329 PMCID: PMC8277541 DOI: 10.1016/j.pmedr.2021.101494] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 01/22/2023] Open
Abstract
Understanding reasons for COVID-19 vaccine hesitancy is necessary to ensure maximum uptake, needed for herd immunity. We conducted a cross-sectional online survey between May 29-June 20, 2020 among a national sample of U.S. adults ages 18 years and over to assess cognitive, attitudinal and normative beliefs associated with not intending to get a COVID-19 vaccine. Of 1219 respondents, 17.7% said that they would not get a vaccine and 24.2% were unsure. In multivariable analyses controlled for gender, age, income, education, religious affiliation, health insurance coverage, and political party affiliation, those who reported that they were unwilling be vaccinated (versus those who were willing) were less likely to agree that vaccines are safe/effective (Relative Risk Ratio (RRR): 0.45, 95% confidence interval (CI): 0.31, 0.66), that everyone has a responsibility to be vaccinated (RRR: 0.39, 95% CI: 0.30, 0.52), that public authorities should be able to mandate vaccination (RRR: 0.75, 95% CI: 0.58, 0.98), and more likely to believe that if everyone else were vaccinated they would not need a vaccine (RRR: 1.36, 95% CI: 1.04, 1.78). Our results suggest that health messages should emphasize the safety and efficacy of vaccines, as well as the fact that vaccinating oneself is important, even if the level of uptake in the community is high.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
| | - Wenhui Feng
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Laura Corlin
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, 200 College Ave, Medford, MA 02155, USA
| | - Thalia Porteny
- Department of Occupational Therapy, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
| | - Andrea Acevedo
- Department of Community Health, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
| | - Deborah Schildkraut
- Department of Political Science, Tufts University, Packard Hall, Medford, MA 02155, USA
| | - Erin King
- Department of Clinical Science, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA
| | - Keren Ladin
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Department of Occupational Therapy, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
| | - Qiang Fu
- Department of Community Health, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
| | - Thomas J. Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- Tufts Clinical and Translational Science Institute, 35 Kneeland Street, Boston, MA 02111, USA
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