Perspectives on the receipt of a COVID-19 vaccine: A survey of employees in two large hospitals in Philadelphia

Non-uptake of COVID-19 vaccines and reasons for non-uptake among healthcare workers in Uganda: a cross-sectional study

BACKGROUND

Vaccines play a crucial role in eradicating and containing disease outbreaks. Therefore, understanding the reasons behind vaccine refusal and associated factors is essential for improving vaccine acceptance rates. Our objective was to examine the determinants of COVID-19 vaccine non-uptake and explore the reasons for non-uptake among healthcare workers (HCWs) in Uganda.

METHODS

Between July and August 2021, we conducted a cross-sectional study among healthcare workers in primary healthcare facilities (private and government) in Entebbe Municipality, Uganda. Participants were recruited using convenience sampling, and consenting individuals received credentials to access an electronic database and complete a structured questionnaire. There were no established HCWs contact registers in the municipality, and the study was conducted during a national lock down, therefore, the HCWs who were on duty at the time of the study were approached. The survey questions were based on the '3Cs' model of vaccine hesitancy and focused on confidence, convenience, and complacency factors. Non-uptake of vaccines was defined as not having received any of the available vaccines in the country. We employed counts, percentages, and simple logit models to summarize the reasons for non-uptake of COVID-19 vaccines and to identify associated factors.

RESULTS

The study recruited 360 HCWs, 61.7% of whom were female, with an average age of 31 years (SD = 7.9). Among them, 124 (34.4%) healthcare workers did not receive any COVID-19 vaccine. Non-uptake of COVID-19 vaccines was independently associated with several factors, including age [35 + years adjusted odds ratio (aOR) = 0.30, 95% CI: 0.13-0.66 compared with 18-24 years], facility ownership [government, aOR = 0.22 (0.10-0.49) compared with private not-for-profit], previous testing for coronavirus [yes, aOR = 0.35 (0.19-0.65)], and previous involvement in COVID-19 vaccine activities [yes, aOR = 0.17 (0.10-0.29)]. The primary reasons cited for non-uptake of COVID-19 vaccines were related to a lack of confidence in the vaccines, such as concerns about side effects (79.8%) and the need for more time to understand the vaccines (89.5%), as well as the importance of weighing benefits and risks (84.7%) before being vaccinated. A smaller proportion, approximately 23%, cited reasons related to complacency and lack of convenience in accessing vaccination services.

CONCLUSION

The high proportion of non-uptake of COVID-19 vaccines among this population primarily stems from a lack of confidence and trust in the vaccines, coupled with insufficient time allowed for users to make informed decisions. This underscores the urgent need for ongoing monitoring and trend analysis of vaccine non-uptake to guide the development and implementation of strategies aimed at building and sustaining vaccine confidence. Adequate time should be allowed to explain benefits of vaccination to the population to allay fears that might exist before actual vaccination is rolled out.

Despite mandated primary series, health care personnel still hesitant about COVID-19 vaccine and immunizing children

IMPORTANCE

Healthcare personnel (HCP) are important messengers for promoting vaccines, for both adults and children. Our investigation describes perceptions of fully vaccinated HCP about COVID-19 vaccine for themselves and primary series for their children.

OBJECTIVE

To determine associations between sociodemographic, employment characteristics and perceptions of COVID-19 vaccines among HCP overall and the subset of HCP with children, who were all mandated to receive a COVID-19 vaccine, in a large US metropolitan region.

DESIGN

Cross-sectional survey of fully vaccinated HCP from a large integrated health system.

SETTING

Participants were electronically enrolled within a multi-site NYS healthcare system from December 21, 2021, to January 21, 2022.

PARTICIPANTS

Of 78,000 employees, approximately one-third accessed promotional emails; 6,537 employees started surveys and 4165 completed them. Immunocompromised HCP (self-reported) were excluded.

EXPOSURE(S) (FOR OBSERVATIONAL STUDIES)

We conducted a survey with measures including demographic variables, employment history, booster status, child vaccination status; vaccine recommendation, confidence, and knowledge.

MAIN OUTCOME(S) AND MEASURES

The primary outcome was COVID-19 vaccine hesitancy for all dose types - primary series or booster doses - among HCP.

RESULTS

Findings from 4,165 completed surveys indicated that almost 17.2 % of all HCP, including administrative and clinical staff, were hesitant or unsure about receiving a COVID-19 vaccine booster, despite the NYS recommendation to do so. Depending on age group, between 20 % and 40 % of HCP were hesitant about having their children vaccinated for COVID-19, regardless of clinical versus non-clinical duties. In multivariable regression analyses, lack of booster dose, unvaccinated children, females, income less than $50,000, and residence in Manhattan remained significantly associated with vaccine hesitancy.

CONCLUSIONS AND RELEVANCE

Despite mandated COVID-19 vaccination, a substantial proportion of HCP remained vaccine hesitant towards adult booster doses and pediatric COVID-19 vaccination. While provider recommendation has been the mainstay of combatting COVID-19 vaccine hesitancy, a gap exists between HCP-despite clinical or administrative status-and the ability to communicate the need for vaccination in a healthcare setting. While previous studies describe the HCP vaccine mandate as a positive force to overcome vaccine hesitancy, we have found that despite a mandate, there is still substantial COVID-19 vaccine hesitancy, misinformation, and reluctance to vaccinate children.

Vaccine hesitancy and hesitant adoption among nursing students in Texas

Background

As the state facing the second-largest nursing workforce shortage in the U.S. and low vaccination rates among residents early in the pandemic, Texas provided a unique opportunity to examine vaccine hesitancy and hesitant adoption among nursing students in an environment where state-level executive orders prohibited mandatory vaccinations.

Methods

The purpose of this study was to describe the level of vaccine hesitancy and hesitant adoption among nursing students in the state of Texas. We used a convenient, opt-in, online survey of nursing students conducted between mid-April and mid-June 2022. The survey was distributed to all pre-licensure nursing programs in Texas.

Results

The majority of survey respondents (n = 599) were between the ages of 18-28 (68 %), female (88 %) and white (57 %). Most received at least one dose of the COVID-19 vaccination (84 %). Of those receiving the vaccine, a high proportion (82 %) were identified as hesitant adopters. Respondents cited concerns about side effects (57 %) most frequently as the reason for vaccine hesitancy.

Conclusion

Given the worldwide nursing shortage, factors potentially impacting the future workforce, such as vaccine hesitancy and hesitant adoption, must be closely monitored. More research is needed to understand the concerns of nursing students and the motivations of hesitant and non-hesitant adopters.

Occupational Health Providers' Perceptions of Employee Vaccine Hesitancy

OBJECTIVE

This study examined the perspectives of occupational health providers (OHPs) on the most frequently encountered clinically relevant reasons for employee vaccine hesitancy.

METHODS

We conducted an anonymous, online, cross-sectional survey of US OHPs ( N = 217). The survey asked OHPs about the major reasons that employees cite for being unwilling to receive the following three categories of vaccines: COVID-19, annual influenza, and others relevant to the workplace.

RESULTS

Concern about adverse effects was the most frequently reported reason for employee vaccine hesitancy for each vaccine category. Mistrust was reported more frequently for COVID-19 than for the influenza vaccine or other vaccines (χ 2P < 0.05). Targets of employee mistrust included government and researchers or scientists, but mistrust of healthcare providers was uncommon.

CONCLUSIONS

These results can be used to inform interventions to address vaccine hesitancy in the occupational health setting.

Mpox knowledge and vaccination hesitancy among healthcare workers in Beijing, China: A cross-sectional survey

Background

Mpox, one of the most serious threats to global health, is now being seen in small but rising numbers in Beijing, China. Our study aimed to investigate healthcare workers' (HCWs) knowledge of Mpox and to explore reasons associated with their hesitancy to vaccinate against Mpox in Beijing, China.

Methods

A cross-sectional study was conducted among HCWs in Beijing from July 24 to August 2, 2023, through an online questionnaire. Participants answered questions about sociodemographic characteristics, Mpox information sources, Mpox knowledge, perception of vaccines, and attitudes toward Mpox vaccination. We used Chi-squared test to compare difference in Mpox vaccination hesitancy between different groups. Multivariable logistic regression models were applied to analyze correlates of vaccination hesitancy among HCWs.

Results

A total of 2331 HCWs completed the questionnaire, with an effective response rate of 92.45 % (2155/2331). Most of the HCWs in this study worked at tertiary hospitals (89.65 %), with a mean age of 36.69 ± 9.08 years. Among the 2155 participants, 52.99 % had over ten years of working experience, and 16.66 % were from high-risk departments relevant to Mpox treatment. Approximately 84.41 % knew about Mpox before this study, 80.79 % exhibited a high level of knowledge about Mpox, whereas 42.37 % were hesitant to be vaccinated against Mpox. Moreover, the hesitancy rate of HCWs in high-risk departments (47.91 %) was higher than in lower-risk departments (41.26 %). Higher educational level (aOR = 1.75, 95 %CI: 1.17-2.62), longer working years (1.71, 1.32-2.22), working at high-risk departments (1.34, 1.05-1.71), and lower level of knowledge about Mpox (1.78, 1.13-2.85) appeared as the most significant determinants of Mpox vaccination hesitancy among HCWs who knew about Mpox. For the HCWs who did not know about Mpox, longer working years (1.96, 1.02-3.78) were significant factors associated with their hesitancy. The predominant reason for hesitancy toward Mpox vaccination among HCWs encompassed apprehensions about vaccine side effects.

Conclusion

HCWs had good knowledge of Mpox, whereas their Mpox vaccination hesitancy was also relatively high in Beijing, China. Increasing HCWs' vaccination confidence and knowledge level about Mpox, especially for those working in high-risk departments, may be an essential way of reducing their hesitancy.

COVID-19 vaccine uptake before and after a vaccine mandate at a major academic hospital: Trends by race/ethnicity and level of patient contact

OBJECTIVES

To assess vaccine coverage rates before and after implementation of a COVID-19 vaccine mandate among Health care Personnel (HCP) and demographic characteristics associated with vaccine uptake Design, Setting, and Participants: Cohort study conducted among 10,889 hospital employees followed from Dec 16, 2020 - October 31, 2021, at a large academic hospital in Philadelphia.

MAIN OUTCOME AND MEASURES

Time to COVID-19 vaccination and vaccine series completion rates before and after implementation of a COVID-19 vaccine mandate based on age, gender, race/ethnicity, and level of patient contact/occupational group.

RESULTS

The vaccination series completion rate was 86.0% prior to mandate announcement, and increased to 98.7% after mandate implementation. Rates before mandate announcement were highest among Asians (96.2%), Whites (94.0%), males (89.7%), employees ≥ 65 years of age (95.2%), and employees with direct patient care (physicians, 99.0%, and nurses, 93.3%). Hospital educational initiatives (including Town Halls and discussions with Black and Hispanic employees with the lowest vaccination rates) appeared to improve uptake. The largest increase in series completion after mandate announcement occurred among Blacks, those of other/multiracial backgrounds, and Hispanics (35.6%, 22.4%, and 10.8%, respectively) as well as those with some or no direct patient contact (24.5% and 18.3%, respectively). Medical or religious exemptions were approved for 64 (<0.6%) employees and 38 (<0.4%) left their positions (8 voluntary, 30 involuntary) specifically due to the COVID-19 vaccine mandate. No clinically meaningful differences by age, gender, or race/ethnicity for those who were vaccinated under the mandate versus those who left their positions were noted.

CONCLUSIONS AND RELEVANCE

These results suggest that while mandates may be challenging to institutions and enforcement unpopular, they play an important role in reducing hesitancy and securing high vaccination rates among HCP, a group at high risk of COVID-19 given their employment and who can be a source of disease transmission to patients.

Best Practices for Implementation of an Employee Health COVID-19 Vaccine Clinic-A Model for Future Pandemic Preparedness

OBJECTIVES

The aims of the study are to determine best practices from two large-scale, academic medical centers' employee coronavirus 2019 (COVID-19) vaccination clinics and to apply them to create scalable modules for rapid administration of 10,000 vaccinations.

METHODS

The weekly number of COVID-19 vaccine doses administered was captured. Processes were compared to determine best practices, which informed the scalable financial model.

RESULTS

Within the first 3 months, more than 60,000 COVID-19 vaccine doses were administered, and 70% of employees were fully vaccinated in 4 months with more than 95% by the vaccine mandate deadline. The estimated cost of delivering one dose was $29.95 ($299,505/10,000) compared with $35-$39 per dose when delivered by an on-site retail pharmacy.

CONCLUSIONS

Successful, safe, and rapid delivery of more than 60,000 COVID-19 vaccine doses in 3 months is practical and scalable. Learnings go beyond COVID-19 and can be applied to future outbreaks/pandemics.

Attitudes toward COVID-19 vaccination of healthcare workers in Israel and vaccination rates during vaccine rollout

A new COVID-19 vaccine was introduced in a remarkably short period of time. Public and healthcare workers (HCWs) were concerned about the safety of the vaccine, especially in light of the use of new technologies. A review regarding attitudes towards COVID-19 vaccination found a 22.5% hesitancy rate among HCWs. Online anonymous questionnaires were delivered using a web-based surveying platform to community HCWs in a central district in Israel from 3 to 19 January 2021. The real COVID-19 vaccination data were collected between the beginning of the vaccination rollout and the end of the month after the survey as well as the real vaccination rate among the general population. Of the 3,172 HCWs, 549 (17%) responded to the questionnaire. The highest positive attitude towards the vaccine was among physicians (95%), while nurses showed the highest level of hesitation (14%) for a specific sector (P < 0.05). However, the real vaccination rates were similar among physicians (63%) and nurses (62%). Surprisingly, the total vaccination rate of HCWs was substantially lower (52%) than that of the general population (71%). The main vaccination motivators were the social and economic effects of the COVID-19 epidemic. Focused strategies to reduce the level of hesitancy among HCWs are needed.

Does the Message Frame Promote People's Willingness to Vaccinate when they Worry about Side Effects from the COVID-19 Vaccine? Evidence from an Online Survey Experiment in China

Vaccination is an effective strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. However, worrying about side effects (WSE) from the COVID-19 vaccine is the leading concern making people hesitant to get vaccinated. Regrettably, there are few studies on alleviating the negative impacts of WSE on COVID-19 vaccination. This study aimed to assess whether message framing (gain- and loss-framed) can moderate the impacts of WSE on the willingness to vaccinate. We conducted an online self-administered survey experiment with three groups: control group (non-framed group), gain-framed groups, and loss-framed groups. In total, 981 participants were randomly assigned to one of the three groups, and their willingness to vaccinate themselves, their children, and elderly members was recorded. People with a higher level of WSE exhibited a lower willingness to vaccinate against COVID-19. However, the gain- and loss-framed messages increased people's willingness to vaccinate themselves, their children, and the elderly. Compared to the gain-framed messages, the loss-framed messages had a greater impact on enhancing people's willingness to self-vaccinate, but not on vaccinating their children and the elderly. Although the gain- and loss-framed messages weakened the negative impacts of WSE on the willingness to be vaccinated, their buffer effect was non-significantly different. The findings in this study suggest that a loss-framed messaging strategy could be a valuable tool in disseminating information on vaccination against COVID-19.

Measuring the importance of influencing factor for COVID-19 vaccination intention in China

Background

Vaccination is considered an effective approach to deter the spread of coronavirus disease (COVID-19). However, vaccine hesitancy is a common issue that makes immunization programs more challenging. To promote vaccination in a targeted and efficient way, this study aims to develop and validate a measurement tool for evaluating the importance of influencing factors related to COVID-19 vaccination intention in China, and to examine the demographic differences.

Methods

In study 1, we developed a Factor Importance Evaluation Questionnaire (FIEQ) based on semi-structured interview results and used exploratory factor analysis (EFA) to explore its factor structure. In study 2, we verified the four-factor structure of FIEQ by confirmatory factor analysis (CFA). We then administered FIEQ to Chinese participants and conducted a student t-test and analysis of variance to examine the differences in the importance evaluation of factors based on gender and educational level.

Results

In study 1, we developed a four-factor construct and retained 20 items after EFA (N = 577), with acceptable reliability (alpha = 0.87) and validity. In study 2, we found that the model fit was good (χ2 = 748.03 (162), p < 0.001, GFI = 0.949, RMSEA = 0.049, SRMR = 0.048, AGFI = 0.934), and reliability was acceptable (alpha = 0.730) (N = 1,496). No gender difference was found in factor importance. However, individuals with different educational levels reported significantly different importance evaluations of three factors, including perceived benefits and social norms (F = 3.786, p = 0.005), perceived influences from reference groups (F = 17.449, p < 0.001), and perceived risks (F = 2.508, p = 0.04).

Conclusion

This study developed and validated FIEQ for measuring the importance of influencing factors related to the COVID-19 vaccination intention in Chinese participants. Moreover, our findings suggest that the educational level may play a role in how individuals evaluate the importance of factors. This study provides insights into the concerns that individuals have regarding vaccination and offers potentially effective and targeted strategies for promoting COVID-19 vaccination.

COVID-19 vaccine acceptance and its determinants among residents of Ambo Town, West Shewa, Oromia Region, Ethiopia: cross-sectional survey

Background

Vaccines against COVID-19 are critical for preventing and managing COVID-19 because immunization is one of the most active and cost-effective health strategies for infectious disease prevention. Knowing the community's willingness and factors affecting COVID-19 vaccine acceptance will support the design of effective promotion strategies. Therefore, this study was aimed at assessing COVID-19 vaccine acceptance and its determinants among the Ambo Town community.

Method

A community-based, cross-sectional study was conducted using structured questionnaires from 1 to 28 February 2022. Four kebeles were selected randomly, and the systematic random sampling procedure was used to select the households. SPSS-25 software was used for data analysis. Ethical approval was received from the Institutional Review Committee of the College of Medicine and Health Sciences of Ambo University, and data were kept confidential.

Result

Of the 391 participants, 385 (98.5%) of the respondents were not vaccinated for COVID-19, and around 126 (32.2%) of the respondents said that they would receive the vaccine if the government provided it. The multivariate logistic regression analysis revealed that males were 1.8 times more likely to accept the COVID-19 vaccine (adjusted odds ratio (AOR) = 1.8, 95% CI: 1.074-3.156) as compared to females. The acceptance of the COVID-19 vaccine was lower by 60% in those who tested for COVID-19 as compared to those who were not tested (AOR = 0.4, 95% CI: 0.27-0.69). Moreover, the participants who had chronic diseases were two times more likely to accept the vaccine. Acceptance of the vaccine was reduced by half among those who believed that there was a scarcity of data on its safety (AOR = 0.5, 95% CI: 0.26-0.80).

Conclusion

The prevalence of COVID-19 vaccination acceptance was low. To enhance the acceptance of the COVID-19 vaccine, the government and different stakeholders should strengthen public education using mass media about the advantages of getting the COVID-19 vaccination.

The coverage of SARS-CoV-2 vaccination and the willingness to receive the SARS-CoV-2 variant vaccine among employees in China

BACKGROUND

COVID-19, which is caused by SARS-CoV-2, is a major global health threat. The dominant variant of SARS-CoV-2 has changed over time due to continuous evolution. We aimed to evaluate the coverage of SARS-CoV-2 vaccination among employees in China, explore their willingness to receive the SARS-CoV-2 variant vaccine and examine the potential factors influencing vaccination coverage and willingness.

METHODS

A cross-sectional epidemiological survey was conducted online from January 1, 2022, to January 30, 2022. The information collected in the survey included sociodemographic characteristics, lifestyle habits, vaccination coverage, willingness to be vaccinated against SARS-CoV-2 variants and the reasons for vaccination and willingness. Multivariable logistic regression models were used to assess the associations of potential factors with the rate of vaccination and the willingness to be vaccinated.

RESULTS

Among 62,395 eligible participants, the coverage of SARS-CoV-2 vaccination was 98.9% for at least one dose and 70.1% for a booster. The great majority of vaccinated individuals (94.4%) voluntarily received the vaccine. A total of 60,694 respondents (97.7%) were willing to be vaccinated against SARS-CoV-2 variants, mainly due to confidence in the effectiveness of vaccines (92.8%). A total of 1431 respondents were unwilling to be vaccinated, mainly because of concerns about the adverse effects of vaccines (77.6%). Longer education duration was associated with a higher rate of SARS-CoV-2 vaccination and willingness to be vaccinated. General or poor health status and having no history of influenza vaccination were associated with a lower rate of SARS-CoV-2 vaccination and willingness to be vaccinated. Additionally, we observed a significant positive association of abuse experience with the willingness to be vaccinated.

CONCLUSION

Although the rate of SARS-CoV-2 vaccination and the willingness to be vaccinated were relatively high in the study population, there were still some respondents with vaccine hesitancy. Relevant strategies based on significant related factors should be developed and implemented to encourage vaccination.

Asian American Vaccination, Testing, and Other Healthcare Knowledge & Behaviors during COVID-19, A Systematic Review

Novel COVID-19 variants continue to endanger global public health. Increasing COVID-19 vaccination, healthcare-related preventative behaviors, and general knowledge rates are all critical in halting COVID-19 spread. We evaluated Asian American COVID-19 healthcare-related behaviors and knowledge, due to the dearth of knowledge in this area and the unique social factor of COVID-19 related discrimination; discriminatory acts during the pandemic may play a role in COVID-19 related behavior adherence. Following PRISMA-P protocol, we conducted a systematic review. The search strategy combined synonyms of health-care behaviors and knowledge. Reviewers synthesized key themes across articles and assessed studies utilizing modified Newcastle-Ottawa criteria. Of the 2,518 articles, 32 were selected. Asian Americans reported greater COVID-19 vaccination willingness and decreased COVID-19 testing relative to other racial groups. Common COVID-19 vaccination concerns included vaccination side effects, long-term safety, and distrust of COVID-19 information sources. Asian Americans had high COVID-19 preventative behavior rates including mask-wearing, handwashing, and social isolation compared to other ethnic groups. Asian Americans, conversely, had lower COVID-19-related healthcare knowledge and telemedicine adoption levels relative to other participants. This systematic review informs public health officials and clinicians of COVID-19 related healthcare knowledge and behaviors in the Asian American population. Equipped with this knowledge, public health officials can better target messaging about vaccine safety concerns to the Asian American community and recognize the importance of tailoring COVID-19 educational materials to the heterogeneous Asian American subpopulations. This systematic review also provides insight into the unique telemedicine challenges physicians may face when engaging with Asian American patients.

Identifying and Evaluating the Socioeconomic Factors of COVID Vaccine Hesitancy Through an Integrated Multicriteria Decision Analysis Approach

The governments have been facing the challenges to develop tailored strategies to decrease COVID vaccine hesitancy (CVH) and refusal and increase the acceptability and uptake to ensure the protection of public health. In Pakistan, it has been a great challenge for the government to increase the acceptability of the COVID vaccine. CVH has been a great hurdle to achieving this objective. The authors found it imperative to identify and evaluate the factors of CVH in Pakistan. For this purpose, the authors used an integrated multicriteria decision analysis method (MCDM) by combining Delphi and DEMATEL methods. The factors of CVH have been identified and finalized using the Delphi method. The experts' opinions were obtained to evaluate the factors. The DEMATEL method was used to find out the most critical factor(s) of CVH. Moreover, the cause/effect relationship was also developed to have a better understating of factors and their relationships. The analysis revealed "ineffective public awareness strategies" as the most critical factor of CVH followed by "misinformation and disinformation, conspiracy theories", and "acquired knowledge". The study also examined the cause-and-effect relationship between the prioritized factors. The government in Pakistan introduced successful efforts to deal with the COVID-19 pandemic, yet the government could do more to increase vaccine acceptance. For this purpose to serve effective scientific and evidence-based public awareness strategies are needed to increase the acquired knowledge and deal with misinformation, disinformation, and conspiracy theories to increase vaccine acceptance. The government could sue the media, especially social media to increase vaccination. The findings of the study provide a detailed understanding of the CVH in Pakistan and develop a comprehensive public health strategy to deal with any health-related potential issues in the future.

COVID-19 vaccine hesitancy in the Saudi Arabian population

This study aimed to measure the level of vaccine hesitancy among the Saudi population using the WHO Vaccine Hesitancy Scale (VHS). A cross-sectional study using a modified vaccine hesitancy scale (VHS) was conducted among Saudi Arabian residents between April 4 and May 24, 2021. The relationship between participants' willingness to uptake COVID-19 vaccines and their demographics, awareness of COVID-19, and health status was evaluated. The chi-square test was employed to compare categorical variables and logistic regression for the associations of demographical characteristics with acceptance of the vaccine. We received a total of 1657 completed responses. 1,126 participants (68%) were vaccinated, of which 19% were vaccinated with one dose only, and 49% were fully vaccinated (with two doses). Safety concerns and worries about side effects were higher among the hesitant group (p<0.001). 96% of the participants from the willing group were not hesitant to have the vaccine, whereas in the same group, 70% thought they had good health and the vaccine was not needed. Logistic regression analysis revealed that participants with chronic diseases had lower odds of being willing to be vaccinated (OR=0.583, p-value 0.04). The study findings suggest key factors associated with COVID-19 vaccine hesitancy in the Saudi population and can help public health authorities plan strategies to minimize vaccine hesitancy and improve awareness about vaccine acceptance.

Adverse reactions of different COVID-19 vaccines among healthcare professionals: A qualitative study in Mosul, Iraq

Background

COVID-19 disease was highly infectious causing a declaration of a global pandemic and the scientists believed that developing a safe and effective vaccine was the solution. Various vaccine candidates were announced by different health authorities. Many factors affect the acceptance of vaccines. This study aims to explore the perceptions, attitudes, and expectations of healthcare professionals (HCPs) toward COVID-19 vaccines.

Method

A qualitative study approach was conducted by using face-to-face semi-structured interviews with HCPs in Mosul city, Iraq.

Results

Twenty-five HCPs participated in the interviews. After qualitative analysis four main themes emerged: perception of vaccines; participants believed that vaccines were vital inventions, motivations to take the vaccine; most HCPs were motivated based on the scientific evidence regarding COVID-19 vaccines, expectations about the safety and efficacy of COVID-19 vaccines; participants had different opinions based on the type of the vaccine and the available data, side effects experienced; severe side effects were expected but only mild adverse reactions were experienced by the majority.

Conclusion

HCPs had good knowledge about COVID-19 vaccines which was not affected by rumors and misinformation. In contrast to their expectations, the experienced side effects of the first and the second doses were mild to moderate in severity. The majority of HCPs based their choice of the vaccine on the efficacy and safety profile of the available options.

When the first vaccine arrived: An investigation of factors that influenced the intention of health care workers in the national health system of Greece to be vaccinated against the SARS COV-2 virus during the first trimester of vaccine arrival

BACKGROUND

COVID-19 vaccination started in Greece in the last days of December 2020. Health care workers (HCWs) of the public national health system (NHS) were on the frontline and they would be role models for all the citizens.

AIM

Investigation of the intention and hesitation of HCWs (doctors, nurses, and nursing assistants) of the NHS of Greece, regarding the vaccine against SARS COV-2 virus and the factors that affect them, during the first trimester of the availability of vaccines, in the country.

METHODS

A multicenter cross-sectional study was conducted in Greece among health professionals (n = 2484) of the NHS. Data were collected with the use of an online questionnaire through snowballing sampling.

RESULTS

Acceptance of a safe and effective COVID- 19 vaccines was higher among doctors (85.6%), followed by nurses (66.3%), and nursing assistants (64.1%). This study confirms pre-existing research on the interaction of gender, age, quality of personal information, educational level, training by the employer, and cognitive background regarding viruses and vaccines.

CONCLUSION

In conclusion, our study showed that once a vaccine was available, most HCWs were willing to be vaccinated. These findings could be used in the future to tailor communication and promotion campaigns, using anthropocentric strategies.

Coronavirus disease 2019 (COVID-19) vaccine hesitancy among physicians, physician assistants, nurse practitioners, and nurses in two academic hospitals in Philadelphia

OBJECTIVE

To evaluate coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare personnel (HCP) with significant clinical exposure to COVID-19 at 2 large, academic hospitals in Philadelphia, Pennsylvania.

DESIGN, SETTING, AND PARTICIPANTS

HCP were surveyed in November-December 2020 about their intention to receive the COVID-19 vaccine.

METHODS

The survey measured the intent among HCP to receive a COVID-19 vaccine, timing of vaccination, and reasons for or against vaccination. Among patient-facing HCP, multivariate regression evaluated the associations between healthcare positions (medical doctor, nurse practitioner or physician assistant, and registered nurse) and vaccine hesitancy (intending to decline, delay, or were unsure about vaccination), adjusting for demographic characteristics, reasons why or why not to receive the vaccine, and prior receipt of routine vaccines.

RESULTS

Among 5,929 HCP (2,253 medical doctors [MDs] and doctors of osteopathy [DOs], 582 nurse practitioners [NPs], 158 physician assistants [PAs], and 2,936 nurses), a higher proportion of nurses (47.3%) were COVID-vaccine hesitant compared with 30.0% of PAs and NPs and 13.1% of MDs and DOs. The most common reasons for vaccine hesitancy included concerns about side effects, the newness of the vaccines, and lack of vaccine knowledge. Regardless of position, Black HCP were more hesitant than White HCP (odds ratio [OR], ∼5) and females were more hesitant than males (OR, ∼2).

CONCLUSIONS

Although most clinical HCP intended to receive a COVID-19 vaccine, intention varied by healthcare position. Consistent with other studies, hesitancy was also significantly associated with race or ethnicity across all positions. These results highlight the importance of understanding and effectively addressing reasons for hesitancy, especially among frontline HCP who are at increased risk of COVID exposure and play a critical role in recommending vaccines to patients.

Tolerance for three commonly administered COVID-19 vaccines by healthcare professionals

Importance

Most healthcare institutions require employees to be vaccinated against SARS-CoV-2 and many also require at least one booster.

Objective

We determine the impact of vaccine type, demographics, and health conditions on COVID-19 vaccine side effects in healthcare professionals.

Design

A COVID-19 immunity study was performed at the 2021 American Association for Clinical Chemistry Annual Scientific meeting. As part of this study, a REDCap survey with cascading questions was administered from September 9, 2021 to October 20, 2021. General questions included participant demographics, past and present health conditions, smoking, exercise, and medications. COVID-19 specific questions asked about SARS-CoV-2 vaccine status and type, vaccine-associated side effects after each dose including any boosters, previous infection with COVID-19, diagnostic testing performed, and type and severity symptoms of COVID-19.

Results

There were 975 participants (47.1% male, median age of 50 years) who completed the survey. Pfizer was the most commonly administered vaccine (56.4%) followed by Moderna (32.0%) and Johnson & Johnson (7.1%). There were no significant differences in vaccine type received by age, health conditions, smoking, exercise, or type or number of prescription medications. Side effects were reported more frequently after second dose (e.g., Moderna or Pfizer) (54.1%) or single/only dose of Johnson & Johnson (47.8%). Males were significantly more likely to report no side effects (p < 0.001), while females were significantly more likely to report injection site reactions (p < 0.001), fatigue (p < 0.001), headache (p < 0.001), muscle pain (p < 0.001), chills (p = 0.001), fever (p = 0.007), and nausea (p < 0.001). There was a significant upward trend in participants reporting no side effects with increasing age (p < 0.001). There were no significant trends in side effects among different races, ethnicities, health conditions, medications, smoking status or exercise. In multivariate logistic regressions analyses, the second dose of Moderna was associated with a significantly higher risk of side effects than both the second dose of Pfizer and the single dose of Johnson & Johnson.

Conclusions and relevance

Younger people, females, and those receiving the second dose of Moderna had more COVID-19 vaccine side effects that per self-report led to moderate to severe limitations. As reported in other studies, the increase in side effects from Moderna may be explained by higher viral mRNA concentrations but be associated with additional protective immunity.

Information and vaccine hesitancy: Evidence from the early stage of the vaccine roll-out in 28 European countries

The success of mass vaccination programs against SARS-CoV-2 hinges on the public’s acceptance of the vaccines. During a vaccine roll-out, individuals have limited information about the potential side-effects and benefits. Given the public health concern of the COVID pandemic, providing appropriate information fast matters for the success of the campaign. In this paper, time-trends in vaccine hesitancy were examined using a sample of 35,390 respondents from the Eurofound’s Living, Working and COVID-19 (LWC) data collected between 12 February and 28 March 2021 across 28 European countries. The data cover the initial stage of the vaccine roll-out. We exploit the fact that during this period, news about rare cases of blood clots with low blood platelets were potentially linked to the Oxford/AstraZeneca vaccine (or Vaxzeveria). Multivariate regression models were used to analyze i) vaccine hesitancy trends, and whether any trend-change was associated with the link between the AstraZeneca vaccine ii) and blood clots (AstraZeneca controversy), and iii) the suspension among several European countries. Our estimates show that vaccine hesitancy increased over the early stage of the vaccine roll-out (0·002, 95% CI: [0·002 to 0·003]), a positive shift took place in the likelihood of hesitancy following the controversy (0·230, 95% CI: [0·157 to 0·302]), with the trend subsequently turning negative (-0·007, 95% CI: [-0·010 to -0·005]). Countries deciding to suspend the AstraZeneca vaccine experienced an increase in vaccine hesitancy after the suspensions (0·068, 95% CI: [0·04 to 0·095]). Trust in institutions is negatively associated with vaccine hesitancy. The results suggest that SARS-CoV-2 vaccine hesitancy increased steadily since the beginning of the vaccine roll-out and the AstraZeneca controversy and its suspension, made modest (though significant) contributions to increased hesitancy.

Acceptance of coronavirus disease 2019 (COVID-19) vaccines among healthcare workers: A meta-analysis

Background

The coronavirus disease 2019 (COVID-19) pandemic has posed increasing challenges to global health systems. Vaccination against COVID-19 can effectively prevent the public, particularly healthcare workers (HCWs), from being infected by this disease.

Objectives

We aim to understand the factors influencing HCWs' acceptance of COVID-19 vaccines.

Methods

We searched PubMed, Embase and Web of Science to collect literature published before May 15, 2022, about HCWs' acceptance of COVID-19 vaccines. The Newcastle-Ottawa quality assessment scale was used to assess the risk of bias and the quality of the included studies. We utilized Stata 14.0 software for this meta-analysis with a random-effects model, and odds ratios (ORs) with 95% confidence intervals (CIs) were reported. This meta-analysis was conducted in alignment with the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline.

Results

Our meta-analysis included 71 articles with 93,508 HCWs involved. The research showed that the acceptance of vaccines had significantly increased among HCWs compared to non-HCWs (OR = 1.91, 95% CI: 1.16-3.12). A willingness to undergo COVID-19 vaccination was observed in 66% (95% CI: 0.61-0.67) of HCWs. Among the HCWs involved, doctors showed a generally increased intention to be vaccinated compared with nurses (OR = 2.22, 95% CI: 1.71-2.89). Additionally, males were found to hold more positive attitudes toward vaccination than females (OR = 1.81, 95% CI: 1.55-2.12). When the effectiveness of COVID-19 vaccines was improved, the vaccination acceptance of HCWs was greatly increased accordingly (OR = 5.03, 95% CI: 2.77-9.11). The HCWs who were willing to vaccinate against seasonal influenza showed an increased acceptance of COVID-19 vaccines (OR = 3.52, 95% CI: 2.34-5.28). Our study also showed that HCWs who were willing to be vaccinated against COVID-19 experienced a reduced rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR = 0.78, 95% CI: 0.66-0.92).

Conclusions

Our analysis revealed that the five factors of occupation, gender, vaccine effectiveness, seasonal influenza vaccines, and SARS-CoV-2 infection presumably affected the acceptance of COVID-19 vaccines among HCWs. It is essential to boost the confidence of HCWs in COVID-19 vaccines for the containment of the epidemic.

COVID-19 Vaccine Acceptance and Uptake among Healthcare Workers in Trinidad and Tobago

Background

COVID-19 vaccine acceptance is important in ensuring the widespread vaccination of the population to achieve herd immunity. Establishing the acceptance of vaccines among healthcare workers, who play a vital role in an immunization program's success, is important. The aim of this study was to assess the influence of social trust and demographic factors on COVID-19 vaccine acceptance among healthcare workers.

Methods

A cross-sectional survey utilizing an electronic questionnaire inquiring about COVID-19 vaccine uptake, preferences, and concerns was distributed via e-mail to 1,351 North Central Regional Health Authority (NCRHA) healthcare workers of the following categories: medical practitioners, nursing personnel, veterinary surgeons, medical interns, dental interns, paramedics, and pharmacists. These professions were selected as they were granted power to administer COVID-19 vaccines during the period of public emergency by the President of Trinidad and Tobago and were therefore likely to be NCRHA healthcare workers directly involved in vaccine administration services. Bivariate analysis using Chi-squared analysis of association was used to determine the association between the respondents' characteristics and the acceptance of the vaccine and the association between vaccine acceptance among healthcare workers and trust. The association between the acceptance of the COVID-19 vaccines and healthcare workers' characteristics and trust was established using multinomial logistic regression.

Results

A total of 584 healthcare workers took part in the study, and 1.4% showed unwillingness to receive the COVID-19 vaccine. The study indicates that age, profession, trust in international public health organizations, and trust in other healthcare providers predict the uptake of COVID-19 vaccines among healthcare workers, with younger age groups and the nursing profession associated with an unwillingness to accept the vaccine. Gender of the healthcare workers does not predict vaccine acceptance. Conclusions and relevance: efforts towards enhanced vaccine acceptance among healthcare workers should take into consideration age, profession, and the trust in international organizations and other healthcare providers. Sensitization programs aimed at informing and creating awareness among healthcare workers about the COVID-19 vaccines should be age-specific as well as occupation-based.

Behavioural determinants of COVID-19 vaccination acceptance among healthcare workers: a rapid review

OBJECTIVES

Vaccinating healthcare workers (HCWs) against COVID-19 has been a public health priority since rollout began in late 2020. Promoting COVID-19 vaccination among HCWs would benefit from identifying modifiable behavioural determinants. We sought to identify and categorize studies looking at COVID-19 vaccination acceptance to identify modifiable factors to increase uptake in HCWs.

STUDY DESIGN

Rapid evidence review.

METHODS

We searched MEDLINE and Cochrane databases until May 2021 and conducted a grey literature search to identify cross-sectional, cohort, and qualitative studies. Key barriers to, and enablers of, vaccine acceptance were categorized using the Theoretical Domains Framework (TDF), a comprehensive theoretical framework comprising 14 behavioural domains.

RESULTS

From 19,591 records, 74 studies were included. Almost two-thirds of responding HCWs were willing to accept a COVID-19 vaccine (median = 64%, interquartile range = 50-78%). Twenty key barriers and enablers were identified and categorized into eight TDF domains. The most frequently identified barriers to COVID-19 vaccination were as follows: concerns about vaccine safety, efficacy, and speed of development (TDF domain: Beliefs about consequences); individuals in certain HCW roles (Social/professional role and identity); and mistrust in state/public health response to COVID-19 (Social influences). Routinely being vaccinated for seasonal influenza (Reinforcement), concerns about contracting COVID-19 (Beliefs about consequences) and working directly with COVID-19 patients (Social/professional role and identity) were key enablers of COVID-19 vaccination among HCWs.

DISCUSSION

Our review identified eight (of a possible 14) behavioural determinants of COVID-19 vaccine acceptance among HCWs that, if targeted, could help design tailored vaccination messaging, policy, campaigns, and programs to support HCWs vaccination uptake.

Factors Influencing Parental and Individual COVID-19 Vaccine Decision Making in a Pediatric Network

Aspects of the COVID-19 vaccination campaign differed from routine vaccines, including emergency use authorizations, the prioritization of access, and the politicization of messaging. Subsequently, many parents reported lower vaccine confidence relative to routine vaccines, and vaccination coverage stalled below targets. This study aimed to understand parental vaccine decision making and compare COVID-19 versus routine vaccine decision making. We conducted nine virtual focus groups between 25 February 2022-11 March 2022 with parents (n = 41) of the Children's Hospital of Philadelphia's patients, recruited via email and stratified by vaccine hesitancy status (non-hesitant vs. hesitant). Transcripts were analyzed using the vaccine hesitancy matrix domains. Of 41 total participants, 25 (61.0%) were non-hesitant, 16 (39.0%) were hesitant or their children were not up-to-date on adolescent vaccines, and most self-identified as female (95.1%) and White/Caucasian (61.0%). Most participants (87.5%) were fully vaccinated against COVID-19 and many of their first children (n = 26, 63.4%) were vaccinated against influenza. Several themes emerged regarding decision making: individual influences, group influences, vaccine and vaccine program influences, and contextual influences. While some influences were similar for routine and COVID-19 vaccine decision making (e.g., needing evidence-based information), other factors were vaccine- or situation-specific. Building trust requires a multi-faceted concerted effort that involves addressing the complex vaccine decision-making process.

Decisions to Choose COVID-19 Vaccination by Health Care Workers in a Southern California Safety Net Medical Center Vary by Sociodemographic Factors

BACKGROUND

Limited information exists regarding COVID-19 vaccine hesitancy among healthcare workers (HCWs). Our previous survey analyzed the reasons for HCWs' decisions to accept vaccination, suggesting that a "one-size fits all" approach may not suffice to increase vaccine uptake.

METHODS

Based on the vaccination acceptance group (acceptor, hesitant, refuser), we examined differences by sociodemographic factors (race/ethnicity, household income, education) from Likert Scale responses to fourteen influences affecting a decision to be vaccinated using the Kruskal-Wallis test and multinomial logistic regression with mutual adjustment for these sociodemographic factors, age, and sex.

RESULTS

Non-Hispanic White vaccine acceptors ranked lower confidence in preventing, withstanding, or treating COVID-19, while Non-Hispanic Blacks more highly regarded the motivation of a religious leader, colleague, or family member. Social media was ranked more influential among Non-Hispanic Asians. Acceptors with lower incomes ranked a job requirement influential; conversely, higher income vaccine hesitant HCWs highly rated this reason. More highly educated acceptors ranked being motivated by colleagues, family, and other HCWs higher. Adjustment weakened some but not all the differences between groups.

CONCLUSIONS

Sociodemographic factors affect HCWs' decisions to be vaccinated against COVID-19. Our findings may help develop more focused and tailored strategies to improve vaccination acceptance.

Vaccine hesitancy and health care providers: Using the preferred cognitive styles and decision- making model and empathy tool to make progress

Low vaccination rates among health care providers (HCPs) pose a risk to themselves, their colleagues, their patients, and the general public. This paper seeks to frame the issues surrounding health care provider vaccine hesitancy and vaccination rates, as well as explore factors influencing respective decision-making, including health care occupation and demographic characteristics. This paper will then propose the use of the Preferred Cognitive Style and Decision-Making (PCSDM) Model and the Empathy Tool to increase health care provider vaccination rates, and will end by discussing several recommendations. It is important while discussing HCP vaccination rates to not view them as a monolithic group or apply “one-size-fits-all” approaches, and thus it is essential to present information and engage in conversations in ways that align with how the HCP takes in and processes information and decisions. Furthermore, it is vital to increase health literacy across the spectrum of HCP programs and professions. To this end, it is important to teach and incorporate the PCSDM Model and Empathy Tool, along with information about how individuals think and make decisions, into vaccine education programs and training sessions.

COVID-19 vaccine booster hesitancy (VBH) of healthcare professionals and students in Poland: Cross-sectional survey-based study

Since healthcare professionals (HCPs) play a critical role in shaping their local communities' attitudes toward vaccines, HCPs' beliefs and attitudes toward vaccination are of vital importance for primary prevention strategies. The present study was designed as a cross-sectional survey-based study utilizing a self-administered questionnaire to collect data about COVID-19 vaccine booster hesitancy (VBH) among Polish HCPs and students of medical universities (MUSs). Out of the 443 included participants, 76.3% were females, 52.6% were HCPs, 31.8% were previously infected by SARS-CoV-2, and 69.3% had already received COVID-19 vaccine booster doses (VBD). Overall, 74.5% of the participants were willing to receive COVID-19 VBD, while 7.9 and 17.6% exhibited their hesitance and rejection, respectively. The most commonly found promoter for acceptance was protection of one's health (95.2%), followed by protection of family's health (81.8%) and protection of community's health (63.3%). Inferential statistics did not show a significant association between COVID-19 VBH and demographic variables, e.g., age and gender; however, the participants who had been previously infected by SARS-CoV-2 were significantly more inclined to reject the VBD. Protection from severe infection, community transmission, good safety profile, and favorable risk-benefit ratio were the significant determinants of the COVID-19 VBD acceptance and uptake. Fear of post-vaccination side effects was one of the key barriers for accepting COVID-19 VBD, which is consistent with the pre-existing literature. Public health campaigns need to highlight the postulated benefits of vaccines and the expected harms of skipping VBD.

Estimates of COVID-19 vaccine uptake in major occupational groups and detailed occupational categories in the United States, April-May 2021

Background

While other studies have reported estimates of COVID‐19 vaccine uptake by broad occupational group, little is known about vaccine uptake by detailed occupational category.

Methods

Data on COVID‐19 vaccination were provided by US adults ages ≥18 years old who responded to the Facebook/Delphi Group COVID‐19 Trends and Impact Survey (Delphi US CTIS) in April–May 2021, reported working for pay in the past 4 weeks, and answered questions about their COVID‐19 vaccine status. Percentages of occupational groups reporting having had at least one COVID‐19 vaccination were weighted to resemble the US general population and calculated for 23 major occupational groups and 120 detailed occupational categories in 15 major groups.

Results

COVID‐19 vaccine uptake for all 828,401 working adult respondents was 73.6%. Uptake varied considerably across the 23 major occupational groups, from 45.7% for Construction and Extraction to 87.9% for Education, Training, and Library. Percentage vaccinated was also very low for Installation, Maintenance, and Repair at 52.1% and Farming, Fishing, and Forestry at 53.9%. Among the 120 detailed occupational categories, the highest percentage vaccinated was 93.9% for Postsecondary Teacher and the three lowest values were 39.1% for Any Extraction Worker in Oil, Gas, Mining, or Quarrying; 40.1% for Vehicle or Mobile Equipment Mechanic, Installer, or Repairer; and 42.0% for Any Construction Trades Worker.

Conclusion

Low vaccination percentages were seen in many US occupations by the end of May 2021, early in the period of widespread availability of vaccines for adults. These findings could help inform the deployment of occupation‐specific vaccinepromotion activities during future viral epidemics and pandemics.

Fear of Illness and Convenient Access to Vaccines Appear to Be the Missing Keys to Successful Vaccination Campaigns: Analysis of the Factors Influencing the Decisions of Hospital Staff in Poland concerning Vaccination against Influenza and COVID-19

The COVID-19 pandemic has lasted for two years as of 2022, and it is common knowledge that vaccines are an essential tool to mitigate the health, economic, and social fallout. Unfortunately, vaccine hesitancy is still a serious global problem, both in the general population and among healthcare workers. The authors used an original questionnaire to conduct an anonymous survey study in the University Clinical Hospital in Wrocław, Poland, in April and May of 2021 after acquiring consent from the Medical University of Wrocław, Poland Bioethical Committee. The study results demonstrate that, to a significant extent, the decisions concerning vaccinations are based on factors that are difficult to change with rational argumentation, including people’s personal opinions or beliefs concerning vaccinations and their earlier experiences with vaccinations. The study results suggest that the impregnating effect of one’s own opinions, beliefs, and experiences can be surmounted if vaccines are dispensed free and conveniently while the pathogen is irrationally and emotionally perceived as untamed and possibly severe and life threatening. It makes a significant difference as in such cases that the percentage of participants whose decisions concerning vaccination are influenced by the risks to life or health of one’s own or others rises by about 27 and 36 percent points, respectively. Therefore, in order to succeed, campaigns for vaccinations need to include strong subjective and emotional communication, appealing to negative emotions and exploiting the public’s fear of the unknown while stressing tangible and personal threats possibly resulting from acquiring a vaccine-preventable infectious disease.

Knowledge about COVID-19 and vaccine acceptability among priority groups defined for vaccination: a Cross-sectional study in Araba/Alava, Spain, before the vaccination against SARS-CoV-2

Background

The acceptability of COVID-19 vaccine varies depending on the time, place, type of vaccine and information available at the time. Knowledge of attitudes and practices towards COVID-19 among the population at high risk of developing the disease would help to tailor the strategy to improve adherence to vaccination recommendations.

Aim

To analyze the willingness, knowledge and risk perception of patients and health care workers (HCW) to get the vaccines against SARS-CoV-2.

Methods

Cross-sectional survey in Araba/Álava province (Spain). Subjects who met the criteria for the influenza vaccination in 2019 and HCWS from the Basque Public Health Service were included. The participants answered a questionnaire on the knowledge, attitudes and practices towards COVID-19 before starting vaccination against SARS-CoV-2. The intention to vaccinate was compared using the chi-squared test.

Results

316 HCWs and 389 patients responded to the survey. Around 90% of the patients and 80% of HCW would accept vaccination in all scenarios according to the questionnaire (p < 0.001). Only 3–12% hesitated about the COVID-19 vaccines. Compared to 40–70% of patients, 60–80% of HCWs perceived a high risk of COVID-19 (p < 0.001). Statistically significant differences were found in 10 of the 17 questions regarding the mechanism of transmission and symptoms.

Conclusion

HCWs had a better knowledge and risk perception of COVID-19 than the surveyed patients. They had a higher proportion of hesitancy to get COVID-19 vaccine, probably related to doubts about the effectiveness of the new vaccines and the scientific evidence.

Vaccine hesitancy in American healthcare workers during the COVID-19 vaccine roll out: an integrative review

OBJECTIVE

The purpose of this integrative review is to examine the literature on vaccine hesitancy among American healthcare workers during the COVID-19 vaccine rollout.

METHODS

A review of quantitative literature on acceptance, intention, refusal, or hesitation to accept the COVID-19 vaccine was conducted, searching in PubMed, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, and Web of Science. Because of the immediacy of the topic, research letters were included in addition to articles. The 18 publications were appraised for quality using the Critical Appraisal Checklist for Cross-Sectional Studies by the Center for Evidence-Based Management.

RESULTS

Estimates of vaccine hesitancy among healthcare workers were similar to the general population. The literature indicates demographic characteristics associated with vaccine hesitancy, including being younger, female, Black, Hispanic, or Latinx. However, examination of the demographic data also points to gaps in the understanding and implications of those characteristics. The newness or perceived rush of vaccine development and implementation were the most cited sources for hesitancy.

CONCLUSION

The studies in this review give clear areas of need for translational research on dissemination and implementation relating to the correlational data, including in areas of comorbid, diasporic, and reproductive health concerns. However, with the gravity of the pandemic and quick arrival of the COVID-19 vaccine happening in the midst of an infodemic, adjunctive interventions could be warranted to combat hesitancy.

Factors associated to acceptance and willingness to pay for COVID vaccine in Nepal

Introduction

Corona virus disease (COVID-19) remains pandemic globally. Vaccination is considered one of the best means to control both morbidity and mortality of COVID-19. The study aims to find out the people's acceptance and willingness to pay for it.

Methods

The study used cross-sectional survey design. Data were collected using a survey questionnaire from 1072 respondents (age 20-60 years) from 14 districts of Nepal. Socio-demographic characteristics of the respondents were independent and acceptance of vaccine was the dependent variable.

Results

The study found that 84% of the respondents accepted the COVID vaccine. Only one out of six did not accept the COVID vaccine while 16% of the respondents stated that they would like to pay for the COVID vaccination. The average willingness to pay (WTP) for vaccination was NRs. 1053 (US$ 9) while median and mode remained the same NRs. 500. The middle age groups (30-49 years), respondents belonged to Madhesi, business people in terms of occupation and the respondents who had completed school level education had a higher acceptance rate than other categories. It was observed that place of residence in terms of provinces or districts, age group, caste/ethnicity, and educational level of the respondents were significantly associated with the acceptance of the COVID vaccine. Moreover, respondents residing from Lumbini Province, age group of 30-39 years, and having secondary or higher education were noticed as more likely to accept the COVID vaccine than the respective compared groups.

Conclusion

Appropriate information, education and communication needs to disseminate to minimize the misinformation about the COVID and lack of trust in vaccine that may lead to low acceptance and poor WTP for vaccine. These findings could be considered while making COVID and the COVID vaccine-related interventions.

New Wave of COVID-19 Vaccine Opinions in the Month the 3rd Booster Dose Arrived

Vaccination has been proposed as one of the most effective methods to combat the COVID-19 pandemic. Since the day the first vaccine, with an efficiency of more than 90%, was announced, the entire vaccination process and its possible consequences in large populations have generated a series of discussions on social media. Whereas the opinions triggered by the administration of the initial COVID-19 vaccine doses have been discussed in depth in the scientific literature, the approval of the so-called 3rd booster dose has only been analyzed in country-specific studies, primarily using questionnaires. In this context, the present paper conducts a stance analysis using a transformer-based deep learning model on a dataset containing 3,841,594 tweets in English collected between 12 July 2021 and 11 August 2021 (the month in which the 3rd dose arrived) and compares the opinions (in favor, neutral and against) with the ones extracted at the beginning of the vaccination process. In terms of COVID-19 vaccination hesitance, an analysis based on hashtags, n-grams and latent Dirichlet allocation is performed that highlights the main reasons behind the reluctance to vaccinate. The proposed approach can be useful in the context of the campaigns related to COVID-19 vaccination as it provides insights related to the public opinion and can be useful in creating communication messages to support the vaccination campaign.

Which hospital workers do (not) want the jab? Behavioral correlates of COVID-19 vaccine willingness among employees of Swiss hospitals

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.

Concerns, attitudes, and intended practices of Caribbean healthcare workers concerning COVID-19 vaccination: A cross-sectional study

BACKGROUND

The Caribbean has a long history of being a global leader in immunization, and one factor contributing to this success has been the commitment of healthcare workers in promoting the benefits of vaccines. Healthcare workers play a critical role in building trust between the public and the immunization program and are generally cited as the most trusted source of information on vaccination. Healthcare workers themselves, therefore, must be confident in vaccination as a public health good and able to transmit this confidence to those who trust them. However, just as with the general public, healthcare workers develop confidence at different rates and may be susceptible to misinformation about vaccines.

METHODS

During April and May 2021, the Pan American Health Organization (PAHO) conducted a mixed-methods survey to assess vaccination attitudes, opinions, and reasoning of 1197 healthcare workers across 14 Caribbean countries.

FINDINGS

Seventy-seven percent of respondents expressed clear intention to be vaccinated for COVID-19 as soon as possible. Intention to be vaccinated as soon as possible was expressed by lower proportions of nurses (66%) and allied health professionals (62%) than physicians (85%) and by younger respondents than older ones (64% vs. 85%, respectively; p < 0.001 for all these comparisons). Across 32 questions about attitudes and opinions, vaccine hesitancy was consistently expressed by higher proportions of nurses and allied health professionals than physicians and by younger respondents than older ones.

INTERPRETATION

Insights from the survey are helping PAHO address healthcare worker concerns with informative messages and supporting countries in policy development to increase vaccine confidence and coverage among Caribbean healthcare workers.

FUNDING

This work has been sponsored by the World Health Organization/Pan American Health Organization, the Government of Germany and The Gavi Alliance.

Addressing hesitancy to COVID-19 vaccines in healthcare assistants

COVID-19 vaccination rates have been suboptimal in frontline healthcare assistants (HCAs). We sought to characterize contributors to COVID-19 vaccine hesitancy among HCAs. We conducted an analysis of online survey responses from members of the National Association of Health Care Assistants from December 2020-January 2021. Respondents were asked what it would take for them to be vaccinated against COVID-19. Responses from 309 HCAs were coded to characterize respondents' willingness to be vaccinated and identify contributors to vaccine hesitancy. Approximately 60% (n = 185) of HCAs expressed hesitancy but would consider getting vaccinated under certain circumstances. We identified 8 overarching themes for contributors to COVID-19 vaccine hesitancy, the most common being safety concerns (70% of respondents). Others included efficacy (11.4%), workplace requirements (9.7%), societal influence (9.2%), and compensation (8.1%). Interventions to increase vaccine uptake among HCAs may be most effective by addressing concerns regarding the short-term and long-term safety implications of COVID-19 vaccines.

Medical factors associated with caregiver intention to vaccinate their children against COVID-19

OBJECTIVE

To describe medical factors that are associated with caregiver intention to vaccinate their children against COVID-19.

METHODS

We conducted a cross-sectional study of families receiving primary care in a mid-Atlantic pediatric healthcare system, linking caregiver-reported data from a survey completed March 19 to April 16, 2021 to comprehensive data from the child's EHR.

RESULTS

513 families were included (28% Black, 16% Hispanic, 44% public insurance, 21% rural, child age range 0-21 years). 44% of caregivers intended to vaccinate their children against COVID-19, while 41% were not sure and 15% would not. After adjusting for socio-demographics, the only medical factors that were associated with caregiver COVID-19 vaccine hesitancy were caregiver COVID-19 vaccination status at the time of the survey (aOR 3.0 if the caregiver did not receive the vaccine compared to those who did, 95% CI 1.7-5.3) and child seasonal influenza immunization history (aOR 3.3 if the child had not received the influenza vaccine in the 2020-2021 season compared to those who did, 95% CI 2.0-5.4). Other medical factors, including family medical experiences with COVID-19, other child immunization history, child health conditions like obesity and asthma, and family engagement with the healthcare system were not associated with caregiver intention to vaccinate their children against COVID-19.

CONCLUSIONS

This study highlights important factors, such as general attitudes towards vaccines and understanding of COVID-19 morbidity risk factors, that healthcare providers should address when having conversations with families about the COVID-19 vaccine.

Factors Associated With Psychological Outcomes Among Vaccinated and Unvaccinated Health Care Workers Against COVID-19 Infection in Bangladesh

Background

Vaccination of healthcare workers (HCWs) is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their patients, as well as to encourage their patients to get immunized. The present study aimed to investigate the psychological outcomes and associated factors among vaccinated and unvaccinated HCWs against COVID-19 infection in Bangladesh.

Methods

From March to August 2021, an online nationwide survey was conducted with a total of 2,038 Bangladeshi HCWs. The frequency of symptoms of general health problems, depression, anxiety, stress, post-traumatic stress disorder, insomnia, and loneliness was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and UCLA-LS scales, respectively.

Results

Compared with unvaccinated HCWs (n = 1,058), vaccinated HCWs (n = 980) had a statistically significant lower prevalence of general health problems (16.7 vs. 59.1%), depression (15.6 vs. 31.9%), post-traumatic stress disorder (22.3 vs. 30.8%), insomnia (23.8 vs. 64.9%), and loneliness symptoms (13.9 vs. 21.8%). Among vaccinated HCWs, females were significantly associated with a higher risk of symptoms of general health problems (AOR, 2.71; 95% CI, 0.97-7.60), anxiety (AOR, 2.17; 95% CI, 1.14-4.13), and loneliness (AOR, 2.52; 95% CI, 1.11-5.73). Except for anxiety and post-traumatic stress disorder symptoms, participants living in urban areas had a significantly lower risk of all psychological outcomes (e.g., depression: AOR, 0.43; 95% CI, 0.27-0.67; stress: AOR, 0.64; 95% CI, 0.47-0.88). Respondents who were married were significantly less likely to experience symptoms of general health problems (AOR, 0.10; 95% CI, 0.02-0.39), depression (AOR, 0.31; 95% CI, 0.22-0.82), insomnia (AOR, 0.46; 95% CI, 0.20-1.03), and loneliness (AOR, 0.31; 95% CI, 0.10-0.92). Participants who worked as doctors were significantly less chance of experiencing symptoms of general health problems (AOR, 0.18; 95% CI, 0.08-0.37), depression (AOR, 0.51; 95% CI, 0.30-0.87), and anxiety (AOR, 0.54; 95% CI, 0.37-0.78). On the other hand, unvaccinated HCWs who were 18-29 years old and had <5 years of work experience were significantly associated with a higher risk of all psychological outcomes except anxiety and insomnia symptoms (e.g., depression among 18-29 years old: AOR, 1.83; 95% CI, 0.27-2.60; stress among those with <5 years of work experience: AOR, 2.37; 95% CI, 0.93-6.07). Participants who worked as nurses were significantly more likely to suffer from depression (AOR, 1.44; 95% CI, 0.84-2.46), anxiety (AOR, 1.42; 95% CI, 0.24-1.73), and stress (AOR, 1.55; 95% CI, 0.31-0.89) symptoms. Except for anxiety and stress symptoms, respondents who worked as frontline workers and provided direct care to infected patients were the significantly higher chance of experiencing all psychological outcomes (e.g., depression among who worked as frontline workers: AOR, 2.41; 95% CI, 0.23-3.73; insomnia among those who provide direct care to infected patients: AOR, 2.60; 95% CI, 0.34-3.06). Participants who were infected with COVID-19 had a significantly less chance of experiencing symptoms of general health problems (AOR, 0.89; 95% CI, 0.65-1.22), depression (AOR, 0.66; 95% CI, 0.48-0.92), and anxiety (AOR, 0.63; 95% CI, 0.46-0.87).

Conclusions

To control the infection and improve psychological outcomes, this study suggests emphasizing the vaccinated to unvaccinated HCWs as soon as possible. They also required special attention, health-related education, and psychological support.

Healthcare workers' perceptions and attitudes towards the UK's COVID-19 vaccination programme: a rapid qualitative appraisal

OBJECTIVES

While there is research relating to perceptions of vaccines among healthcare workers (HCWs), the evidence base in relation to COVID-19 remains limited. The aim of this study was to explore HCWs' perceptions and attitudes towards vaccines and the COVID-19 vaccination programme in the UK, including their expectations and views on promoting vaccination to others.

DESIGN

This study was designed as a rapid qualitative appraisal, integrating data from a review of UK policies and guidance on COVID-19 vaccination with data from in-depth semistructured telephone interviews with frontline HCWs in the UK. Data were analysed using framework analysis.

PARTICIPANTS

Interviews were carried out with a purposive sample of HCWs from two large London-based hospital Trusts (n=24) and 24 government policies, and guidelines on the vaccination programme were reviewed.

RESULTS

The level of uncertainty about the long-term safety of vaccines and efficacy against mutant strains made it difficult for HCWs to balance the benefits against the risks of vaccination. HCWs felt that government decisions on vaccine rollout had not been supported by evidence-based science, and this impacted their level of trust and confidence in the programme. The spread of misinformation online also impacted HCWs' attitudes towards vaccination, particularly among junior level and black, Asian and minority ethnic (BAME) HCWs. Most HCWs felt encouraged to promote vaccination to their patients, and the majority said they would advocate vaccination or engage in conversations about vaccination with others when relevant.

CONCLUSION

In order to improve HCWs' trust and confidence in the UK's COVID-19 vaccination programme, there needs to be clarity about what is known and not known about the vaccines and transparency around the evidence-base supporting government decisions on vaccine rollout. Effort is also needed to dispel the spread of vaccine-related misinformation online and to address specific concerns, particularly among BAME and junior-level HCWs.

Healthcare workers' perceptions and attitudes towards the UK's COVID-19 vaccination programme: a rapid qualitative appraisal

OBJECTIVES

While there is research relating to perceptions of vaccines among healthcare workers (HCWs), the evidence base in relation to COVID-19 remains limited. The aim of this study was to explore HCWs' perceptions and attitudes towards vaccines and the COVID-19 vaccination programme in the UK, including their expectations and views on promoting vaccination to others.

DESIGN

This study was designed as a rapid qualitative appraisal, integrating data from a review of UK policies and guidance on COVID-19 vaccination with data from in-depth semistructured telephone interviews with frontline HCWs in the UK. Data were analysed using framework analysis.

PARTICIPANTS

Interviews were carried out with a purposive sample of HCWs from two large London-based hospital Trusts (n=24) and 24 government policies, and guidelines on the vaccination programme were reviewed.

RESULTS

The level of uncertainty about the long-term safety of vaccines and efficacy against mutant strains made it difficult for HCWs to balance the benefits against the risks of vaccination. HCWs felt that government decisions on vaccine rollout had not been supported by evidence-based science, and this impacted their level of trust and confidence in the programme. The spread of misinformation online also impacted HCWs' attitudes towards vaccination, particularly among junior level and black, Asian and minority ethnic (BAME) HCWs. Most HCWs felt encouraged to promote vaccination to their patients, and the majority said they would advocate vaccination or engage in conversations about vaccination with others when relevant.

CONCLUSION

In order to improve HCWs' trust and confidence in the UK's COVID-19 vaccination programme, there needs to be clarity about what is known and not known about the vaccines and transparency around the evidence-base supporting government decisions on vaccine rollout. Effort is also needed to dispel the spread of vaccine-related misinformation online and to address specific concerns, particularly among BAME and junior-level HCWs.

Factors Associated with Parental Acceptance of COVID-19 Vaccination: A Multicenter Pediatric Emergency Department Cross-sectional Analysis

Study objective

During the delta surge of the COVID-19 pandemic in 2021, we sought to identify characteristics and beliefs associated with COVID-19 vaccination acceptance in parents of pediatric emergency department (ED) patients.

Methods

We conducted a cross-sectional survey-based study of the parents of children aged 3 to 16 years presenting to 1 of 9 pediatric EDs from June to August 2021 to assess the parental acceptance of COVID-19 vaccines. Using multiple variable regression, we ascertained which factors were associated with parental and pediatric COVID-19 vaccination acceptance.

Results

Of 1,491 parents approached, 1,298 (87%) participated, of whom 50% of the parents and 27% of their children aged 12 years or older and older were vaccinated. Characteristics associated with parental COVID-19 vaccination were trust in scientists (adjusted odds ratio [aOR] 5.11, 95% confidence interval [CI] 3.65 to 7.15), recent influenza vaccination (aOR 2.66, 95% CI 1.98 to 3.58), college degree (aOR 1.97, 95% CI 1.36 to 2.85), increasing parental age (aOR 1.80, 95% CI 1.45 to 2.22), a friend or family member hospitalized because of COVID-19 (aOR 1.34, 95% CI 1.05 to 1.72), and higher income (aOR 1.60, 95% CI 1.27 to 2.00). Characteristics associated with pediatric COVID-19 vaccination (children aged ≥12 years) or intended COVID-19 pediatric vaccination, once approved for use, (children aged <12 years) were parental trust in scientists (aOR 5.37, 95% CI 3.65 to 7.88), recent influenza vaccination (aOR 1.89, 95% CI 1.29 to 2.77), trust in the media (aOR 1.68, 95% CI 1.19 to 2.37), parental college degree (aOR 1.49, 95% CI 1.01 to 2.20), and increasing parental age (aOR 1.26, 95% CI 1.01 to 1.57).

Conclusion

Overall COVID-19 vaccination acceptance was low. Trust in scientists had the strongest association with parental COVID-19 vaccine acceptance for both themselves and their children.

Systematic Review and Meta-Analysis of COVID-19 Vaccination Acceptance

INTRODUCTION

Vaccination is an essential intervention to curb the coronavirus disease 2019 (COVID-19) pandemic. This review aimed to estimate the pooled proportion of COVID-19 vaccine acceptance worldwide.

METHODS

A systematic search of the MEDLINE (PubMed) database using "COVID-19," "vaccine" and "acceptance" to obtain original research articles published between 2020 and July 2021. Only studies with full text and that were published in English were included. The Joanna Briggs Institute meta-analysis was used to assess the data quality. The meta-analysis was performed using generic inverse variance with a random-effects model using the Review Manager software.

RESULTS

A total of 172 studies across 50 countries worldwide were included. Subgroup analyses were performed with regard to vaccine acceptance, regions, population, gender, vaccine effectiveness, and survey time. The pooled proportion of COVID-19 vaccine acceptance was 61% (95% CI: 59, 64). It was higher in Southeast Asia, among healthcare workers, in males, for vaccines with 95% effectiveness, and during the first survey.

CONCLUSION

COVID-19 vaccine acceptance needs to be increased to achieve herd immunity to protect the population from the disease. It is crucial to enhance public awareness of COVID-19 vaccination and improve access to vaccines.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2021, identifier CRD42021268645.

Acceptability of COVID-19 Vaccine Among Hospital Employees in the Department of Paediatrics, Gynaecology and Obstetrics in the University Hospitals of Geneva, Switzerland

Background and Aims

COVID-19 vaccination has been in the spotlight for almost a year now, both within the scientific community and in the general population. The issue of healthcare workers' (HCWs) hesitancy is particularly salient, given that they are at the forefront of the fight against COVID-19. Not only could unvaccinated HCW spread the disease, but HCWs are also critical messengers in building confidence towards COVID-19 vaccines. The goal of this study was to examine the perception of COVID-19 risk and of its vaccine acceptance among employees (i.e., HCW plus administrative staff) in the Department of Paediatrics, Gynaecology and Obstetrics at the University Hospitals of Geneva, for the purpose of drawing lessons on the determinants of vaccination morale.

Methods

We conducted an anonymous online survey comparing vaccination attitudes among vaccinated and unvaccinated workers in June 2021. It included questions on perception of COVID-19 risks and COVID-19 vaccines. Vaccination was not mandatory in our institution but was strongly recommended.

Results

In June 2021, 66% of the 1,800 employees of our department had received two doses of COVID-19 vaccine by the time of the survey. Among the employees, 776 participated (43%) to the survey, and among them 684 (88%) had chosen to be vaccinated. Participants working for longer in a hospital, with a chronic disease and a household contact with chronic disease were more likely to be vaccinated. Doctors were twice as likely to be vaccinated than nurses. Among unvaccinated hospital employees, 48 (52%) responded that they would not change their mind. Further, 35 (38%) were not feeling in danger of contracting severe COVID-19, and 32 (35%) had fears about possible side effects of COVID-19 vaccines that they wanted to discuss with a specialist.

Conclusion

Our study indicates that, while two-third of the employees had been vaccinated, quite many were still hesitant. The unvaccinated explained their choice by not feeling at risk of complicated COVID-19, and because of fear of possible side effects associated with the vaccine. Investments in COVID-19 vaccine education is a critical component for increasing vaccine acceptance among the unvaccinated.

Assesment of Physicians’ Attitudes Towards COVID-19 Vaccine

Objective: The aim of this study is to physicians attitudes towards the COVID-19 vaccine. Methods: Our research is a cross-sectional study, which was conducted between January 4th and February 26th, 2021. A Google Forms questionnaire was prepared according to the literature. The first part of the two-part questionnaire included the sociodemographic characteristics of the physicians and some variables thought to be related to COVID-19. In the second part, questions from the “Attitudes Towards COVID-19 Vaccine Scale (ATCVS)” were included. Multiple linear regression analysis with variables that were significant in univariate analysis was used for further analysis. Results: Three hundred fifteen (71.9%) of a total of 438 participants stated that they were assigned to units related to COVID-19 during the pandemic. With more than 10 years of work in the profession, physicians had a more positive attitude towards vaccination than those with 1 – 5 years’ experience. Most of the physicians reported that there were insufficient studies on these newly developed vaccines. Possible adverse effects, uncertainty about the efficacy and safety of the vaccine, and beliefs that people are not at risk for severe disease were prominent. Conclusions: Despite all the uncertainties about the efficacy, safety, and long-term adverse effects of newly developed COVID vaccines, it was determined that 79% of the physicians approached the vaccine positively. The most important reason for vaccine hesitation was the insufficient studies about COVID-19 vaccines.

Covid-19 Vaccine Acceptance and Determinant Factors among General Public in East Africa: A Systematic Review and Meta-Analysis

Background

Vaccines are an effective and ideal solution that can reduce the burden of disease worldwide. Although vaccines are the most effective way to prevent infectious diseases. Anti-vaccine conspiracy theories impair vaccination acceptance intentions. Several studies were conducted in East Africa. However, these studies had reported inconsistent findings. Therefore, this systematic review aimed to pool the prevalence of COVID-19 vaccine acceptance and identify its determinants.

Methods

PubMed, Google Scholar, and GLOBAL HEALTH databases were used to retrieve previously published studies. All papers published in the English language up to February 28, 2022 were included. The result was written and reported according to the PRISMA updated guideline. A random-effect model was used to estimate the pooled prevalence and effect sizes. Heterogeneity was assessed using I² test statistics. Publication bias was assessed using funnel plot and egger’s test statistics. Statistical tests result at P-value<0.05 were declared as having significance.

Result: A total of 25 Cross-sectional studies with a total sample size of 33,044 were included in this study. The pooled prevalence of Covid-19 vaccine acceptance was 60.2%, (95%CI: 52.8- 67.3). Egger’s test statistics (P = 0.003) showed there is a significant publication bias. Attending above secondary school (AOR: 2.1, 95%CI: 1.37, 2.96), having good knowledge about the vaccine (AOR: 2.1, 95%CI: 1.6, 2.8), having a positive attitude towards vaccine (AOR: 3.8, 95%CI: 2.3, 6.2), history of COVID-19 infection (AOR: 2.7, 95%CI: 1.6, 4.7) and being male (AOR: 1.8, 95%CI: 1.2, 2.7) were found to have a significant association with COVID-19 vaccine acceptance.

Conclusion

The COVID-19 vaccination acceptance rate was good, but it could be improved. The findings could help governments to figure out the best way to carry out COVID-19 mass vaccination campaigns. There is a lack of data in most countries. Therefore, we suggest more studies be conducted in the future.

Perceived COVID-19 vaccine effectiveness, acceptance, and drivers of vaccination decision-making among the general adult population: A global survey of 20 countries

Background

Mass vaccination campaigns have significantly reduced the COVID-19 burden. However, vaccine hesitancy has posed significant global concerns. The purpose of this study was to determine the characteristics that influence perceptions of COVID-19 vaccine efficacy, acceptability, hesitancy and decision making to take vaccine among general adult populations in a variety of socioeconomic and cultural contexts.

Methods

Using a snowball sampling approach, we conducted an online cross-sectional study in 20 countries across four continents from February to May 2021.

Results

A total of 10,477 participants were included in the analyses with a mean age of 36±14.3 years. The findings revealed the prevalence of perceptions towards COVID-19 vaccine’s effectiveness (78.8%), acceptance (81.8%), hesitancy (47.2%), and drivers of vaccination decision-making (convenience [73.3%], health providers’ advice [81.8%], and costs [57.0%]). The county-wise distribution included effectiveness (67.8–95.9%; 67.8% in Egypt to 95.9% in Malaysia), acceptance (64.7–96.0%; 64.7% in Australia to 96.0% in Malaysia), hesitancy (31.5–86.0%; 31.5% in Egypt to 86.0% in Vietnam), convenience (49.7–95.7%; 49.7% in Austria to 95.7% in Malaysia), advice (66.1–97.3%; 66.1% in Austria to 97.3% in Malaysia), and costs (16.0–91.3%; 16.0% in Vietnam to 91.3% in Malaysia). In multivariable regression analysis, several socio-demographic characteristics were identified as associated factors of outcome variables including, i) vaccine effectiveness: younger age, male, urban residence, higher education, and higher income; ii) acceptance: younger age, male, urban residence, higher education, married, and higher income; and iii) hesitancy: male, higher education, employed, unmarried, and lower income. Likewise, the factors associated with vaccination decision-making including i) convenience: younger age, urban residence, higher education, married, and lower income; ii) advice: younger age, urban residence, higher education, unemployed/student, married, and medium income; and iii) costs: younger age, higher education, unemployed/student, and lower income.

Conclusions

Most participants believed that vaccination would effectively control and prevent COVID-19, and they would take vaccinations upon availability. Determinant factors found in this study are critical and should be considered as essential elements in developing COVID-19 vaccination campaigns to boost vaccination uptake in the populations.

This large-scale multi-country study explores perceived COVID-19 vaccine effectiveness, acceptability, and hesitancy rates and their related factors among the general adult populations from 20 countries. We found that a considerable proportion of the participants has an intention to receive the COVID-19 vaccine. However, more than half still expressed their hesitancy to receive the vaccines. Countries where the majority of respondents responded that they would accept COVID-19 vaccination included Malaysia (96.0%), Bangladesh (93.6%), and Iraq (91.8%). The majority of the participants from Vietnam (86.0%) and Turkey (74.7%) expressed hesitance to receive COVID-19 vaccine. Perceived vaccine effectiveness ranged from 67.8% in Egypt to 95.9% in Malaysia. The participants believed that convenience, health providers’ advice, and costs of vaccines are important for people to decide whether to accept COVID-19 vaccines. Country of residence, age, sex, level of education, area of residence, marital status, and family economic status were significantly associated with tendency to undergo COVID-19 vaccination and the perception that COVID-19 vaccine decision-making is influenced by convenience. The findings of this study provide useful guidance for tailored interventions to enhance the acceptance of COVID-19 vaccine. Promotional program addressed on detected socioeconomic factors is warranted.

COVID-19 vaccine acceptance among healthcare workers in India: Results from a cross-sectional survey

Remarkable scientific progress has enabled expeditious development of effective vaccines against COVID-19. While healthcare workers (HCWs) have been at the frontline of the pandemic response, vaccine acceptance amongst them needs further study. We conducted a web-based survey to assess vaccine acceptance among HCWs in India between January and February 2021, shortly after the launch of India's vaccination campaign. Descriptive statistics were used to examine respondent demographics and Likert scale responses. Binomial logistic regression analyses were used to identify factors associated with vaccine acceptance. The survey yielded 624 respondents from 25 states and five union territories in India; 53.5% were male, and median age was 37 years (IQR 32-46). Amongst all respondents, 84.1% (525/624) supported COVID-19 vaccines, and 63.2% (141/223) of those unvaccinated at the time of survey administration were willing to accept a vaccine. Trust in government sources, healthcare providers or scientific journal articles for COVID-19 related information was reported by 66.8%, while confidence in social media for this information was reported by only 4.5%. Amongst those who had not yet received a COVID-19 vaccine, factors independently associated with vaccine acceptance included age (aOR 3.50 [95% CI, 1.04-11.76] for those above 45 years compared to younger HCWs aged 18-29 years), belief in vaccine effectiveness and safety (aOR 3.78 [95% CI 1.15-12.38]), and provision of free/no-cost vaccine (aOR 2.63 [95% CI, 1.06-6.50]). Most respondents (80%) were confident about their hospital being equipped to efficiently rollout COVID-19 vaccines to the general population. While overall attitudes towards COVID-19 vaccination were positive among HCWs in India, acceptance was lower among healthier and younger HCWs. Data availability on vaccine safety and effectiveness, and cost considerations were important for acceptance. Targeted interventions are needed to improve vaccine acceptance amongst HCWs, since they are critical in promoting vaccine acceptance amongst the general population.

COVID-19 Vaccination Acceptance among Healthcare Workers and General Population at the Very Beginning of the National Vaccination Program in Poland: A Cross-Sectional, Exploratory Study

The aim of the study was to assess the acceptance level of COVID-19 vaccination among healthcare workers (HCW) and the general population in Poland at the start of the national COVID-19 vaccination program from 18-31 December 2020. A cross-sectional anonymous survey was conducted in a group of 1976 people: 1042 health professionals and 934 non-medical professionals using an on-line questionnaire. The most skeptical about the COVID-19 vaccine were students of non-medical faculties, non-medical professions, and administrative-technical health service staff (26.2%, 38.7% and 41.2%, respectively). The most positive attitude to vaccination was reported by doctors, medical students and pharmacists (80.6%, 76.9% and 65.7%, respectively). Doctors (64.7%) and medical students (63.7%) most often declared confidence in vaccines compared to nurses (34.5%). Distrust about vaccine safety was declared by nurses (46.6%) and pharmacists (40.0%). HCW encouraged others to vaccinate more eagerly (65.8%) than non-medical professions (28.3%). Thus, a considerable proportion of HCW in Poland expressed concern about vaccines just prior to the beginning of the COVID-19 immunization program. The significant decrease in the willingness to vaccinate observed in Poland towards the end of 2021 must be considered in the light of the serious COVID-19 vaccination hesitancy in the Polish population.

Sociodemographic Predictors Associated with the Willingness to Get Vaccinated against COVID-19 in Peru: A Cross-Sectional Survey

During the race for the development of a vaccine against COVID-19, even before its commercialization, part of the population has already shown a growing fear of its application. We designed an analytical cross-sectional study using an anonymous survey in the 25 departments of Peru. We surveyed whether the participants were planning on getting vaccinated, as well as other characteristics that were cross-checked in a uni-, bi- and multivariate manner. Of the 1776 respondents, 70% (1251) stated that they were planning to be vaccinated, 20% (346) did not know yet or doubted it, and 10% (179) did not want to be vaccinated. We observed that those who did not get infected with COVID-19 exhibited a higher frequency to not wanting or were uncertain about getting vaccinated (aPR: 1.40; 95% CI: 1.09-1.81; p-value = 0.008). In contrast, there was a lower frequency of vaccine refusal among university students (aPR: 0.75; 95% CI: 0.61-0.92; p-value = 0.005) and healthcare workers (aPR: 0.59; 95% CI: 0.44-0.80; p-value = 0.001); adjusted by place of residence. There is still an important percentage of respondents who do not want to be vaccinated or are hesitant to do it, which was associated with educational level, being a healthcare worker and if they were previously infected with COVID-19. Our results could offer useful information about COVID-19 vaccination campaigns.