Walking the Tightrope: Reevaluating science communication in the era of COVID-19 vaccines

Changes in vaccine attitudes and recommendations among US Healthcare Personnel during the COVID-19 pandemic

A recommendation from healthcare personnel (HCP) is a strong predictor of vaccination. This study aimed to measure how HCP vaccine attitudes and recommendations changed during the COVID-19 pandemic. HCP were surveyed in January 2023 using a double opt-in network panel. Survey responses were summarized and stratified by HCP type and COVID-19 booster status. Multivariable logistic regression models were fitted. Comparisons were made to a September 2021 survey, with differences tested for significance (p < 0.05) using Pearson's χ2 Test. Nearly 82% of the 1207 HCP surveyed had received a COVID-19 booster, most commonly pediatricians (94%), followed by family medicine doctors (87%), pharmacists (74%), and nurses (73%) (p < 0.01). HCP with high trust in the Centers for Disease Control and Prevention (CDC) had nearly 6 times the odds (OR: 5.5; 95%CI: 3.9-7.7) of being boosted compared to HCP with low trust. From September 2021 to January 2023, the proportion of HCP recommending vaccines (COVID-19 and routine) to their patients decreased substantially for nearly all vaccines and patient populations specified. Trust in CDC also decreased (from 79 to 73%, p < 0.01), as did support for HCP COVID-19 vaccine mandates (from 65 to 46%, p < 0.01). HCP interest in additional online resources to improve their vaccine discussions with patients increased from 46 to 66% (p < 0.01). Additional regularly updated online resources from trusted medical sources that clarify progressing science and address dynamic public concerns are needed to improve vaccine confidence among HCP and help them support their patients' decision-making.

COVID-19 vaccination attitudes, values, intentions: US parents for their children, September 2021

OBJECTIVES

To compare vaccine-related attitudes and values of parents of children 2-17 years old to other adults, examine intentions to vaccinate their children, and identify factors associated with intending to vaccinate children.

METHODS

A nationally representative survey was conducted in September 2021 (just before the EUA for children 5-11 years old) using Ipsos KnowledgePanel, a probability-based web panel. The survey measured COVID-19 vaccination status, intentions, attitudes, values, and trust in public health authorities among US adults. Scale response options to survey items were dichotomized, and cross-tabulations and logistic regressions were performed.

RESULTS

Parents had lower odds of reporting being vaccinated against COVID-19 than other adults even after adjusting for associated sociodemographic characteristics such as age (aOR: 0.66; 95 %CI: 0.50-0.87). The most prevalent parental concerns about COVID-19 vaccines included the speed of their development (88 %), potential side effects (78 %), suspicion of government (77 %), and suspicion of pharmaceutical companies (72 %). Fewer than half (42 %) of parents intended to vaccinate their children 5-11 years old, while 38 % were uncertain and 20 % were unlikely to ever vaccinate their children. Vaccinated parents had higher odds than unvaccinated parents of intending to vaccinate their children (OR: 675.51; 95 %CI: 106.46-4286.12). Discussions with healthcare providers who encouraged COVID-19 vaccination were positively associated with intent to vaccinate children (OR: 11.29; 95 %CI: 2.60-49.02).

CONCLUSIONS

We found parental vaccination and conversations with providers were positively associated with intent to vaccinate children. Decisions about childhood vaccination need to be supported by healthcare providers and a public health system that makes vaccine access and related information equitable and accessible. Vaccination-related decision making should be guided by healthcare providers and provide information about safety and risk to children.

Believing in science: Linking religious beliefs and identity with vaccination intentions and trust in science during the COVID-19 pandemic

Despite evidence supporting numerous scientific issues (e.g. climate change, vaccinations) many people still doubt the legitimacy of science. Moreover, individuals may be prone to scepticism about scientific findings that misalign with their ideological beliefs and identities. This research investigated whether trust in science (as well as government and media) and COVID-19 vaccination intentions varied as a function of (non)religious group identity, religiosity, religion-science compatibility beliefs, and/or political orientation in two online studies (N = 565) with university students and a Canadian community sample between January and June 2021. In both studies, vaccination intentions and trust in science varied as a function of (non)religious group identity and beliefs. Vaccine hesitancy was further linked to religiosity through a lack of trust in science. Given the ideological divides that the pandemic has exacerbated, this research has implications for informing public health strategies for relaying scientific findings to the public and encouraging vaccine uptake in culturally appropriate ways.

New trends in science communication fostering evidence-informed policymaking

This article aims to assess novel trends in science communication relating to how policymakers in the field of innovation and digitalisation policy consume and use scientific findings. We investigate the mutual influence that science communication and policy have on each other and answer the question how emerging science communication trends in the science-policy nexus might influence the use of scientific findings in the policymaking process. By using Google and the largest scholarly repositories, Google Scholar, ResearchGate, and Academia.edu, from 1 st March to 31 st May 2020, we reviewed policy documents and academic literature containing relevant information on the evolution of characteristics of global, European, and national science communication activities and the interrelated policy responses to identify the most relevant current trends in the evidence-to-policy process alongside three key challenges; trust, translation, and timing. The three identified main trends are (1) a stronger engagement between science and policy, (2) more open, reliable, and accountable science communication practices with policymakers, and (3) the increasing digitalisation and visualisation of science communication. We deepened our investigation by conducting online semi-structured interviews with relevant policy stakeholders at the international and national level between 1 st May and 31 st July 2020. With the support of the European Commission and building on the existing network of partners, we identified decision-makers and advisors with relevant experience in fields related to innovation and digitalisation policy working in four countries that represent different levels of generalized social trust: Austria, Italy, Hungary, and the Netherlands, and at the international/European Union level. After an online consultation process with a global set of policymakers, these theoretical findings were translated to policy recommendations showcasing possible solutions in science communication that may be initiated, strengthened, or continued by policy stakeholders in order to reach a more effective and efficient uptake of scientific findings in evidence-informed policymaking.

Attitudes and Values of US Adults Not Yet Up-to-Date on COVID-19 Vaccines in September 2022

(1) Background: Periodic resurgences in COVID-19 due to more contagious variants highlight the need to increase coverage of booster doses. (2) Methods: Our September 2022 nationally representative survey of US adults measured COVID-19 vaccination status, intentions, attitudes, values, and confidence in information sources. (3) Findings: Although 85% of the weighted sample reported receiving at least one dose of a COVID-19 vaccine, only 63% reported being up-to-date on COVID-19 vaccines (e.g., received a booster dose). Only 12% of those not yet up-to-date indicated they were likely to get up-to-date as soon as possible, whereas 42% were unlikely to ever get up-to-date, and 46% were still uncertain. Most of those not up-to-date on their COVID-19 vaccines were under 45 years of age (58%), without a bachelor's degree (76%), making under $75,000 annually (53%), and Republican or Independent (82%). Prevalent concerns about COVID-19 vaccines among those uncertain about getting up-to-date included: potential side effects that have not been figured out yet (88%), speed of development (77%), newness (75%), ingredients (69%), drug companies making money (67%), allergic reactions (65%), and experimenting on people (63%). (4) Conclusions: Nearly half of adults not yet up-to-date on COVID-19 vaccines were uncertain about doing so, indicating an opportunity to support their decision-making.

Make it or break it: On-time vaccination intent at the time of Covid-19

On-time effective vaccination is critical to curbing a pandemic, but this is often hampered by citizens' hesitancy to get quickly vaccinated. This research concentrates on the hypothesis that, besides traditional factors in the literature, vaccination success would hinge on two dimensions: a) addressing a broader set of risk perception factors than health-related issues only, and b) securing sufficient social and institutional trust at the time of vaccination campaign launch. We test this hypothesis regarding Covid-19 vaccination preferences in six European countries and at the early stage of the pandemic by April 2020. We find that addressing the two roadblock dimensions could further boost Covid-19 vaccination coverage by 22%. The study also offers three extra innovations. The first is that the traditional segmentation logic between vaccine "acceptors", "hesitants" and "refusers" is further justified by the fact that segments have different attitudes: refusers care less about health issues than they are worried about family tensions and finance (dimension 1 of our hypothesis). In contrast, hesitants are the battlefield for more transparency by media and government actions (dimension 2 of our hypothesis). The second added value is that we extend our hypothesis testing with a supervised non-parametric machine learning technique (Random Forests). Again, consistent with our hypothesis, this method picks up higher-order interaction between risk and trust variables that strongly predict on-time vaccination intent. We finally explicitly adjust survey responses to account for possible reporting bias. Among others, vaccine-reluctant citizens may under-report their limited will to get vaccinated.

Strengthening scientific credibility against misinformation and disinformation: Where do we stand now?

Health behaviors related to COVID-19 prevention measures, especially vaccination, are used to exemplify mechanisms whereby misinformation and disinformation can spark an "infodemic": a situation in which false information can spread more rapidly and widely than its truthful, science-based counterpart. We define key terminologies and identify potential sources that led to the pandemic infodemic, and highlight the harmful implications of such events. Issues related to scientific communication, how the public perceives information, and factors influencing individuals' decision-making are also discussed. This is the first in a series of two perspective articles on this topic.

MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial

BACKGROUND

Many pregnant women and parents have concerns about vaccines. This analysis examined the impact of MomsTalkShots, an individually tailored educational application, on vaccine attitudes of pregnant women and mothers.

METHODS

MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomizing at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia between June 2017 and July 2018. All participants (n = 2087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and two follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1041) were randomly assigned to receive educational videos through MomsTalkShots, algorithmically tailored to their vaccine intentions, attitudes, and demographics. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots regardless of the practice/provider intervention.

RESULTS

By 1 month post-birth, MomsTalkShots increased perceived risk of maternal influenza disease (61% among MomsTalkShots recipients vs 55% among controls; Odds Ratio: 1.61, 95% Confidence Interval: 1.23-2.09), confidence in influenza vaccine efficacy (73% vs 63%; OR: 1.97, 95%CI: 1.47-2.65), and perceived vaccine knowledge (55% vs 48%; OR: 1.39, 95%CI: 1.13-1.72). Among those intending not to vaccinate at baseline, MomsTalkShots increased perceived risk of maternal influenza disease (38% vs 32%; OR: 2.07, 95%CI: 1.15-3.71) and confidence in influenza vaccine efficacy (44% vs 28%; OR: 2.62, 95%CI: 1.46-4.69). By 1 year post-birth, MomsTalkShots increased perceived vaccine knowledge (62% vs 50%; OR: 1.74, 95%CI: 1.36-2.24) and trust in vaccine information from obstetricians and pediatricians (64% vs 55%; OR: 1.53, 95%CI: 1.17-2.00). Among those uncertain about vaccinating at baseline, MomsTalkShots increased perceived vaccine knowledge (47% vs 12%; OR: 6.89, 95%CI: 1.52-31.25) and reduced infant vaccine safety concerns (71% vs 91%; OR: 0.24, 95%CI: 0.06-0.98).

CONCLUSIONS

MomsTalkShots improved pregnant women's and mothers' knowledge and perceptions of maternal and infant vaccines and the diseases they prevent, and offers a scalable tool to address vaccine hesitancy.

TRIAL REGISTRATION

Registered at Clinicaltrials.gov on 13/09/2016 (registration number: NCT02898688).

COVID-19 vaccine acceptance among adults in four major US metropolitan areas and nationwide

This study assesses attitudes towards COVID-19 vaccination and the predictive value of COVID-VAC, a novel scale, among adults in the four largest US metropolitan areas and nationally. A 36-item survey of 6037 Americans was conducted in mid-April 2021. The study reports factors for COVID-19 vaccine acceptance among: (1) already vaccinated; (2) unvaccinated but willing to accept a vaccine; and (3) unvaccinated and unwilling to vaccinate. More than 20% were unwilling to vaccinate, expressing concerns about vaccine efficacy and safety and questioning the disease's severity. Poverty, working outside of the home and conservative political views are predictors of unwillingness. Conversely, those who either personally tested positive for COVID-19, or had a family member who did so, were more likely to accept vaccination. Majorities of all respondents supported vaccination mandates for employees and university students. Respondents preferred to receive vaccines in their doctor´s office. Lower income and conservative ideology, but not race, were strongly associated with vaccine unwillingness. The predictive value of COVID-VAC was demonstrated. While vaccination mandates are likely to be accepted, additional effective, targeted interventions to increase vaccine uptake are needed urgently.

Exploration of the Experience of Care Home Managers of COVID-19 Vaccination Programme Implementation and Uptake by Residents and Staff in Care Homes in Northern Ireland

The Coronavirus 2019 (COVID-19) pandemic disproportionately affected people living and working in care homes. This study aimed to explore the experience of care home managers on the implementation and uptake of the COVID-19 vaccination programme by residents and staff in care homes in Northern Ireland. An exploratory mixed methods approach was used, i.e., semi-structured interviews to design the cross-sectional survey and content analysis of statements using open ended questions. Care home managers were approached and sixty-seven valid quantitative and forty-nine descriptive responses were analysed. The study identified eight themes which described factors that motivated residents (family visits and relationship with managers and staff), and staff vaccine uptake (return to normal life at work and trust in care home managers). The identified themes also confirmed that vaccine uptake is negatively influenced by perceived side effects. The findings indicated that social media can promote or decelerate the uptake of vaccine despite the accessibility to a successful vaccination programme. The study highlights the important role of managers in handling the challenges through building trust and establishing relationships with staff and residents. The findings identified challenges to the uptake of the COVID-19 vaccine by staff and residents that can inform the implementation of future vaccination programmes.