COVID-19 vaccine perceptions and uptake in a national prospective cohort of essential workers

Longitudinal parental perception of COVID-19 vaccines for children in a multi-site, cohort study

OBJECTIVES

Pediatric COVID-19 vaccine hesitancy and uptake is not well understood. Among parents of a prospective cohort of children aged 6 months-17 years, we assessed COVID-19 vaccine knowledge, attitudes, and practices (KAP), and uptake over 15 months.

METHODS

The PROTECT study collected sociodemographic characteristics of children at enrollment and COVID-19 vaccination data and parental KAPs quarterly. Univariable and multivariable logistic regression models were used to test the effect of KAPs on vaccine uptake; McNemar's test for paired samples was used to evaluate KAP change over time.

RESULTS

A total of 2,837 children were enrolled, with more than half (61 %) vaccinated by October 2022. Positive parental beliefs about vaccine safety and effectiveness strongly predicted vaccine uptake among children aged 5-11 years (aOR 13.1, 95 % CI 8.5-20.4 and aOR 6.4, 95 % CI 4.3-9.6, respectively) and children aged 12+ years (aOR 7.0, 95 % CI 3.8-13.0 and aOR 8.9, 95 % CI 4.4-18.0). Compared to enrollment, at follow-up parents (of vaccinated and unvaccinated children) reported higher self-assessed vaccine knowledge, but more negative beliefs towards vaccine safety, effectiveness, and trust in government. Parents unlikely to vaccinate their children at enrollment reported more positive beliefs on vaccine knowledge, safety, and effectiveness at follow-up.

CONCLUSION

The PROTECT cohort allows for an examination of factors driving vaccine uptake and how beliefs about COVID-19 and the COVID-19 vaccines change over time. Findings of the current analysis suggest that these beliefs change over time and policies aiming to increase vaccine uptake should focus on vaccine safety and effectiveness.

Understanding COVID-19 vaccination behaviors and intentions in Ghana: A Behavioral Insights (BI) study

INTRODUCTION

Vaccine uptake is influenced by a variety of factors. Behavioral Insights (BI) can be used to address vaccine hesitancy to understand the factors that influence the decision to take or refuse a vaccine.

METHODOLOGY

This two-part study consisted of a survey designed to identify the influence of various drivers of people's COVID-19 vaccination status and their intention to take the vaccine in Ghana, as well as an experiment to test which of several behaviorally informed message frames had the greatest effect on vaccine acceptance. Data was collected from a total of 1494 participants; 1089 respondents (73%) reported already being vaccinated and 405 respondents (27%) reported not being vaccinated yet. The mobile phone-based surveys were conducted between December 2021 and January 2022 using Random Digit Dialing (RDD) to recruit study participants. Data analysis included regression models, relative weights analyses, and ANOVAs.

RESULTS

The findings indicated that vaccine uptake in Ghana is influenced more by social factors (what others think) than by practical factors such as ease of vaccination. Respondents' perceptions of their family's and religious leaders' attitudes towards the vaccine were among the most influential drivers. Unexpectedly, healthcare providers' positive attitudes about the COVID-19 vaccine had a significant negative relationship with respondents' vaccination behavior. Vaccine intention was positively predicted by risk perception, ease of vaccination, and the degree to which respondents considered the vaccine effective. Perceptions of religious leaders' attitudes also significantly and positively predicted respondents' intention to get vaccinated. Although perceptions of religious leaders' views about the vaccine are an important driver of vaccine acceptance, results asking respondents to rank-order who influences them suggest that people may not be consciously aware-or do not want to admit-the degree to which they are affected by what religious leaders think. Message frames that included fear, altruism, social norms were all followed by positive responses toward the vaccine, as were messages with three distinct messengers: Ghana Health Services, a doctor, and religious leaders.

CONCLUSIONS

What drives COVID-19 vaccine intentions does not necessarily drive behaviors. The results of this study can be used to develop appropriate COVID-19 vaccine uptake strategies targeting the most important drivers of COVID-19 vaccine acceptance, using effective message frames.

COVID-19 vaccination requirements, encouragement and hesitancy among non-health care, non-congregate workers in Chicago: results from the WEVax survey

BACKGROUND

While frontline and essential workers were prioritized for COVID-19 vaccination in the United States, coverage rates and encouragement strategies among non-health care workers have not been well-described. The Chicago Department of Public Health surveyed non-health care businesses to fill these knowledge gaps and identify potential mechanisms for improving vaccine uptake.

METHODS

The Workplace Encouragement for COVID-19 Vaccination in Chicago survey (WEVax Chicago) was administered using REDCap from July 11 to September 12, 2022, to businesses previously contacted for COVID-19 surveillance and vaccine-related outreach. Stratified random sampling by industry was used to select businesses for phone follow-up; zip codes with low COVID-19 vaccine coverage were oversampled. Business and workforce characteristics including employee vaccination rates were reported. Frequencies of requirement, verification, and eight other strategies to encourage employee vaccination were assessed, along with barriers to uptake. Fisher's exact test compared business characteristics, and Kruskal-Wallis test compared numbers of encouragement strategies reported among businesses with high (> 75%) vs. lower or missing vaccination rates.

RESULTS

Forty-nine businesses completed the survey, with 86% having 500 or fewer employees and 35% in frontline essential industries. More than half (59%) reported high COVID-19 vaccination rates among full-time employees; most (75%) workplaces reporting lower coverage were manufacturing businesses with fewer than 100 employees. Verifying vaccination was more common than requiring vaccination (51% vs. 28%). The most frequently reported encouragement strategies aimed to improve convenience of vaccination (e.g., offering leave to be vaccinated (67%) or to recover from side effects (71%)), while most barriers to uptake were related to vaccine confidence (concerns of safety, side effects, and other skepticism). More high-coverage workplaces reported requiring (p = 0.03) or verifying vaccination (p = 0.07), though the mean and median numbers of strategies used were slightly greater among lower-coverage versus higher-coverage businesses.

CONCLUSIONS

Many WEVax respondents reported high COVID-19 vaccine coverage among employees. Vaccine requirement, verification and addressing vaccine mistrust may have more potential to improve coverage among working-age Chicagoans than increasing convenience of vaccination. Vaccine promotion strategies among non-health care workers should target low-coverage businesses and assess motivators in addition to barriers among workers and businesses.

Association of death or illness from COVID-19 among family and friends on vaccine uptake within four months of the Emergency Use Authorization. Findings from a national survey in the United States

OBJECTIVE

To examine the relationship between knowing that a friend or family member became ill with, or died from, COVID-19 and receiving a vaccine dose within four months of the FDA's Emergency Use Authorization.

METHODS

A national sample of 1,517 respondents were surveyed from April 7 to April 12, 2021, 1,193 of whom were eligible for the vaccine when the data were collected.

RESULTS

Respondents who knew someone who became ill with COVID-19 (AOR = 2.32, 95 % CI 1.74-3.09) or knew someone who died (AOR = 2.29, 95 % CI 1.32-3.99) from COVID-19 were more likely to receive at least a single COVID-19 vaccine dose.

CONCLUSION

Encouraging people to share their COVID-19 illness and bereavement experiences with their local network such as friends, families, social-networks and via social media might help increase vaccine uptake.

The influence of information sources on intention changes to receive COVID-19 vaccination: A prospective cohort study in Japan

BACKGROUND

Before the COVID-19 vaccine became available, many Japanese people were undecided about whether or not to receive them. Their decisions were keys to achieving herd immunity. The impact of the type of information source on the COVID-19 vaccine uptake decision-making process remains unclear. We aimed to investigate the association between information source usage on COVID-19 and subsequent vaccine uptake status among those who have yet to decide whether to receive vaccines from non-prioritized people for vaccination.

METHODS

Prospective cohort online self-administered surveys were conducted in February 2021 (T1), before the start of the mass vaccination program, and September-October 2021 (T2), when the vaccines were available to all citizens. The survey's target population was registered monitors of an Internet research company. Participants who answered "I want to get vaccinated after waiting to see how it goes." at T1 were eligible for analysis. The outcome variable was the COVID-19 vaccine uptake status in T2, and the predictors were 20 types of information sources, categorized based on people (family members, etc.), institutions (governments, etc.), or media (TV news, etc.). Adjusted odds ratio and 95% confidence intervals were estimated using logistic regression adjusted for possible confounders.

RESULTS

The 5,139 respondents, mean age and standard deviation was 42.8 ± 12.5, 55.7% female, were eligible for analysis. 85.7% completed vaccination (including reserved/intended people) in T2. In the multivariate logistic analysis, odds ratios (95% confidence interval) for vaccine uptake were 1.49 (1.18-1.89) for workplaces/schools, 1.81 (1.33-2.47) for LINE, 0.69 (0.55-0.86) for Internet news and 0.62 (0.48-0.82) for video sharing sites.

CONCLUSIONS

The type of information source usage played an important role in the decision to vaccinate against COVID-19. Although caution is needed in interpreting the results, obtaining information from workplaces/schools and LINE was influential in promoting immunization.

Parental decision and intent towards COVID-19 vaccination in children with asthma: an econometric analysis

Objective

Vaccination will be instrumental in controlling the COVID-19 pandemic, and vaccination of children will be necessary to achieve herd immunity. Given that children with chronic health conditions may be at increased risk of COVID-19, it is crucial to understand factors influencing parental decisions about whether to have their child vaccinated. The study objectives were to measure parental intent to have their child with asthma vaccinated against COVID-19 and identify the determinants of their vaccination decision.

Study design

This study is based on a cross-sectional exploratory observational online survey assessing parents' risk perception in the context of COVID-19.

Methods

In this study conducted in August 2020, the primary outcome was parent’s answer to the question on their intention to get their child vaccinated if a vaccine against COVID-19 was available. Participants were also asked about their intention to get vaccinated themselves. Independent variables studied included sociodemographic, clinical data (e.g. presence of other chronic diseases), psychological, cognitive and risk perception related to COVID-19. Simultaneous equations models (3SLS) and seemingly unrelated regressions model (SUR) were carried out to identify factors associated with intention to have the child vaccinated and participants’ intention to get vaccinated themselves against COVID-19.

Results

A total of 305 participants completed the survey. Overall, 19.1% of participants reported being unlikely or very unlikely to vaccinate their child against COVID-19 if a vaccine was available. Similarly, 21.0% were unlikely or very unlikely to get vaccinated themselves. The following factors were significantly associated with parents’ decision to have their child vaccinated: parental level of education (p = 0.003), employment status (p < 0.001), sex of the child (p = 0.019), presence of other chronic diseases (p = 0.028), whether or not the child had been vaccinated against influenza in the past (p < 0.001), parental anxiety (p = 0.046), and consultation with a health professional since the beginning of the pandemic (p = 0.009). There was a strong relationship between likelihood of not intending to have one’s child vaccinated and personal intent not to get vaccinated.

Conclusion

These findings are essential in planning for the communication and dissemination of COVID-19 vaccination information to parents, especially for children with asthma or other chronic medical conditions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13933-z.

Evaluating COVID-19 Vaccine Willingness and Hesitancy among Parents of Children Aged 5–11 Years with Chronic Conditions in Italy

COVID-19 vaccination has been extended to include children aged 5–11 years. This cross-sectional survey evaluated parental COVID-19 vaccine willingness and hesitancy, and associated factors, for their children aged 5–11 years with chronic conditions. A telephone survey was conducted from 14 December 2021 to 4 January 2022. The questionnaire assessed participants’ socio-demographic and health-related information, attitudes towards COVID-19 infection, hesitancy, by using the PACV-5 (Parent Attitudes About Childhood Vaccines Survey Tool), and sources of information. A total of 430 answers were collected anonymously. Respondents with no cohabitant who had been infected by SARS-CoV-2 and having been vaccinated against COVID-19 had a higher concern about the severity of COVID-19. The parents’ perceived risk that the child could be infected by SARS-CoV-2 was higher in those more concerned about the severity of COVID-19, with an older child, and who had at least one cohabitant positive for COVID-19. Only 38.8% parents were willing to vaccinate their children against COVID-19. Parents who did not need additional information, those with higher education, those who have been vaccinated against COVID-19, those whose child was older, who had received information on this vaccination from physicians, with higher self-reported concern about the severity of COVID-19, and who had a higher perceived risk that their child could be infected by SARS-CoV-2, expressed a greater willingness to vaccinate their child. Overall, 26.3% were high-hesitant, with a PACV-5 score ≥ 7. Respondents who did not get the COVID-19 vaccine, were less educated, with a lower concern about severity of COVID-19, and with a lower perceived risk that their child could be infected by SARS-CoV-2, were more likely to be high-hesitant. New policies and educational programs regarding COVID-19 vaccination for children with chronic conditions are needed to reduce hesitancy and increase vaccination uptake.