Adolescents’ attitudes to the COVID-19 vaccination

Psychological variables linked to hesitation toward vaccination against COVID-19 among late adolescents and young adults: The role of magical thinking and right-wing authoritarianism

INTRODUCTION

Several studies on the predisposition to be subjected to vaccination have shown that vaccine hesitation is a global phenomenon influenced by a lack of knowledge and awareness, as well as perceived risks and benefits. The purpose of this study was to investigate the mediating role of right-wing authoritarianism in the relationship between magical thinking and positive attitudes toward COVID-19 vaccines (i.e. trust of vaccine benefits, worries over unforeseen future effects, concerns about commercial profits, preference for natural immunity).

METHOD

The sample consisted of 201 Italian young adults, 49 males (24.4%), and 152 females (75.6%), aged between 18 and 25. Data were collected during 2022.

RESULTS

The results confirmed the role of right-wing authoritarianism as a mediator for magical thinking on positive vaccine attitudes. Findings indicated a positive association between right-wing authoritarianism and magical thinking and a negative relationship of both the aforementioned variables on positive vaccine attitudes. SEM analyses showed a direct positive association from magical thinking to right-wing authoritarianism and a direct negative association from right-wing authoritarianism to trust of vaccine benefits, to low worries over unforeseen future effects, to lack of concerns about commercial profits and to low preference for natural immunity.

CONCLUSIONS

The findings highlight that common contribution of odd or magical beliefs and right-wing authoritarianism may slow the spread of vaccines among late adolescents and young adults. Our findings provide insight on what effective communication with vaccine-resistant individuals should look like in order to increase the chances of reaching vaccine-hesitant individuals.

Are parents' willing to vaccinate their children against COVID-19? A qualitative study based on the Health Belief Model

In response to the COVID-19 pandemic, several countries have started implementing voluntary or involuntary mass vaccination programs. Although vaccine acceptance is high among adults, uncertainty about whether to vaccinate children against COVID-19 remains a controversial theme. To date, few qualitative studies have explored parents' views on this topic. A qualitative descriptive study design was used to collect data and individual in-depth interviews were conducted with 50 parents in the Makkah region of Saudi Arabia. The Health Belief Model (HBM) was used as a guide in developing the interview guide. Each question was related to a construct of the HBM. The data were then analyzed using thematic content analysis and interpreted using NVivo software. Two major themes emerged: motivation to vaccinate children, which was influenced by perceived benefits, perceived severity, perceived suitability, collective responsibilities, confidence, and cues to action; and barriers to vaccination in children, which included complacency, rapid vaccine development, and uncertainty about the long-term side effects of the vaccine. The findings of this study revealed that the public is not sufficiently informed about the efficacy or side effects of the COVID-19 vaccine, increasing the awareness of which will help parents make informed decisions regarding vaccinating their children and potentially increase vaccine acceptance.

Assessing the health, social, educational and economic impact of the COVID-19 pandemic on adolescents in low- and middle-income countries: a rapid review of the literature

COVID-19 has caused profound health, social, educational and economic devastation around the world, especially among the lives of adolescents in low- and middle-income countries. This paper looks at a wide array of outcomes impacting adolescents' daily lives including health (mental, physical, sexual and reproductive health, vaccine perceptions and overlap between these topics), social relationships (family and peer), education and socio-economic disparities. Both scientific and grey literature between December 2019 and February 2022 were sought from PubMed, Google Scholar and organisations conducting research among adolescents, and coded. A total of 89 articles were included, 73% of which were peer-reviewed; 37% of the articles were from WHO's Western Pacific region; 62% of the articles were cross-sectional; 75% were quantitative. Three major topics emerged in more than half the articles: mental health (72%), education (61%) and socio-economic ramifications (55%). However, there were regional differences in topics and many of them overlapped. The results indicate that, where there has been research, almost all findings have been linked to worse mental health during the pandemic. Overall, remote education was seen as a negative experience. The ramification of school closures on future aspirations, in particular early school leaving, highlights the importance of prioritising education during future pandemics based on the situation within the country. Gender and other disparities have made marginalised adolescents vulnerable to the economic ramifications of containment measures. Given the risks identified, there is a pressing need to put adolescents at the centre of establishing priorities for their health agenda for post-pandemic recovery.

Intention to Vaccinate against COVID-19 in Adolescents: A Systematic Review

BACKGROUND

Multiple COVID-19 vaccines have been approved for use in adolescents; these vaccines play a critical role in limiting the transmission and impact of COVID-19. This systematic review aims to summarize the willingness of adolescents aged 10 to 19 years to receive the COVID-19 vaccination and the factors influencing their decision.

METHODS

A search of literature published between January 2018 and August 2022 was performed in Medline©, EMBASE©. and CINAHL© electronic databases. Studies published in English that assessed adolescents' intentions to receive the COVID-19 vaccine were included. Qualitative studies and those unrelated to the COVID-19 vaccine were excluded. The study was conducted based on the PRISMA guidelines.

RESULTS

Of the 1074 articles retrieved, 13 were included in the final review. Most studies were conducted in the US (n = 3) and China (n = 3). The pooled prevalence of COVID-19 vaccine acceptance among adolescents was 63% (95% CI: 52-73%). Factors influencing intent to vaccinate were divided into five categories: "Socio-demographic determinants"; "Communication about COVID-19 pandemic and vaccination"; "COVID-19 vaccine and related issues"; "COVID-19 infection and related issues" and "Other determinants". The enablers were sociodemographic factors including older age, higher education level, good health perception, and parental norms in terms of parental vaccination acceptance; perceived vaccine effectiveness and safety; a desire to protect themselves and others; recent vaccination; and anxiety. The barriers were concerns over vaccine effectiveness, safety, and long-term side effects; low perceived necessity and risk of infection; and needle phobia.

CONCLUSIONS

This review highlighted that adolescents' intent to vaccinate is driven by a desire to protect themselves and others. However, concerns over vaccine effectiveness, safety, and long-term side effects hinder COVID-19 vaccine uptake. To improve vaccination acceptance, policymakers should address adolescents' concerns via more targeted public health messaging, while schools should leverage peer norms to positively influence vaccination intent.

"It Doesn't Cure, but It Protects": COVID-19 Vaccines through the Eyes of Children and Their Parents

Recently, studies have examined COVID-19 vaccine acceptance and/or hesitancy amongst adult populations across the globe. However, there is a paucity of literature illustrating children's voices in vaccination debates. This article draws on qualitative data collected via a mixed-methods study that explored South Africans' experiences during the COVID-19 pandemic between 2020 and 2021. Interviews were conducted with a purposive sample (N = 29) of children (>18 years) and their parents regarding their initial perspectives on COVID-19 vaccines. Given the dyadic nature of our study, we explored the intergenerational influence that parents' perspectives had on children's vaccine acceptability and the role that vaccine literacy, or lack thereof, played in vaccine decision making. Findings showed a great level of vaccine acceptability among children and parents, where many placed hopes in the vaccines to promote societal health and wellbeing. Intergenerational transfer of perspectives was observed where children's willingness to receive a vaccine was intrinsically linked to their parents' vaccine acceptability. Some participants also expressed concerns about COVID-19 vaccines, related to misinformation, mistrust, and limited vaccine literacy. We discuss the findings as they relate to vaccine and health literacy, also considering the prospective implications of this work as we enter the "recovery" period of the pandemic.

Adolescents' Opinions on COVID-19 Vaccine Hesitancy: Hints toward Enhancing Pandemic Preparedness in the Future

To understand and assess vaccine reluctance, it is necessary to evaluate people's perceptions and grasp potential reasons for generic apprehension. In our analysis, we focus on adolescents' impressions towards anti-vaxxer behavior. The aim of the study is to figure out students' opinions about vaccine reluctance, connecting possible explanations that motivate anti-vaxxer decisions with common specific personality traits. We further investigate people's forecasts concerning the evolution of the pandemic. Between 2021 and 2022, we conducted a randomized survey experiment on a sample of high school individuals (N=395) living in different Italian regions. At that time, the vaccination campaign had already been promoted for nearly one year. From the analysis, it emerges that vaccinated people (92%), especially males, tend to be more pessimistic and attribute a higher level of generic distrust in science to anti-vaxxers. The results show that family background (mother's education) represents the most influential regressor: individuals coming from less educated families are less prone to attribute generic distrust and distrust of vaccines as principal reasons for vaccine reluctance. Similarly, those who rarely use social media develop a minor tendency to believe in a generic pessimism of anti-vaxxers. However, concerning the future of the pandemic, they are less likely to be optimistic toward vaccines. Overall, our findings shed light on adolescents' perceptions regarding the factors that influence vaccine hesitancy and highlight the need for targeted communication strategies to improve vaccination rates.

Hesitancy, reactogenicity and immunogenicity of the mRNA and whole-virus inactivated Covid-19 vaccines in pediatric neuromuscular diseases

The mRNA-based BNT162b2 and inactivated whole-virus CoronaVac are two widely used COVID-19 vaccines that confer immune protection to healthy individuals. However, hesitancy toward COVID-19 vaccination appeared to be common for patients with neuromuscular diseases (NMDs) due to the paucity of data on the safety and efficacy in this high-risk patient population. Therefore, we examined the underlying factors associated with vaccine hesitancy across time for NMDs and assessed the reactogenicity and immunogenicity of these two vaccines. Patients aged 8-18 years with no cognitive delay were invited to complete surveys in January and April 2022. Patients aged 2-21 years were enrolled for COVID-19 vaccination between June 2021 and April 2022, and they recorded adverse reactions (ARs) for 7 days after vaccination. Peripheral blood was obtained before and within 49 days after vaccination to measure serological antibody responses compared to healthy children and adolescents. Forty-one patients completed vaccine hesitancy surveys for both timepoints, while 22 joined the reactogenicity and immunogenicity arm of the study. Two or more family members vaccinated against COVID-19 was positively associated with intention of vaccination (odds ratio 11.7, 95% CI 1.81-75.1, p = .010). Pain at the injection site, fatigue, and myalgia were the commonest ARs. Most ARs were mild (75.5%, n = 71/94). All 19 patients seroconverted against the wildtype SARS-CoV-2 after two doses of either vaccine, similar to 280 healthy counterparts. There was lower neutralization against the Omicron BA.1 variant. BNT162b2 and CoronaVac were safe and immunogenic for patients with NMDs, even in those on low-dose corticosteroids.

Perception regarding COVID-19 vaccine and COVID appropriate behavior among adolescents at a tertiary hospital, West Bengal: A longitudinal survey

Background

Vaccination against COVID 19 and observing COVID appropriate behavior are effective measures to control, manage and prevent COVID-19 infection. With India starting its adolescent vaccination program, this study aimed to explore the adolescents' perception of vaccination, their COVID-appropriate behavior, compliance with two doses of COVID-19 vaccines and the experienced side effects following vaccination.

Methods

A longitudinal survey was conducted among 440 adolescents visiting the COVID Vaccination Center (CVC) of a tertiary hospital in West Bengal. In the survey, adolescents were asked about family socio-demographic characteristics, their opinions on COVID-19 vaccines, and COVID-19 Appropriate Behavior (CAB) practices. Voluntary participants were given a questionnaire to fill and a telephonic interview was taken regarding side effects experienced following the vaccination and their compliance to both doses of vaccine.

Results

The majority of adolescents (99.3%) had taken vaccines by their own wish. The reason for willingness to take the vaccine was the fear of being infected with COVID-19 infection (50.5%). Maximum adolescents got information regarding the COVID vaccination program through the internet (41.8%) followed by family members (30.5%). The majority of adolescents (70.9%) had a good perception of COVID-19 vaccination. A significant number of adolescents (44.8%) strongly disagreed with the statement that they don't need to follow COVID appropriate behavior after vaccination.

Conclusion

The majority of adolescents had a good perception regarding COVID-19.

Factors impacting parental uptake of COVID-19 vaccination for U.S. Children ages 5-17

COVID-19 vaccination of U.S. children lags behind adult vaccination, but remains critical in mitigating the pandemic. Using a subset of a nationally representative survey, this study examined factors contributing to parental uptake of COVID-19 vaccine for children ages 12-17 and 5-11, stratified by parental COVID-19 vaccination status. Among vaccinated parents, uptake was higher for 12-17-year-olds (78.6%) than 5-11-year-olds (50.7%); only two unvaccinated parents vaccinated their children. Child influenza vaccination was predictive of uptake for both age groups, while side effect concerns remained significant only for younger children. Although parents were more likely to involve adolescents in vaccine decision-making than younger children, this was not predictive of vaccine uptake. These results highlight the importance of addressing the unique and shared concerns parents have regarding COVID-19 vaccination for children of varying ages. Future work should further explore adolescent/child perspectives of involvement in COVID-19 vaccination decision-making to support developmentally appropriate involvement.

Knowledge, Attitude, and Behavior toward COVID-19 Vaccination in Young Italians

Purpose: The knowledge, attitudes, and behavior of young Italians towards the COVID-19 vaccination were analyzed in order to provide information useful to elaborate the strategies that can be implemented to obtain the best possible vaccination coverage in this population. Methods: A cross-sectional study was conducted on 5313 young people aged between 11 and 30 years. Data were collected through an online survey during the period from 1 to 10 March 2021. The answers to the questionnaire were analyzed using SPSS statistical software. Intention to vaccinate was studied by univariate analysis using Pearson’s chi-square test to assess differences between groups for categorical variables, and by multivariate analysis applying the binary logistic regression model, and the Hosmer−Lemeshow test was performed to assess goodness of fit. Results: Television (32.1%), internet/search engine (25.9%), and social networks (10.4%) were the main sources of information for young Italians. The survey analysis showed that 74.5% (3956) of the respondents were willing to be vaccinated against COVID-19 versus 25.5% (1357) who were against it. Demographic data, in particular, age, gender, experience with influenza vaccine, and level of knowledge about the disease, were significant determinants (p < 0.001) for the choice to vaccinate against COVID-19. Discussion: These results suggest that in order to implement the vaccination campaign, correct information is needed to improve awareness of the vaccine and COVID-19, while also taking into account the target group, which differs not only in age but also in the sources of information used compared to the adult population.

Safety and immunogenicity of SARS-CoV-2 vaccine MVC-COV1901 in Taiwanese adolescents: a randomized phase 2 trial

Adolescents and children play an important role in SARS-CoV-2 transmission and epidemiology. MVC-COV1901 is a subunit SARS-CoV-2 vaccine based on stabilized spike protein adjuvanted with CpG 1018 and aluminum hydroxide that has received emergency use approval (EUA) for adults in Taiwan. In this study, we have investigated the safety and immunogenicity of two doses of MVC-COV1901 in adolescents. Healthy adolescents from the age of 12-17 years were randomly assigned to receive two intramuscular doses of either MVC-COV1901 or placebo at 28 days apart. Adverse events were mostly mild and were similar in MVC-COV1901 and placebo groups, with the most commonly reported adverse events being pain/tenderness and malaise/fatigue. All immunogenicity endpoints in the adolescent group were non-inferior to the endpoints seen in the young adult and placebo groups. The results here advocate the use of MVC-COV1901 in adolescents in the ongoing efforts to control the pandemic.ClinicalTrials.gov registration: NCT04951388.

The awareness and acceptance of anti-COVID 19 vaccination in adolescence

BACKGROUND

COVID-19 had devastating effects on children's and adolescents' life, including neuropsychological impairment, discontinuation of social life and education. Since June 2021, antiCOVID19 vaccination has become available to adolescents in Italy up to 12 years and since December 2021 to children aged more than 5 years. The pediatric population represents a challenging target for vaccination. Aim of the study is to perform a survey among adolescents to explore factors associated with COVID 19 immunization and their perceptions about COVID-19 vaccines.

METHODS

Italian students aged 10-17 years were invited to participate in an anonymous online survey regarding their immunization against COVID-19 and their opinion on the immunization practice through a web link to the questionnaire. The study period was March-June 2022. Statistical analysis was performed with SPSS v 21.

RESULTS

In the study period, 895 students entered the survey. A total of 87.3% of respondents were immunized against SARS-CoV2. The most important predictors of being immunized against SARS-CoV2 were having both parents immunized (p < 0, 001) and being aged over 12 years. In the unvaccinated group, the decision was mostly influenced by the family (65.8%). Regardless the immunization status, respondents were willing to receive information about COVID 19 vaccination mostly by their family doctor (51.8%) and at school (28.9%).

CONCLUSIONS

Parents' decisions and attitudes strongly affected the immunization status of adolescents. Students' willing to receive COVID 19 vaccine information by family doctors and at school, underline the potential role of paediatricians and school educators in contributing to an increased vaccine coverage among the paediatric age.

COVID-19 vaccine acceptance and hesitancy among ethnic minorities in Hong Kong

Ethnic minorities account for 8% of the Hong Kong population, most are Filipino and Indonesian domestic helpers taking care of children and the elderly. To understand the COVID-19 vaccination rates and factors associated with vaccine acceptance of ethnic minorities, we performed a cross-sectional questionnaire study recruiting Hong Kong ethnic minorities aged ≥18 years between 1 July and 18 July 2021 in public areas. Demographics, knowledge about COVID-19, vaccination status, intention and reasons to receive the vaccine, and planning to be re-vaccinated were analyzed. Continuous and categorical variables were compared using unpaired t-test and Chi-square test, respectively. Potential confounders were adjusted using multiple logistic regression. 2,012 ethnic minorities participated, with a mean age of 39 years, of which 97.6% were female, 79.5% were Filipino, and 17.5% were Indonesian. 80.6% of participants were categorized as vaccine acceptance, and 69.2% were willing to be re-vaccinated. There were significantly more Filipinos than Indonesians in the vaccine acceptance group (p < .001). Subjects in the vaccine acceptance group were more likely to have higher education (p < .001), a higher COVID-19 knowledge score (p < .001), received information from the Government website (p = .003) and not from their friends or family members (p = .02), and were more confident in judging the accuracy of the information (p < .001). Logistic regression showed the mean knowledge score (β = 3.07, p < .001) and receiving information from official Government websites (adjusted OR = 1.37, p = .03) were significant factors that positively influenced vaccine acceptance. The Hong Kong Government should improve COVID-19 vaccination acceptance among ethnic minorities through public education using official channels.

The Role of Knowledge, Attitude, Confidence, and Sociodemographic Factors in COVID-19 Vaccination Adherence among Adolescents in Indonesia: A Nationwide Survey

COVID-19 vaccination in adolescents is important because the adolescent population has the highest incidence of COVID-19. This study aimed to explore the factors associated with COVID-19 vaccination adherence among Indonesian adolescents. This cross-sectional study involved 7986 adolescents, polled through online and offline surveys conducted in six major islands of Indonesia. The online questionnaire was distributed through popular social messaging and social media platforms. Our team also contacted schools and public places to recruit participants from remote areas. In total, 7299 respondents completed the questionnaire. Binary logistic analysis revealed that higher levels of knowledge, positive attitudes, and confidence in the COVID-19 vaccine were significantly associated with higher COVID-19 vaccination adherence in adolescents. Sociodemographic factors were also significantly associated with higher adherence to vaccination programs. Meanwhile, younger age and habitation in private housing were related to lower adherence to the vaccination program. Parental factors related to adolescent compliance were education level, household income, history of infection of family or friends with COVID-19, and working status. The national authorities and stakeholders should take extensive measures to increase attitude, knowledge, confidence, and family support among adolescence through multiple channels.

Myocarditis or Pericarditis Following the COVID-19 Vaccination in Adolescents: A Systematic Review

Background: By 16 May 2022, 12,186,798,032 people had been vaccinated with COVID-19 vaccines. Our study found that myocarditis/pericarditis may occur in adolescents after COVID-19 vaccination. Methods: In this regard, we conducted a meta-analysis of seven groups of adolescents aged 12–19 years to compare the incidence of myocarditis/pericarditis after vaccination and compare the relative risk incidence after the first and second doses of a COVID-19 vaccine, and between males and females for risk incidence. Results: We analyzed 22,020,997 subjects from seven studies, including 130 cases of confirmed myocarditis/pericarditis. The overall mean incidence rate was 1.69 cases per 100,000 person-years. Of these, 19 of the 12,122,244 people who received a first dose of a COVID-19 vaccine had myocarditis/pericarditis, an incidence rate of 0.0022% (95% CI 0.0001–0.0034), and 111 of the 1,008,753 people who received a second dose had myocarditis/pericarditis, an incidence rate of 0.0107% (95% CI 0.0059–0.0155). The prevalence relative ratio (RR) after the first and second doses was RR = 5.53 (95% CI: 3.01–10.16), with a higher prevalence after the second dose than after the first dose of a COVID-19 vaccine. After a second dose of a COVID-19 vaccine, the RR for males relative to females was RR = 13.91 (95% CI: 4.30–44.95), with a more pronounced risk of disease in males than in females. Conclusions: Our study showed that myocarditis/pericarditis occurred after vaccination with the BNT162b2 or Comirnaty vaccine, especially after the second vaccination in male adolescents, but the incidence of myocarditis/pericarditis after vaccination with the above vaccines was very rare (0.0022%). Therefore, it is recommended that adolescents should be vaccinated with the COVID-19 universal vaccine as soon as possible and closely monitored for subsequent adverse reactions, which can be treated promptly.

Immunogenicity of BNT162b2 Vaccination against SARS-CoV-2 Omicron Variant and Attitudes toward a COVID-19 Booster Dose among Healthy Thai Adolescents

Despite the BNT162b2 vaccination coverage, rapid transmission of Omicron SARS-CoV-2 has occurred, which is suspected to be due to the immune escape of the variant or waning vaccine efficacy of multiple BNT162b2 vaccination doses. Our study aims to compare immunogenicity against Omicron prior to and post a booster dose of BNT162b2 in healthy adolescents, and to evaluate their attitudes toward booster dose vaccination. A cross sectional study was conducted among healthy adolescents aged 12–17 who received two doses of BNT162b2 more than 5 months ago. Participants and their guardians performed self-reported questionnaires regarding reasons for receiving the booster. A 30 ug booster dose of BNT162b2 was offered. Immunogenicity was evaluated by a surrogate virus neutralization test (sVNT) against the Omicron variant, and anti-spike-receptor-binding-domain IgG (anti-S-RBD IgG) taken pre-booster and 14-days post-booster. From March to April 2022, 120 healthy Thai adolescents with a median age of 15 years (IQR 14–16) were enrolled. sVNT against Omicron pre- and post-booster had 11.9 (95%CI 0–23.9) and 94.3 (90.6–97.4) % inhibition. Geometric means (GMs) of anti-S-RBD IgG increased from 837 (728, 953) to 3041 (2893, 3229) BAU/mL. Major reasons to receive the booster vaccination were perceived as vaccine efficacy, reduced risk of spreading infection to family, and safe resumption of social activities. A booster dose of BNT162b2 elicits high immunogenicity against the Omicron variant. Motivation for receiving booster doses is to reduce risk of infection.

Bi-objective optimization for a multi-period COVID-19 vaccination planning problem

This work investigates a new multi-period vaccination planning problem that simultaneously optimizes the total travel distance of vaccination recipients (service level) and the operational cost. An optimal plan determines, for each period, which vaccination sites to open, how many vaccination stations to launch at each site, how to assign recipients from different locations to opened sites, and the replenishment quantity of each site. We formulate this new problem as a bi-objective mixed-integer linear program (MILP). We first propose a weighted-sum and an ϵ -constraint methods, which rely on solving many single-objective MILPs and thus lose efficiency for practical-sized instances. To this end, we further develop a tailored genetic algorithm where an improved assignment strategy and a new dynamic programming method are designed to obtain good feasible solutions. Results from a case study indicate that our methods reduce the operational cost and the total travel distance by up to 9.3% and 36.6%, respectively. Managerial implications suggest enlarging the service capacity of vaccination sites can help improve the performance of the vaccination program. The enhanced performance of our heuristic is due to the newly proposed assignment strategy and dynamic programming method. Our findings demonstrate that vaccination programs during pandemics can significantly benefit from formal methods, drastically improving service levels and decreasing operational costs.

Awareness, Barriers and Concerns of Adolescents Toward the COVID-19 Vaccine: A Cross-Sectional Study in Singapore

Background

COVID-19 vaccination is a key public health measure to mitigate the crippling effects of the pandemic. COVID-19 vaccination began in adults and targeted adolescents at a later stage. However, medical decision-making on its uptake among the latter was unknown, which could be affected by their literacy and concerns about the vaccine. The study aimed to elucidate the awareness, concerns and barriers of adolescents toward the COVID-19 vaccine.

Methods

A cross-sectional online survey using a self-developed questionnaire was conducted between June to November 2021. The adolescent participants were students from institutes of post-secondary education who were recruited via convenience sampling. The data were collated from an officially approved electronic platform, audited and analyzed. Continuous and categorical variables were expressed as mean (standard deviation) and percentages, respectively.

Results

A total of 460 adolescents participated in the study (mean age: 16.99 ± 0.99; 73% female). Most of them (91.5%) were aware of the COVID-19 vaccines. The main barriers to vaccination were uncertainty about long-term health risks (38.6%) and vaccine efficacy (37.3%). Regarding the potential vaccine side effects, they were concerned about: anaphylactic shock (73.2%), low blood pressure (58.3%) and fast heartbeat (58.0%). Only 58% expressed willingness for repeated COVID-19 vaccination.

Conclusion

Despite high COVID-19 vaccine awareness, the adolescents were concerned about the potentially severe but rare side-effects. The study identified apprehension regarding vaccine efficacy and the potential long-term health impact as the main barriers to vaccination. Future studies should address these concerns to scale vaccination programs among adolescents.

Evaluation of Knowledge, Attitudes and Practices Related to Self-Testing Procedure against COVID-19 among Greek Students: A Pilot Study

The COVID-19 pandemic has had a major impact on health, economy, society and education. In the effort to return to normalcy, according to the instructions of the Greek Government for the resumption of the operation of schools, a screening Rapid Antigen Detection Test with the method of self-testing is required for students twice per week, for the early identification and isolation of positive cases. We aimed to pivotally investigate the knowledge, attitudes and practices related to self-testing procedures against COVID-19 among Greek students. A questionnaire was distributed to a convenient sample of students in the region of Athens. Information about the vaccination coverage against SARS-CoV-2 was also obtained. Our study included 1000 students, with 70% of them having an average grade at school. Most of the participants were aware of coronavirus (98.6%) and the self-test (95.5%). The vast majority of students (97%) performed self-testing twice per week, with the 70% them being assisted by someone else. Nearly one sixth of the participants had been infected by COVID-19 (14%) while 36% of them have already been vaccinated against SARS-CoV-2. In conclusion, we report high compliance with the COVID-19 self-testing procedure among students in Attica, Greece. Older age adolescents are more likely to not comply with the regulations of self-testing. Consequently, tailored interventions targeted at older age adolescents are warranted in order to increase the acceptability of self-testing.

Survey data on the attitudes of adolescents in Hong Kong towards the COVID-19 vaccination

To our best knowledge, this article presents a novel data set on Hong Kong's adolescents’ attitude towards the COVID-19 vaccination, excluding their parental opinions. This research used a cross-sectional questionnaire survey, which collects data from the population at a single point in time. Our questionnaire was designed in both English and Chinese for the adolescents’ convenience, using a self-designed, online questionnaire website, which was sent to 30 secondary schools across Hong Kong at the beginning of June 2021, to be completed by 31st June 2021. This gathered a total of 2609 surveys, excluding those which did not fit into the criteria. As the data has identified factors that affect vaccine hesitancy, government authorities can use the data to choose effective ways to promote the COVID-19 vaccination and to educate the general population about the benefits of receiving it.

COVID-19 Vaccine Hesitancy among Adolescents: Cross-Sectional School Survey in Four Chinese Cities Prior to Vaccine Availability

To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy (“not sure”) and resistance (“do not want it”). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40–1.88; OR = 1.81; 95% CI: 1.44–2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14–1.55; OR = 1.57; 95% CI: 1.25–1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50–1.97; OR = 3.57; 95% CI: 2.86–4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56–4.11; OR = 27.68; 95% CI: 21.81–35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72–0.98; OR = 0.66; 95% CI: 0.52–0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09–1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68–0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73–0.96), and having doctors’ recommendation (OR = 0.86; 95% CI: 0.76–0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.