Shades of doubt: Measuring and classifying vaccination confidence in Europe

Psychosocial experience of the Covid-19 crisis among people who use or inject drugs in Algeria: A community-based qualitative study

The COVID-19 crisis had a global impact and many marginalised groups, such as people who use or inject drugs, are more vulnerable to the SARS-CoV-2 virus and its consequences due to their pre-existing health inequalities. Moreover, people who use/inject drugs are also criminalised in some countries such as Algeria. This analysis aimed to explore the psychosocial experience of the COVID-19 crisis among people who use/inject drugs in Algeria. Twenty-nine qualitative interviews were conducted in 2021 with a community-based approach. Results of the thematic content analysis showed the intersectional effects of the COVID-19 crisis among people who use or inject drugs through the experience of a double crisis: one related to COVID-19 and the second to their specific difficulties related to drug use. Addressing social inequalities in health of people who use or inject drugs, through better recognition of their rights and needs, is crucial to improving their health.

COVID-19 vaccination perspectives among patients with Long COVID: A qualitative study

Individuals who have Long COVID may have unique perspectives about COVID-19 vaccination due to the significant impact that COVID-19 has had on their lives. However, little is known about the specific vaccination perspectives among this patient population. The goal of our study was to improve our understanding of perspectives about COVID-19 vaccines among individuals with Long COVID. Interviews were conducted with patients receiving care at a post-COVID recovery clinic. Deductive thematic analysis was used to characterize participant perspectives according to the vaccine acceptance continuum framework, which recognizes a spectrum from vaccine acceptance to refusal. From interviews with 21 patients, we identified perspectives across the continuum of vaccine acceptance. These perspectives included acceptance of vaccines to prevent future illness, concerns about vaccine side effects on Long COVID symptoms, and refusal of vaccines due to perceived natural immunity. A limitation of our study is that these perspectives are specific to individuals receiving care at one post-COVID recovery clinic. In conclusion, our study demonstrates that some patients with Long COVID are uncertain about COVID-19 vaccines and boosters but may also be amenable to conversations that impact future vaccination acceptance. Patient perspectives should be considered when communicating recommendations for COVID-19 vaccinations to this population.

How has co-design been used to address vaccine hesitancy globally? A systematic review

Improving vaccine confidence is a topic of major public health importance. Reasons for vaccine hesitancy are multifactorial, making it challenging to find strategies to address them. This systematic review aimed to synthesize the literature on how co-design has been used to reduce vaccine hesitancy. We searched six databases in March and October 2024. Eligible studies described the co-design process used to develop interventions for addressing vaccine hesitancy and increasing vaccine confidence. We assessed the quality of included studies, extracted and descriptively summarized the key data. Twenty-seven articles were included, 20 of which were based in a high-income setting. Most studies centered on the COVID-19 (n = 9) and HPV (n = 9) vaccines. Co-design yielded diverse interventions, with videos being the most common intervention format (n = 11). We observed substantial variations in the reporting style and terminology used within the studies and limited attempts to assess intervention effectiveness.

Context matters: How to research vaccine attitudes and uptake after the COVID-19 crisis

The pandemic dramatically accelerated research on vaccine attitudes and uptake, a field which mobilizes researchers from the social sciences and humanities as well as biomedical and public health disciplines. The field has the potential to contribute much more, but the growth in research and the deeper connections between disciplines brings challenges as well as opportunities. This perspective article assesses the recent development of the field, exploring progress whilst emphasizing that not enough attention has been paid to national and local contexts. This lack of contextual attention limits the progress of research and hinders our capacity to learn from the COVID-19 crisis. We suggest three concrete responses: building and recognizing new publishing formats for reporting and synthesizing studies at a country level; establishing country-level interdisciplinary networks to connect research and praxis; and strengthening international comparative survey work by enhancing the focus on local contextual factors.

Impact of the COVID-19 vaccination on confusion around vaccination in general: A longitudinal study on a university population over 18 months

Even before the COVID-19 pandemic, vaccine hesitancy was one of the main global public health threats. Unfortunately, the COVID-19 crisis and its associated risks only reinforced this hesitancy. This study aimed to identify to what extent the COVID-19 vaccination affected confusion around vaccination in general, its change and any associated factors. A questionnaire was distributed to the university population of Liège between April-June 2021 (Time 1) and July-September 2022 (Time 2). The impact of the COVID-19 vaccination on confusion around vaccination in general (score 0 to 100) was divided into three groups based on the tertiles of the study sample at different times and whether or not any change had been observed. Ordinal and multinomial regression analyses were performed to assess the relationship between the confusion and various determinants. The sample consisted of 491 participants. Time 1 vs Time 2, 41.3% vs 35.4% seemed to be less confused, 24.2% vs 28.7% were moderately confused and 34.4% vs 35.8% more confused, respectively. In terms of change, 19.4% of participants were less confused, 55.2% had not changed their opinion and 25.5% were more confused. The determinants causing confusion at both times and regarding change were self-perception, health literacy, past vaccination experiences and COVID-19 related factors (COVID-19 vaccination intention and trust in source of information at Time 1; preferred source of information, trust in vaccine producers and conspiratorial beliefs at Time 2; trust in vaccine producers for change). The results demonstrated that the COVID-19 vaccination impacted confusion around vaccination in general. Both unrelated and related COVID-19 factors, particularly regarding the progression of the pandemic, seem to have contributed to this confusion. Contributing factors require a personalised approach, evidence-based information being communicated with messages adapted to the situation and its evolution designed to allay individuals' fears about vaccination.

Vaccine development using artificial intelligence and machine learning: A review

The COVID-19 pandemic has underscored the critical importance of effective vaccines, yet their development is a challenging and demanding process. It requires identifying antigens that elicit protective immunity, selecting adjuvants that enhance immunogenicity, and designing delivery systems that ensure optimal efficacy. Artificial intelligence (AI) can facilitate this process by using machine learning methods to analyze large and diverse datasets, suggest novel vaccine candidates, and refine their design and predict their performance. This review explores how AI can be applied to various aspects of vaccine development, such as predicting immune response from protein sequences, discovering adjuvants, optimizing vaccine doses, modeling vaccine supply chains, and predicting protein structures. We also address the challenges and ethical issues that emerge from the use of AI in vaccine development, such as data privacy, algorithmic bias, and health data sensitivity. We contend that AI has immense potential to accelerate vaccine development and respond to future pandemics, but it also requires careful attention to the quality and validity of the data and methods used.

"I can't see the forest for the ticks, uhm, trees …": The role of online forums in parents' vaccination trajectories

When it comes to health-related information-seeking behavior, online communities play a key role for some groups, such as parents. With a case study of online communities in a loosely organized vaccination system, that of Austria, we study how parents make use of a prominent online forum (parents.at) in their vaccination trajectories and situate this analysis in its socio-political context. Based on inductive qualitative analysis of relevant threads (n = 27), we find that parents use forums in three ways: First, the forum serves as a platform through which parents seek orientation in a loosely organized and fragmented vaccination system. Second, the forum offers space for sharing, collecting, and evaluating different forms of expertise. In doing so, parents carve out a space in which they can comfortably put lay expertise and credentialed expertise on a par, particularly in their advice to peers. Third, and on that basis, parents use the forum for deliberating on future or past vaccination-related decisions. In doing so, they frequently draw on idiosyncratic notions of individual risks and benefits. These three practices enable parents to accumulate and share what we label navigational capital. We conclude that parents resort to online spaces both out of a subjective need and, for some, as a result of a dysfunction of the national childhood vaccination program which offers little orientation for parents.

COVID-19 and influenza vaccine-hesitancy subgroups

Health communicators are faced with the challenge that people can hesitate vaccines for different reasons. Our aim was to identify and describe the qualities of distinct COVID-19 and influenza vaccine-hesitancy subgroups to facilitate the development of tailored vaccine-hesitancy communication. In two studies, we used agglomerative hierarchical cluster analysis to identify COVID-19 (N = 554) and influenza (N = 539) vaccine-hesitancy subgroups in the general population based on nine vaccine hesitancy-related variables (intent to get vaccinated, perceived vaccine safety, perceived vaccine efficacy, perceived disease threat, perceived vaccination responsibility, perceived vaccination convenience, distrust in authorities, conspiracy mentality, and reliance on anecdotal testimonies). We identified and described six distinct COVID-19 vaccine-hesitancy subgroups (the Vaccination Positive, the Ambivalent, the Fearing Skeptic, the Unconvinced, the Constrained Skeptic, and the Vaccination Opponent), and three influenza vaccine-hesitancy subgroups (the Vaccination Positive, the Complacent, and the Vaccination Opponent), with different levels of hesitancy. We discuss the implications of the results for health communicators. Our results shed light on the (dis)similarities between people who hesitate COVID-19 and influenza vaccines and suggest that there is greater variety in hesitancy concerning COVID-19 vaccinations than influenza vaccinations. These findings can be used to design and test tailored vaccination messages.

Biden's approval, record inflation, economic recovery, COVID-19 mortality, and vaccination rate among Americans-A longitudinal study of state-level data from April 2021 to January 2022

The COVID-19 pandemic has brought an unprecedented impact on Americans for over three years. One effective strategy to mitigate the pandemic's damage lies in the vaccine. This study aims to investigate the effects of state-level predictors that vary month-by-month on changes in vaccination rates. Panel data of state-level indicators are built for all 50 states from April 2021 to January 2022. The dependent variable is the monthly increase in vaccination rate, and the independent variables include measures of Biden's approval, inflation, economic recovery, and COVID-19 mortality for each month of this study period. Fixed-effects regression is adopted for longitudinal statistical estimation. Findings show that over time Biden's approval and COVID-19 death are positively associated with the growth in the vaccination rate, while inflation and economic recovery are negatively associated with the vaccination rate. Significant interactions are identified among these predictors. The findings from analyzing panel indicators at the state level complement the current literature dominated by examining cross-sectional data and provide public health officials with fresh insights to promote the vaccine rollout.

The social and socio-political embeddedness of COVID-19 vaccination decision-making: A five-country qualitative interview study from Europe

The uptake ofCOVID-19 vaccines has varied considerably across European countries. This study investigates people's decision-making process regarding vaccination by analyzing qualitative interviews (n = 214) with residents from five European countries: Austria, Germany, Italy, Portugal, and Switzerland. We identify three factors that shape vaccination decision-making: individual experiences and pre-existing attitudes towards vaccination, social environment, and socio-political context. Based on this analysis, we present a typology of decision-making regarding COVID-19 vaccines, where some types present stable stances towards vaccines and others change over time. Trust in government and relevant stakeholders, broader social factors, and people's direct social environment were particularly relevant to these dynamics. We conclude that vaccination campaigns should be considered long-term projects (also outside of pandemics) in need of regular adjustment, communication and fine-tuning to ensure public trust. This is particularly pertinent for booster vaccinations, such as COVID-19 or influenza.