Prayer frequency and COVID-19 vaccine hesitancy among older adults in Europe

Childhood factors and their impact on COVID-19 vaccine acceptance in older adults across Europe

OBJECTIVES

This study investigates how childhood factors, including early vaccinations and socio-demographic variables, influence COVID-19 vaccine acceptance among older adults across Europe.

STUDY DESIGN

Longitudinal panel study using data from the SHARE survey across 27 European countries.

METHODS

We analyzed responses from 43,790 participants aged 50+ who took part in both the SHARELIFE (waves 3 or 7) and the second SHARE Corona Survey. Childhood factors examined included early vaccinations, socioeconomic status (SES), health, and cognition. Additional variables were region, sex, and birth cohort. Multivariate logistic regression models were used to assess associations between these factors and COVID-19 vaccine acceptance, adjusting for household wealth, chronic diseases, education, and household composition.

RESULTS

Overall, 84.9 % of participants reported accepting the COVID-19 vaccine. Childhood vaccinations were significantly associated with higher odds of vaccine acceptance (OR: 1.65, 95 % CI: 1.39-1.96). Females (OR: 0.92, 95 % CI: 0.86-0.99), younger cohorts (born after 1956: OR: 0.61, 95 % CI: 0.53-0.71), and individuals from disadvantaged childhood SES backgrounds (OR: 0.85, 95 % CI: 0.77-0.94), were less likely to accept the vaccine. Regional differences were evident, with Eastern Europe showing the lowest acceptance rates (OR: 0.34, 95 % CI: 0.31-0.38). Low childhood cognition was also associated with a lower vaccine acceptance (OR: 0.72, 95 % CI: 0.72-0.89).

CONCLUSIONS

Childhood factors, including early vaccinations and socio-demographic variables, significantly influence COVID-19 vaccine acceptance in older Europeans. Interventions should focus on reducing disparities, enhancing trust in healthcare systems, and promoting early vaccination and parental engagement to foster long-term positive attitudes toward immunization.

Unraveling COVID-19 vaccine hesitancy in Europeans 50 and older through a lens of preventive practices

BACKGROUND

The COVID-19 pandemic underscored the issue of vaccine hesitancy, leading researchers to study the determinants of people's willingness to receive the COVID-19 vaccine. This study is the first to comprehensively investigate the role of preventive practices at both the individual and contextual level, drawing on the theoretical concept of "cultural health capital".

METHODS

Utilizing data from the Survey of Health, Ageing, and Retirement (SHARE), covering information from 18,454 individuals aged 50 years and above residing in 25 European countries, we examined the influence of past engagement in preventive practices and the prevalence of such practices within a country on the likelihood of COVID-19 vaccine uptake. Our analysis included (i) previous vaccination behaviors, (ii) other healthcare-related behaviors, and (iii) lifestyle factors at both the individual and contextual levels. Leveraging the longitudinal design of the SHARE, we accounted for the temporal ordering of the relationships.

RESULTS

At the individual level, almost all preventive behaviors were significantly related to people's willingness to receive the COVID-19 vaccine. Individuals who (i) had received an influenza vaccination prior to the COVID-19 outbreak and during childhood, (ii) had regularly participated in dental and blood pressure check-ups throughout their lives, and (iii) did not engage in lifestyle-related risk behaviors, were more likely to accept the COVID-19 vaccine. Notably, alcohol use was not significantly associated. At the contextual level, only the vaccination coverage rate for influenza was found to be robustly related, indicating that individuals were more inclined to receive the COVID-19 vaccine in countries with higher influenza vaccination rates prior to the pandemic.

CONCLUSION

Active participation in preventive practices and effective implementation of vaccination campaigns can contribute to the development of (institutional) cultural health capital, which ultimately promotes a greater willingness to get vaccinated against COVID-19.

The Impact of Vaccination on COVID-19, Influenza, and Respiratory Syncytial Virus-Related Outcomes: A Narrative Review

Vaccination represents a core preventive strategy for public health, with interrelated and multifaceted effects across health and socioeconomic domains. Beyond immediate disease prevention, immunization positively influences downstream health outcomes by mitigating complications of preexisting comorbidities and promoting healthy aging. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus, and respiratory syncytial virus (RSV) are common respiratory viruses responsible for broad societal cost and substantial morbidity and mortality, particularly among at-risk individuals, including older adults and people with frailty or certain comorbid conditions. In this narrative review, we summarize the overall impact of vaccination for these 3 viruses, focusing on mRNA vaccines, each of which exhibits unique patterns of infection, risk, and transmission dynamics, but collectively represent a target for preventive strategies. Vaccines for COVID-19 (caused by SARS-CoV-2) and influenza are effective against the most severe outcomes, such as hospitalization and death; these vaccines represent the most potent and cost-effective interventions for the protection of population and individual health against COVID-19 and influenza, particularly for older adults and those with comorbid conditions. Based on promising results of efficacy for the prevention of RSV-associated lower respiratory tract disease, the first RSV vaccines were approved in 2023. Immunization strategies should account for various factors leading to poor uptake, including vaccine hesitancy, socioeconomic barriers to access, cultural beliefs, and lack of knowledge of vaccines and disease states. Coadministration of vaccines and combination vaccines, such as multicomponent mRNA vaccines, offer potential advantages in logistics and delivery, thus improving uptake and reducing barriers to adoption of new vaccines. The success of the mRNA vaccine platform was powerfully demonstrated during the COVID-19 pandemic; these and other new approaches show promise as a means to overcome existing challenges in vaccine development and to sustain protection against viral changes over time.A graphical abstract and video abstract is available with this article.

The role of religion and COVID-19 vaccine uptake in England

BACKGROUND

While many countries have successfully deployed COVID-19 vaccination programmes, there are disparities in their uptake. One factor influencing vaccine coverage is religion. Existing research has found a link between religious beliefs and vaccine hesitancy. This study looks at religion in England to examine its relationship with public health.

METHODS

This analysis used data from a survey of over 12,000 respondents in England, conducted through the YouGov Online Panel. Respondents were asked whether they identified with a religion, and if so which, and the number of COVID-19 vaccinations they had received. We employed logistic regressions to analyse the data, accounting for age, gender, education, generalised trust, trust in government, and political ideology.

RESULTS

We find that respondents who identify as part of the Church of England have had significantly more COVID-19 vaccinations. Conversely, adherents to the Pentecostal Evangelical and Islamic faiths have had significantly fewer COVID-19 vaccinations. These relationships hold even when adjusting for age, education, level of trust, and political affiliation.

CONCLUSION

This research indicates a potential influence of religious affiliation on vaccine uptake, highlighting the need for more carefully-tailored public health programmes. Recognizing the diverse associations of different religious affiliations on health behaviour is important for shaping future vaccination campaigns and policy interventions. Engaging with religious communities and leaders may be one method through which to deal with vaccine hesitancy and improve public health.

Sex differences in vision and hearing impairments across age and European regions : Findings from SHARE

AIM

Although sensory impairments are common conditions among older people, research often fails to consider the role of sex. We examined sex differences in vision impairment and hearing impairment across age and European regions.

METHODS

We conducted a cross-sectional study based on a pooled sample of 65,656 females and 54,881 males aged 50 years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Logistic regression models with robust standard errors providing odds ratios (OR) and 95% confidence intervals (CI) were used to examine associations.

RESULTS

European females had generally higher odds of vision impairment (OR 1.16, 95% CI 1.12-1.21) but lower odds of hearing impairment than European males (OR 0.70, 95% CI 0.67-0.73). The female disadvantage in vision increased with advancing age, whereas the female advantage in hearing decreased. No overall sex difference in vision was found in northern Europe, but females had more vision impairments than males in southern (OR 1.23, 95% CI 1.14-1.32), western (OR 1.14, 95% CI 1.08-1.21) and eastern (OR 1.10, 95% CI 1.02-1.20) Europe. Females were healthier than males in terms of hearing in all regions, with the largest female advantage in northern Europe (OR 0.58, 95% CI 0.53-0.64).

CONCLUSION

Our findings demonstrate an overall consistent pattern of sex differences in sensory impairments across Europe showing an increasing female disadvantage in vision and a decreasing female advantage in hearing with advancing age.

The disparity in hesitancy toward COVID-19 vaccination between older individuals in nursing homes and those in the community in Taizhou, China

PURPOSE

Older individuals are priority coronavirus disease 2019 (COVID-19) vaccine recipients. Our aim was to investigate the prevalence of and factors influencing vaccine hesitancy in older individuals living in nursing homes and communities.

METHODS

A self-administered COVID-19 vaccine hesitancy survey was conducted from September 2021 to December 2021 among people aged ≥ 60 years in eight nursing homes (382 participants) and the community (112 participants) in Taizhou, China. The response rate was 72.1% (382/530) for older adults in nursing homes and 68.7% (112/163) for older adults in the community.

RESULTS

We found that 58.1% of the older individuals in nursing homes and 36.6% of those in the community were hesitant to receive the COVID-19 vaccine and that there was a statistically significant difference (P < 0.001). Multiple logistic regression results indicated that the main factors influencing hesitation among the older individuals in nursing homes were being male (Odds Ratio (OR) = 1.67, 95% Confidence Interval (CI): 1.01-2.76); their cognitive level, including having a high perceived risk of COVID-19 infection (OR = 3.06, 95% CI: 1.73-5.43) or the perception of low vaccine safety (OR = 3.08, 95% CI: 1.545- 6.145); anxiety (OR = 3.43, 95% CI: 1.96-5.99); and no previous influenza vaccination (OR = 1.82, 95% CI: 1.13-2.93); whereas those for older individuals in the community were comorbid chronic diseases (OR = 3.13, 95% CI: 1.11- 8.78) and community workers not recommending the vaccine (OR = 8.223, 95% CI: 1.77-38.27).

CONCLUSION

The proportion of older individuals in nursing homes who were hesitant to receive the COVID-19 vaccine was significantly higher than for older individuals in the community. Targeted measures should be implemented to reduce vaccine hesitancy and improve vaccination rates in response to the special environment of nursing homes and the characteristics of this population.

Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study

BACKGROUND

COVID-19 vaccine hesitancy reduces vaccination rates, which is detrimental to building herd immunity and halting the spread of COVID-19 and its variations. Most researches have simply identified the reasons affecting COVID-19 vaccination reluctance without delving into its dynamics, which makes forecasting future trends difficult.

OBJECTIVE

This study aimed to examine the current COVID-19 vaccine booster hesitancy rate in Chinese adults as well as the dynamics of vaccine hesitancy and its influencing factors. The results of this study will have practical implications for policy responses in mainland China, and effective COVID-19 booster vaccination in specific populations.

METHODS

The web-based survey was completed by creating questionnaires and using a stratified random sampling method to collect information from adults (≥18 years old) among 2556 households in 4 geographical regions of China. We collected sociodemographic information, health status, awareness of COVID-19 and its vaccine, self-perceptions, trust in medical staff and vaccine developers, and so on. The odds ratios and 95% CI for the statistical associations were estimated using logistic regression models.

RESULTS

Overall, 6659 participants (females: n=3540, 53.2%; males: n=3119, 46.8%) responded. In total, 533 (8%; 95% CI 7.4%-8.7%) participants presented a clear hesitancy in receiving the COVID-19 booster vaccination, while 736 (11.1%; 95% CI 10.3%-11.8%) expressed hesitancy in regular booster vaccination. A higher prevalence of vaccine hesitancy in both booster vaccination and regular booster vaccination was observed among participants with a history of allergies, experiencing chronic disease, lower levels of public health prevention measures or susceptibility or benefits or self-efficiency, higher levels of severity or barriers, and lower trust in both medical staff and vaccine developers (P<.05). The females and participants with higher education levels, higher levels of barriers, lower levels of susceptibility, and lower trust in vaccine developers preferred to have attitudinal changes from acceptance to hesitancy, while people with higher education levels, lower self-report health conditions, experiencing chronic disease, history of allergies, and lower trust in medical staff and developers were all positively associated with constant COVID-19 booster hesitancy.

CONCLUSIONS

The prevalence of COVID-19 vaccine booster hesitancy is not high in mainland China. However, there is a slight increment in hesitancy on regular booster vaccination. Conducting targeted information guidance for people with higher education levels and chronic diseases, as well as improving accessibility to booster vaccination and increasing trust in medical staff and vaccine producers may be highly effective in reducing vaccine hesitancy.

Ethical Challenges Involved in COVID-19 Vaccine Mandates for Children: A Systematic Review

The new COVID-19 pandemic has affected day-to-day life, creating various ethical dilemmas. COVID-19 vaccination is seen as an effective way to halt the pandemic. Ethical challenges can arise when the vaccines are mandated for all ages, but more so when mandated for children. This systematic review discusses the pros and cons of the COVID-19 vaccine mandate for children. The primary objective of this study is to summarize exclusively the various ethical conflicts, impacts, and requirements that arise as a result of the COVID-19 vaccine mandate laws on children. The secondary objective is to analyze the reasons for parents refusing to allow their children to be given the COVID-19 vaccine sand the effective strategies to increase vaccine uptake among children. The study involved a systematic review, identification of relevant literature and reviews following the PRISMA-ScR recommendations. The keywords 'COVID-19 vaccine mandates on children' were used to mine the literature from PubMed and WHO COVID-19 Research Database. Limitations placed on the original searches were: English language, humans, ethics, and children. Out of 529 studies, only 13 satisfied the selection criteria. The sample included studies with a wide, diverse range of methods, settings, research, authors, and journals. COVID-19 vaccine mandates on children need to be scrutinized. Implementing the COVID-19 vaccination drive in a scientific way is acceptable. As children are the fastest-growing population and have the highest life expectancy, it is important to take into account that the vaccines do not disturb their growth and development.