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Vicario CM, Mucciardi M, Faraone G, Lucifora C, Schade HM, Falzone A, Salehinejad MA, Craparo G, Nitsche MA. Individual predictors of vaccine hesitancy in the Italian post COVID-19 pandemic era. Hum Vaccin Immunother 2024; 20:2306677. [PMID: 38289323 PMCID: PMC10829816 DOI: 10.1080/21645515.2024.2306677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
A wide range of survey studies have explored vaccination hesitancy/resistance during the COVID-19 pandemic and provided evidence that this can be explained by several individual variables from the ideological, clinical, and socio-affective domain. However, evidence about which individual variables predict vaccine hesitancy in the post-pandemic state of COVID-19 is meager. We administered a battery of questionnaires to a group of 120 Italian participants with high and low scores on the adult vaccine hesitancy scale (aVHS) to investigate the predictive role of ideological (i.e. political orientation), clinical (i.e. anxiety, interoceptive accuracy), and socio-affective (i.e. alexithymia, disgust sensitivity/propensity, empathy) variables on vaccine hesitancy/resistance. This study provides evidence that lower interoceptive awareness and cognitive empathy are predictors of a greater hesitancy to get vaccinated in the post-pandemic COVID-19 state.
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Affiliation(s)
- Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Massimo Mucciardi
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Giulia Faraone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Chiara Lucifora
- Dipartimento di Filosofia e Comunicazione, Università di Bologna, Bologna, Italy
| | - Hannah M Schade
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina, Messina, Italy
| | - Mohammad A Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, Cittadella Universitaria, Enna, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
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Smittenaar R, Quaife SL, von Wagner C, Higgins T, Hubbell E, Lee L. Impact of screening participation on modelled mortality benefits of a multi-cancer early detection test by socioeconomic group in England. J Epidemiol Community Health 2024; 78:345-353. [PMID: 38429085 PMCID: PMC11103338 DOI: 10.1136/jech-2023-220834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/10/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Cancer burden is higher and cancer screening participation is lower among individuals living in more socioeconomically deprived areas of England, contributing to worse health outcomes and shorter life expectancy. Owing to higher multi-cancer early detection (MCED) test sensitivity for poor-prognosis cancers and greater cancer burden in groups experiencing greater deprivation, MCED screening programmes may have greater relative benefits in these groups. We modelled potential differential benefits of MCED screening between deprivation groups in England at different levels of screening participation. METHODS We applied the interception multi-cancer screening model to cancer incidence and survival data made available by the National Cancer Registration and Analysis Service in England to estimate reductions in late-stage diagnoses and cancer mortality from an MCED screening programme by deprivation group across 24 cancer types. We assessed the impact of varying the proportion of people who participated in annual screening in each deprivation group on these estimates. RESULTS The modelled benefits of an MCED screening programme were substantial: reductions in late-stage diagnoses were 160 and 274 per 100 000 persons in the least and most deprived groups, respectively. Reductions in cancer mortality were 60 and 99 per 100 000 persons in the least and most deprived groups, respectively. Benefits were greatest in the most deprived group at every participation level and were attenuated with lower screening participation. CONCLUSIONS For the greatest possible population benefit and to decrease health inequalities, an MCED implementation strategy should focus on enhancing equitable, informed participation, enabling equal participation across all socioeconomic deprivation groups. TRIAL REGISTRATION NUMBER NCT05611632.
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Affiliation(s)
| | | | | | - Thomas Higgins
- National Cancer Registration and Analysis Service, Leeds, UK
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Abbasi S, Matsui-Masai M, Yasui F, Hayashi A, Tockary TA, Mochida Y, Akinaga S, Kohara M, Kataoka K, Uchida S. Carrier-free mRNA vaccine induces robust immunity against SARS-CoV-2 in mice and non-human primates without systemic reactogenicity. Mol Ther 2024; 32:1266-1283. [PMID: 38569556 PMCID: PMC11081875 DOI: 10.1016/j.ymthe.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Carrier-free naked mRNA vaccines may reduce the reactogenicity associated with delivery carriers; however, their effectiveness against infectious diseases has been suboptimal. To boost efficacy, we targeted the skin layer rich in antigen-presenting cells (APCs) and utilized a jet injector. The jet injection efficiently introduced naked mRNA into skin cells, including APCs in mice. Further analyses indicated that APCs, after taking up antigen mRNA in the skin, migrated to the lymph nodes (LNs) for antigen presentation. Additionally, the jet injection provoked localized lymphocyte infiltration in the skin, serving as a physical adjuvant for vaccination. Without a delivery carrier, our approach confined mRNA distribution to the injection site, preventing systemic mRNA leakage and associated systemic proinflammatory reactions. In mouse vaccination, the naked mRNA jet injection elicited robust antigen-specific antibody production over 6 months, along with germinal center formation in LNs and the induction of both CD4- and CD8-positive T cells. By targeting the SARS-CoV-2 spike protein, this approach provided protection against viral challenge. Furthermore, our approach generated neutralizing antibodies against SARS-CoV-2 in non-human primates at levels comparable to those observed in mice. In conclusion, our approach offers a safe and effective option for mRNA vaccines targeting infectious diseases.
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Affiliation(s)
- Saed Abbasi
- Innovation Center of NanoMedicine (iCONM), Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan
| | - Miki Matsui-Masai
- Department of Research, NANO MRNA Co., Ltd., 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan
| | - Fumihiko Yasui
- Department of Diseases and Infection, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Akimasa Hayashi
- Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan
| | - Theofilus A Tockary
- Innovation Center of NanoMedicine (iCONM), Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan
| | - Yuki Mochida
- Innovation Center of NanoMedicine (iCONM), Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan; Department of Advanced Nanomedical Engineering, Medical Research Institute, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Shiro Akinaga
- Department of Research, NANO MRNA Co., Ltd., 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan
| | - Michinori Kohara
- Department of Microbiology and Cell Biology, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Kazunori Kataoka
- Innovation Center of NanoMedicine (iCONM), Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan.
| | - Satoshi Uchida
- Innovation Center of NanoMedicine (iCONM), Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan; Department of Advanced Nanomedical Engineering, Medical Research Institute, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
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4
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Fan Q, Hu W, Han X, Henderson SL, Geng Y. Understanding and mitigating negative affect in preventive health behaviors: Evidence from the COVID-19 vaccination process. J Health Psychol 2024:13591053241242526. [PMID: 38561913 DOI: 10.1177/13591053241242526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The study investigated the willingness for vaccine uptake during the COVID-19 pandemic (April-June 2021), and explored the effect of both mindfulness and health education in managing negative affect post-vaccination. In study 1, a sample of 468 Chinese college students completed a one-time survey, assessing loneliness, stress, medical fear, and vaccination likelihood. Results showed that medical fear mediated the relationship between loneliness, stress and vaccination likelihood. In study 2, 70 college students were randomly assigned to one of three intervention conditions (mindfulness, health education, and control) during vaccination. Participants in mindfulness group showed lower negative affect scores than the control group post-intervention (p = 0.019). However, no significant difference was reported between health education with the other two conditions. As such, medical fear would be an important factor to target for improving the likelihood of vaccine uptake. Furthermore, a short mindfulness intervention was effective to improve experience of vaccination through mitigating negative affect.
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Affiliation(s)
- Qianqian Fan
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Wanying Hu
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Xinxin Han
- School of Education, Zhengzhou University, Zhengzhou, China
| | | | - Yaoguo Geng
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, China
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Song Y, Mehl F, Zeichner SL. Vaccine Strategies to Elicit Mucosal Immunity. Vaccines (Basel) 2024; 12:191. [PMID: 38400174 PMCID: PMC10892965 DOI: 10.3390/vaccines12020191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Vaccines are essential tools to prevent infection and control transmission of infectious diseases that threaten public health. Most infectious agents enter their hosts across mucosal surfaces, which make up key first lines of host defense against pathogens. Mucosal immune responses play critical roles in host immune defense to provide durable and better recall responses. Substantial attention has been focused on developing effective mucosal vaccines to elicit robust localized and systemic immune responses by administration via mucosal routes. Mucosal vaccines that elicit effective immune responses yield protection superior to parenterally delivered vaccines. Beyond their valuable immunogenicity, mucosal vaccines can be less expensive and easier to administer without a need for injection materials and more highly trained personnel. However, developing effective mucosal vaccines faces many challenges, and much effort has been directed at their development. In this article, we review the history of mucosal vaccine development and present an overview of mucosal compartment biology and the roles that mucosal immunity plays in defending against infection, knowledge that has helped inform mucosal vaccine development. We explore new progress in mucosal vaccine design and optimization and novel approaches created to improve the efficacy and safety of mucosal vaccines.
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Affiliation(s)
- Yufeng Song
- Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, USA; (Y.S.)
| | - Frances Mehl
- Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, USA; (Y.S.)
| | - Steven L. Zeichner
- Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, USA; (Y.S.)
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA 22908, USA
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Mabbott AP, Bedford H. Pain management in infant immunisation: A cross-sectional survey of UK primary care nurses. Prim Health Care Res Dev 2023; 24:e71. [PMID: 38126393 PMCID: PMC10790675 DOI: 10.1017/s146342362300066x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. AIM This study aimed to explore primary care practice nurses' (PNs) use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice. METHODS A questionnaire was developed and distributed to nurses throughout the UK via convenience sampling in paper and online formats. Questions assessed the frequency of pain management intervention use during infant immunisation and barriers to their use. FINDINGS A total of 255 questionnaire responses were received. Over 90% (n = 226) of respondents never used topical anaesthetics or sweet solutions during immunisations, while 41.9% advised breastfeeding occasionally (n = 103). Parent-/caregiver-led distraction was the most frequently used intervention, with most nurses using it occasionally (47.9%, n = 116) or often (30.6%, n = 74). Most practices had no immunisation pain management policy (81.1%, n = 184), and most PNs' previous training had not included pain management (86.9%, n = 186). Barriers to intervention use included lack of time, knowledge and resources. Excluding distraction, pain management strategies were infrequently or never used during infant immunisation. Key barriers to using evidence-based strategies were lack of time, knowledge and resources.
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Affiliation(s)
- Annie P. Mabbott
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Helen Bedford
- University College London Great Ormond Street Institute of Child Health, London, UK
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Kantor J, Vanderslott S, Morrison M, Pollard AJ, Carlisle RC. The Oxford Needle Experience (ONE) scale: a UK-based and US-based online mixed-methods psychometric development and validation study of an instrument to assess needle fear, attitudes and expectations in the general public. BMJ Open 2023; 13:e074466. [PMID: 38097240 PMCID: PMC10729041 DOI: 10.1136/bmjopen-2023-074466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To develop and validate the Oxford Needle Experience (ONE) scale, an instrument to assess needle fear, attitudes and expectations in the general population. DESIGN Cross-sectional validation study. SETTING Internet-based with participants in the UK and USA. PARTICIPANTS UK and US representative samples stratified by age, sex, and ethnicity using the Prolific Academic platform. MAIN OUTCOME MEASURES Exploratory factor analysis with categorical variables and a polychoric correlation matrix followed by promax oblique rotation on the UK sample for the ONE scale. Confirmatory factor analysis (CFA) with a Satorra-Bentler scaled test statistic evaluating the root mean squared error of approximation (RMSEA), standardised root mean squared residual (SRMR) and comparative fit index (CFI) on the US sample. Reliability as internal consistency using McDonald's omega. Convergent validity using the Pearson correlation coefficient. Predictive and discriminant validity using logistic regression ORs of association (OR). RESULTS The population included 1000 respondents, 500 in the UK and 500 in the USA. Minimum average partial correlation and a scree plot suggested four factors should be retained: injection hesitancy, blood-related hesitancy, recalled negative experiences and perceived benefits, yielding a 19-question scale. On CFA, the RMSEA was 0.070 (90% CI, 0.064 to 0.077), SRMR 0.053 and CFI 0.925. McDonald's omega was 0.92 and 0.93 in the UK and US samples, respectively. Convergent validity with the four-item Oxford Coronavirus Explanations, Attitudes and Narratives Survey (OCEANS) needle fear scale demonstrated a strong correlation (r=0.83). Predictive validity with a single-question COVID-19 vaccination status question demonstrated a strong association, OR (95% CI) 0.97 (0.96 to 0.98), p<0.0001 in the US sample. Discriminant validity with a question regarding the importance of controlling what enters the body confirmed the ONE score does not predict this unrelated outcome, OR 1.00 (0.99, 1.01), p=0.996 in the US sample. CONCLUSIONS The ONE scale is a reliable and valid multidimensional scale that may be useful in predicting vaccine hesitancy, designing public health interventions to improve vaccine uptake and exploring alternatives to needles for medical procedures.
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Affiliation(s)
- Jonathan Kantor
- Oxford Vaccine Group, University of Oxford, Oxford, UK
- Biomedical Ultrasonics, Biotherapy, and Biopharmaceuticals Laboratory (BUBBL), Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
- Department of Dermatology, Center for Global Health, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Michael Morrison
- Centre for Health, Law, and Emerging Technologies (HeLEX), University of Oxford, Oxford, UK
| | | | - Robert C Carlisle
- Biomedical Ultrasonics, Biotherapy, and Biopharmaceuticals Laboratory (BUBBL), Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
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Li M, Yang L, Wang C, Cui M, Wen Z, Liao Z, Han Z, Zhao Y, Lang B, Chen H, Qian J, Shu Y, Zeng X, Sun C. Rapid Induction of Long-Lasting Systemic and Mucosal Immunity via Thermostable Microneedle-Mediated Chitosan Oligosaccharide-Encapsulated DNA Nanoparticles. ACS NANO 2023; 17:24200-24217. [PMID: 37991848 DOI: 10.1021/acsnano.3c09521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Most existing vaccines, delivered by intramuscular injection (IM), are typically associated with stringent storage requirements under cold-chain distribution and professional administration by medical personnel and often result in the induction of weak mucosal immunity. In this context, we reported a microneedle (MN) patch to deliver chitosan oligosaccharide (COS)-encapsulated DNA vaccines (DNA@COS) encoding spike and nucleocapsid proteins of SARS-CoV-2 as a vaccination technology. Compared with IM immunization, intradermal administration via the MN-mediated DNA vaccine effectively induces a comparable level of neutralizing antibody against SARS-CoV-2 variants. Surprisingly, we found that MN-mediated intradermal immunization elicited superior systemic and mucosal T cell immunity with enhanced magnitude, polyfunctionality, and persistence. Importantly, the DNA@COS nanoparticle vaccine loaded in an MN patch can be stored at room temperature for at least 1 month without a significant decrease of its immunogenicity. Mechanically, our strategy enhanced dendritic cell maturation and antiviral immunity by activating the cGAS-STING-mediated IFN signaling pathway. In conclusion, this work provides valuable insights for the rapid development of an easy-to-administer and thermostable technology for mucosal vaccines.
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Affiliation(s)
- Minchao Li
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Li Yang
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Congcong Wang
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Mingting Cui
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Ziyu Wen
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Zhiheng Liao
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Zirong Han
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Yangguo Zhao
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Bing Lang
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Hongzhong Chen
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jun Qian
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
| | - Yuelong Shu
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
- Key Laboratory of Pathogen Infection Prevention and Control (MOE), State Key Laboratory of Respiratory Health and Multimorbidity, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102629, P.R. China
| | - Xiaowei Zeng
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Caijun Sun
- School of Public Health (Shenzhen), Sun Yat-sen University; Shenzhen, 518107, China
- Key Laboratory of Tropical Disease Control (Sun Yat-sen university), Ministry of Education, Guangzhou 514400, China
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University; Guangdong 518107, China
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Collier AF, Schaefer KR, Uddin A, Noonan C, Dillard DA, Son-Stone L, Manson SM, Buchwald D, MacLehose R. COVID-19 vaccination in urban American Indian and Alaska Native children: Parental characteristics, beliefs and attitudes associated with vaccine acceptance. Vaccine X 2023; 15:100406. [PMID: 38058791 PMCID: PMC10696120 DOI: 10.1016/j.jvacx.2023.100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/07/2023] [Accepted: 11/12/2023] [Indexed: 12/08/2023] Open
Abstract
Background Little is known about vaccination rates for American Indian and Alaska Native (AI/AN) parents and their children, or parental decisions in this regard. Improving vaccination rates is a serious concern due to the disproportionate incidence and morbidity of COVID-19 in AI/AN people. Purpose Our goal was to describe urban AI/AN parental attributes associated with COVID-19 vaccination of their children. Methods Survey participants (n = 572) were ≥18 years of age, had children ≥5 years of age, AI/AN, and seen at one of six urban health organizations serving primarily AI/AN people within the prior year. They were asked about gender, age, education, marital status, perceived stress, trauma history, whether they had received the COVID-19 vaccine, tested positive for COVID-19 in the past, and if their child was vaccinated. They were also asked about 16 vaccine hesitancy reasons. Results Parental vaccination rate was 82%, with 59% of their children vaccinated. Parents who vaccinated their children were older, had higher education, lower stress and trauma, and were more likely to be vaccinated compared to parents who did not vaccinate their children. Forty-two percent of parents indicated they would likely vaccinate their unvaccinated child in the future. Sixteen vaccine hesitancy reasons revealed four factors: distrust, inconvenience, lack of concern about the pandemic, and AI/AN concerns. Parents who had no plans to vaccinate their children had the highest vaccine distrust and lack of concern about the pandemic. Parents with greater vaccine distrust and AI/AN specific concern reported significantly greater trauma history and higher levels of education. Conclusion Even though vaccination rates for AI/AN parents and children are high, the consequences of COVID-19 for AI/AN people are more severe than for other US populations. Providers should use trauma-informed, trust-building and culturally competent communication when discussing choices about vaccination with AI/AN parents.
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Affiliation(s)
| | | | - Azhar Uddin
- Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States
| | | | - Linda Son-Stone
- First Nations Community Healthsource, Albuquerque, NM, United States
| | - Spero M. Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, United States
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States
| | - Richard MacLehose
- Department of Epidemiology and Community Health, University of Minnesota, School of Public Health, United States
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Murdan S, Wei L, van Riet-Nales DA, Gurmu AE, Usifoh SF, Tăerel AE, Yıldız-Peköz A, Krajnović D, Azzopardi LM, Brock T, Fernandes AI, dos Santos ALS, Anto BP, Vallet T, Lee EE, Jeong KH, Akel M, Tam E, Volmer D, Douss T, Shukla S, Yamamura S, Lou X, van Riet BH, Usifoh CO, Duwiejua M, Ruiz F, Furnham A. Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100378. [PMID: 38094713 PMCID: PMC10716026 DOI: 10.1016/j.rcsop.2023.100378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/04/2023] [Accepted: 11/22/2023] [Indexed: 03/07/2024] Open
Abstract
Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected. A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart-Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected. A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one.
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Affiliation(s)
| | - Li Wei
- UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
| | | | - Abyot Endale Gurmu
- Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Stella Folajole Usifoh
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
| | - Adriana-Elena Tăerel
- Faculty of Pharmacy, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Ayca Yıldız-Peköz
- Dept. of Pharmaceutical Technology, Faculty of Pharmacy, Istanbul University, Turkey
| | - Dušanka Krajnović
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Lilian M. Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery University of Malta, Msida, Malta
| | - Tina Brock
- Department of Clinical Pharmacy, UCSF School of Pharmacy, UCSF Box 0622, 521 Parnassus Ave, San Francisco 94143, USA
| | - Ana I. Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Caparica, Almada, Portugal
| | | | - Berko Panyin Anto
- Dept of Clinical & Social Pharmacy, Faculty of Pharmacy & Pharmaceutical sciences, KNUST, Kumasi, Ghana
| | - Thibault Vallet
- ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France
| | | | | | - Marwan Akel
- School of Pharmacy, Lebanese International University, Lebanon
- Inspect-Lb (Institut National De Santé Publique, D'épidémiologie Clinique Et De Toxicologie-Liban), Beirut, Lebanon
| | - Eliza Tam
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Daisy Volmer
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, 50411 Tartu, Estonia
| | | | - Sharvari Shukla
- Symbiosis Statistical Institute, Symbiosis International (Deemed University), Pune, India
| | - Shigeo Yamamura
- Department of Biostatistics, Faculty of Pharmaceutical Sciences, Josai International University, Togane, Chiba, Japan
| | | | - Bauke H.G. van Riet
- Department of Radiotherapy, Netherlands Cancer Institute (at the time of participant recruitment in the Netherlands: MEB and VU University Medical Center), Amsterdam, the Netherlands
| | - Cyril O. Usifoh
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
| | - Mahama Duwiejua
- Dept of Clinical & Social Pharmacy, Faculty of Pharmacy & Pharmaceutical sciences, KNUST, Kumasi, Ghana
| | - Fabrice Ruiz
- ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France
| | - Adrian Furnham
- Dept Leadership and Orgnaisational Behaviour, Norwegian Business School, Norway
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11
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Kirtane AR, Tang C, Freitas D, Bernstock JD, Traverso G. Challenges and opportunities in the development of mucosal mRNA vaccines. Curr Opin Immunol 2023; 85:102388. [PMID: 37776698 DOI: 10.1016/j.coi.2023.102388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/02/2023]
Abstract
mRNA vaccines have played a critical role in controlling the SARS-CoV-2 pandemic, and are being actively studied for use in other diseases. There is a growing interest in applying mRNA vaccines at mucosal surfaces as it enables access to a unique immune reservoir in a less-invasive manner. However, mucosal surfaces present several barriers to mRNA uptake, including degrading enzymes, mucus, and clearance mechanisms. In this mini-review, we discuss our understanding of the immune response to mucosal mRNA vaccines as it compares to systemic mRNA vaccines. We also highlight physical and chemical methods for enhancing mRNA uptake across mucosal tissues. Mucosal mRNA vaccination is a nascent field of research, which will greatly benefit from fundamental investigations into the mechanisms of immune activation and the development of technologies for improved delivery.
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Affiliation(s)
- Ameya R Kirtane
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Chaoyang Tang
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Dylan Freitas
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joshua D Bernstock
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Giovanni Traverso
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
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12
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Tan JM, Reeve E, Fraser L, Proudman SM, Wiese MD. Barriers and Enablers in the Use of Parenteral Methotrexate in Rheumatoid Arthritis Patients: A Scoping Review. Arthritis Care Res (Hoboken) 2023; 75:2306-2315. [PMID: 37128818 DOI: 10.1002/acr.25141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/22/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Methotrexate (MTX) is effective in controlling disease activity in rheumatoid arthritis (RA). Parenteral MTX may have benefits over oral MTX, but it is rarely used in practice. To better understand this low usage rate, it is necessary to explore the barriers and enablers of therapy from the perspective of RA patients. The objectives of this scoping review were to describe RA patients' perspectives on the barriers and enablers in the use of parenteral MTX and to identify the research gaps in this field. METHODS The search was performed in Medline, Embase, Scopus, and Cochrane Library from inception to May 2021. Data synthesis was conducted using the Theoretical Framework of Acceptability. This scoping review included any type of study that explored the use of parenteral MTX by adult RA patients from the patients' perspective, written in English. RESULTS Fifteen studies were included; findings related to the constructs "affective attitude," "burden," "intervention coherence," and "self-efficacy" were explored the most, while some were rarely ("opportunity cost" and "perceived effectiveness") or not ("ethicality") reported. RA patients were generally satisfied with MTX injections ("affective attitude"). From the burden construct, the requirement for dexterity for administering MTX by injection was considered a barrier, whereas the lack of significant pain from MTX injection was considered an enabler. CONCLUSION The findings suggested that patients generally preferred parenteral MTX formulations with attributes that facilitate self-administration. However, much of the identified research focused on prefilled pen devices, and significant gaps were identified, such as a lack of qualitative research.
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Affiliation(s)
- Jiun Ming Tan
- University of South Australia, Adelaide, South Australia, Australia
| | - Emily Reeve
- Monash University, Parkville, Victoria, Australia, and University of South Australia, Adelaide, Australia
| | - Lauren Fraser
- University of South Australia, Adelaide, South Australia, Australia
| | - Susanna M Proudman
- Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia
| | - Michael D Wiese
- University of South Australia, Adelaide, South Australia, Australia
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13
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Ali-Saleh O, Khatib M, Hadid S, Dahamsheh K, Basis F. Factors Related to the Compliance of Arab Parents in Israel to the Vaccination of Children and Adolescents against COVID-19. Vaccines (Basel) 2023; 11:1540. [PMID: 37896945 PMCID: PMC10610611 DOI: 10.3390/vaccines11101540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
The Arab minority consists of 20% of the Israeli population. Most of the Arab minority live in rural villages, mostly in closed communities, with specific psycho-social and sociodemographic characteristics. Previous studies showed different attitudes to COVID-19 vaccination among Arab adults. OBJECTIVES To examine the influence of factors on the willingness of parents to vaccinate their young and adolescent children and if there is a difference between parents' attitudes to both groups. METHODS AND MATERIALS The survey examined correlations between variables and attitudes toward the vaccine and the pandemic and was disseminated anonymously to parents of children between the ages of 5 and 18 in the Arab population of Israel through social media networks, using the snowball method. Statistical analyses included the Pearson correlation, MANCOVA, and logistic regression tests. RESULTS In total, 361 Arab Israeli parents participated. As mentioned above, 130 parents had both children and adolescents. Overall, 48 parents (36.9%) chose not to vaccinate both their children and adolescents, 52 parents (40.0%) chose to vaccinate only their adolescents, only 1 parent (0.8%) chose to vaccinate only the child, and 29 parents (22.3%) vaccinated both their children and adolescents. Significant correlations were found among a higher age of parents and socioeconomic status, attitudes toward COVID vaccination, subjective norms, perceived severity of the disease, perceived benefits of vaccination, and trust in formal sources. DISCUSSION There is a difference between parents' decision to be vaccinated and their willingness to vaccinate their children. There is a difference between their decision to vaccinate their adolescents and their young children. Different factors positively or negatively influenced parents' decisions. Addressing these factors by authorities may increase compliance of Arab minorities with instructions in the future.
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Affiliation(s)
- Ola Ali-Saleh
- The Max Stern Yezreel Valley College, Emek Yezrael 1930600, Israel;
| | - Mohammad Khatib
- The Galilee Society, Zefat Academic College, University of Haifa, Zefat 13206, Israel;
- Zefat Academic College, Safed 1320611, Israel
| | - Salam Hadid
- Nazareth Academic School of Nursing, Nazareth 16100, Israel; (S.H.); (K.D.)
| | - Kamal Dahamsheh
- Nazareth Academic School of Nursing, Nazareth 16100, Israel; (S.H.); (K.D.)
| | - Fuad Basis
- Rambam Health Care Campus, Haifa 3109601, Israel
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14
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Wang H, Cui M, Li S, Wu F, Jiang S, Chen H, Yuan J, Sun C. Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China. Front Public Health 2023; 11:1192709. [PMID: 37818300 PMCID: PMC10560725 DOI: 10.3389/fpubh.2023.1192709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/31/2023] [Indexed: 10/12/2023] Open
Abstract
Background To date, most vaccines, including the COVID-19 vaccine, are mainly administered by intramuscular injection, which might lead to vaccine hesitancy in some populations due to needle fear. Alternatively, needle-free immunization technology is extensively developed to improve the efficacy and acceptance of vaccination. However, there is no study to report the perception and willingness toward various immunization routes of the COVID-19 vaccine in the general population. Methods A cross-sectional survey was conducted nationwide using an online questionnaire. Bivariate analyses were undertaken to assess variable associations among the participants who reported a hesitancy to receive the COVID-19 booster vaccination. Multivariable logistic regression with a backward step-wise approach was used to analyze the predicted factors associated with the willingness to receive the COVID-19 booster vaccination. Results A total of 3,244 valid respondents were included in this survey, and 63.2% of participants thought they had a good understanding of intramuscular injection, but only 20.7, 9.2, 9.4, and 6.0% of participants had a self-perceived good understanding of inhalation vaccine, nasal spray vaccine, oral vaccine, and microneedle patch vaccine. Correspondingly, there was high acceptance for intramuscular injection (76.5%), followed by oral inhalation (64.4%) and nasal spray (43.0%). Those participants who were only willing to receive an intramuscular vaccine had less vaccine knowledge (OR = 0.78; 95% CI: 0.65-0.94) than those who were willing to receive a needle-free vaccine (OR = 1.97; 95% CI: 1.52-2.57). Some factors were found to be associated with vaccine hesitancy toward booster COVID-19 vaccination. Conclusion Needle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations.
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Affiliation(s)
- Haohang Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Mingting Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Shunran Li
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Fan Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Shiqiang Jiang
- Nanshan District Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Jianhui Yuan
- Nanshan District Center for Disease Control and Prevention, Shenzhen, China
| | - Caijun Sun
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China
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15
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Baldeon Vaca G, Meyer M, Cadete A, Hsiao CJ, Golding A, Jeon A, Jacquinet E, Azcue E, Guan CM, Sanchez-Felix X, Pietzsch CA, Mire CE, Hyde MA, Comeaux ME, Williams JM, Sung JC, Carfi A, Edwards DK, Bukreyev A, Bahl K. Intranasal mRNA-LNP vaccination protects hamsters from SARS-CoV-2 infection. SCIENCE ADVANCES 2023; 9:eadh1655. [PMID: 37738334 PMCID: PMC10516494 DOI: 10.1126/sciadv.adh1655] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/23/2023] [Indexed: 09/24/2023]
Abstract
Intranasal vaccination represents a promising approach for preventing disease caused by respiratory pathogens by eliciting a mucosal immune response in the respiratory tract that may act as an early barrier to infection and transmission. This study investigated immunogenicity and protective efficacy of intranasally administered messenger RNA (mRNA)-lipid nanoparticle (LNP) encapsulated vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Syrian golden hamsters. Intranasal mRNA-LNP vaccination systemically induced spike-specific binding [immunoglobulin G (IgG) and IgA] and neutralizing antibodies. Intranasally vaccinated hamsters also had decreased viral loads in the respiratory tract, reduced lung pathology, and prevented weight loss after SARS-CoV-2 challenge. Together, this study demonstrates successful immunogenicity and protection against respiratory viral infection by an intranasally administered mRNA-LNP vaccine.
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Affiliation(s)
| | - Michelle Meyer
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
| | | | | | | | | | | | | | | | | | - Colette A. Pietzsch
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
| | - Chad E. Mire
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
| | - Matthew A. Hyde
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
| | - Margaret E. Comeaux
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
| | - Julie M. Williams
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
| | | | | | | | - Alexander Bukreyev
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Galveston National Laboratory, Galveston, TX, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
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16
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Fasce A, Schmid P, Holford DL, Bates L, Gurevych I, Lewandowsky S. A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling. Nat Hum Behav 2023; 7:1462-1480. [PMID: 37460761 DOI: 10.1038/s41562-023-01644-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/25/2023] [Indexed: 09/23/2023]
Abstract
The proliferation of anti-vaccination arguments is a threat to the success of many immunization programmes. Effective rebuttal of contrarian arguments requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitude roots-that is, the underlying psychological attributes driving a person's belief-of opposition to vaccines. Here, through a pre-registered systematic literature review of 152 scientific articles and thematic analysis of anti-vaccination arguments, we developed a hierarchical taxonomy that relates common arguments and themes to 11 attitude roots that explain why an individual might express opposition to vaccination. We further validated our taxonomy on coronavirus disease 2019 anti-vaccination misinformation, through a combination of human coding and machine learning using natural language processing algorithms. Overall, the taxonomy serves as a theoretical framework to link expressed opposition of vaccines to their underlying psychological processes. This enables future work to develop targeted rebuttals and other interventions that address the underlying motives of anti-vaccination arguments.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn L Holford
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Essex, Colchester, UK
| | - Luke Bates
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Iryna Gurevych
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
- Department of Psychology, University of Potsdam, Potsdam, Germany
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17
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Welch SR, Spengler JR, Genzer SC, Coleman-McCray JD, Harmon JR, Sorvillo TE, Scholte FE, Rodriguez SE, O’Neal TJ, Ritter JM, Ficarra G, Davies KA, Kainulainen MH, Karaaslan E, Bergeron É, Goldsmith CS, Lo MK, Nichol ST, Montgomery JM, Spiropoulou CF. Single-dose mucosal replicon-particle vaccine protects against lethal Nipah virus infection up to 3 days after vaccination. SCIENCE ADVANCES 2023; 9:eadh4057. [PMID: 37540755 PMCID: PMC10403222 DOI: 10.1126/sciadv.adh4057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/05/2023] [Indexed: 08/06/2023]
Abstract
Nipah virus (NiV) causes a highly lethal disease in humans who present with acute respiratory or neurological signs. No vaccines against NiV have been approved to date. Here, we report on the clinical impact of a novel NiV-derived nonspreading replicon particle lacking the fusion (F) protein gene (NiVΔF) as a vaccine in three small animal models of disease. A broad antibody response was detected that included immunoglobulin G (IgG) and IgA subtypes with demonstrable Fc-mediated effector function targeting multiple viral antigens. Single-dose intranasal vaccination up to 3 days before challenge prevented clinical signs and reduced virus levels in hamsters and immunocompromised mice; decreases were seen in tissues and mucosal secretions, critically decreasing potential for virus transmission. This virus replicon particle system provides a vital tool to the field and demonstrates utility as a highly efficacious and safe vaccine candidate that can be administered parenterally or mucosally to protect against lethal Nipah disease.
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Affiliation(s)
- Stephen R. Welch
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jessica R. Spengler
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Sarah C. Genzer
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - JoAnn D. Coleman-McCray
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
- Infectious Disease Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jessica R. Harmon
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Teresa E. Sorvillo
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Florine E. M. Scholte
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Sergio E. Rodriguez
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - T. Justin O’Neal
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jana M. Ritter
- Infectious Disease Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Georgia Ficarra
- Infectious Disease Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Katherine A. Davies
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Markus H. Kainulainen
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Elif Karaaslan
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Éric Bergeron
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Cynthia S. Goldsmith
- Infectious Disease Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Michael K. Lo
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Stuart T. Nichol
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Joel M. Montgomery
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Christina F. Spiropoulou
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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18
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Su Y, Zhang X, Zhang S. The impact of collective action dilemma on vaccine hesitancy: Evidence from China. Hum Vaccin Immunother 2023; 19:2256041. [PMID: 37747070 PMCID: PMC10521338 DOI: 10.1080/21645515.2023.2256041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Vaccine hesitancy has dramatically decreased the speed of vaccination and stalled global health development. While the factors influencing vaccine hesitancy and mitigation measures have been explored in depth by existing studies, research from the perspective of human interaction is lacking. Based on the theory of collective action, this paper analyzes how free riding behavior affects vaccine hesitancy and how the vaccine hesitancy caused by free riding behavior can be solved. Using 2,203 survey data sets from China, this paper examines the influence of the collective action dilemma - represented by free riding behavior - on COVID-19 vaccine hesitancy. The empirical results show that the existence of free riding behavior is an essential cause of vaccine hesitancy. Based on this conclusion, this paper discusses how to further alleviate the problem of vaccine hesitancy caused by collective action dilemmas by promoting cooperation. The findings of this paper may be helpful to promote various types of vaccines and further suggest that countries should assume the perspective of solving the collective action dilemma to achieve increased vaccination rates.
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Affiliation(s)
- Yiqing Su
- School of Public Policy and Management, Guangxi University, Nanning, China
| | - Xiaoting Zhang
- School of Public Policy and Management, Guangxi University, Nanning, China
| | - Shifei Zhang
- School of Public Policy and Management, Guangxi University, Nanning, China
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19
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Han Q, Zheng B, Abakoumkin G, Leander NP, Stroebe W. Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior. Appl Psychol Health Well Being 2023; 15:825-845. [PMID: 36345695 PMCID: PMC9877847 DOI: 10.1111/aphw.12411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/15/2022] [Indexed: 11/10/2022]
Abstract
It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p < .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p < .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p < .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.
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Affiliation(s)
- Qing Han
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | - Bang Zheng
- Department of Non‐communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Ageing Epidemiology Research Unit, School of Public HealthImperial College LondonLondonUK
| | - Georgios Abakoumkin
- Laboratory of Psychology, Department of Early Childhood EducationUniversity of ThessalyVolosGreece
| | - N. Pontus Leander
- Department of Social and Organizational PsychologyUniversity of GroningenGroningenThe Netherlands
- Department of PsychologyWayne State UniversityDetroitMichiganUSA
| | - Wolfgang Stroebe
- Department of Social and Organizational PsychologyUniversity of GroningenGroningenThe Netherlands
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20
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Vicario CM, Makris S, Culicetto L, Lucifora C, Falzone A, Martino G, Ferraioli F, Nitsche MA, Avenanti A, Craparo G. Evidence of Altered Fear Extinction Learning in Individuals with High Vaccine Hesitancy During Covid-19 Pandemic. CLINICAL NEUROPSYCHIATRY 2023; 20:364-369. [PMID: 37791094 PMCID: PMC10544234 DOI: 10.36131/cnfioritieditore20230417] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Objective A relevance of fear and concerns about vaccine development and its side effects are suggested to explain COVID-19 vaccine hesitancy. However, evidence supporting the phobic origin hypothesis of hesitancy for COVID-19 and other vaccinations remains indirect and elusive. Method We addressed this issue by investigating the existence of a relationship between fear conditioning, extinction, and the respective vaccination hesitancy and anxiety scores in a group of 25 individuals. Results Overall, we show that the general mechanism of fear extinction learning is impaired in individuals with high vaccine hesitancy. State and trait anxiety scores do not account for this result. Conclusions These findings suggest that attitudes against vaccination could be linked to an altered inhibitory learning process.
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Affiliation(s)
- Carmelo M. Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Stergios Makris
- Department of Psychology, Edge Hill University, Ormskirk, Liverpool, UK
| | - Laura Culicetto
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Chiara Lucifora
- Institute of Technologies and Cognitive Sciences (ISTC-CNR), 00185, Rome, Italy and Department of Philosophy and Communication, University of Bologna, Bologna, Italy
| | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Francesca Ferraioli
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, Messina, Italy
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139, Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, 33617, Bielefeld, Germany
| | - Alessio Avenanti
- Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari", Alma Mater Studiorum Università di Bologna, Cesena Campus, 47521 Cesena, Italy; Neuropsicology and Cognitive Neuroscience Research Center (CINPSI Neurocog), Universidad Católica Del Maule, 3460000 Talca, Chile
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy
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21
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Holford DL, Fasce A, Costello TH, Lewandowsky S. Psychological profiles of anti-vaccination argument endorsement. Sci Rep 2023; 13:11219. [PMID: 37460585 DOI: 10.1038/s41598-023-30883-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/02/2023] [Indexed: 07/20/2023] Open
Abstract
The proliferation of anti-vaccination arguments online can threaten immunisation programmes, including those targeting COVID-19. To effectively refute misinformed views about vaccination, communicators need to go beyond providing correct information and debunking of misconceptions, and must consider the underlying motivations of people who hold contrarian views. Drawing on a taxonomy of anti-vaccination arguments that identified 11 "attitude roots"-i.e., psychological attributes-that motivate an individual's vaccine-hesitant attitude, we assessed whether these attitude roots were identifiable in argument endorsements and responses to psychological construct measures corresponding to the presumed attitude roots. In two UK samples (total n = 1250), we found that participants exhibited monological belief patterns in their highly correlated endorsements of anti-vaccination arguments drawn from different attitude roots, and that psychological constructs representing the attitude roots significantly predicted argument endorsement strength and vaccine hesitancy. We identified four different latent anti-vaccination profiles amongst our participants' responses. We conclude that endorsement of anti-vaccination arguments meaningfully dovetails with attitude roots clustering around anti-scientific beliefs and partisan ideologies, but that the balance between those attitudes differs considerably between people. Communicators must be aware of those individual differences.
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Affiliation(s)
- Dawn L Holford
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK.
| | - Angelo Fasce
- University of Coimbra, 3004-531, Coimbra, Portugal
| | | | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK
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22
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Knisely JM, Buyon LE, Mandt R, Farkas R, Balasingam S, Bok K, Buchholz UJ, D'Souza MP, Gordon JL, King DFL, Le TT, Leitner WW, Seder RA, Togias A, Tollefsen S, Vaughn DW, Wolfe DN, Taylor KL, Fauci AS. Mucosal vaccines for SARS-CoV-2: scientific gaps and opportunities-workshop report. NPJ Vaccines 2023; 8:53. [PMID: 37045860 PMCID: PMC10091310 DOI: 10.1038/s41541-023-00654-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Affiliation(s)
- Jane M Knisely
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Lucas E Buyon
- Office of Scientific Management and Operations, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Rebecca Mandt
- Office of Scientific Management and Operations, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Rebecca Farkas
- Coalition for Epidemic Preparedness Innovations, Skøyen Atrium, Askekroken 11, 0277, Oslo, Norway
| | | | - Karin Bok
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ursula J Buchholz
- RNA Viruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, US
| | - M Patricia D'Souza
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Jennifer L Gordon
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Deborah F L King
- Infectious Disease, Prevention, Wellcome Trust, UK, London, NW1 2BE, UK
| | - Tung T Le
- Coalition for Epidemic Preparedness Innovations, Skøyen Atrium, Askekroken 11, 0277, Oslo, Norway
| | - Wolfgang W Leitner
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA
| | - Robert A Seder
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA
| | - Stig Tollefsen
- Coalition for Epidemic Preparedness Innovations, Skøyen Atrium, Askekroken 11, 0277, Oslo, Norway
| | | | - Daniel N Wolfe
- Administration for Strategic Preparedness and Response, Biomedical Advanced Research and Development Authority, 200 C Street SW, Washington, DC, 20024, USA
| | - Kimberly L Taylor
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Anthony S Fauci
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
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23
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Baryakova TH, Pogostin BH, Langer R, McHugh KJ. Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems. Nat Rev Drug Discov 2023; 22:387-409. [PMID: 36973491 PMCID: PMC10041531 DOI: 10.1038/s41573-023-00670-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 03/29/2023]
Abstract
Poor medication adherence is a pervasive issue with considerable health and socioeconomic consequences. Although the underlying reasons are generally understood, traditional intervention strategies rooted in patient-centric education and empowerment have proved to be prohibitively complex and/or ineffective. Formulating a pharmaceutical in a drug delivery system (DDS) is a promising alternative that can directly mitigate many common impediments to adherence, including frequent dosing, adverse effects and a delayed onset of action. Existing DDSs have already positively influenced patient acceptability and improved rates of adherence across various disease and intervention types. The next generation of systems have the potential to instate an even more radical paradigm shift by, for example, permitting oral delivery of biomacromolecules, allowing for autonomous dose regulation and enabling several doses to be mimicked with a single administration. Their success, however, is contingent on their ability to address the problems that have made DDSs unsuccessful in the past.
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Affiliation(s)
| | | | - Robert Langer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Kevin J McHugh
- Department of Bioengineering, Rice University, Houston, TX, USA.
- Department of Chemistry, Rice University, Houston, TX, USA.
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24
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Adu P, Popoola T, Medvedev ON, Collings S, Mbinta J, Aspin C, Simpson CR. Implications for COVID-19 vaccine uptake: A systematic review. J Infect Public Health 2023; 16:441-466. [PMID: 36738689 PMCID: PMC9884645 DOI: 10.1016/j.jiph.2023.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/21/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake. METHODS We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA). RESULTS Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy. CONCLUSION Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.
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Affiliation(s)
- Peter Adu
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand.
| | - Tosin Popoola
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
| | | | - Sunny Collings
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand.
| | - James Mbinta
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand.
| | - Clive Aspin
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand.
| | - Colin R. Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
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25
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Mohizin A, Imran JH, Lee KS, Kim JK. Dynamic interaction of injected liquid jet with skin layer interfaces revealed by microsecond imaging of optically cleared ex vivo skin tissue model. J Biol Eng 2023; 17:15. [PMID: 36849998 PMCID: PMC9969392 DOI: 10.1186/s13036-023-00335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/21/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Needle-free jet injection (NFJI) systems enable a controlled and targeted delivery of drugs into skin tissue. However, a scarce understanding of their underlying mechanisms has been a major deterrent to the development of an efficient system. Primarily, the lack of a suitable visualization technique that could capture the dynamics of the injected fluid-tissue interaction with a microsecond range temporal resolution has emerged as a main limitation. A conventional needle-free injection system may inject the fluids within a few milliseconds and may need a temporal resolution in the microsecond range for obtaining the required images. However, the presently available imaging techniques for skin tissue visualization fail to achieve these required spatial and temporal resolutions. Previous studies on injected fluid-tissue interaction dynamics were conducted using in vitro media with a stiffness similar to that of skin tissue. However, these media are poor substitutes for real skin tissue, and the need for an imaging technique having ex vivo or in vivo imaging capability has been echoed in the previous reports. METHODS A near-infrared imaging technique that utilizes the optical absorption and fluorescence emission of indocyanine green dye, coupled with a tissue clearing technique, was developed for visualizing a NFJI in an ex vivo porcine skin tissue. RESULTS The optimal imaging conditions obtained by considering the optical properties of the developed system and mechanical properties of the cleared ex vivo samples are presented. Crucial information on the dynamic interaction of the injected liquid jet with the ex vivo skin tissue layers and their interfaces could be obtained. CONCLUSIONS The reported technique can be instrumental for understanding the injection mechanism and for the development of an efficient transdermal NFJI system as well.
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Affiliation(s)
- Abdul Mohizin
- grid.91443.3b0000 0001 0788 9816School of Mechanical Engineering, Kookmin University, 77 Jeongneung-Ro, Seongbuk-Gu, Seoul, 02707 Republic of Korea
| | - Jakir Hossain Imran
- grid.91443.3b0000 0001 0788 9816Department of Mechanical Engineering, Graduate School, Kookmin University, Seoul, 02707 Republic of Korea
| | - Kee Sung Lee
- grid.91443.3b0000 0001 0788 9816School of Mechanical Engineering, Kookmin University, 77 Jeongneung-Ro, Seongbuk-Gu, Seoul, 02707 Republic of Korea
| | - Jung Kyung Kim
- School of Mechanical Engineering, Kookmin University, 77 Jeongneung-Ro, Seongbuk-Gu, Seoul, 02707, Republic of Korea.
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26
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Tulloch JS, Lawrenson K, Gordon AL, Ghebrehewet S, Ashton M, Peddie S, Parvulescu P. COVID-19 vaccine hesitancy in care home staff: A survey of Liverpool care homes. Vaccine 2023; 41:1290-1294. [PMID: 36669970 PMCID: PMC9826986 DOI: 10.1016/j.vaccine.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 12/16/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
Uptake of COVID-19 vaccine first doses in UK care homes has been higher among residents compared to staff. We aimed to identify causes of lower COVID-19 vaccine uptake amongst care home staff within Liverpool. An anonymised online survey was distributed to all care home managers, between the 21st and the 29th January 2021. 53 % of 87 care homes responded. The overall COVID-19 vaccination rate was 52.6 % (n = 1119). Reasons, identified by care home managers for staff being unvaccinated included: concerns about lack of vaccine research (37.0 %), staff being off-site during vaccination sessions (36.5 %), pregnancy and fertility concerns (5.6 %), and allergic reactions concerns (3.2 %). Care home managers wanted to tackle vaccine hesitancy through conversations with health professionals, and provision of evidence dispelling vaccine misinformation. Vaccine hesitancy and logistical issues were the main causes for reduced vaccine uptake among care home staff. The former could be addressed by targeted training, and public health communication campaigns to build confidence and acceptance of COVID-19 vaccines.
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Affiliation(s)
- John S.P. Tulloch
- Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Karen Lawrenson
- Public Health Department, Liverpool City Council, Liverpool, UK
| | - Adam L Gordon
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Sam Ghebrehewet
- Public Health England North West, Cheshire & Merseyside Health Protection Team, Liverpool, UK
| | - Matthew Ashton
- Public Health Department, Liverpool City Council, Liverpool, UK
| | - Steve Peddie
- Adult Social Care Department, Liverpool City Council, Liverpool, UK
| | - Paula Parvulescu
- Public Health Department, Liverpool City Council, Liverpool, UK.
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27
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Ann S, Baumann O. Psychological mechanisms and interventions directed at vaccination attitudes. FRONTIERS IN SOCIOLOGY 2023; 8:1076015. [PMID: 36844879 PMCID: PMC9945221 DOI: 10.3389/fsoc.2023.1076015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Attitudes about vaccination impact not only the individual but also society. Therefore, understanding the underlying psychological processes of those who disagree with vaccination is critical for creating compassion through understanding and change through promoting autonomy. The current review aimed to fill a gap in the literature, outlining the state of the recent research on vaccination attitudes, specifically on the underlying mechanisms driving anti-vaccination movements and individuals' thoughts and behaviors. In addition, we aimed to evaluate current research on the effectiveness of interventions targeting these mechanisms. Overall, results indicated that those declining vaccines had beliefs related to distrust in the scientific community and pharmaceutical companies and moral preferences for purity and liberty. In addition, our review identified the potential for utilizing motivational interviewing techniques as an intervention. This literature review provides a platform for further research and enhances the current understanding of vaccination attitudes.
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28
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Wynter-Adams D, Thomas-Brown P. COVID-19 vaccine hesitancy in a developing country: prevalence, explanatory factors and implications for the future. Public Health 2023; 217:146-154. [PMID: 36889053 PMCID: PMC9899772 DOI: 10.1016/j.puhe.2023.01.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 01/27/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Vaccine hesitancy is a public health challenge highlighted during the COVID-19 pandemic. This study sought to determine the prevalence and explanatory factors leading to COVID-19 vaccine hesitancy in the Jamaican population to inform vaccination strategies. STUDY DESIGN This was an exploratory cross-sectional study. METHODS An exploratory survey was distributed electronically between September and October 2021 to gather information on COVID-19 vaccination behaviour and beliefs among the Jamaican population. Data were expressed as frequencies and analysed using Chi-squared followed by multivariate logistic regressions. Significant analyses were determined at P < 0.05. RESULTS Of the 678 eligible responses, most were females (71.5%, n = 485), between ages 18-45 years (68.2%, n = 462), had tertiary education (83.4%, n = 564) and were employed (73.4%, n = 498), with 10.6% (n = 44) being healthcare workers. COVID-19 vaccine hesitancy was present in 29.8% (n = 202) of the survey population, mainly because of safety and efficacy concerns and a general lack of reliable information about the vaccines. The likelihood of hesitancy increased amongst respondents under 36 years (odds ratio [OR] 6.8, 95% confidence interval [CI] 3.6, 12.9), those who delayed initial acceptance of vaccines (OR 2.7, 95% CI 2.3, 3.1); parents for their children and with long waits at vaccination centres. Likelihood of hesitancy decreased for respondents over 36 years (OR 3.7, 95% CI 1.8, 7.8) and with vaccine support from pastors/religious leaders (OR 1.6, 95% CI 1.1, 2.4). CONCLUSIONS Vaccine hesitancy was more prevalent in younger respondents who were never exposed to the effects of vaccine-preventable diseases. Religious leaders had more influence than healthcare workers to increase vaccine uptake.
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Affiliation(s)
- D Wynter-Adams
- Caribbean School of Sport Sciences, The University of Technology, Jamaica, 237 Old Hope Road, Kingston 6, Jamaica.
| | - P Thomas-Brown
- School of Pharmacy, College of Health Sciences, The University of Technology, Jamaica, 237 Old Hope Road, Kingston 6, Jamaica
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29
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Woolley SD, Chambers R, Bishop JRB, Logan A, McMillan P, Fletcher TE, Taegtmeyer M, O'Shea MK. COVID-19 risk, attitudes and behaviour study (CRAB study): A knowledge, attitudes, and practise qualitative study of COVID-19 in the Royal Navy. Front Public Health 2023; 10:1101817. [PMID: 36711341 PMCID: PMC9878343 DOI: 10.3389/fpubh.2022.1101817] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction Outbreaks of SARS-CoV-2 onboard maritime platforms spread rapidly and have high attack rates. The aim of the COVID-19 Risk, Attitudes and Behaviour (CRAB) study was to investigate the knowledge, attitudes, and practises in the Royal Navy in relation to COVID-19 prevention. Methods The CRAB study was a cross-sectional survey, using a census sampling method, conducted in May and June 2021. An online questionnaire was distributed to all serving Royal Navy regular personnel using either the MyNavy application or via a QR code through email for a continuous 14 day period. The questionnaire was based on an existing validated questionnaire used for avian influenza epidemics. Questions investigated individual perceptions of COVID-19 seriousness, compliance with prevention methods, explored vaccination intention and vaccine hesitancy (unvaccinated individuals who declined or were unsure about receiving a COVID-19 vaccine). The chi-squared test of best fit was used to compare the demographic responses against the whole organisation, with p-value < 0.05 deemed significant. Odds ratios were used to investigate associations between demographic groups and responses to questions, with an odds ratio crossing 1.0 deemed non-significant. Results The response rate was 6% (2,080/33,200), with 315 responses collated in the pilot phase and 1,765 in the main study phase. Male participants were less likely to rate COVID-19 as serious (OR 0.34; 95% CI: 0.23-0.49). BAME ethnicity (OR 2.41; 95% CI: 1.12-5.17) rated it as more serious. At the time of the study 62% of respondents had received one dose of a COVID-19 vaccine. In the 797 unvaccinated personnel, vaccine hesitancy accounted for 24.2% (193/797), of whom 136 were white males. Those who had a higher COVID-19 serious rating, the most significant factor for non-adherence to COVID-19 prevention measures in both vaccinated (OR 1.61 [95%CI: 1.20-2.17]) and vaccine-hesitant (OR 3.24 [95%CI: 1.63-6.41]) individuals was colleagues' non-adherence. The most trusted source of information on vaccines was provided by the Defence Medical Services (77.2% [1,606/2,080]). Conclusion This study has identified reasons for COVID-19 protective measure adherence, sources of information trusted by respondents and vaccine hesitancy, in the Royal Navy. The questionnaire can be used to investigate attitudes and behaviours in future emerging infectious diseases.
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Affiliation(s)
- Stephen D. Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom,Institute of Naval Medicine, Alverstoke, United Kingdom,Tropical and Infectious Diseases Unit, Liverpool University Hospitals Foundation NHS Trust, Liverpool, United Kingdom,*Correspondence: Stephen D. Woolley ✉
| | - Robert Chambers
- Royal Navy Healthcare, Royal Navy Headquarters, HMS EXCELLENT, Portsmouth, United Kingdom
| | - Jonathan R. B. Bishop
- NIHR SRMRC, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Amy Logan
- Royal Navy Healthcare, Royal Navy Headquarters, HMS EXCELLENT, Portsmouth, United Kingdom
| | - Peter McMillan
- Royal Navy Healthcare, Royal Navy Headquarters, HMS EXCELLENT, Portsmouth, United Kingdom
| | - Thomas E. Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom,Tropical and Infectious Diseases Unit, Liverpool University Hospitals Foundation NHS Trust, Liverpool, United Kingdom,Academic Department of Military Medicine, Royal Centre for Defence Medicine, Joint Hospital Group, ICT Building, Birmingham Research Park, Birmingham, United Kingdom
| | - Miriam Taegtmeyer
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals Foundation NHS Trust, Liverpool, United Kingdom,Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Matthew K. O'Shea
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Joint Hospital Group, ICT Building, Birmingham Research Park, Birmingham, United Kingdom,Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Austriaco N. Yeast oral vaccines against infectious diseases. Front Microbiol 2023; 14:1150412. [PMID: 37138614 PMCID: PMC10149678 DOI: 10.3389/fmicb.2023.1150412] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Vaccines that are delivered orally have several advantages over their counterparts that are administered via injection. Despite the advantages of oral delivery, however, approved oral vaccines are currently limited either to diseases that affect the gastrointestinal tract or to pathogens that have a crucial life cycle stage in the gut. Moreover, all of the approved oral vaccines for these diseases involve live-attenuated or inactivated pathogens. This mini-review summarizes the potential and challenges of yeast oral vaccine delivery systems for animal and human infectious diseases. These delivery systems utilize whole yeast recombinant cells that are consumed orally to transport candidate antigens to the immune system of the gut. This review begins with a discussion of the challenges associated with oral administration of vaccines and the distinct benefits offered by whole yeast delivery systems over other delivery systems. It then surveys the emerging yeast oral vaccines that have been developed over the past decade to combat animal and human diseases. In recent years, several candidate vaccines have emerged that can elicit the necessary immune response to provide significant protection against challenge by pathogen. They serve as proof of principle to show that yeast oral vaccines hold much promise.
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Anxiety-Related Disorders in the Context of Racism. Curr Psychiatry Rep 2023; 25:31-43. [PMID: 36645562 PMCID: PMC9841144 DOI: 10.1007/s11920-022-01408-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW The literature on racism and anxiety-related disorders, especially social anxiety, specific phobia, and generalized anxiety disorder, is notably lacking. This report aims to review recent evidence demonstrating the link between racial discrimination and various anxiety-related disorders. RECENT FINDINGS Anxiety-related disorders were the most significant mediator for daily discrimination and suicidal thoughts, above both depression and substance use. Further, studies showed that racial discrimination promotes posttraumatic stress and racial trauma among people of color. Systemic racism puts people of color at a higher risk for anxiety disorders than White people. Clinical case examples provide lived evidence of diverse racial and ethnic individuals suffering from anxiety-related disorders, with the development and worsening of symptoms due to racism and microaggressions. There is a prominent need for recent research on anxiety-related disorders and racism. Recommendations for clinicians and future research directions are provided. These actions are required to address bias and mental health inequities and empower people of color.
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Rho NK. Revisiting the Role of Local Cryotherapy for Acne Treatment: A Review and Update. J Clin Med 2022; 12:jcm12010026. [PMID: 36614827 PMCID: PMC9821281 DOI: 10.3390/jcm12010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Acne vulgaris is a well-recognized condition among adolescents and adults that adversely affects their quality of life. Local cryotherapy has long been reported to be effective in treating acne vulgaris, inducing a more rapid involution of acne than topical medications. However, the use of cryotherapy has been limited for acne treatment due to several drawbacks, including procedural pain and pigmentary alterations. Currently, newer cryotherapy devices are gaining attention in dermatology due to their ability to monitor and precisely control the target temperature. In this narrative review, a brief history and the latest update on acne cryotherapy will be presented. Additionally, a special emphasis is placed on the role of cryotherapy, alone or in combination with intralesional steroid injections for nodulocystic acne.
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Affiliation(s)
- Nark-Kyoung Rho
- Leaders Aesthetic Laser & Cosmetic Surgery Center, Seoul 06014, Republic of Korea
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33
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Vinnell LJ, Becker JS, Doyle EEH, Gray L. COVID-19 vaccine intentions in Aotearoa New Zealand: Behaviour, risk perceptions, and collective versus individual motivations. CURRENT RESEARCH IN ECOLOGICAL AND SOCIAL PSYCHOLOGY 2022; 4:100082. [PMID: 36536877 PMCID: PMC9753451 DOI: 10.1016/j.cresp.2022.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 06/08/2023]
Abstract
The global SARS-CoV-2 (COVID-19) pandemic presents a pressing health challenge for all countries, including Aotearoa New Zealand (NZ). As of early 2022, NZ public health measures have reduced impacts of the pandemic, but ongoing efforts to limit illness and fatalities will be significantly aided by widescale uptake of available vaccines including COVID-19 booster doses. Decades of research have established a broad range of demographic, social, cognitive, and behavioural factors which influence peoples' uptake of vaccinations, including a large amount of research in the last two years focused on COVID-19 vaccination in particular. In this study, we surveyed people in New Zealand (N = 660) in May and June of 2021, at which point the vaccine had been made available to high-risk groups. We explored individual versus collective motivations, finding that people who were hesitant about COVID-19 vaccination scored lower on independent self-construals (how people define themselves) but higher on community identity, weaker but still positive perceived social norms, lower general risk of COVID-19 to New Zealanders and higher vaccine risk for both themselves and others, and lower response-efficacy both for personal and collective benefits. Overall, the findings suggest some benefit of collective over individual appeals, but that generally messaging to encourage vaccination should focus on conveying social norms, risk from COVID-19 broadly, and vaccine safety and efficacy.
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Affiliation(s)
- Lauren J Vinnell
- Joint Centre for Disaster Research, Massey University, Wellington Campus, 94 Tasman Street, Mount Cook, Wellington 6021, New Zealand
| | - Julia S Becker
- Joint Centre for Disaster Research, Massey University, Wellington Campus, 94 Tasman Street, Mount Cook, Wellington 6021, New Zealand
| | - Emma E H Doyle
- Joint Centre for Disaster Research, Massey University, Wellington Campus, 94 Tasman Street, Mount Cook, Wellington 6021, New Zealand
| | - Lesley Gray
- Joint Centre for Disaster Research, Massey University, Wellington Campus, 94 Tasman Street, Mount Cook, Wellington 6021, New Zealand
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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Oniszczenko W, Turek A. The relationship between fear of COVID-19 infection, fear of COVID-19 vaccination and Big Five personality traits: a mediation model. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2022; 11:1-10. [PMID: 38013827 PMCID: PMC10654332 DOI: 10.5114/cipp/155944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/07/2022] [Accepted: 10/20/2022] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The primary objective of our correlational, cross-sectional study was to determine the relationship between fear of COVID-19 infection and fear of COVID-19 vaccination and the role of the Big Five personality traits in this relationship. PARTICIPANTS AND PROCEDURE The study sample consisted of 462 participants, including 286 women and 176 men, aged 18 to 75, recruited from the general population. The Big Five personality traits were diagnosed using the Polish version of the Ten-Item Personality Inventory. We used an 11-point numerical rating scale to measure the intensity of fear of COVID-19 infection as well as fear of COVID-19 vaccination. RESULTS The results indicate that fear of infection has a weak positive correlation with fear of vaccination. Both types of fear have a weak negative correlation with emotional stability and openness to experience. People diagnosed with COVID-19 have significantly higher levels of fear of vaccination and lower levels of emotional stability compared to those without a COVID-19 diagnosis. Fear of infection proves a good predictor of fear of vaccination and a likely mediator between emotional stability and fear of vaccination against COVID-19. CONCLUSIONS The results may increase our understanding of the role of personality traits, such as emotional stability, in the fear of infection and COVID-19 vaccination hesitancy.
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Affiliation(s)
| | - Anna Turek
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Perception of Availability, Accessibility, and Affordability of COVID-19 Vaccines and Hesitancy: A Cross-Sectional Study in India. Vaccines (Basel) 2022; 10:vaccines10122009. [PMID: 36560419 PMCID: PMC9785313 DOI: 10.3390/vaccines10122009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Results: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.
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Xu G, Mao Y, Jiang T, Gao B, He B. Structural design strategies of microneedle-based vaccines for transdermal immunity augmentation. J Control Release 2022; 351:907-922. [DOI: 10.1016/j.jconrel.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022]
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Isham L, Sheng Loe B, Hicks A, Wilson N, Bird JC, Bentall RP, Freeman D. The meaning in grandiose delusions: measure development and cohort studies in clinical psychosis and non-clinical general population groups in the UK and Ireland. Lancet Psychiatry 2022; 9:792-803. [PMID: 36049491 DOI: 10.1016/s2215-0366(22)00236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The content of grandiose delusions-inaccurate beliefs that one has special powers, wealth, mission, or identity-is likely to be highly meaningful. The meaning, for example providing a sense of purpose, could prove to be a key factor in the delusion taking hold. We aimed to empirically define and develop measures of the experience of meaning in grandiose delusions and the sources of this meaning, and to test whether severity of grandiosity in clinical and non-clinical populations is associated with level of meaning. METHODS We did a cross-sectional self-report questionnaire study in two cohorts: non-clinical participants aged 18 years and older, with UK or Irish nationality or residence; and patients with affective or non-affective psychosis diagnoses, aged 16 years and older, and accessing secondary care mental health services in 39 National Health Service providers in England and Wales. Participants with high grandiosity completed two large item pools: one assessing the experience of meaning in grandiose delusions (Grandiosity Meaning Measure [termed gram]) and one assessing the sources of meaning (Grandiosity Meaning Measure-Sources [termed grams]). The Grandiosity Meaning Measure and Grandiosity Meaning Measure-Sources were developed using exploratory factor analysis and confirmatory factor analysis. Structural equation modelling was used to test the associations of meaning with the severity of grandiosity. The primary outcome measure for grandiosity was the Specific Psychotic Experiences Questionnaire (grandiosity subscale) and associations were tested with the Grandiosity Meaning Measure and the Grandiosity Meaning Measure-Sources. FINDINGS From Aug 30, 2019, to Nov 21, 2020, 13 323 non-clinical participants were enrolled. 2821 (21%) were men and 10 134 (76%) were women, 11 974 (90%) were White, and the mean age was 39·5 years (SD 18·6 [range 18-93]). From March 22, 2021, to March 3, 2022, 798 patients with psychosis were enrolled. 475 (60%) were men and 313 (39%) were women, 614 (77%) were White, and the mean age was 43·4 years (SD 13·8 [range 16-81]). The experience of meaning in relation to grandiose delusions had three components: coherence, purpose, and significance. The sources of meaning had seven components: positive social perceptions, spirituality, overcoming adversity, confidence in self among others, greater good, supporting loved ones, and happiness. The measurement of meaning was invariant across clinical and non-clinical populations. In the clinical population, each person typically endorsed multiple meanings and sources of meaning for the grandiose delusion. Meaning in grandiose delusions was strongly associated with severity of grandiosity, explaining 53·5% of variance, and with grandiose delusion conviction explaining 27·4% of variance. Grandiosity was especially associated with sense of purpose, and grandiose delusion conviction with coherence. Similar findings were found for the non-clinical population. INTERPRETATION Meaning is inherently tied to grandiose delusions. This study provides a framework for research and clinical practice to understand the different types of meaning of grandiosity. The framework is likely to have clinical use in psychological therapy to help guide patients to find sources of equivalent meaning from other areas of their lives and thereby reduce the extent to which the grandiose delusion is needed. FUNDING Health Education England and National Institute for Health and Care Research.
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Affiliation(s)
- Louise Isham
- Oxford Cognitive Approaches to Psychosis, Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Bao Sheng Loe
- The Psychometrics Centre, Cambridge Judge Business School, University of Cambridge, Cambridge, UK
| | - Alice Hicks
- Patient Advisory Group, University of Oxford, Oxford, UK; The McPin Foundation, London, UK
| | - Natalie Wilson
- Patient Advisory Group, University of Oxford, Oxford, UK; The McPin Foundation, London, UK
| | - Jessica C Bird
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Daniel Freeman
- Oxford Cognitive Approaches to Psychosis, Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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Orok E, Ndem E, Daniel E. Knowledge, attitude and perception of medical students on COVID-19 vaccines: A study carried out in a Nigerian University. Front Public Health 2022; 10:942283. [PMID: 36211686 PMCID: PMC9535657 DOI: 10.3389/fpubh.2022.942283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/25/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Vaccine development, distribution, and immunization of large populations have been identified as vital mitigation strategies for curbing the spread of COVID-19. However, vaccine hesitancy is a major barrier to this. The knowledge and perception of COVID-19 vaccines can improve vaccine acceptance. The purpose of this study was to assess medical students' knowledge, attitude, and perception of COVID-19 vaccines. Methods This study was a cross-sectional web-based survey conducted among undergraduate students from the faculties of Basic medical sciences and Clinical sciences, University of Uyo, Akwa Ibom State, Nigeria. The students' knowledge was ranked as excellent (>70%), good (50-69%) and poor (<50%) while perception was categorized into positive (>50%), and negative (<50%). The difference in knowledge based on demographics was analyzed using the Independent sample t-test. The association between demographics, and students' perception was carried out using the Chi-square and Fisher's Exact tests. Analyses were conducted using SPSS software version 25. Results A total of 233 students consented to participate in the study out of which 51.1% were female. Forty-eight students (20.6%) had good knowledge while 41.2% of the participants accepted to take the COVID-19 vaccine. Positive perception was reported among 51.1% (119) of the students. Conclusion There was poor knowledge and positive perception among majority of the students. Educational intervention in form of training should be done to improve medical students' knowledge and perception toward COVID-19 vaccination.
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Affiliation(s)
- Edidiong Orok
- Department of Clinical Pharmacy and Public Health, College of Pharmacy, Afe Babalola University, Ado Ekiti, Nigeria,*Correspondence: Edidiong Orok
| | - Ekpedeme Ndem
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Nigeria
| | - Eunice Daniel
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Nigeria
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Hako S, Kambara K, Ogata A. The development and validation of the multidimensional fear-of-injection scale. Health Psychol Behav Med 2022; 10:806-817. [PMID: 36051458 PMCID: PMC9427041 DOI: 10.1080/21642850.2022.2116328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background Adults and children alike can feel anxious and afraid of needles. As a result, some people avoid necessary medical injections, leading to health problems. Assessing the fear of injections should consider fear factors, avoidance behaviors, and physical symptoms. We have developed a single scale that measures each of these variables. Conventional fear-of-injection scales do not simultaneously measure the aforementioned components, and thus may not adequately capture the fear of injections. Furthermore, no scale has been developed in Japan to measure the fear of injections. Method A multidimensional fear-of-injection scale was developed in Study 1. The participants, 419 university students, were administered a questionnaire to check the reliability and validity of the scale. In Study 2, to establish the cut-off value of the scale, we conducted a questionnaire and analyzed the data of 771 university students. The outcome is the multidimensional fear-of-injection scale. Results The results from factor analysis showed that this scale has a four-factor structure (direct fear, indirect fear, physiological response, and avoidance behaviors). The results of the receiver operating characteristic analysis showed that a cut-off value of 35 points identifies people with a subjective fear of injections. Conclusion The multidimensional fear-of-injection scale is a comprehensive measure of the fear of injections and serves as an effective indicator for intervention and screening. Additionally, it provides a quantitative assessment of the fear of injection in Japan.
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Affiliation(s)
- Suzuka Hako
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima City, Hiroshima, Japan
| | - Kohei Kambara
- Faculty of Psychology, Doshisha University, Kyotanabe-shi, Kyoto-fu, Japan
| | - Akiko Ogata
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima City, Hiroshima, Japan
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Bain N, Nguyen M, Grech L, Day D, McCartney A, Webber K, Kwok A, Harris S, Chau H, Chan B, Nott L, Hamad N, Tognela A, Underhill C, Loe BS, Freeman D, Segelov E. COVID-19 Vaccine Hesitancy in Australian Patients with Solid Organ Cancers. Vaccines (Basel) 2022; 10:vaccines10091373. [PMID: 36146450 PMCID: PMC9503648 DOI: 10.3390/vaccines10091373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Vaccination is the cornerstone of the global public health response to the COVID-19 pandemic. Excess morbidity and mortality of COVID-19 infection is seen in people with cancer. COVID-19 vaccine hesitancy has been observed in this medically vulnerable population, although associated attitudes and beliefs remain poorly understood. Methods: An online cross-sectional survey of people with solid organ cancers was conducted through nine health services across Australia. Demographics, cancer-related characteristics and vaccine uptake were collected. Perceptions and beliefs regarding COVID-19 vaccination were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-6. Results: Between June and October 2021, 2691 people with solid organ cancers completed the survey. The median age was 62.5 years (SD = 11.8; range 19–95), 40.9% were male, 71.3% lived in metropolitan areas and 90.3% spoke English as their first language. The commonest cancer diagnoses were breast (36.6%), genitourinary (18.6%) and gastrointestinal (18.3%); 59.2% had localized disease and 56.0% were receiving anti-cancer therapy. Most participants (79.7%) had at least one COVID-19 vaccine dose. Vaccine uptake was higher in people who were older, male, metropolitan, spoke English as a first language and had a cancer diagnosis for more than six months. Vaccine hesitancy was higher in people who were younger, female, spoke English as a non-dominant language and lived in a regional location, and lower in people with genitourinary cancer. Vaccinated respondents were more concerned about being infected with COVID-19 and less concerned about vaccine safety and efficacy. Conclusions: People with cancer have concerns about acquiring COVID-19, which they balance against vaccine-related concerns about the potential impact on their disease progress and/or treatment. Detailed exploration of concerns in cancer patients provides valuable insights, both for discussions with individual patients and public health messaging for this vulnerable population.
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Affiliation(s)
- Nathan Bain
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Mike Nguyen
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
- Correspondence: ; Tel.: +61-3-8572-2392
| | - Lisa Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Daphne Day
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Amelia McCartney
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Kate Webber
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Alastair Kwok
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Sam Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC 3550, Australia
| | - Hieu Chau
- Department of Oncology, Latrobe Regional Hospital, Traralgon, VIC 3844, Australia
| | - Bryan Chan
- Department of Oncology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
- School of Medicine, Griffith University, Birtinya, QLD 4575, Australia
| | - Louise Nott
- Icon Cancer Centre Hobart, Hobart, TAS 7000, Australia
| | - Nada Hamad
- Department of Hematology, St Vincent’s Hospital Sydney, Darlinghurst, NSW 2010, Australia
- School of Clinical Medicine, Medicine & Health, University of New South Wales, Kensington, NSW 2052, Australia
- School of Medicine, University of Notre Dame Australia, Chippendale, NSW 2007, Australia
| | - Annette Tognela
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
| | - Craig Underhill
- Border Medical Oncology Research Unit, Albury, NSW 2640, Australia
- Rural Medical School, University of New South Wales, Albury, NSW 2640, Australia
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge CB2 1AG, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health National Health Service Foundation Trust, Oxford OX3 7JX, UK
| | - Eva Segelov
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
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Berihun G, Walle Z, Teshome D, Berhanu L, Derso M. COVID-19 Vaccine Acceptance and Associated Factors Among College Students in Dessie City, Northeastern Ethiopia. J Multidiscip Healthc 2022; 15:1735-1746. [PMID: 35990405 PMCID: PMC9384869 DOI: 10.2147/jmdh.s381151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background The COVID-19 vaccine is regarded as an effective measure for reducing the pandemic’s impact. But, COVID-19 disease burden reduction efforts are being affected by the rising vaccine resistance. Objective To assess the COVID-19 vaccine acceptance and associated factors among college students in Dessie city, Northeastern Ethiopia. Methods An institutional-based cross-sectional study was carried out among college students in Dessie town from July 1–20, 2021. The association between independent and dependent variables was assessed by binary logistic regression analysis using crude odds ratio and adjusted odds ratio. Variables having p values of less than 0.05 at the 95% confidence interval were regarded as potential determinants of COVID-19 vaccine acceptance. Results A total of 422 college students participated in the study with a response rate of 95.6%. More than half 226 (56.2%) of the participants had willingness to accept COVID-19 vaccine. Respondents who had history of chronic medical illness (AOR: 4.340, 95% CI: 1.166, 16.149), training on COVID-19 vaccine (AOR: 4.755, 95% CI: 2.606, 6.674), history of regular vaccine uptake (AOR: 2.534, 95% CI: 1.412, 4.549), perception of COVID-19 severity (AOR: 4.109, 95% CI: 2.190, 7.710), perception that COVID-19 can be prevented by vaccine (AOR: 2.420, 95% CI: 1.160, 5.049), and development of herd immunity against COVID-19 vaccines (AOR: 2.566, 95% CI: 1.431, 4.599) were factors significantly associated with COVID-19 vaccine acceptance. Conclusion The acceptance of COVID-19 vaccine among college students was low. The history of chronic medical illness, training on COVID-19 vaccine, history of vaccine uptake, perception that COVID-19 can be prevented by vaccine, perception of herd immunity development against COVID-19, and severity of COVID 19 infection were factors significantly associated with the acceptance of COVID-19 vaccine. Hence, it is necessary to promote COVID-19 vaccination among college students through health education and vaccine outreach.
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Affiliation(s)
- Gete Berihun
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zebader Walle
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Daniel Teshome
- Department of Anatomy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Leykun Berhanu
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mohammed Derso
- Department of Biochemistry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Lacey C, Frampton C, Beaglehole B. oVRcome - Self-guided virtual reality for specific phobias: A randomised controlled trial. Aust N Z J Psychiatry 2022; 57:736-744. [PMID: 35818296 DOI: 10.1177/00048674221110779] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mobile health applications for mental health are widely accessible but most have had limited research evaluation. Virtual reality exposure therapy is an emerging treatment for specific phobias. Most virtual reality studies have investigated high-end virtual reality devices, typically only available in research and limited clinical settings for a single phobia. This study evaluated the effectiveness of oVRcome, a mobile health application combining self-guided virtual reality exposure and cognitive behaviour therapy, for five specific phobias. METHODS This is a 2-arm 6-week randomised controlled trial, with a waitlist control group and follow-up at week 12. Participants were required to live in New Zealand; be aged 18-64 years; have a fear of flying, heights, spiders, dogs and needles; score above 4 on the Brief Standard Self-rating scale for phobic patients; and have access to a smartphone and Internet. oVRcome consists of six modules of psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through virtual reality and relapse prevention over 6 weeks. The primary outcome was the change from baseline to week 6 on the Severity Measures for Specific Phobia - Adults. All analyses were performed on intention-to-treat set. RESULTS A total of 126 participants were randomised, and 109 completed the follow-up at week 6, for a retention rate of 86.5%. The mean change in Severity Measures for Specific Phobia - Adults score from baseline to week 6 was greater in the active group compared with the waitlist group (active group -20.53 [standard deviation = 8.24]; waitlist group: - 12.31 [standard deviation = 10.66]; p < 0.001). The effect size for this difference was 0.86. CONCLUSION Self-guided use of the oVRcome app was effective at reducing severity of specific phobia symptoms in a sample of people with a self-reported fear of flying, heights, spiders, dogs or needles.Trial registry clinicaltrials.gov NCT04909177.
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Affiliation(s)
- Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Chris Frampton
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
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Leslie M, Pinto N, Fadaak R. Improving Conversations With COVID-19 Vaccine Hesitant Patients: Action Research to Support Family Physicians. Ann Fam Med 2022; 20:368-373. [PMID: 35443974 PMCID: PMC9328713 DOI: 10.1370/afm.2816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 02/01/2022] [Accepted: 03/02/2022] [Indexed: 11/09/2022] Open
Abstract
Vaccination delivery and efforts to counter vaccine hesitancy have become focal issues for family medicine teams as the COVID-19 pandemic has evolved. Conducting action research, our team developed an interactive web-based guide to improve clinical conversations around a broad range of vaccine hesitancies presented by patients. The paper presents a step-by-step account of the guide being codesigned with family physicians-its targeted end users-in a process that included validation interviews; role-play interviews; and user-tested design. The validation interviews sought to understand the pragmatic realities of vaccine hesitancy in family medicine clinical practice relative to relevant psychological theories. The role-play interviews drew out conversational strategies and advice from family physicians. The principles of motivational interviewing-an evidence-based approach to vaccine hesitancy conversations that supplements information deficit approaches-were used to codesign the content and layout of the guide. User counts, stakeholder engagement, and web-based analytics indicate the guide is being used extensively. Formal evaluation of the guide is presently underway.Originally published as Annals "Online First" article.
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Affiliation(s)
- Myles Leslie
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nicole Pinto
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Raad Fadaak
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
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Tetui M, Grindrod K, Waite N, VanderDoes J, Taddio A. Integrating the CARD (Comfort Ask Relax Distract) system in a mass vaccination clinic to improve the experience of individuals during COVID-19 vaccination: a pre-post implementation study. Hum Vaccin Immunother 2022; 18:2089500. [PMID: 35723609 PMCID: PMC9620984 DOI: 10.1080/21645515.2022.2089500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Many people have negative experiences with vaccination due to stress-related reactions including fear and pain. We used a pre-post study design to evaluate the impact of implementing a modified version of the CARD (Comfort-Ask-Relax-Distract) system on stress-related reactions in individuals aged 12 y or older undergoing COVID-19 vaccinations in mass vaccination clinics. Vaccine recipients reported their level of pain, fear and dizziness during vaccination. Clinic staff reported their attitudes about CARD and use of CARD interventions. CARD improved client symptoms across genders and ages with an average reduction in needle pain, fear and dizziness of 75%, 40% and 44%, respectively. CARD was more effective in younger individuals. Clinic staff reported positive attitudes about CARD and uptake of selected CARD interventions. In summary, the modified CARD system reduced stress-related responses in a general population undergoing COVID-19 vaccinations in a mass vaccination clinic, was feasible and acceptable to staff. Future implementation efforts are recommended that include more diverse cultural contexts and incorporate education of individuals about CARD ahead of time.
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Affiliation(s)
- Moses Tetui
- School of Pharmacy, University of Waterloo, Waterloo, Canada.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | - Jeremy VanderDoes
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
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45
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Kowalsky JM. Predicting COVID-19 and seasonal influenza vaccine uptake: The impact of fear and vasovagal symptoms. Appl Psychol Health Well Being 2022; 15:293-314. [PMID: 35705510 PMCID: PMC9349497 DOI: 10.1111/aphw.12380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
Vaccines are vital to protecting health. However, fear and experiencing vasovagal symptoms (e.g., dizziness) are deterrents to medical procedures. Thus, study aims were to test (1) if vaccine relevant fears predict vasovagal symptoms during or following seasonal influenza vaccination and (2) if vaccine relevant fears and vasovagal symptoms predict seasonal influenza and COVID-19 vaccine uptake. Using a prospective design, 1077 participants recruited online completed surveys during Oct 2019 assessing vaccine relevant fears, and May-June 2020 assessing 2019-2020 seasonal influenza vaccine uptake, ratings of vasovagal symptoms, and seasonal influenza and COVID-19 vaccination intention. A behavioral follow up assessing 2020-2021 seasonal influenza and COVID-19 vaccine uptake took place June-July 2021. Heightened vaccine relevant fears predicted reduced 2019-2020 seasonal influenza vaccine uptake and greater vasovagal symptoms among those who did receive a seasonal influenza vaccine. Serial mediation analyses identified significant indirect effects with greater vaccine relevant fears reducing 2020-2021 seasonal influenza vaccine uptake through intention and reducing COVID-19 vaccine uptake through vasovagal symptoms and intention. Intervention research to reduce fear and prevent vasovagal symptoms to support vaccine uptake is warranted.
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46
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Iliyasu Z, Garba MR, Gajida AU, Amole TG, Umar AA, Abdullahi HM, Kwaku AA, Salihu HM, Aliyu MH. 'Why Should I Take the COVID-19 Vaccine after Recovering from the Disease?' A Mixed-methods Study of Correlates of COVID-19 Vaccine Acceptability among Health Workers in Northern Nigeria. Pathog Glob Health 2022; 116:254-262. [PMID: 34937530 PMCID: PMC9132432 DOI: 10.1080/20477724.2021.2011674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
We assessed the acceptability of COVID-19 vaccine, predictors, and reasons for vaccine hesitancy among clinical and non-clinical staff at a tertiary hospital in Kano, northern Nigeria.Using a mixed-methods design, structured questionnaires were administered to 284 hospital staff, followed by 20 in-depth interviews with a purposive sub-sample. Logistic regression and the framework approach were used to analyze the data.Only 24.3% (n = 69) of the respondents were willing to accept the COVID-19 vaccine. Acceptance was lower among females (Adjusted Odds Ratio (aOR) = 0.37, 95% Confidence Interval (95%CI): 0.18-0.77 (male vs. female), nurses/midwives (aOR = 0.41, 95%CI:0.13-0.60, physicians vs. nurses/midwives), persons not tested for COVID-19 (aOR = 0.32, 95%CI 0.13-0.79) (no vs. yes) and those who perceived themselves to be at low risk of COVID-19 (aOR = 0.47, 95%CI,0.21-0.89, low vs. high). In contrast, vaccine acceptance was higher among more experienced workers (aOR = 2.28, 95%CI:1.16-8.55, ≥10 vs. <5 years). Vaccine acceptance was also higher among persons who did not worry about vaccine efficacy (aOR = 2.35, 95%CI:1.18-6.54, no vs. yes), or about vaccine safety (aOR = 1.76, 95%CI: 1.16-5.09, no vs. yes), side effects (aOR = 1.85, 95%CI:1.17-5.04, no vs. yes), or rumors (aOR = 2.55, 95%CI:1.25-5.20, no vs. yes). The top four reasons for vaccine hesitancy included distrust, inadequate information, fear of long-term effects, and infertility-related rumors.Concerted efforts are required to build COVID-19 vaccine confidence among health workers in Kano, Nigeria.Our findings can help guide implementation of COVID-19 vaccination in similar settings.
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Affiliation(s)
- Zubairu Iliyasu
- Department of Community Medicine, Bayero University, Kano, Nigeria,CONTACT Zubairu Iliyasu Epidemiology & Biostatistics Division Department of Community, Medicine Bayero University, Kano, Nigeria
| | | | - Auwalu U. Gajida
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | - Taiwo G. Amole
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | - Amina A. Umar
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | | | - Aminatu A. Kwaku
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | - Hamisu M. Salihu
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Muktar H. Aliyu
- Department of Health Policy and Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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47
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Mertens G, Lodder P, Smeets T, Duijndam S. Fear of COVID-19 predicts vaccination willingness 14 months later. J Anxiety Disord 2022; 88:102574. [PMID: 35512598 PMCID: PMC9047433 DOI: 10.1016/j.janxdis.2022.102574] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 01/25/2023]
Abstract
Vaccines are an important tool for governments and health agencies to contain and curb the Coronavirus Disease-19 (COVID-19) pandemic. However, despite their effectiveness and safeness, a substantial portion of the population worldwide is hesitant to get vaccinated. In the current study, we examined whether fear of COVID-19 predicts vaccination willingness. In a longitudinal study (N = 938), fear for COVID-19 was assessed in April 2020 and vaccination willingness was measured in June 2021. Approximately 11% of our sample indicated that they were not willing to get vaccinated. Results of a logistic regression showed that increased fear of COVID-19 predicts vaccination willingness 14 months later, even when controlling for several anxious personality traits, infection control perceptions, risks for loved ones, self-rated health, previous infection, media use, and demographic variables. These results show that fear of COVID-19 is a relevant construct to consider for predicting and possibly influencing vaccination willingness. Nonetheless, sensitivity and specificity of fear of COVID-19 to predict vaccination willingness were quite low and only became slightly better when fear of COVID-19 was measured concurrently. This indicates that other potential factors, such as perceived risks of the vaccines, probably also play a role in explaining vaccination willingness.
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Affiliation(s)
- Gaëtan Mertens
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Paul Lodder
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands,Department of Methods and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Tom Smeets
- Department of Methods and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Stefanie Duijndam
- Department of Methods and Statistics, Tilburg University, Tilburg, the Netherlands
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48
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Miao Y, Li Y, Zhang W, Wu J, Gu J, Wang M, Wei W, Ye B, Miao C, Tarimo CS, Dong W. The Psychological Experience of COVID-19 Vaccination and Its Impact on the Willingness to Receive Booster Vaccines among the Chinese Population: Evidence from a National Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095464. [PMID: 35564859 PMCID: PMC9100074 DOI: 10.3390/ijerph19095464] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/22/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national cross-sectional online survey among Chinese individuals (aged over 18), using the snowball sampling approach, with 26,755 participants. Factor analysis and binary logistic regression were used to evaluate the existing associations. The overall COVID-19 vaccination psychological experience score of the participants was 25.83 (25.78~25.89; scores ranged from 7–35). A total of 93.83% (95%CI = 93.54~94.12) of respondents indicated a willingness to receive booster vaccines. After classifying psychological experiences associated with COVID-19 vaccination into positive and negative experiences and adjusting for confounding factors, for the former, the willingness to receive booster vaccines for participants with the highest scores of 13–15 was 3.933 times higher (OR = 3.933, 95%CI = 3.176~4.871) than participants who obtained scores of 3–9, and for the latter, the willingness to receive booster vaccines for participants with the highest scores of 19–20 was 8.871 times higher (OR = 8.871, 95%CI = 6.240~12.612) than participants who obtained scores of 4–13. Our study suggests that a good psychological experience with vaccination is positively associated with an increased willingness to receive booster vaccines.
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Affiliation(s)
- Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Jianqin Gu
- Research Center for Lifestyle Medicine, School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China;
| | - Meiyun Wang
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China; (M.W.); (W.W.)
| | - Wei Wei
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China; (M.W.); (W.W.)
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Chengyuan Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China; (M.W.); (W.W.)
- Correspondence: author: ; Tel.: +86-187-037-17579
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49
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Hamilton K, Hagger MS. The Vaccination Concerns in COVID-19 Scale (VaCCS): Development and validation. PLoS One 2022; 17:e0264784. [PMID: 35286331 PMCID: PMC8920277 DOI: 10.1371/journal.pone.0264784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/16/2022] [Indexed: 01/01/2023] Open
Abstract
Vaccines are highly effective in minimizing serious cases of COVID-19 and pivotal to managing the COVID-19 pandemic. Despite widespread availability, vaccination rates fall short of levels required to bring about widespread immunity, with low rates attributed to vaccine hesitancy. It is therefore important to identify the beliefs and concerns associated with vaccine intentions and uptake. The present study aimed to develop and validate, using the AMEE Guide, the Vaccination Concerns in COVID-19 Scale (VaCCS), a comprehensive measure of beliefs and concerns with respect to COVID-19 vaccines. In the scale development phase, samples of Australian (N = 53) and USA (N = 48) residents completed an initial open-response survey to elicit beliefs and concerns about COVID-19 vaccines. A concurrent rapid literature review was conducted to identify content from existing scales on vaccination beliefs. An initial pool of items was developed informed by the survey responses and rapid review. The readability and face validity of the item pool was assessed by behavioral science experts (N = 5) and non-experts (N = 10). In the scale validation phase, samples of Australian (N = 522) and USA (N = 499) residents completed scaled versions of the final item pool and measures of socio-political, health beliefs and outcomes, and trait measures. Exploratory factor analysis yielded a scale comprising 35 items with 8 subscales, and subsequent confirmatory factor analyses indicated acceptable fit of the scale structure with the data in each sample and factorial invariance across samples. Concurrent and predictive validity tests indicated a theoretically and conceptually predictable pattern of relations between the VaCCS subscales with the socio-political, health beliefs and outcomes, and trait measures, and key subscales predicted intentions to receive the COVID-19 vaccine. The VaCCS provides a novel measure to assess beliefs and concerns toward COVID-19 vaccination that researchers and practitioners can use in its entirety or select specific sub-scales to use according to their needs.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Health Sciences Research Institute, University of California, Merced, California, United States of America
| | - Martin S Hagger
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Health Sciences Research Institute, University of California, Merced, California, United States of America.,Psychological Sciences, University of California, Merced, California, United States of America.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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50
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Wu J, Ma M, Miao Y, Ye B, Li Q, Tarimo CS, Wang M, Gu J, Wei W, Zhao L, Mu Z, Fu X. COVID-19 Vaccination Acceptance Among Chinese Population and Its Implications for the Pandemic: A National Cross-Sectional Study. Front Public Health 2022; 10:796467. [PMID: 35211440 PMCID: PMC8860971 DOI: 10.3389/fpubh.2022.796467] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/14/2022] [Indexed: 12/27/2022] Open
Abstract
Objective To examine the COVID-19 vaccination rate among a representative sample of adults from 31 provinces on the Chinese mainland and identify its influencing factors. Methods We gathered sociodemographic information, data on people's awareness and behavior regarding COVID-19 and the COVID-19 vaccine, the accessibility of COVID-19 vaccination services, community environmental factors influencing people's awareness and behavior regarding the vaccination, information about people's skepticism on COVID-19 vaccine, and information about people's trust in doctors as well as vaccine developers through an online nationwide cross-sectional survey among Chinese adults (18 years and older). The odds ratios (OR) and 95% confidence intervals (CI) for the statistical associations were estimated using logistic regression models. Results A total of 29,925 participants (51.4% females and 48.6% males) responded. 89.4% of the participants had already received a COVID-19 vaccination. After adjusting for demographic characteristics, awareness of COVID-19 pandemic/ COVID-19 vaccine, community environmental factors, awareness and behavior of general vaccinations, we discovered that having no religious affiliation, having the same occupational status as a result of coronavirus epidemic, being a non-smoker, always engaging in physical activity, having a lower social status, perceiving COVID-19 to be easily curable, and having easier access to vaccination are all associated with high vaccination rate (all P <0.05). Conclusions 31 provinces in mainland China currently have a relatively high rate of COVID-19 vaccination. To further increase the rate of COVID-19 vaccination, we must remove barriers associated with the community context and improve access to COVID-19 vaccine services. In addition, taking proactive and effective measures to address the reasons for non-vaccination with COVID-19 will aid in epidemic prevention and control.
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Affiliation(s)
- Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China.,Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Meiyun Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Wei Wei
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Lipei Zhao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zihan Mu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoli Fu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
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