1
|
Guan Y. The effectiveness of coercive measures in motivating vaccination: Evidence from China during the COVID-19 pandemic. Glob Public Health 2025; 20:2445827. [PMID: 39773331 DOI: 10.1080/17441692.2024.2445827] [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: 05/16/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025]
Abstract
Governments worldwide have implemented mandates, restrictions, and other coercive measures to secure adequate vaccine coverage, with the COVID-19 pandemic providing numerous examples. While the ethics and public reception of such measures are matters of heated discussion, their effectiveness in motivating individuals to get vaccinated remains incompletely understood. This study addresses that gap by analyzing data from a 2022 nationwide online survey conducted in China. Respondents recruited through proportional quota sampling to reflect key demographic characteristics of the population were asked to specify their COVID-19 vaccination status and the reason behind their decision. Results reveal that while most respondents reported getting vaccinated voluntarily, 14.6% attributed their vaccination to the government's coercive mobilisation efforts. Moreover, members of the ruling Chinese Communist Party, as well as individuals favouring Western vaccines unavailable in China, were more likely to cite coercive mobilisation as the reason for their vaccination. These findings suggest that coercive measures can motivate a substantial proportion of the population to get vaccinated, especially those closely connected to the political system and those with unmet vaccination preferences. Given the controversy surrounding such measures, this enhanced understanding of their effectiveness could help with formulating targeted policies to combat infectious diseases and safeguard public health.
Collapse
Affiliation(s)
- Yue Guan
- Department of Global Studies, Aarhus University, Aarhus C, Denmark
| |
Collapse
|
2
|
Humble RM, Lee JSW, Du C, Driedger SM, Dubé E, MacDonald SE. COVID-19 vaccine acceptance and preference for future delivery among language minority, newcomer, and racialized peoples in Canada: a national cross-sectional and longitudinal study. Ann Med 2025; 57:2445777. [PMID: 39729392 DOI: 10.1080/07853890.2024.2445777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/29/2024] [Accepted: 12/02/2024] [Indexed: 12/29/2024] Open
Abstract
BACKGROUND Despite high COVID-19 vaccine coverage in Canada, vaccine acceptance and preferred delivery among newcomers, racialized persons, and those who primarily speak minority languages are not well understood. This national study explores COVID-19 vaccine acceptance, access to vaccines, and delivery preferences among ethnoculturally diverse population groups. METHODS We conducted two national cross-sectional surveys during the pandemic (Dec 2020 and Oct-Nov 2021). Binary logistic regression analysis investigated the association between newcomer, language, and racialized minority respondents' perceptions and acceptance of COVID-19 vaccines, experiences of discrimination when accessing health services, and sociodemographic characteristics. McNemar-Bowker tests were used to assess changes in responses collected at two time points. RESULTS Among 1630 respondents, 30.8% arrived in Canada within the last five years, 87.4% self-identified as a racialized minority, and 37.2% primarily spoke languages other than English or French. Although single dose COVID-19 vaccine uptake was at 92.7% among respondents, 14.8% experienced difficulty accessing vaccines, citing a need for translated resources or multi-lingual personnel. In longitudinal analysis, respondents were increasingly motivated over time to overcome barriers to accessing vaccines (61.4% to 69.6%, p = <.001). Fifty-nine percent (59.9%) of respondents would accept annual vaccination and over half would accept co-administration with routine (56.2%) or influenza (52.3%) vaccines. Experiences of racism/discrimination upon health service access were reported by 12.3% of respondents, who recommended increasing culturally safe practices and community involvement at vaccination sites. CONCLUSIONS Understanding how newcomers, racialized peoples, and minority language speakers perceive and access COVID-19 vaccines will support vaccination campaigns to optimize equitable access.
Collapse
Affiliation(s)
- Robin M Humble
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Janet Sau Wun Lee
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Crystal Du
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Quebec City, QC, Canada
| | - Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
3
|
Hsieh PH. Psychological reactance to vaccine mandates on Twitter: a study of sentiments in the United States. J Public Health Policy 2025; 46:269-283. [PMID: 39828759 PMCID: PMC12119348 DOI: 10.1057/s41271-025-00554-0] [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] [Accepted: 01/05/2025] [Indexed: 01/22/2025]
Abstract
This study examines the relationship between vaccine mandates and public sentiment toward vaccines and health officials on Twitter. I analyzed 6.6 million vaccine-related tweets from July 2021 to February 2022 in the United States. Leveraging a large language model, BERT, I identified tweets discussing vaccine mandates even when lacking explicit keywords. Compared to non-mandate tweets, those mentioning mandates exhibit greater negativity, anger, and freedom-related language. Furthermore, increased state-level discussion of mandates correlates with rising levels of negativity and anger toward both vaccines and public health officials. Finally, greater disparity in vaccination progress across counties within a state is associated with increased anger in tweets directed toward both.
Collapse
Affiliation(s)
- Pei-Hsun Hsieh
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, PA, 19104-6304, USA.
| |
Collapse
|
4
|
Baysac DJ, Guay M, Chen R, Dubé È, MacDonald SE, Driedger SM, Gilbert NL. Did inequalities in COVID-19 vaccination resolve over time? Insights from the Canadian Community Health Survey. Vaccine 2025; 56:127153. [PMID: 40294479 DOI: 10.1016/j.vaccine.2025.127153] [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: 12/05/2024] [Revised: 04/14/2025] [Accepted: 04/15/2025] [Indexed: 04/30/2025]
Abstract
INTRODUCTION Disparities in COVID-19 vaccination coverage emerged during the vaccination campaign. This study aimed to assess whether inequalities in COVID-19 vaccination coverage in Canada persisted or resolved throughout the vaccine rollout. METHODS Using data from the Canadian Community Health Survey, the analysis included people 18 and older from all ten provinces. Vaccination coverage for at least one dose of a COVID-19 vaccine was determined in three periods: June 2021-February 2022 (n = 28,182), February-June 2022 (n = 25,742), and July-December 2022 (n = 23,119). Statistically significant gaps across groups were assessed using non-overlapping 95 % confidence intervals (CI). RESULTS In June 2021-February 2022, coverage for at least one dose (95 % CI) was 85.5 % (79.0-90.3) for off-reserve First Nations people, 85.7 % (79.6-90.1) for Métis people, 79.6 % (72.1-85.4) for Black people, 83.0 % (72.9-89.9) for Arab people, and 92.9 % (92.3-93.5) for White people. By July-December 2022, coverage was 87.4 % (80.2-92.3), 90.5 % (85.5-93.8), 92.1 % (87.2-95.2), 95.6 % (90.6-98.0), and 95.1 % (94.5-95.6), respectively, in the same populations. The gap between off-reserve First Nations and White people remained significant, at 7.4 percentage points (pp.) in the first period and 7.6 pp. in the third period. As for Métis and White people, the gap decreased from 7.3 pp. to 4.6 pp. In the first period, the gap compared to White people was 13.4 pp. for Black people and 9.9 pp. for Arab people, and resolved in the third period. Significant gaps also remained across age groups, levels of educational attainment, household income, for those residing in rural areas, those living with children under 12 years old, and those without a regular healthcare provider. CONCLUSION Despite efforts to address them, several inequalities persisted throughout the vaccine rollout, underscoring the need for refined strategies to reach all population segments. As Canadian vaccination registries do not collect sociodemographic data beyond date of birth, sex and place of residence, survey data is needed to measure these disparities.
Collapse
Affiliation(s)
- Donalyne-Joy Baysac
- Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, Canada.
| | - Mireille Guay
- Healthy Environments and Consumer Safety Branch, Health Canada, Canada
| | - Ruoke Chen
- Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, Canada
| | - Ève Dubé
- Department of Anthropology, Université Laval, Canada
| | | | - S Michelle Driedger
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Nicolas L Gilbert
- Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, Canada
| |
Collapse
|
5
|
Adame BJ, Corman SR, Von Feldt PA, Meneses CM, O'Rourke HP, Tahir A. Reactance as a cause of COVID-19 vaccination hesitancy. Vaccine 2025; 57:127209. [PMID: 40344811 DOI: 10.1016/j.vaccine.2025.127209] [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: 09/13/2024] [Revised: 04/28/2025] [Accepted: 04/29/2025] [Indexed: 05/11/2025]
Abstract
COVID-19 remains a serious threat to public health. In the United States, 70 % of the population is considered fully vaccinated, a level too low to create "herd" immunity. Thus, vaccine hesitancy remains a current problem for public health and is an important constraint on mitigating future pandemics. This study evaluates three components of health messaging that might be targeted for counteracting hesitance, vested interests, reactance, and perceived threat. Structural equation modeling of survey data from a demographically representative and politically balanced sample of 1588 U.S. residents showed that reactance was the only significant explanation for self-reported vaccination status. Its effect was stronger for conservatives, with reactance strongly and negatively influencing vaccine acceptance as a mediating factor. The same path was significant for liberals but with a drastically smaller total effect. Liberals also had a small but significant direct effect of reactance on reported vaccination. These findings indicate that to encourage the highest possible acceptance, future vaccine policy and messaging must avoid threatening perceived individual freedoms and stress personal choice. We suggest such measures.
Collapse
Affiliation(s)
- Bradley J Adame
- The Center for Strategic Communication, Arizona State University, USA; The Hugh Downs School of Human Communication, Arizona State University, USA.
| | - Steven R Corman
- The Center for Strategic Communication, Arizona State University, USA; The Hugh Downs School of Human Communication, Arizona State University, USA.
| | - Paige A Von Feldt
- The Hugh Downs School of Human Communication, Arizona State University, USA.
| | - Christina M Meneses
- The Hugh Downs School of Human Communication, Arizona State University, USA.
| | - Holly P O'Rourke
- Department of Psychology, University of California, Riverside, USA.
| | - Anique Tahir
- Ira A. Fulton Schools of Engineering, Arizona State Univeristy, USA.
| |
Collapse
|
6
|
Aljeaidi MS, Haaksma ML, Tan ECK. Socioeconomic status and adherence to COVID-19 preventative measures in Australia: A national cohort study. Health Promot J Austr 2025; 36:e932. [PMID: 39533745 DOI: 10.1002/hpja.932] [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: 04/06/2024] [Revised: 10/20/2024] [Accepted: 10/30/2024] [Indexed: 11/16/2024] Open
Abstract
ISSUE ADDRESSED The uptake of recommended preventative measures is a critical concern for protecting the public against COVID-19 outbreaks and future pandemics. However, it is unclear to what extent COVID-19 preventative measures were followed in Australia. This study aims to determine adherence level to COVID-19 preventative measures in 2021, and whether these were associated with socioeconomic status (SES). STUDY DESIGN This was a national cross-sectional study using data from the Household Income and Labour Dynamics in Australia (HILDA) survey. METHODS This study included 15 457 community-dwelling adults (18 years or older) who participated in the 2021 wave of HILDA survey. SES was assessed by the Socio-Economic Index For Areas (SEIFA) score, split into quintiles. Outcomes included self-reported adherence to COVID-19 preventative measures (mask wearing, keeping distance, staying home; sum score range 3-15) and COVID-19 status (yes/no). Linear and logistic regression were used accordingly to assess the association between SES and the sum score of adherence to COVID-19 measures, and COVID-19 vaccination status. RESULTS Adherence to COVID-19 preventative measures and uptake of COVID-19 vaccine in Australia in 2021 were moderate (between 60% and 70%). Regression models showed higher SES was associated with a slightly higher score of adherence (β = .08, 95% CI = .04-.12) and a higher likelihood of self-reporting receiving COVID-19 vaccination (OR 1.27, 95% CI = 1.23-1.31). CONCLUSION SES was positively associated with the level of adherence to COVID-19 preventative measures and the probability of receiving COVID-19 vaccine. The findings of this study highlight the potential benefits of considering SES, particularly its impact on equity and access, when designing an educational program or awareness campaign in times of crisis. SO WHAT?: The findings of this study highlight the importance of considering SES when designing an educational program or an awareness campaign in times of crisis.
Collapse
Affiliation(s)
| | - Miriam L Haaksma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Edwin C K Tan
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
7
|
Antonini M, Genie MG, Attwell K, Attema AE, Ward JK, Melegaro A, Torbica A, Kelly B, Berardi C, Sequeira AR, McGregor N, Kellner A, Brammli-Greenberg S, Hinwood M, Murauskienė L, Behmane D, Balogh ZJ, Hagen TP, Paolucci F. Are we ready for the next pandemic? Public preferences and trade-offs between vaccine characteristics and societal restrictions across 21 countries. Soc Sci Med 2025; 366:117687. [PMID: 39939032 DOI: 10.1016/j.socscimed.2025.117687] [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: 06/18/2024] [Revised: 12/30/2024] [Accepted: 01/07/2025] [Indexed: 02/14/2025]
Abstract
In vaccination decisions, individuals must weigh the benefits against the risks of remaining unvaccinated and potentially facing social restrictions. Previous studies have focused on individual preferences for vaccine characteristics and societal restrictions separately. This study aims to quantify public preferences and the potential trade-offs between vaccine characteristics and societal restrictions, including lockdowns and vaccine mandates, in the context of a future pandemic. We conducted a discrete choice experiment (DCE) involving 47,114 respondents from 21 countries between July 2022 and June 2023 through an online panel. Participants were presented with choices between two hypothetical vaccination programs and an option to opt-out. A latent class logit model was used to estimate trade-offs among attributes. Despite some level of preference heterogeneity across countries and respondents' profiles, we consistently identified three classes of respondents: vaccine refusers, vaccine-hesitant, and pro-vaccine individuals. Vaccine attributes were generally deemed more important than societal restriction attributes. We detected strong preferences for the highest levels of vaccine effectiveness and for domestically produced vaccines across most countries. Being fully vaccinated against COVID-19 was the strongest predictor of pro-vaccine class preferences. Women and younger people were more likely to be vaccine refusers compared to men and older individuals. In some countries, vaccine hesitancy and refusal were linked to lower socioeconomic status, whereas in others, individuals with higher education and higher income were more likely to exhibit hesitancy. Our findings emphasize the need for tailored vaccination programs that consider local contexts and demographics. Building trust in national regulatory authorities and international organizations through targeted communication, along with investing in domestic production facilities, can improve vaccine uptake and enhance public health responses in the future.
Collapse
Affiliation(s)
- Marcello Antonini
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Mesfin G Genie
- Newcastle Business School, University of Newcastle, Newcastle, NSW, 2300, Australia; Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, UK; Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC, 27701, USA
| | - Katie Attwell
- VaxPolLab, Political Science and International Relations, School of Social Sciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - Arthur E Attema
- EsCHER, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3062, PA, Rotterdam, the Netherlands
| | - Jeremy K Ward
- Université Paris Cité, CNRS, Inserm, Cermes3, F-94800, Villejuif, France
| | - Alessia Melegaro
- Department of Social and Political Sciences, Bocconi University, 20136, Milano, Italy
| | - Aleksandra Torbica
- Department of Social and Political Sciences, Bocconi University, 20136, Milano, Italy
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Chiara Berardi
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK; Newcastle Business School, University of Newcastle, Newcastle, NSW, 2300, Australia
| | - Ana Rita Sequeira
- Murdoch Business School, Murdoch University, Murdoch, WA, 6150, Australia; 10 ISCTE-IUL - Lisbon University Institute, Portugal
| | - Neil McGregor
- NAIHE (Singapore), University of Newcastle Australia, Australia
| | - Adrian Kellner
- Department of Health Management and Health Economics, University of Oslo, Forskningsveien 3a, 0317, Oslo, Norway
| | - Shuli Brammli-Greenberg
- Department of Health Administration and Economics, Braun School of Public Health, Faculty of Medicine, the Hebrew University of Jerusalem, Israel
| | - Madeleine Hinwood
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, NSW, Australia
| | - Liubovė Murauskienė
- Department of Public Health. Faculty of Medicine, Vilnius University, Lithuania
| | - Daiga Behmane
- Faculty of Public Health and Social Welfare, Riga Stradins University, Rīga, LV-1007, Latvia
| | - Zsolt J Balogh
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK; Department of Traumatology, John Hunter Hospital, Newcastle, NSW, 2310, Australia
| | - Terje P Hagen
- Department of Health Management and Health Economics, University of Oslo, Forskningsveien 3a, 0317, Oslo, Norway
| | - Francesco Paolucci
- Newcastle Business School, University of Newcastle, Newcastle, NSW, 2300, Australia; Department of Sociology and Business Law, University of Bologna, Bologna, 40126, Italy
| |
Collapse
|
8
|
Gomez-Vidal C, Palmer AN, Kitchens K, Ratliff GA, Graaf G. Unincorporation in counties as a political determinant of health: An exploration of five states. SSM Popul Health 2024; 28:101728. [PMID: 39686944 PMCID: PMC11647457 DOI: 10.1016/j.ssmph.2024.101728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 11/16/2024] [Accepted: 11/17/2024] [Indexed: 12/18/2024] Open
Abstract
Local government policies and practices shape the context of the places that can alter a population's life chances through socioeconomic factors, built environments, and healthcare access. County governments, one of the most ubiquitous U.S. political structures, impact health outcomes within their jurisdiction through multiple policy levers and pathways. By identifying which political determinants within counties are associated with variation in life expectancy and premature death, we can better intervene on modifiable factors. One overlooked political determinant from public health studies is the county's responsibility as the primary local government for approximately a third of the U.S. population and 93% of land in unincorporated areas. To conduct an ecological study and assess associations between county population health and county responsibility for unincorporated areas and populations, we created and tested two county indicators of unincorporation. Multilevel multivariable regression results showed that larger proportions of unincorporated land within a county are associated with lower average county life expectancy. More testing of the measurement is needed to understand the relationship between unincorporation, county government, and population health outcomes.
Collapse
Affiliation(s)
- Cristina Gomez-Vidal
- School of Social Welfare, University of California, Berkeley 120 Haviland Hall, Berkeley, CA, 94709, USA
| | - Ashley N. Palmer
- Department of Social Work, Harris College of Nursing & Health Sciences, Texas Christian University, 2800 South University Drive, Fort Worth, TX, 76109, USA
| | - Katherine Kitchens
- School of Social Work, University of Texas at Arlington, 501 W. Mitchell Street, Arlington, TX, 76019-0129, USA
| | - G. Allen Ratliff
- School of Social Work, University of Nevada, 1664 N. Virginia Street, Reno, NV, 89557, USA
| | - Genevieve Graaf
- School of Social Work, University of Texas at Arlington, 501 W. Mitchell Street, Arlington, TX, 76019-0129, USA
| |
Collapse
|
9
|
Ricke IJ, Spaulding AB, Rajtar NN, Lundberg L, Nguyen RHN. Political Affiliation, Policy Measures, and Intention to Receive COVID-19 and Influenza Vaccines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1608. [PMID: 39767449 PMCID: PMC11675663 DOI: 10.3390/ijerph21121608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 11/25/2024] [Accepted: 11/29/2024] [Indexed: 01/11/2025]
Abstract
Our study aimed to assess the impact of political affiliation, personal beliefs, and policy measures on the intention to receive routine COVID-19 and influenza vaccines in the coming year. A cross-sectional study of 1256 individuals at Minnesota State and County Fairs was conducted to assess their intention to receive COVID-19 booster and influenza vaccines in the coming year. The association between vaccine intention and political affiliation, belief in collective responsibility, and workplace/school vaccine requirements were analyzed using multinomial logistic regression. Vaccine intention in the coming year was high among our participants; 65% intended to receive both vaccines, 11% intended to receive only the influenza vaccine, 7% intended to receive only the COVID-19 vaccine, and 17% planned to receive neither. Political affiliation was strongly associated with the intention to receive both vaccines. Republicans were far more likely than Democrats to report plans to receive neither vaccine (aOR: 12.8; 95% CI: 6.2-26.6), or only the influenza vaccine in the coming year (aOR: 8.7; 95% CI: 4.2-17.9). Additionally, those who planned to receive both vaccines were significantly more likely to view vaccines as a collective responsibility. This study highlights the significant influence of political affiliation and beliefs in collective responsibility on vaccine intentions.
Collapse
Affiliation(s)
- Isabel J. Ricke
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Alicen B. Spaulding
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nickolas N. Rajtar
- Department of Plant Pathology, University of Minnesota, St. Paul, MN 55108, USA
| | - Lauren Lundberg
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Ruby H. N. Nguyen
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| |
Collapse
|
10
|
Matovu JKB, Nuwematsiko R, Aanyu C, Tabwenda L, Okade T, Musoke D, Buregyeya E. COVID-19 vaccination, perceptions about the vaccine and willingness to take the vaccine among unvaccinated individuals at two Ugandan border points of entry. BMC Public Health 2024; 24:3308. [PMID: 39604916 PMCID: PMC11603881 DOI: 10.1186/s12889-024-20823-z] [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: 05/01/2024] [Accepted: 11/21/2024] [Indexed: 11/29/2024] Open
Abstract
BACKGROUND A recent systematic review shows high COVID-19 vaccine effectiveness in fully-vaccinated people in Africa. However, vaccine uptake has varied across populations. We assessed the uptake, perceptions of and willingness to take the COVID-19 vaccine among unvaccinated individuals at two Ugandan border points of entry. METHODS This was a cross-sectional quantitative study conducted at Malaba and Mutukula points of entry into Uganda between February and March 2023. We targeted people living in, working at, or transiting through the two points of entry, including truck drivers, point-of-entry customs officers and female sex workers, market vendors, among others. Data were collected on socio-demographic characteristics, vaccine uptake, perceptions and willingness to take the vaccine among unvaccinated individuals. We computed descriptive statistics and determined the factors associated with uptake of and willingness to take the vaccine using a modified Poisson regression model. Data analysis was conducted using STATA statistical package (version 14.0). RESULTS Of the 854 respondents, 50% (n = 427) were from Mutukula. Overall, 80.3% (n = 686) of the respondents reported that they had received at least one vaccine dose; no booster doses were reported. Respondents perceived that the vaccine was efficacious against COVID-19. COVID-19 vaccine uptake was associated with age-group 35-44 years [adjusted Prevalence Ratio [aPR] (95%CI) = 1.13 (1.01, 1.27)] or 45 + years [aPR (95%CI) = 1.19 (1.07, 1.33)]; being a truck driver [aPR (95%CI) = 1.16 (1.04, 1.29)] or health worker [aPR (95%CI) = 1.18 (1.05, 1.32)]; and the belief that the COVID-19 vaccine is protective against COVID-19 [aPR (95%CI) = 1.32 (1.10, 1.58)]. Nearly 60% of unvaccinated respondents (n = 99) were willing to take the COVID-19 vaccine. Willingness to take the vaccine was associated with the belief that one can contract the coronavirus if not vaccinated [aPR (95%CI) = 3.67 (1.90, 7.10)] or the community was at risk of COVID-19 [aPR (95%CI) = 1.86 (1.33, 2.62)]. CONCLUSION COVID-19 vaccine uptake was high in this setting while nearly six out of every ten unvaccinated individuals were willing to take the vaccine. Our findings lend credence for ongoing vaccination efforts at points of entry to contain the importation of new COVID-19 variants into the country.
Collapse
Affiliation(s)
- Joseph K B Matovu
- Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda.
- Faculty of Health Sciences, Busitema University, Mbale, Uganda.
| | | | - Christine Aanyu
- Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Lilian Tabwenda
- Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Tom Okade
- Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - David Musoke
- Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Esther Buregyeya
- Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| |
Collapse
|
11
|
Betsch C, Eitze S, Korn L, Shamsrizi P, Taubert F. [Vaccine hesitancy in postpandemic times-A guide for physicians]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2024; 65:1056-1065. [PMID: 39327285 DOI: 10.1007/s00108-024-01784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2024] [Indexed: 09/28/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic emphasized the importance of vaccinations for the prevention of life-threatening diseases and for avoiding the overburdening of the healthcare system. Despite the clear advantage of vaccinations, increasing vaccine hesitancy has been observed worldwide, especially among young people who are potential future parents. Vaccine hesitancy describes the delayed or lack of willingness to utilize recommended vaccinations and represents a substantial challenge for public health. This article analyzes the causes of vaccine hesitancy in the postpandemic period and discusses factors that could make communication successful. The role of artificial intelligence and structured evidence-based discussion techniques, such as the empathetic refutation interview, are emphasized. The aim is to provide practice-oriented recommendations to be able to provide physicians with tools that can help in the education counselling with insecure patients and can promote the acceptance of vaccinations.
Collapse
Affiliation(s)
- Cornelia Betsch
- Institute for Planetary Health Behaviour, Gesundheitskommunikation, Universität Erfurt, Max-Weber-Allee 3, 99089, Erfurt, Deutschland.
- Implementationsforschung, Gesundheitskommunikation, Bernhard-Nocht-Institut für Tropenmedizin, Bernhard-Nocht-Straße 74, 20359, Hamburg, Deutschland.
| | - Sarah Eitze
- Institute for Planetary Health Behaviour, Gesundheitskommunikation, Universität Erfurt, Max-Weber-Allee 3, 99089, Erfurt, Deutschland
- Implementationsforschung, Gesundheitskommunikation, Bernhard-Nocht-Institut für Tropenmedizin, Bernhard-Nocht-Straße 74, 20359, Hamburg, Deutschland
| | - Lars Korn
- Institute for Planetary Health Behaviour, Gesundheitskommunikation, Universität Erfurt, Max-Weber-Allee 3, 99089, Erfurt, Deutschland
- Implementationsforschung, Gesundheitskommunikation, Bernhard-Nocht-Institut für Tropenmedizin, Bernhard-Nocht-Straße 74, 20359, Hamburg, Deutschland
| | - Parichehr Shamsrizi
- Institute for Planetary Health Behaviour, Gesundheitskommunikation, Universität Erfurt, Max-Weber-Allee 3, 99089, Erfurt, Deutschland
- Implementationsforschung, Gesundheitskommunikation, Bernhard-Nocht-Institut für Tropenmedizin, Bernhard-Nocht-Straße 74, 20359, Hamburg, Deutschland
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, Gesundheitskommunikation, Universität Erfurt, Max-Weber-Allee 3, 99089, Erfurt, Deutschland
- Implementationsforschung, Gesundheitskommunikation, Bernhard-Nocht-Institut für Tropenmedizin, Bernhard-Nocht-Straße 74, 20359, Hamburg, Deutschland
| |
Collapse
|
12
|
Bather JR, Burke EM, Plepys CM, Rajbhandari-Thapa J, Furr-Holden D, Goodman MS. An Immediate but Fleeting Interest in MPH Programs After the Onset of COVID-19: An Interrupted Time-Series Analysis. Public Health Rep 2024:333549241288140. [PMID: 39437021 PMCID: PMC11556456 DOI: 10.1177/00333549241288140] [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: 10/25/2024] Open
Abstract
OBJECTIVES The relationship between the onset of the COVID-19 pandemic and interest in master of public health (MPH) programs is unknown. We examined trends in MPH application rates for 31 MPH concentrations and specifically for the MPH concentration in epidemiology and differences by race and ethnicity before and after the onset of the COVID-19 pandemic. METHODS We constructed a quasi-experimental design to examine trends in MPH application rates from academic years 2015-2016 through 2022-2023 by using Centralized Application Service for Schools and Programs of Public Health data. We used an interrupted time-series analysis to test whether application rates surged after the pandemic's onset (academic years 2019-2020 through 2020-2021) and whether this increase persisted during the pandemic (academic years 2020-2021 through 2022-2023). We fit models for the overall sample, a combined racially and ethnically minoritized sample, each racial and ethnic group separately, and a non-US citizen sample. RESULTS The pandemic's onset correlated with an immediate increase in application rates across most samples: overall (38%) and among American Indian/Alaska Native/Native Hawaiian/Pacific Islander (91%), Asian (35%), Black (42%), Hispanic (60%), multiracial (30%), racially and ethnically minoritized (44%), and White (53%) samples. However, this trend was not sustained; application rate trends during the pandemic were significantly lower than prepandemic trends. Application rate trends for all MPH concentrations and the MPH in epidemiology concentration among non-US citizens were significantly higher during the pandemic than prepandemic. CONCLUSIONS Our results highlight the need for innovative strategies to sustain MPH degree interest and a diverse applicant pool.
Collapse
Affiliation(s)
- Jemar R. Bather
- Center for Anti-racism, Social Justice & Public Health, New York University School of Global Public Health, New York, NY, USA
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, USA
| | - Emily M. Burke
- Association of Schools and Programs of Public Health, Washington, DC, USA
| | | | | | - Debra Furr-Holden
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA
| | - Melody S. Goodman
- Center for Anti-racism, Social Justice & Public Health, New York University School of Global Public Health, New York, NY, USA
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, USA
| |
Collapse
|
13
|
Wilson H, McKee M. Newspaper Representation of Mandatory Vaccination Against COVID-19 for Healthcare Workers in England: A Qualitative Framing Analysis. JOURNAL OF HEALTH COMMUNICATION 2024; 29:580-589. [PMID: 39194004 DOI: 10.1080/10810730.2024.2394763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
In 2021, vaccination against COVID-19 became mandatory for healthcare workers in England. The media coverage of the mandate was extensive and became an issue of public interest. This study aimed to understand the United Kingdom (UK) debate on mandatory COVID-19 vaccination through a framing analysis of UK media coverage. Articles written between November 2021 and April 2022 were identified from UK national newspapers: The Daily (and Sunday) Telegraph, the Times (and Sunday Times), the Guardian (and the Observer), the Independent, the Daily Mail (and Mail on Sunday), the Daily Mirror, the Daily Express, and the Sun. Articles were selected using eligibility criteria before framing analysis was undertaken. The sample included 204 articles. Safe Staffing, Treatment of Staff, Change in Covid Context, and Protect Patient Safety were identified as frames used to stimulate debate on the mandatory vaccination policy. Such frames established three broader concepts in the media: civil liberty theory, duty-based ethics, and social-vulnerability theory. This study analyzed how mandatory COVID-19 vaccination for healthcare workers in England was framed in the UK national media. The broader concepts built in the media heightened debate on the policy, creating a voluminous amount of coverage and criticism that may have played a role in the mandate's reversal.
Collapse
Affiliation(s)
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
14
|
Kahwaji A, Alaryan T, Alhelwani H, Salem M, Alsuliman T. Understanding the influence of social media on COVID-19 vaccine acceptance in a war-torn Syria: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38956. [PMID: 39121327 PMCID: PMC11315535 DOI: 10.1097/md.0000000000038956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/26/2024] [Indexed: 08/11/2024] Open
Abstract
Social media has become a source of disseminating information to the public during the COVID-19 outbreak which has been a great advantage for healthcare centers. However, foreign anti-vaccination campaigns on social media increased the disbelief in vaccine safety. To our knowledge, the effects of social media on COVID-19 vaccine acceptance are not well-studied in low-income countries. The primary objective of this survey is to investigate Syrians' dependence on social media platforms to get information about vaccines, and to what extent it affects their vaccination decision. A web-based cross-sectional study was conducted in Syria from May 26th to July 26th, 2022 using an online questionnaire as Google Form posted on various social media platforms. The questionnaire consisted of 53 questions related to each of the socio-demographic characteristics, beliefs, and knowledge about COVID-19 vaccination, willingness to get vaccinated, and social media frequency use and its effects. Univariate and multivariate logistic regression was performed to identify factors associated with vaccination behavior. A total of 780 questionnaires were completed; around 42.2% of study participants did not get the vaccine, and 24% would take it only under compulsory rules. Also, only 3.08% of the participants answered correctly on the knowledge-evaluation questions. Results of the univariate analysis showed that being female, living in an urban residential area, and having good vaccine knowledge were positive predictors of vaccine receiving. The unvaccinated group had a higher likelihood of being college students, not trusting in the vaccine, knowing relatively less about the vaccine, and not having previously been exposed to the virus. No significant correlation between vaccination status and using social media was shown in our investigation. However, our results show the importance of social media information in health-related decisions in war-torn countries and emphasize further investigations to confirm causality and determine the best health policy choice.
Collapse
Affiliation(s)
- Areej Kahwaji
- Faculty of Pharmacy, Damascus University, Damascus, Syria
| | - Thurya Alaryan
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Damascus University, Damascus, Syria
| | | | - Moath Salem
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Tamim Alsuliman
- Sorbonne University, Paris, France
- Service d’d’Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France
- INSERM, Paris, France
| |
Collapse
|
15
|
Wang Y, Stoecker C, Callison K, Hernandez JH. State COVID-19 Vaccine Mandates and Uptake Among Health Care Workers in the US. JAMA Netw Open 2024; 7:e2426847. [PMID: 39141387 PMCID: PMC11325213 DOI: 10.1001/jamanetworkopen.2024.26847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/02/2024] [Indexed: 08/15/2024] Open
Abstract
Importance Seventeen states introduced COVID-19 vaccine mandates for health care workers (HCWs) in mid-2021. Prior research on the effect of these mandates was centered on the nursing home sector, and more evidence is needed for their effect on the entire HCW population. Objective To examine the association between state COVID-19 vaccine mandates for HCWs and vaccine uptake in this population. Design, Setting, and Participants This repeated cross-sectional study included biweekly, individual-level data for adults aged 25 to 64 years who were working or volunteering in health care settings obtained from the Household Pulse Survey between May 26 and October 11, 2021. Analyses were conducted between November 2022 and October 2023. Exposure Announcement of a state COVID-19 vaccine mandate for HCWs. Main Outcomes and Measures An indicator for whether a sampled HCW ever received a COVID-19 vaccine and an indicator for whether an HCW completed or intended to complete the primary COVID-19 vaccination series. Event study analyses using staggered difference-in-differences methods compared vaccine uptake among HCWs in mandate and nonmandate states before and after each mandate announcement. The sample was further stratified by the availability of regular COVID-19 testing in place of a vaccination (ie, a test-out option) and by the ages of HCWs (25-49 or 50-64 years) to examine heterogeneous associations. Results The study sample included 31 142 HCWs (mean [SD] age, 45.5 [10.6] years; 72.1% female) from 45 states, 16 of which introduced COVID-19 vaccine mandates for HCWs. Results indicated a mandate-associated 3.46-percentage point (pp) (95% CI, 0.29-6.63 pp; P = .03) increase in the proportion of HCWs ever vaccinated against COVID-19 and a 3.64-pp (95% CI, 0.72-6.57 pp; P = .02) increase in the proportion that completed or intended to complete the primary vaccination series 2 weeks after mandate announcement from baseline proportions of 87.98% and 86.12%, respectively. In the stratified analyses, positive associations were only detected in mandate states with no test-out option and among HCWs aged 25 to 49 years, which suggested vaccination increases of 3.32% to 7.09% compared with baseline proportions. Conclusions and Relevance This repeated cross-sectional study found that state COVID-19 vaccine mandates for HCWs were associated with increased vaccine uptake among HCWs, especially among younger HCWs and those in states with no test-out option. These findings suggest the potential for vaccine mandates to further promote vaccinations in an already highly vaccinated HCW population, especially when no test-out option is in place.
Collapse
Affiliation(s)
- Yin Wang
- Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Charles Stoecker
- Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Kevin Callison
- Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Julie H. Hernandez
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| |
Collapse
|
16
|
Fayaz-Farkhad B, Jung H. Do COVID-19 Vaccination Policies Backfire? The Effects of Mandates, Vaccination Passports, and Financial Incentives on COVID-19 Vaccination. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024; 19:660-674. [PMID: 38048051 PMCID: PMC11295420 DOI: 10.1177/17456916231178708] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Faced with the challenges of motivating people to vaccinate, many countries have introduced policy-level interventions to encourage vaccination against COVID-19. For example, mandates were widely imposed requiring individuals to vaccinate to work and attend school, and vaccination passports required individuals to show proof of vaccination to travel and access public spaces and events. Furthermore, some countries also began offering financial incentives for getting vaccinated. One major criticism of these policies was the possibility that they would produce reactance and thus undermine voluntary vaccination. This article therefore reviews relevant empirical evidence to examine whether this is indeed the case. Specifically, we devote separate sections to reviewing and discussing the impacts of three major policies that were implemented during the COVID-19 pandemic: vaccination mandates, vaccination passports, and the provision of financial incentives. A careful analysis of the evidence provides little support that these policies backfire but instead can effectively promote vaccination at the population level. The policies are not without limitations, however, such as their inability to mobilize those that are strongly hesitant to vaccines. Finally, we discuss how policy-level interventions should be designed and implemented to address future epidemics and pandemics.
Collapse
Affiliation(s)
| | - Haesung Jung
- Annenberg School for Communication, University of Pennsylvania
| |
Collapse
|
17
|
Petrovic N. Reassessing the VaxTax. JOURNAL OF MEDICAL ETHICS 2024; 50:222-225. [PMID: 37673670 DOI: 10.1136/jme-2023-109045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/12/2023] [Indexed: 09/08/2023]
Abstract
To counter the imbalance in vaccine distribution during the COVID-19 pandemic, Albertsen and more recently Germani et al have suggested a new system of taxation coined as 'VaxTax' that would force higher-income countries to fund the access of low-income and middle-income countries (LMICs) to new vaccines in times of pandemic. I will argue that this idea faces numerous challenges of ethical, sociopolitical and economical nature that may hinder any effort to solve the numerous health challenges that LMICs face. I argue that while it is an interesting idea, it is neither sufficient nor will it ever be easily implemented because of socioeconomic or practical reasons.
Collapse
|
18
|
Steinmayr A, Rossi M. Vaccine-skeptic physicians and patient vaccination decisions. HEALTH ECONOMICS 2024; 33:509-525. [PMID: 38015034 DOI: 10.1002/hec.4781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/12/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
What is the role of general practitioners (GPs) in supporting or hindering public health efforts? We investigate the influence of vaccine-skeptic GPs on their patients' decisions to get a COVID-19 vaccination. We identify vaccine-skeptic GPs from the signatories of an open letter in which 199 Austrian physicians expressed their skepticism about COVID-19 vaccines. We examine small rural municipalities where patients choose a GP primarily based on geographic proximity. These vaccine-skeptic GPs reduced the vaccination rate by 5.6 percentage points. This estimate implies that they discouraged 7.9% of the vaccinable population. The effect appears to stem from discouragement rather than rationing vaccine access.
Collapse
|
19
|
Arsenault C, Lewis TP, Kapoor NR, Okiro EA, Leslie HH, Armeni P, Jarhyan P, Doubova SV, Wright KD, Aryal A, Kounnavong S, Mohan S, Odipo E, Lee HY, Shin J, Ayele W, Medina-Ranilla J, Espinoza-Pajuelo L, Derseh Mebratie A, García Elorrio E, Mazzoni A, Oh J, SteelFisher GK, Tarricone R, Kruk ME. Health system quality and COVID-19 vaccination: a cross-sectional analysis in 14 countries. Lancet Glob Health 2024; 12:e156-e165. [PMID: 38096888 PMCID: PMC10716622 DOI: 10.1016/s2214-109x(23)00490-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/12/2023] [Accepted: 10/10/2023] [Indexed: 12/17/2023]
Abstract
The social and behavioural determinants of COVID-19 vaccination have been described previously. However, little is known about how vaccinated people use and rate their health system. We used surveys conducted in 14 countries to study the health system correlates of COVID-19 vaccination. Country-specific logistic regression models were adjusted for respondent age, education, income, chronic illness, history of COVID-19, urban residence, and minority ethnic, racial, or linguistic group. Estimates were summarised across countries using random effects meta-analysis. Vaccination coverage with at least two or three doses ranged from 29% in India to 85% in Peru. Greater health-care use, having a regular and high-quality provider, and receiving other preventive health services were positively associated with vaccination. Confidence in the health system and government also increased the odds of vaccination. By contrast, having unmet health-care needs or experiencing discrimination or a medical mistake decreased the odds of vaccination. Associations between health system predictors and vaccination tended to be stronger in high-income countries and in countries with the most COVID-19-related deaths. Access to quality health systems might affect vaccine decisions. Building strong primary care systems and ensuring a baseline level of quality that is affordable for all should be central to pandemic preparedness strategies.
Collapse
Affiliation(s)
- Catherine Arsenault
- Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington DC, USA.
| | - Todd P Lewis
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Neena R Kapoor
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Emelda A Okiro
- Population & Health Impact Surveillance Group, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Hannah H Leslie
- Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Patrizio Armeni
- CERGAS SDA Bocconi School of Management, Bocconi University, Milan, Italy
| | | | - Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Katherine D Wright
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Amit Aryal
- Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | | | - Sailesh Mohan
- Public Health Foundation of India, Gurgaon, Haryana, India
| | - Emily Odipo
- Population & Health Impact Surveillance Group, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Hwa-Young Lee
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, South Korea
| | - Jeonghyun Shin
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Wondimu Ayele
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jesús Medina-Ranilla
- Faculty of Public Health and Administration, Epidemiology Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Laura Espinoza-Pajuelo
- Faculty of Public Health and Administration, Epidemiology Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Agustina Mazzoni
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Juhwan Oh
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Gillian K SteelFisher
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rosanna Tarricone
- CERGAS SDA Bocconi School of Management, Bocconi University, Milan, Italy
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
20
|
Mayer D, Barun B, Lazibat K, Lasić S, Adamec I, Gabelić T, Krbot Skorić M, Habek M. COVID-19 vaccination uptake in people with multiple sclerosis compared to the general population. Acta Neurol Belg 2023; 123:2269-2275. [PMID: 37261658 PMCID: PMC10233513 DOI: 10.1007/s13760-023-02296-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To determine the COVID-19 vaccine uptake among people with multiple sclerosis (pwMS) compared to the general population in Croatia. METHODS Data from all pwMS entered in the MS Base register until March 24th, 2022 were extracted including age, sex, MS phenotype, disease-modifying therapy (DMT), and date of COVID-19 vaccination. Data on the general population of Croatia were obtained from the vaccination register of the Croatian Institute of Public Health. RESULTS 64.4% pwMS were fully COVID-19 vaccinated which was comparable to 66.3% of the general population. More pwMS were fully vaccinated in the age group 20-24 (74.1% vs 51.7%), and fewer pwMS were fully vaccinated in the age group 65-69 (33.3% vs 80.4%) compared to the general population of the same age group, respectively. PwMS who received at least one dose of any COVID-19 vaccine were older (40.5 vs 37.6 years, p = 0.01), had higher EDSS (2.0 vs 1.0, p = 0.025), and had longer disease duration (6.39 vs 5.35 years, p = 0.02), were more likely to have progressive disease course (p = 0.049) and were on high efficacy DMTs (p = 0.045) compared to unvaccinated pwMS. Longer disease duration positively predicted vaccine uptake. CONCLUSION Croatia has suboptimal COVID-19 vaccination uptake without a significant difference between the general population and pwMS.
Collapse
Affiliation(s)
- Dijana Mayer
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Barbara Barun
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Karla Lazibat
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Slava Lasić
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Adamec
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tereza Gabelić
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Magdalena Krbot Skorić
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia
| | - Mario Habek
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| |
Collapse
|
21
|
Giwa A, Adeagbo M, Tate SA, Tulli-Shah M, Salami B. COVID-19 Vaccine Mandates and Vaccine Hesitancy among Black People in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7119. [PMID: 38063549 PMCID: PMC10706298 DOI: 10.3390/ijerph20237119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES COVID-19 vaccine mandates increased vaccination rates globally. Implemented as a one-size-fits-all policy, these mandates have unintended harmful consequences for many, including Black Canadians. This article reports findings on the interconnectedness of vaccine mandates and vaccine hesitancy by describing a range of responses to mandatory COVID-19 vaccination policies among Black people in Canada. METHODS Using qualitative research methods, semi-structured interviews with 36 Black people living in Canada aged 18 years and over across 6 provinces in Canada were conducted. Participants were selected across intersectional categories including migration status, income, religion, education, sex, and Black ethnicity. Thematic analysis informed the identification of key themes using Foucauldian notions of biopower and governmentality. RESULTS Our results show how the power relations present in the ways many Black people actualize vaccine intentions. Two main themes were identified: acceptance of the COVID-19 vaccine in the context of governmentality and resistance to vaccine mandates driven by oppression, mistrust, and religion. CONCLUSION COVID-19 vaccine mandates may have reinforced mistrust of the government and decreased confidence in the COVID-19 vaccine. Policy makers need to consider non-discriminatory public health policies and monitor how these policies are implemented over time and across multiple sectors to better understand vaccine hesitancy.
Collapse
Affiliation(s)
- Aisha Giwa
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| | - Morolake Adeagbo
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| | - Shirley Anne Tate
- Department of Sociology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Mia Tulli-Shah
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| | - Bukola Salami
- College of Health Sciences, School of Public Health University of Alberta, Edmonton, AB T6G 1C9, Canada (M.T.-S.); (B.S.)
| |
Collapse
|
22
|
Natalia YA, Delporte M, De Witte D, Beutels P, Dewatripont M, Molenberghs G. Assessing the impact of COVID-19 passes and mandates on disease transmission, vaccination intention, and uptake: a scoping review. BMC Public Health 2023; 23:2279. [PMID: 37978472 PMCID: PMC10656887 DOI: 10.1186/s12889-023-17203-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE Policymakers have struggled to maintain SARS-CoV-2 transmission at levels that are manageable to contain the COVID-19 disease burden while enabling a maximum of societal and economic activities. One of the tools that have been used to facilitate this is the so-called "COVID-19 pass". We aimed to document current evidence on the effectiveness of COVID-19 passes, distinguishing their indirect effects by improving vaccination intention and uptake from their direct effects on COVID-19 transmission measured by the incidence of cases, hospitalizations, and deaths. METHODS We performed a scoping review on the scientific literature of the proposed topic covering the period January 2021 to September 2022, in accordance with the PRISMA-ScR guidelines for scoping reviews. RESULTS Out of a yield of 4,693 publications, 45 studies from multiple countries were retained for full-text review. The results suggest that implementing COVID-19 passes tends to reduce the incidence of cases, hospitalizations, and deaths due to COVID-19. The use of COVID-19 passes was also shown to improve overall vaccination uptake and intention, but not in people who hold strong anti-COVID-19 vaccine beliefs. CONCLUSION The evidence from the literature we reviewed tends to indicate positive direct and indirect effects from the use of COVID-19 passes. A major limitation to establishing this firmly is the entanglement of individual effects of multiple measures being implemented simultaneously.
Collapse
Affiliation(s)
| | - Margaux Delporte
- I-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Dries De Witte
- I-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Mathias Dewatripont
- I3h, ECARES and Solvay Brussels School of Economics and Management, Université Libre de Bruxelles, Brussels, Belgium
| | - Geert Molenberghs
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
- I-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| |
Collapse
|
23
|
Fitzpatrick T, Camillo CA, Hillis S, Habbick M, Roerig M, Muhajarine N, Allin S. The Impact Of Provincial Proof- Of-Vaccination Policies On Age-Specific First-Dose Uptake Of COVID-19 Vaccines In Canada. Health Aff (Millwood) 2023; 42:1595-1605. [PMID: 37931201 DOI: 10.1377/hlthaff.2022.01237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Requirements of proof of COVID-19 vaccination were mandated for nonessential businesses and venues by Canada's ten provinces throughout the fall of 2021. Leveraging variations in the timing of these measures across the provinces, we applied event study regression to estimate the impact the announcement of these measures had nationally on age-specific first-dose uptake in the subsequent seven-week period. Proof-of-vaccination mandate announcements were associated with a rapid, significant increase in first-dose uptake, particularly in people younger than age fifty. However, these behavioral changes were short-lived, with uptake returning to preannouncement levels-or lower-in all age groups within six weeks, despite mandates remaining in place for at least four months; this decline occurred earlier and was more apparent among adolescents ages 12-17. We estimated that nationally, 290,168 additional people received their first dose in the seven weeks after provinces announced proof-of-vaccination policies, for a 17.5 percent increase over the number of vaccinations estimated in the absence of these policies. This study provides novel age-specific evidence showing that proof-of-vaccination mandates led to an immediate, significant increase in national first-dose uptake and were particularly effective for increasing vaccination uptake in younger to middle-aged adults. Proof-of-vaccination mandates may be effective short-term policy measures for increasing population vaccination uptake, but their impact may differ across age groups.
Collapse
Affiliation(s)
| | - Cheryl A Camillo
- Cheryl A. Camillo, University of Regina, Regina, Saskatchewan, Canada
| | - Shelby Hillis
- Shelby Hillis, Coronavirus Variants Rapid Response Network, Ottawa, Ontario, Canada
| | - Marin Habbick
- Marin Habbick, Coronavirus Variants Rapid Response Network
| | | | - Nazeem Muhajarine
- Nazeem Muhajarine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | |
Collapse
|
24
|
Raman B, Banerjee A, Vajjala SM. Quantification of COVID-19 Vaccine Coercion in India: A Survey Study. Cureus 2023; 15:e48638. [PMID: 38090438 PMCID: PMC10711416 DOI: 10.7759/cureus.48638] [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] [Accepted: 11/09/2023] [Indexed: 10/16/2024] Open
Abstract
INTRODUCTION Informed consent is the cornerstone of medical ethics, enshrined in the constitution of most countries, as well as in international documents. However, mandates for coronavirus disease 2019 (COVID-19) vaccination as well as coercion were prevalent in many places in the world, including in India. Against this background, we did a cross-sectional study to assess and quantify the extent of COVID-19 vaccine coercion in India. METHODS A cross-sectional study was conducted after obtaining ethical clearance from the Indian Institute of Technology Bombay (IITB). This survey was conducted using a pretested questionnaire anonymously amongst college students and adults in Mumbai from October 2022 to December 2022. The questionnaire contained details of why the vaccine was taken, and if the participant was a student. Descriptive analysis was conducted and frequencies, percentages along with 95% confidence intervals were used to summarize the findings. RESULTS A total of 483 participants responded, which included both students and non-students, of which 470 participants reported having taken the vaccine. A total of 106 (21.95%, 95% CI 18.48%-25.85%) reported to have been pressured into taking the vaccine. The level of coercion was similar among college students (78, 21.61%, 95% CI 17.67%-26.14%) and non-student adults (28, 22.95%, 95% CI 15.82%-31.43%). Conclusion: A significant proportion was coerced into taking the vaccines, violating the requirement for informed consent. These results are of paramount importance for future policies as well as for posterity.
Collapse
Affiliation(s)
- Bhaskaran Raman
- Department of Computer Science and Engineering, Indian Institute of Technology Bombay, Mumbai, IND
| | - Amitav Banerjee
- Department of Community Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Dr. DY Patil Vidyapeeth, Pune, IND
| | - Sai Mahesh Vajjala
- Department of Community Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Dr. DY Patil Vidyapeeth, Pune, IND
| |
Collapse
|
25
|
Wong E, Sutton B, McLaughlin T, McGrath C, Baptista M, Stripp A, Stuart RL. Achieving COVID-19 vaccination equity in South Eastern Metropolitan Victoria, Australia: a population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 39:100900. [PMID: 37928002 PMCID: PMC10625028 DOI: 10.1016/j.lanwpc.2023.100900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/26/2023] [Accepted: 08/23/2023] [Indexed: 11/07/2023]
Abstract
Background We describe COVID-19 first and second vaccine uptake across Local Government Areas (LGAs) in Victoria using southeast metropolitan Melbourne catchment as a case study. We explore key policy and implementation strategies that contributed to equitable uptake. Methods Population level data within the South East Public Health Unit (SEPHU) was used to compare trends in COVID-19 vaccination first and second dose uptake for each of the 11 LGAs in year 2021. Changes in vaccination uptake over the year were reviewed against social and public health measures used during the COVID-19 pandemic in Victoria and strategies in the SEPHU vaccination program. Findings By September 2021, 57% of the eligible population in the least disadvantaged LGA, Bayside, had received their second dose vaccination compared to 32% in the most disadvantaged LGA, Greater Dandenong. By end of 2021, the gap had narrowed with 95% in Bayside and 92% in Greater Dandenong having received their second dose. The increase in vaccination uptake for both LGAs was bimodal. Government policies on vaccine eligibility and the opening of mass vaccination sites preceded the first peak in vaccination uptake. Strong community engagement, addressing misinformation, providing culturally appropriate vaccination services and mass outbreaks preceded the second peak in vaccination uptake. Interpretation Vaccine equity across culturally and economically diverse populations can be achieved through a combination of robust, targeted community engagement, mass deployment of appropriate workforce, vaccination services tailored to cultural needs and sensitivities and accessibility to mass vaccination sites on a backdrop of state-wide policies that incentivise vaccination. Funding None.
Collapse
Affiliation(s)
- Evelyn Wong
- Monash Health, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Brett Sutton
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Department of Health, Victoria, Australia
| | | | | | - Mohana Baptista
- Monash Health, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Andrew Stripp
- Monash Health, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Rhonda L. Stuart
- Monash Health, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| |
Collapse
|
26
|
Chen SX, Ye FTF, Cheng KL, Ng JCK, Lam BCP, Hui BPH, Au AKY, Wu WCH, Gu D, Zeng Y. Social media trust predicts lower COVID-19 vaccination rates and higher excess mortality over 2 years. PNAS NEXUS 2023; 2:pgad318. [PMID: 37841324 PMCID: PMC10568527 DOI: 10.1093/pnasnexus/pgad318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
Trust plays a crucial role in implementing public health interventions against the COVID-19 pandemic. We examined the prospective associations of interpersonal, institutional, and media trust with vaccination rates and excess mortality over time in two multinational studies. In study 1, we investigated the country-level relationships between interpersonal trust, vaccination rates, and excess mortality across 54 countries. Interpersonal trust at the country level was calculated by aggregating data of 80,317 participants from the World Values Survey in 2017-20. Data on vaccination rates and excess mortality were obtained from the World Health Organization. Our findings indicated that higher levels of interpersonal trust were linked to higher vaccination rates and lower excess mortality rates in both 2020 and 2021. In study 2, we collected data from 18,171 adults in 35 countries/societies, stratified by age, gender, and region of residence. At the country/society level, interpersonal trust and trust in local healthcare facilities, local healthcare services, and healthcare professionals were associated with higher vaccination rates and lower excess mortality, whereas social media trust was associated with lower vaccination rates and higher excess mortality across three time points over 2 years. Our findings are robust when controlling for country-level covariates of the government stringency index, population density, and medical resources (i.e. critical care beds) in both studies.
Collapse
Affiliation(s)
- Sylvia Xiaohua Chen
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Frank Tian-fang Ye
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kai Lam Cheng
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jacky C K Ng
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ben C P Lam
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia
| | - Bryant P H Hui
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Algae K Y Au
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wesley C H Wu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Danan Gu
- Independent Researcher, New York, USA
| | - Yi Zeng
- National School of Development, Peking University, Beijing, China
| |
Collapse
|
27
|
Zhu DT, Serhan M, Mithani SS, Smith D, Ang J, Thomas M, Wilson K. The barriers, facilitators and association of vaccine certificates on COVID-19 vaccine uptake: a scoping review. Global Health 2023; 19:73. [PMID: 37759306 PMCID: PMC10537206 DOI: 10.1186/s12992-023-00969-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Globally, COVID-19 vaccines have proven to be instrumental for promoting population health by reducing illness from SARS-CoV-2. Vaccine certificates emerged as a potentially promising solution for encouraging vaccination and facilitating the safe reopening of society, however, they were controversial due to criticisms of infringing upon individual rights. While there is extensive literature describing the ethical, legal, and public health implications of vaccine certificates, there is currently a gap in knowledge about the association of vaccine certificates on vaccine uptake during the COVID-19 pandemic and barriers and facilitators to their use. OBJECTIVES The objectives of this scoping review are to (i) describe the existing literature on the association of vaccine certificates on the rates of COVID-19 vaccine uptake across several countries and (ii) describe the intrinsic and extrinsic barriers or facilitators that moderate this relationship. METHODS We conducted a scoping review based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched three bibliographic databases (APA PsychInfo, Embase Classic + Embase, OVID-Medline) and preprint severs during the first week of July 2023. Three reviewers independently screened the studies based on pre-specified eligibility criteria and performed quality assessments of the primary literature and data extraction. RESULTS Sixteen studies met the inclusion criteria. 14 or these were surveys and 2 were modelling studies. The majority documented that vaccine certificates were significantly associated with increased rates of COVID-19 vaccine uptake (n = 12), motivated by factors such as travel/employer requirements, influence from the government/peers, and trust in the safety, efficacy, and science behind COVID-19 vaccines. Three studies had non-significant or mixed findings. Only one study found a significant decrease in COVID-19 vaccine uptake, motivated by pervasive distrust in the QR code-based system of digital vaccine certificates in Russia. Quality of survey studies was generally high. CONCLUSION Our findings provide insights into the existing literature on vaccine certificates association with vaccine uptake in several different jurisdictions and barriers and facilitators to their uptake. This information can be used to guide future examinations of the implementation of vaccine certificates and more effective implementations.
Collapse
Affiliation(s)
- David T Zhu
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Medical Scientist Training Program, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Mohamed Serhan
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Salima S Mithani
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - David Smith
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Joyce Ang
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Maya Thomas
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kumanan Wilson
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Department of Medicine, University of Ottawa, Ottawa, Canada.
- Bruyère Research Institute, Ottawa, Canada.
- O'Neill Institute, Georgetown University, Washington DC, USA.
| |
Collapse
|
28
|
Tradigo G, Das JK, Vizza P, Roy S, Guzzi PH, Veltri P. Strategies and Trends in COVID-19 Vaccination Delivery: What We Learn and What We May Use for the Future. Vaccines (Basel) 2023; 11:1496. [PMID: 37766172 PMCID: PMC10535057 DOI: 10.3390/vaccines11091496] [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: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Vaccination has been the most effective way to control the outbreak of the COVID-19 pandemic. The numbers and types of vaccines have reached considerable proportions, even if the question of vaccine procedures and frequency still needs to be resolved. We have come to learn the necessity of defining vaccination distribution strategies with regard to COVID-19 that could be used for any future pandemics of similar gravity. In fact, vaccine monitoring implies the existence of a strategy that should be measurable in terms of input and output, based on a mathematical model, including death rates, the spread of infections, symptoms, hospitalization, and so on. This paper addresses the issue of vaccine diffusion and strategies for monitoring the pandemic. It provides a description of the importance and take up of vaccines and the links between procedures and the containment of COVID-19 variants, as well as the long-term effects. Finally, the paper focuses on the global scenario in a world undergoing profound social and political change, with particular attention on current and future health provision. This contribution would represent an example of vaccination experiences, which can be useful in other pandemic or epidemiological contexts.
Collapse
Affiliation(s)
- Giuseppe Tradigo
- Department of Computer Science, eCampus University, 22060 Novedrate, Italy;
| | - Jayanta Kumar Das
- Longitudinal Studies Section, Translation Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA;
| | - Patrizia Vizza
- Department of Surgical and Medical Science, Magna Græcia University, 88100 Catanzaro, Italy;
| | - Swarup Roy
- Network Reconstruction & Analysis (NetRA) Lab, Department of Computer Applications, Sikkim University, Gangtok 737102, India;
| | - Pietro Hiram Guzzi
- Department of Surgical and Medical Science, Magna Græcia University, 88100 Catanzaro, Italy;
| | - Pierangelo Veltri
- Department of Computer Science, Modelling, Electronics and Systems, University of Calabria, 87036 Rende, Italy;
| |
Collapse
|
29
|
Elinder M, Erixson O, Öhman M. Cognitive ability, health policy, and the dynamics of COVID-19 vaccination. JOURNAL OF HEALTH ECONOMICS 2023; 91:102802. [PMID: 37672962 DOI: 10.1016/j.jhealeco.2023.102802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023]
Abstract
We examine the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden. We find a strong positive association between cognitive ability and swift vaccination, which remains even after controlling for confounding variables with a twin-design. The results suggest that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination. Consistent with this, we show that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.
Collapse
Affiliation(s)
- Mikael Elinder
- Department of Economics, Uppsala University, Uppsala, Sweden
| | - Oscar Erixson
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden.
| | - Mattias Öhman
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
| |
Collapse
|
30
|
Anato JLF, Ma H, Hamilton MA, Xia Y, Harper S, Buckeridge D, Brisson M, Hillmer MP, Malikov K, Kerem A, Beall R, Wagner CE, Racine É, Baral S, Dubé È, Mishra S, Maheu-Giroux M. Impact of a vaccine passport on first-dose SARS-CoV-2 vaccine coverage by age and area-level social determinants of health in the Canadian provinces of Quebec and Ontario: an interrupted time series analysis. CMAJ Open 2023; 11:E995-E1005. [PMID: 37875315 PMCID: PMC10609911 DOI: 10.9778/cmajo.20220242] [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] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND In Canada, all provinces implemented vaccine passports in 2021 to reduce SARS-CoV-2 transmission in non-essential indoor spaces and increase vaccine uptake (policies active September 2021-March 2022 in Quebec and Ontario). We sought to evaluate the impact of vaccine passport policies on first-dose SARS-CoV-2 vaccination coverage by age, and area-level income and proportion of racialized residents. METHODS We performed interrupted time series analyses using data from Quebec's and Ontario's vaccine registries linked to census information (population of 20.5 million people aged ≥ 12 yr; unit of analysis: dissemination area). We fit negative binomial regressions to first-dose vaccinations, using natural splines adjusting for baseline vaccination coverage (start: July 2021; end: October 2021 for Quebec, November 2021 for Ontario). We obtained counterfactual vaccination rates and coverage, and estimated the absolute and relative impacts of vaccine passports. RESULTS In both provinces, first-dose vaccination coverage before the announcement of vaccine passports was 82% (age ≥ 12 yr). The announcement resulted in estimated increases in coverage of 0.9 percentage points (95% confidence interval [CI] 0.4-1.2) in Quebec and 0.7 percentage points (95% CI 0.5-0.8) in Ontario. This corresponds to 23% (95% CI 10%-36%) and 19% (95% CI 15%-22%) more vaccinations over 11 weeks. The impact was larger among people aged 12-39 years. Despite lower coverage in lower-income and more-racialized areas, there was little variability in the absolute impact by area-level income or proportion racialized in either province. INTERPRETATION In the context of high vaccine coverage across 2 provinces, the announcement of vaccine passports had a small impact on first-dose coverage, with little impact on reducing economic and racial inequities in vaccine coverage. Findings suggest that other policies are needed to improve vaccination coverage among lower-income and racialized neighbourhoods and communities.
Collapse
Affiliation(s)
- Jorge Luis Flores Anato
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Huiting Ma
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Mackenzie A Hamilton
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Yiqing Xia
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Sam Harper
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - David Buckeridge
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Marc Brisson
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Michael P Hillmer
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Kamil Malikov
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Aidin Kerem
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Reed Beall
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Caroline E Wagner
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Étienne Racine
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Stefan Baral
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Ève Dubé
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Sharmistha Mishra
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
| |
Collapse
|
31
|
Murmann M, Reed AC, Scott M, Presseau J, Heer C, May K, Ramzy A, Huynh CN, Skidmore B, Welch V, Little J, Wilson K, Brouwers M, Hsu AT. Exploring COVID-19 education to support vaccine confidence amongst the general adult population with special considerations for healthcare and long-term care staff: A scoping review. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1352. [PMID: 37581103 PMCID: PMC10423318 DOI: 10.1002/cl2.1352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Background Despite the demonstrated efficacy of approved COVID-19 vaccines, high levels of hesitancy were observed in the first few months of the COVID-19 vaccines' rollout. Factors contributing to vaccine hesitancy are well-described in the literature. Among the various strategies for promoting vaccine confidence, educational interventions provide a foundationally and widely implemented set of approaches for supporting individuals in their vaccine decisions. However, the evidence around the measurable impact of various educational strategies to improve vaccine confidence is limited. We conducted a scoping review with the aim of exploring and characterizing educational interventions delivered during the pandemic to support COVID-19 vaccine confidence in adults. Methods We developed a search strategy with a medical information scientist and searched five databases, including Ovid MEDLINE and Web of Science, as well as grey literature. We considered all study designs and reports. Interventions delivered to children or adolescents, interventions on non-COVID-19 vaccines, as well as national or mass vaccination campaigns without documented interaction(s) between facilitator(s) and a specific audience were excluded. Articles were independently screened by three reviewers. After screening 4602 titles and abstracts and 174 full-text articles across two rounds of searches, 22 articles met our inclusion criteria. Ten additional studies were identified through hand searching. Data from included studies were charted and results were described narratively. Results We included 32 studies and synthesized their educational delivery structure, participants (i.e., facilitators and priority audience), and content. Formal, group-based presentations were the most common type of educational intervention in the included studies (75%). A third of studies (34%) used multiple strategies, with many formal group-based presentations being coupled with additional individual-based interventions (29%). Given the novelty of the COVID-19 vaccines and the unique current context, studies reported personalized conversations, question periods, and addressing misinformation as important components of the educational approaches reviewed. Conclusions Various educational interventions were delivered during the COVID-19 pandemic, with many initiatives involving multifaceted interventions utilizing both formal and informal approaches that leveraged community (cultural, religious) partnerships when developing and facilitating COVID-19 vaccine education. Train-the-trainer approaches with recognized community members could be of value as trust and personal connections were identified as strong enablers throughout the review.
Collapse
Affiliation(s)
- Maya Murmann
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
| | - Anna Cooper Reed
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
| | - Mary Scott
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
| | - Justin Presseau
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteThe Ottawa HospitalOttawaOntarioCanada
| | - Carrie Heer
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
| | - Kathryn May
- Civic CampusThe Ottawa HospitalOttawaOntarioCanada
| | - Amy Ramzy
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
| | - Chau N. Huynh
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
| | | | - Vivian Welch
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Julian Little
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Kumanan Wilson
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
- Department of Family MedicineUniversity of OttawaOttawaOntarioCanada
- Department of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Melissa Brouwers
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Amy T. Hsu
- Bruyère Research InstituteBruyèreOttawaOntarioCanada
- Ottawa Hospital Research InstituteThe Ottawa HospitalOttawaOntarioCanada
- Department of Family MedicineUniversity of OttawaOttawaOntarioCanada
| |
Collapse
|
32
|
Karlsson LC, Garrison A, Holford D, Fasce A, Lewandowsky S, Taubert F, Schmid P, Betsch C, Rodrigues F, Fressard L, Verger P, Soveri A. Healthcare professionals' attitudes to mandatory COVID-19 vaccination: Cross-sectional survey data from four European countries. Hum Vaccin Immunother 2023; 19:2256442. [PMID: 37724556 PMCID: PMC10512846 DOI: 10.1080/21645515.2023.2256442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
Mandatory vaccinations are widely debated since they restrict individuals' autonomy in their health decisions. As healthcare professionals (HCPs) are a common target group of vaccine mandates, and also form a link between vaccination policies and the public, understanding their attitudes toward vaccine mandates is important. The present study investigated physicians' attitudes to COVID-19 vaccine mandates in four European countries: Finland, France, Germany, and Portugal. An electronic survey assessing attitudes to COVID-19 vaccine mandates and general vaccination attitudes (e.g. perceived vaccine safety, trust in health authorities, and openness to patients) was sent to physicians in the spring of 2022. A total of 2796 physicians responded. Across all countries, 78% of the physicians were in favor of COVID-19 vaccine mandates for HCPs, 49% favored COVID-19 vaccine mandates for the public, and 67% endorsed COVID-19 health passes. Notable differences were observed between countries, with attitudes to mandates found to be more positive in countries where the mandate, or similar mandates, were in effect. The associations between attitudes to mandates and general vaccination attitudes were mostly small to neglectable and differed between countries. Nevertheless, physicians with more positive mandate attitudes perceived vaccines as more beneficial (in Finland and France) and had greater trust in medical authorities (in France and Germany). The present study contributes to the body of research within social and behavioral sciences that support evidence-based vaccination policymaking.
Collapse
Affiliation(s)
- Linda C. Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Frederike Taubert
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | - Philipp Schmid
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Cornelia Betsch
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | | | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
| |
Collapse
|
33
|
Mongin D, Buclin CP, Cullati S, Courvoisier DS. COVID-19 Vaccination Rate under Different Political Incentive: A Counterfactual Trend Approach Using Nationwide Data. Vaccines (Basel) 2023; 11:1149. [PMID: 37514965 PMCID: PMC10385043 DOI: 10.3390/vaccines11071149] [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: 05/24/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: France implemented a COVID-19 certificate in July 2021 to incentivize the population to uptake COVID-19 vaccines. However, little is known about the variation in its impact across age groups and its dependence on socio-demographic, economic, logistic, or political factors. (2) Methods: Using France's weekly first dose vaccination rate, a counterfactual trend approach allowed for the estimation of the vaccination rate across age groups at a small geographical level before and after the implementation of the health pass. The effect of the health pass was operationalized as the vaccination rate among those who would not be vaccinated without it. (3) Results: Vaccination before the health pass varied greatly among age groups and was mainly influenced by territory (lower in rural and overseas territories when compared to urban and metropolitan ones), political beliefs, and socio-economic disparities. Vaccine logistics played a minor but significant role, while the impact of COVID-19 did not affect the vaccination rate. The health pass increased the vaccination overall but with varying efficiency across groups. It convinced mainly young people politically close to the governmental vaccination strategy and living in urban metropolitan areas with low socio-economical discrepancies. The selected variables explained most of the variability of the vaccination rate before the health pass; they explained, at most, a third of the variation in the health pass effect on vaccination. (4) Conclusions: From a public health perspective, the French health pass increased the overall vaccination, but failed to promote preventive behaviours in all segments of society, particularly in vulnerable communities.
Collapse
Affiliation(s)
- Denis Mongin
- Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland
| | - Clement P Buclin
- Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland
| | - Stephane Cullati
- Division Quality of Care, Geneva University Hospitals, CH-1211 Geneva, Switzerland
- Population Health Laboratory (#PopHealthLab), Faculty of Science and Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
| | - Delphine S Courvoisier
- Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland
- Division Quality of Care, Geneva University Hospitals, CH-1211 Geneva, Switzerland
| |
Collapse
|
34
|
Santolini R. The COVID-19 green certificate's effect on vaccine uptake in French and Italian regions. JOURNAL OF POLICY MODELING 2023; 45:S0161-8938(23)00053-4. [PMID: 38620110 PMCID: PMC10290179 DOI: 10.1016/j.jpolmod.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/12/2023] [Accepted: 05/08/2023] [Indexed: 04/17/2024]
Abstract
The COVID-19 green certificates were introduced in many countries in 2021 to encourage vaccine uptake against the COVID-19 virus in order to reduce the spread of severe infection among the population, ensure the safety of cross-border movements, and facilitate the resumption of social life and economic activities. This study uses a single-group interrupted time series approach to examine the effect of the green certificate announcement on the first doses of the COVID-19 vaccine in 20 Italian and 18 French regions during the summer of 2021. The estimation results show that the green certificate announcement mitigated regional disparities in vaccine uptake. It persuaded undecided people to have their first doses of the COVID-19 vaccine, especially in regions lagging in the mass vaccination campaign. It was less effective in those regions where there was already a high level of vaccine protection. The announcement also proved to be an effective political strategy with which to increase the first-dose rates immediately, but not in the long term.
Collapse
Affiliation(s)
- Raffaella Santolini
- Department of Economics and Social Sciences Università Politecnica delle Marche Piazzale Martelli 8, 60121 Ancona Italy
| |
Collapse
|
35
|
The end of an emergency. Nat Hum Behav 2023; 7:657-658. [PMID: 37225926 DOI: 10.1038/s41562-023-01627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
|
36
|
Politis M, Sotiriou S, Doxani C, Stefanidis I, Zintzaras E, Rachiotis G. Healthcare Workers' Attitudes towards Mandatory COVID-19 Vaccination: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11040880. [PMID: 37112791 PMCID: PMC10142794 DOI: 10.3390/vaccines11040880] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND COVID-19 vaccine mandates are considered a controversial public health policy both in public debate and among healthcare workers (HCWs). Thus, the objective of this systematic review is to give a deep insight into HCWs' views and attitudes towards COVID-19 vaccination mandates amid the ongoing COVID-19 pandemic. METHODS A systematic literature search of five databases (PubMed, Scopus, Embase, CINAHL, and Web of Science) was conducted between July 2022 and November 2022. Original quantitative studies that addressed the attitudes of HCWs regarding COVID-19 vaccine mandates were considered eligible for this systematic review. All the included studies (n = 57) were critically appraised and assessed for risk of systematic bias. Meta-analyses were performed, providing a pooled estimate of HCWs' acceptance towards COVID-19 vaccine mandates for: 1. HCWs and 2. the general population. RESULTS In total, 64% (95% CI: 55%, 72%) of HCWs favored COVID-19 vaccine mandates for HCWs, while 50% (95% CI: 38%, 61%) supported mandating COVID-19 vaccines for the general population. CONCLUSIONS Our findings indicate that mandatory vaccination against COVID-19 is a highly controversial issue among HCWs. The present study provides stakeholders and policy makers with useful evidence related to the compulsory or non-compulsory nature of COVID-19 vaccinations for HCWs and the general population. Other: The protocol used in this review is registered on PROSPERO with the ID number: CRD42022350275.
Collapse
Affiliation(s)
- Marios Politis
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
| | - Sotiris Sotiriou
- Department of Pathology, Faculty of Medicine, Aristotle University, 54124 Thessaloniki, Greece
| | - Chrysoula Doxani
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
| | - Ioannis Stefanidis
- Department of Nephrology, School of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Elias Zintzaras
- Department of Biomathematics, School of Medicine, University of Thessaly, 41222 Larissa, Greece
- Center for Clinical Evidence Synthesis, Tufts University School of Medicine, Boston, MA 02111, USA
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, School of Medicine, University of Thessaly, 41110 Larissa, Greece
| |
Collapse
|
37
|
El-Mohandes A, Wyka K, White TM, El-Sadr WM, Rauh L, Vasan A, Greene D, Rabin K, Ratzan SC, Chaudhri S, Kimball S, Lazarus JV. Comparison of Current Attitudes Toward COVID-19 Vaccination in New York City and the US Nationally. JOURNAL OF HEALTH COMMUNICATION 2023; 28:34-44. [PMID: 37390011 DOI: 10.1080/10810730.2023.2208071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
COVID-19 vaccination has resulted in decreased hospitalization and mortality, particularly among those who have received a booster. As new effective pharmaceutical treatments are now available and requirements for non-pharmaceutical interventions (e.g. masking) are relaxed, perceptions of the risk and health consequences of SARS-CoV-2 infection have decreased, risking potential resurgence. This June 2022 cross-sectional comparative study of representative samples in New York City (NYC, n = 2500) and the United States (US, n = 1000) aimed to assess differences in reported vaccine acceptance as well as attitudes toward vaccination mandates and new COVID-19 information and treatments. NYC respondents reported higher COVID-19 vaccine acceptance and support for vaccine mandate than U.S. respondents, yet lower acceptance for the booster dose. Nearly one-third of both NYC and U.S. respondents reported paying less attention to COVID-19 vaccine information than a year earlier, suggesting health communicators may need innovation and creativity to reach those with waning attention to COVID-19-related information.
Collapse
Affiliation(s)
- Ayman El-Mohandes
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Katarzyna Wyka
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Trenton M White
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Lauren Rauh
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Ashwin Vasan
- Office of the Commissioner of Health, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Danielle Greene
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Kenneth Rabin
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Scott C Ratzan
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
| | - Simran Chaudhri
- Office of the Commissioner of Health, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Spencer Kimball
- Emerson Polling, Emerson College, Boston, Massachusetts, USA
| | - Jeffrey V Lazarus
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, New York, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| |
Collapse
|
38
|
The effect of vaccine mandate announcements on vaccine uptake in Canada: An interrupted time series analysis. Vaccine 2023; 41:2932-2940. [PMID: 37019696 PMCID: PMC10068515 DOI: 10.1016/j.vaccine.2023.03.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
Introduction In 2021, the ten provinces in Canada enacted COVID-19 vaccine mandates that restricted access to non-essential businesses and services to those that could provide proof of full vaccination to decrease the risk of transmission and provide an incentive for vaccination. This analysis aims to examine the effects of vaccine mandate announcements on vaccine uptake over time by age group and province. Methods Aggregated data from the Canadian COVID-19 Vaccination Coverage Surveillance System (CCVCSS) were used to measure vaccine uptake (defined as the weekly proportion of individuals who received at least one dose) among those 12 years and older following the announcement of vaccination requirements. We performed an interrupted time series analysis using a quasi-binomial autoregressive model adjusted for the weekly number of new COVID-19 cases, hospitalizations, and deaths to model the effect of mandate announcements on vaccine uptake. Additionally, counterfactuals were produced for each province and age group to estimate vaccine uptake without mandate implementation. Results The times series models demonstrated significant increases in vaccine uptake following mandate announcement in BC, AB, SK, MB, NS, and NL. No trends in the effect of mandate announcements were observed by age group. In AB and SK, counterfactual analysis showed that announcement were followed by 8 % and 7 % (310,890 and 71,711 people, respectively) increases in vaccination coverage over the following 10 weeks. In MB, NS, and NL, there was at least a 5 % (63,936, 44,054, and 29,814 people, respectively) increase in coverage. Lastly, BC announcements were followed by a 4 % (203,300 people) increase in coverage. Conclusion Vaccine mandate announcements could have increased vaccine uptake. However, it is difficult to interpret this effect within the larger epidemiological context. Effectiveness of the mandates can be affected by pre-existing levels of uptake, hesitancy, timing of announcements and local COVID-19 activity.
Collapse
|
39
|
AlShurman BA, Tetui M, Nanyonjo A, Butt ZA, Waite NM, Vernon-Wilson E, Wong G, Grindrod K. Understanding the COVID-19 Vaccine Policy Terrain in Ontario Canada: A Policy Analysis of the Actors, Content, Processes, and Context. Vaccines (Basel) 2023; 11:782. [PMID: 37112694 PMCID: PMC10143674 DOI: 10.3390/vaccines11040782] [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: 02/26/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
(1) Background: Canada had a unique approach to COVID-19 vaccine policy making. The objective of this study was to understand the evolution of COVID-19 vaccination policies in Ontario, Canada, using the policy triangle framework. (2) Methods: We searched government websites and social media to identify COVID-19 vaccination policies in Ontario, Canada, which were posted between 1 October 2020, and 1 December 2021. We used the policy triangle framework to explore the policy actors, content, processes, and context. (3) Results: We reviewed 117 Canadian COVID-19 vaccine policy documents. Our review found that federal actors provided guidance, provincial actors made actionable policy, and community actors adapted policy to local contexts. The policy processes aimed to approve and distribute vaccines while continuously updating policies. The policy content focused on group prioritization and vaccine scarcity issues such as the delayed second dose and the mixed vaccine schedules. Finally, the policies were made in the context of changing vaccine science, global and national vaccine scarcity, and a growing awareness of the inequitable impacts of pandemics on specific communities. (4) Conclusions: We found that the triad of vaccine scarcity, evolving efficacy and safety data, and social inequities all contributed to the creation of vaccine policies that were difficult to efficiently communicate to the public. A lesson learned is that the need for dynamic policies must be balanced with the complexity of effective communication and on-the-ground delivery of care.
Collapse
Affiliation(s)
- Bara’ Abdallah AlShurman
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G5, Canada
| | - Moses Tetui
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G5, Canada
- School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada
- Department of Epidemiology and Global Health, Umeå University, 907 37 Umeå, Sweden
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Way, Brayford, Pool, Lincoln LN6 7TS, UK
| | - Zahid Ahmad Butt
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G5, Canada
| | - Nancy M. Waite
- School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada
| | | | - Ginny Wong
- School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Kitchener, ON N2G 1C5, Canada
| |
Collapse
|
40
|
Stamm TA, Partheymüller J, Mosor E, Ritschl V, Kritzinger S, Alunno A, Eberl JM. Determinants of COVID-19 vaccine fatigue. Nat Med 2023; 29:1164-1171. [PMID: 36973410 DOI: 10.1038/s41591-023-02282-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
There is growing concern that Coronavirus Disease 2019 (COVID-19) vaccine fatigue will be a major obstacle in maintaining immunity in the general population. In this study, we assessed vaccine acceptance in future scenarios in two conjoint experiments, investigating determinants such as new vaccines, communication, costs/incentives and legal rules. The experiments were embedded in an online survey (n = 6,357 participants) conducted in two European countries (Austria and Italy). Our results suggest that vaccination campaigns should be tailored to subgroups based on their vaccination status. Among the unvaccinated, campaign messages conveying community spirit had a positive effect (0.343, confidence interval (CI) 0.019-0.666), whereas offering positive incentives, such as a cash reward (0.722, CI 0.429-1.014) or voucher (0.670, CI 0.373-0.967), was pivotal to the decision-making of those vaccinated once or twice. Among the triple vaccinated, vaccination readiness increased when adapted vaccines were offered (0.279, CI 0.182-0.377), but costs (-0.795, CI -0.935 to -0.654) and medical dissensus (-0.161, CI -0.293 to -0.030) reduced their likelihood to get vaccinated. We conclude that failing to mobilize the triple vaccinated is likely to result in booster vaccination rates falling short of expectations. For long-term success, measures fostering institutional trust should be considered. These results provide guidance to those responsible for future COVID-19 vaccination campaigns.
Collapse
Affiliation(s)
- Tanja A Stamm
- Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria.
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria.
| | | | - Erika Mosor
- Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Valentin Ritschl
- Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | | | - Alessia Alunno
- Department of Life, Health & Environmental Sciences, University of L'Aquila and Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | | |
Collapse
|
41
|
Sciurti A, Baccolini V, Renzi E, De Blasiis MR, Siena LM, Isonne C, Migliara G, Massimi A, De Vito C, Marzuillo C, Villari P. Attitudes of University Students towards Mandatory COVID-19 Vaccination Policies: A Cross-Sectional Survey in Rome, Italy. Vaccines (Basel) 2023; 11:vaccines11040721. [PMID: 37112633 PMCID: PMC10141490 DOI: 10.3390/vaccines11040721] [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: 03/01/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Mandatory vaccination (MV) against COVID-19 is a contentious topic. In this study, we used logistic regression models to identify attitudes among Sapienza University students towards MV for COVID-19. We considered three different scenarios: mandatory COVID-19 vaccination (MCV) for healthcare workers (HCWs) (Model 1), for all people aged ≥ 12 years (Model 2), and for admission to schools and universities (Model 3). We collected 5287 questionnaires over a six-month period and divided these into three groups (September-October 2021, November-December 2021, and January-February 2022). MCV for HCWs was the most strongly supported policy (69.8% in favour), followed by MCV for admission to schools and universities (58.3%), and MCV for the general population (54.6%). In a multivariable analysis, the models showed both similarities and differences. There was no association of socio-demographic characteristics with the outcomes, apart from being enrolled in non-healthcare courses, which negatively affected Models 2 and 3. A greater COVID-19 risk perception was generally associated with a more positive attitude towards MCV, although heterogeneously across models. Vaccination status was a predictor of being in favour of MCV for HCWs, whereas being surveyed in November-February 2022 favoured MCV for admission to schools and universities. Attitudes towards MCV were variable across policies; thus, to avoid unintended consequences, these aspects should be carefully considered by policymakers.
Collapse
Affiliation(s)
- Antonio Sciurti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Roberta De Blasiis
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Leonardo Maria Siena
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Isonne
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| |
Collapse
|
42
|
Wang C, Shen L, Weng W. Modelling physical contacts to evaluate the individual risk in a dense crowd. Sci Rep 2023; 13:3929. [PMID: 36894613 PMCID: PMC9995744 DOI: 10.1038/s41598-023-31148-z] [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: 08/20/2022] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Tumble and stampede in a dense crowd may be caused by irrational behaviours of individuals and always troubles the safety management of crowd activities. Risk evaluation based on pedestrian dynamical models can be regarded as an effective method of preventing crowd disasters. Here, a method depending on a combination of collision impulses and pushing forces was used to model the physical contacts between individuals in a dense crowd, by which the acceleration error during physical contacts caused by a traditional dynamical equation can be avoided. The human domino effect in a dense crowd could be successfully reproduced, and the crushing and trampling risk of a microscopic individual in a crowd could be quantitatively evaluated separately. This method provides a more reliable and integral data foundation for evaluating individual risk that shows better portability and repeatability than macroscopic crowd risk evaluation methods and will also be conducive to preventing crowd disasters.
Collapse
Affiliation(s)
- Chongyang Wang
- Department of Engineering Physics, Institute of Public Safety Research, Tsinghua University, Beijing, China.,Beijing Key Laboratory of City Integrated Emergency Response Science, Tsinghua University, Beijing, China.,China Petrochemical Corporation, Beijing, China
| | - Liangchang Shen
- Department of Engineering Physics, Institute of Public Safety Research, Tsinghua University, Beijing, China.,Beijing Key Laboratory of City Integrated Emergency Response Science, Tsinghua University, Beijing, China
| | - Wenguo Weng
- Department of Engineering Physics, Institute of Public Safety Research, Tsinghua University, Beijing, China. .,Beijing Key Laboratory of City Integrated Emergency Response Science, Tsinghua University, Beijing, China.
| |
Collapse
|
43
|
Bussolo M, Sarma N, Torre I. The links between COVID-19 vaccine acceptance and non-pharmaceutical interventions. Soc Sci Med 2023; 320:115682. [PMID: 36709691 PMCID: PMC9840231 DOI: 10.1016/j.socscimed.2023.115682] [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: 06/23/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
The information set from which individuals make their decision on vaccination includes signals from trusted agents, such as governments, community leaders and the media. By implementing restrictions, or by relaxing them, governments can provide a signal about the underlying risk of the pandemic and indirectly affect vaccination take-up. Rather than focusing on measures specifically designed to increase vaccine acceptance, this paper studies how governments' non-pharmaceutical policy responses to the pandemic can modify the degree of preventive health behavior, including vaccination. To do so, we use repeated waves of a global survey on COVID-19 Beliefs, Behaviors and Norms covering 18 countries from October 2020 to March 2021. Controlling for the usual determinants, we explore how individuals' willingness to get vaccinated is affected by changes in government restriction measures (as measured by the Oxford Stringency Index). This relationship is mediated by individual characteristics, social norms (social pressure to conform with what most people do), and trust in government institutions. Our results point to a complex picture as the implementation of restrictions is associated with increased acceptance in some contexts and decreased acceptance in others. The stringency of government restrictions has significant positive correlations with vaccine acceptance in contexts of weak social norms of vaccine acceptance and lower trust in government. In countries or communities with tighter social norms and high trust in health authorities, vaccine acceptance is high but less sensitive to changes in policies. These results suggest that the effect of government policy stringency is stronger among individuals who report lower trust and weaker social norms of vaccine acceptance.
Collapse
Affiliation(s)
| | | | - Iván Torre
- World Bank, 1818 H St NW, Washington, DC, 20433, USA.
| |
Collapse
|
44
|
van Kessel R, Kyriopoulos I, Wong BLH, Mossialos E. The Effect of the COVID-19 Pandemic on Digital Health-Seeking Behavior: Big Data Interrupted Time-Series Analysis of Google Trends. J Med Internet Res 2023; 25:e42401. [PMID: 36603152 PMCID: PMC9848442 DOI: 10.2196/42401] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Due to the emergency responses early in the COVID-19 pandemic, the use of digital health in health care increased abruptly. However, it remains unclear whether this introduction was sustained in the long term, especially with patients being able to decide between digital and traditional health services once the latter regained their functionality throughout the COVID-19 pandemic. OBJECTIVE We aim to understand how the public interest in digital health changed as proxy for digital health-seeking behavior and to what extent this change was sustainable over time. METHODS We used an interrupted time-series analysis of Google Trends data with break points on March 11, 2020 (declaration of COVID-19 as a pandemic by the World Health Organization), and December 20, 2020 (the announcement of the first COVID-19 vaccines). Nationally representative time-series data from February 2019 to August 2021 were extracted from Google Trends for 6 countries with English as their dominant language: Canada, the United States, the United Kingdom, New Zealand, Australia, and Ireland. We measured the changes in relative search volumes of the keywords online doctor, telehealth, online health, telemedicine, and health app. In doing so, we capture the prepandemic trend, the immediate change due to the announcement of COVID-19 being a pandemic, and the gradual change after the announcement. RESULTS Digital health search volumes immediately increased in all countries under study after the announcement of COVID-19 being a pandemic. There was some variation in what keywords were used per country. However, searches declined after this immediate spike, sometimes reverting to prepandemic levels. The announcement of COVID-19 vaccines did not consistently impact digital health search volumes in the countries under study. The exception is the search volume of health app, which was observed as either being stable or gradually increasing during the pandemic. CONCLUSIONS Our findings suggest that the increased public interest in digital health associated with the pandemic did not sustain, alluding to remaining structural barriers. Further building of digital health capacity and developing robust digital health governance frameworks remain crucial to facilitating sustainable digital health transformation.
Collapse
Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Brian Li Han Wong
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Steering Committee, Digital Health Section, European Public Health Association, Utrecht, Netherlands
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| |
Collapse
|
45
|
Hierro LÁ, Patiño D, Atienza P, Garzón AJ, Cantarero D. The effect of altruism on COVID-19 vaccination rates. HEALTH ECONOMICS REVIEW 2023; 13:2. [PMID: 36595138 PMCID: PMC9807973 DOI: 10.1186/s13561-022-00415-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND After the emergence of the first vaccines against the COVID-19, public health authorities have promoted mass vaccination in order to achieve herd immunity and reduce the effects of the disease. Vaccination rates have differed between countries, depending on supply (availability of resources) and demand (altruism and resistance to vaccination) factors. METHODS This work considers the hypothesis that individuals' health altruism has been an important factor to explain the different levels of vaccination between countries, using the number of transplants as a proxy for altruism. Taking European Union's countries to remove, as far as possible, supply factors that might affect vaccination, we carry out cross-sectional regressions for the most favorable date of the vaccination process (maximum vaccination speed) and for each month during the vaccination campaign. RESULTS Our findings confirm that altruism has affected vaccination rates against the COVID-19. We find a direct relationship between transplants rates (proxy variable) and vaccination rates during periods in which the decision to be vaccinated depended on the individual's choice, without supply restrictions. The results show that other demand factors have worked against vaccination: political polarization and belonging to the group of countries of the former Eastern bloc. CONCLUSIONS Altruism is a useful tool to define future vaccination strategies, since it favors the individuals' awareness for vaccination.
Collapse
Affiliation(s)
- Luis Á Hierro
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain
| | - David Patiño
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain
| | - Pedro Atienza
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain.
| | - Antonio J Garzón
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain
| | - David Cantarero
- Department of Economics, Universidad de Cantabria, Research Group on Health Economics and Health Services Management-Marqués de Valdecilla Research Institute (IDIVAL), Avda. de los Castros S/N, 39005, Santander, Spain
| |
Collapse
|
46
|
Ugas MA, Avery L, Wang Y, Berlin A, Giuliani ME, Krzyzanowska M, Papadakos TJ, Quartey NK(L, Samoil D, Papadakos JK. COVID-19 and Cancer Patients in the Second Year of the Pandemic: Investigating Treatment Impact, Information Sources, and COVID-19-Related Knowledge, Attitudes and Practices. Curr Oncol 2022; 29:8917-8936. [PMID: 36421354 PMCID: PMC9689213 DOI: 10.3390/curroncol29110701] [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: 10/08/2022] [Revised: 10/31/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The novel coronavirus that has triggered the present COVID-19 pandemic continues to spread globally, resulting in widespread morbidity and mortality. Patients with cancer remain one of the most vulnerable subsets of the population to the disease. This study examined the effects of the pandemic on cancer patients' treatment, psychology, knowledge, attitudes, and practices. METHODS A survey was emailed to 9861 patients at a cancer centre in Toronto, Canada. Descriptive results were summarized. Qualitative feedback was coded and summarized. Regression modelling was used to explore factors associated with patient psychological well-being, knowledge, attitudes, and practices. RESULTS A total of 1760 surveys were completed, with a response rate of 17.8%. Most participants did not experience any pandemic-related treatment delays, and vaccination rates were high. Participants who identified themselves as non-white (OR 3.30, CI: 1.30-5.30; p ≤ 0.001), and those who referred to journal articles for information (p = 0.002) reported higher psychological impact scores. There were no significant predictors of whether participants would use personal protective equipment when leaving their homes or whether they would go to crowded places. DISCUSSION This study provides another snapshot of cancer patients perceptions and needs during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mohamed A. Ugas
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON M5G 2N2, Canada
| | - Lisa Avery
- Biostatistics Department, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Yanning Wang
- Biostatistics Department, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada
| | - Alejandro Berlin
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada
- Techna Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Meredith E. Giuliani
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON M5G 2N2, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada
- The Institute for Education Research (TIER), University Health Network, Toronto, ON M5T 1V4, Canada
| | - Monika Krzyzanowska
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada
- Division of Medical Oncology, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Tina J. Papadakos
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON M5G 2N2, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada
- The Institute for Education Research (TIER), University Health Network, Toronto, ON M5T 1V4, Canada
| | - Naa Kwarley (Linda) Quartey
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON M5G 2N2, Canada
| | - Diana Samoil
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON M5G 2N2, Canada
| | - Janet K. Papadakos
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, ON M5G 2N2, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada
- The Institute for Education Research (TIER), University Health Network, Toronto, ON M5T 1V4, Canada
| |
Collapse
|
47
|
Boyneburgk KV, Bellazzi F. COVID-19 Vaccines and the Virtues. Public Health Ethics 2022; 15:209-219. [PMID: 36727098 PMCID: PMC9883710 DOI: 10.1093/phe/phac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
From a moral point of view, what arguments are there for and against seeking COVID-19 vaccination? Can it be morally permissible to require (parts of) a population to receive a vaccine? The present paper adopts a perspective of virtue ethics and argues both that it is morally right for an individual virtuous moral agent to seek COVID-19 vaccination and for a virtuous ruler to impose mandatory vaccinations on her population. We begin by first presenting virtue ethics and the current vaccine controversy. Second, we examine whether a virtuous individual should get vaccinated. Third, we consider whether, from a moral point of view, it is right for a ruler to impose mandatory vaccinations on her citizens. Fourth, we answer some objections to our argument. Finally, we conclude that virtue ethical considerations warrant both the individual choice of getting vaccinated and mandatory vaccinations against COVID-19.
Collapse
Affiliation(s)
- Konrad v Boyneburgk
- Corresponding author: Konrad v. Boyneburgk, Department of Philosophy, King’s College London, London, UK.
| | | |
Collapse
|
48
|
Salman M, Mallhi TH, Tanveer N, Shehzadi N, Khan HM, Mustafa ZU, Khan TM, Hussain K, Mohamed MS, Maqbool F, Aftab RA, Butt MH, Panda DS, Alotaibi NH, Khedr AIM, Alanazi AS, Alatawi AD, Alzarea AI, Sulatana K, Khan YH. Evaluation of Conspiracy Beliefs, Vaccine Hesitancy, and Willingness to Pay towards COVID-19 Vaccines in Six Countries from Asian and African Regions: A Large Multinational Analysis. Vaccines (Basel) 2022; 10:1866. [PMID: 36366374 PMCID: PMC9694922 DOI: 10.3390/vaccines10111866] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
Vaccination protects people from serious illness and associated complications. Conspiracy theories and misinformation on vaccines have been rampant during the COVID-19 pandemic and are considered significant drivers of vaccine hesitancy. Since vaccine hesitancy can undermine efforts to immunize the population against COVID-19 and interferes with the vaccination rate, this study aimed to ascertain the COVID-19-vaccine-related conspiracy beliefs, vaccine hesitancy, views regarding vaccine mandates, and willingness to pay for vaccines among the general population. A web-based, cross-sectional survey was conducted (April−August 2021) among the adult population in six countries (Pakistan, Saudi Arabia, India, Malaysia, Sudan, and Egypt). Participants were recruited using an exponential, non-discriminate snowball sampling method. A validated self-completed electronic questionnaire was used for the data collection. All the participants responded to questions on various domains of the study instrument, including conspiracy beliefs, vaccine hesitancy, and willingness to pay. The responses were scored according to predefined criteria and stratified into various groups. All data were entered and analyzed using SPSS version 22. A total of 2481 responses were included in the study (Pakistan 24.1%, Saudi Arabia 19.5%, India 11.6%, Malaysia 8.1%, Sudan 19.3%, and Egypt 17.3%). There was a preponderance of participants ≤40 years old (18−25 years: 55.8%, 26−40 years: 28.5%) and females (57.1%). The average score of the COVID-19 vaccine conspiracy belief scale (C19V-CBS) was 2.30 ± 2.12 (median 2; range 0−7). Our analysis showed that 30% of the respondents were found to achieve the ideal score of zero, indicating no conspiracy belief. The mean score of the COVID-19 vaccine hesitancy scale (C19V-HS) was 25.93 ± 8.11 (range: 10−50). The majority (45.7%) had C19V-HA scores of 21−30 and nearly 28% achieved a score greater than 30, indicating a higher degree of hesitancy. There was a significant positive correlation between conspiracy beliefs and vaccine hesitancy (Spearman’s rho = 0.547, p < 0.001). Half of the study population were against the vaccine mandate. Respondents in favor of governmental enforcement of COVID-19 vaccines had significantly (p < 0.001) lower scores on the C19V-CBS and C19V-HS scale. Nearly 52% reported that they would only take vaccine if it were free, and only 24% were willing to pay for COVID-19 vaccines. A high prevalence of conspiracy beliefs and vaccine hesitancy was observed in the targeted countries. Our findings highlight the dire need for aggressive measures to counter the conspiracy beliefs and factors underlying this vaccine hesitancy.
Collapse
Affiliation(s)
- Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Nida Tanveer
- Institute of Molecular Cardiology, University of Louisville, Louisville, KY 40202, USA
| | - Naureen Shehzadi
- College of Pharmacy, University of the Punjab, Lahore 54000, Pakistan
| | - Humaira Majeed Khan
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Zia Ul Mustafa
- Department of Pharmacy Services, District Headquarter Hospital, Pakpattan 57400, Pakistan
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Science, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan
| | - Khalid Hussain
- College of Pharmacy, University of the Punjab, Lahore 54000, Pakistan
| | - Malik Suliman Mohamed
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Faheem Maqbool
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Raja Ahsan Aftab
- School of Pharmacy, Taylor’s University, Selangor 47500, Malaysia
| | - Muhammad Hammad Butt
- Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, 75123 Uppsala, Sweden
| | - Dibya Sundar Panda
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Amgad I. M. Khedr
- Department of Pharmacognosy, Faculty of pharmacy, Port Said University, Port Said 42526, Egypt
| | - Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Ahmed D. Alatawi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Abdulaziz Ibrahim Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| | - Kishwar Sulatana
- Faculty of Pharmacy, The University of Lahore, 1 km Defense Road, Lahore 54000, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Al-Jouf Province, Saudi Arabia
| |
Collapse
|
49
|
Charrier L, Garlasco J, Thomas R, Gardois P, Bo M, Zotti CM. An Overview of Strategies to Improve Vaccination Compliance before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11044. [PMID: 36078757 PMCID: PMC9518554 DOI: 10.3390/ijerph191711044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 05/14/2023]
Abstract
The debate on vaccination mandate was fuelled over the past two years by the COVID-19 pandemic. This study aimed at overviewing vaccination strategies and corresponding vaccine coverages for childhood vaccinations before the pandemic and for SARS-CoV-2 in high-income countries. A qualitative comparison was also performed between the two contexts: unlike for childhood vaccinations, only one European country (Austria) imposed generalised COVID-19 mandates, most countries preferring targeted mandates for higher-risk categories (Italy, Greece) or workers in key public services (Finland, Australia, New Zealand, UK, Germany). Many countries (Norway, Sweden, Netherlands, Portugal, Spain) confirmed their traditional voluntary vaccination approach also for COVID-19, while others (Slovenia and Hungary), historically relying on compulsory vaccination strategies, surprisingly opted for voluntary SARS-CoV-2 vaccination, with unsatisfactory results in terms of immunisation rates. However, no tangible relationship was generally found between vaccination policies and immunisation coverages: data show that, unlike some countries with mandates, countries where vaccinations are merely recommended could achieve higher coverages, even beyond the recommended 95% threshold. The COVID-19 experience has enriched pre-existent vaccination strategy debates by adding interesting elements concerning attitudes towards vaccines in a novel and unexplored context. Interpreting the available results by considering the different cultural contexts and vaccine hesitancy determinants can help to better understand the complexity of the relationship between policies and achieved coverages.
Collapse
Affiliation(s)
- Lorena Charrier
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis Via Santena, I-10126 Turin, Italy
| | - Jacopo Garlasco
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis Via Santena, I-10126 Turin, Italy
| | - Robin Thomas
- Northern Metropolitan Department Direction, Local Health Authority Turin 3 (ASL TO3), 152 Via Don Giovanni Sapino, I-10078 Venaria Reale, Italy
| | - Paolo Gardois
- Biblioteca Federata di Medicina “Ferdinando Rossi”, University of Turin, 5/bis Via Santena, I-10126 Turin, Italy
| | - Marco Bo
- Hospital Medical Direction, Local Health Authority Turin 5 (ASL TO5), 1 Piazza Silvio Pellico, I-10023 Chieri, Italy
| | - Carla Maria Zotti
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis Via Santena, I-10126 Turin, Italy
| |
Collapse
|
50
|
Cohn E, Chimowitz M, Long T, Varma JK, Chokshi DA. The effect of a proof-of-vaccination requirement, incentive payments, and employer-based mandates on COVID-19 vaccination rates in New York City: a synthetic-control analysis. Lancet Public Health 2022; 7:e754-e762. [PMID: 36057274 PMCID: PMC9433052 DOI: 10.1016/s2468-2667(22)00196-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND COVID-19 vaccines have been available to all adults in the USA since April, 2021, but many adults remain unvaccinated. We aimed to assess the joint effect of a proof-of-vaccination requirement, incentive payments, and employer-based mandates on rates of adult vaccination in New York City (NYC). METHODS We constructed a synthetic control group for NYC composed of other counties in the core of large, metropolitan areas in the USA. The vaccination outcomes for NYC were compared against those of the synthetic control group from July 26, 2021, to Nov 1, 2021, to determine the differential effects of the policies. Analyses were conducted on county-level vaccination data reported by the Centers for Disease Control and Prevention. The synthetic control group was constructed by matching on county-level preintervention vaccination outcomes, partisanship, economic attributes, demographics, and metropolitan area population. Statistical inference was conducted using placebo tests for non-treated counties. FINDINGS The synthetic control group resembled NYC across attributes used in the matching process. The cumulative adult vaccination rate for NYC (in adults aged 18 years or older who received at least one dose of an authorised COVID-19 vaccine) increased from 72·5% to 89·4% (+16·9 percentage points [pp]) during the intervention period, compared with an increase from 72·5% to 83·2% (+10·7 pp) for the synthetic control group, a difference of 6·2 pp (95% CI 1·4-10·7), or 410 201 people (90 966-706 532). Daily vaccinations for NYC were consistently higher than those in the synthetic control group, a pattern that started shortly after the start of the intervention period. INTERPRETATION The combination of a proof-of-vaccination requirement, incentive payments, and vaccine mandates increased vaccination rates among adults in NYC compared with jurisdictions that did not use the same measures. Whether the impact of these measures occurred by inducing more people to get vaccinated, or by accelerating vaccinations that would have occurred later, the increase in vaccination rates likely averted illness and death. FUNDING None.
Collapse
Affiliation(s)
- Ezra Cohn
- New York City Mayor's Office of Management and Budget, New York, NY, USA.
| | - Michael Chimowitz
- New York City Mayor's Office of Management and Budget, New York, NY, USA
| | - Theodore Long
- New York City Health and Hospitals, New York, NY, USA
| | | | - Dave A Chokshi
- New York University, Grossman School of Medicine, New York, NY, USA
| |
Collapse
|