COVID-19 vaccine hesitancy and attitudes in Qatar: A national cross-sectional survey of a migrant-majority population

Exploring Parental Hesitancy Toward Childhood COVID-19 Vaccination in the United Arab Emirates

Parental concern regarding COVID-19 vaccination for children remains a significant public health issue. This study examines factors influencing vaccine hesitancy among parents of children aged 5 to 16, focusing on demographics, past vaccination behavior, and trust in information sources. An online cross-sectional survey of 393 parents was conducted. Results showed that children younger than 11 years old were vaccinated against COVID-19 at much lower rates compared to older children, 29.5% of 5-7-year-old children were vaccinated, whereas 97.6% of 14-16-year-old children were vaccinated. Children who had been up-to-date with routine vaccinations were significantly more likely to be vaccinated for COVID-19 (OR = 8.422 among children younger than 11, p < 0.001; OR = 12.113 among children older than 11, p < 0.001). Fathers were more hesitant than mothers (OR = 1.953, p = 0.004), and parents younger than 40 reported greater hesitation than older parents (OR = 2.272, p < 0.001). Interestingly, parents with higher levels of education reported greater hesitation, possibly because they were exposed to misleading scientific data on the internet. Healthcare practitioners were trusted by 76.8% of parents who sought vaccine information from their child's doctor, compared to 20.3% who looked to social media. Concerns about vaccine safety, including the newness of the vaccine and side effects, were highly prevalent. The implications of these findings suggest a need for public health campaigns to clear up misinformation, emphasize trusted clinical sources, and reach out to groups showing hesitation, particularly younger and educated parents. Cultural beliefs and psychological constructs, such as risk perception and trust in institutions, shape vaccine hesitancy, making it essential to identify key demographic and psychological factors to improve vaccine confidence and achieve greater uptake among United Arab Emirates (UAE) parents.

COVID-19 Vaccine Hesitancy: A Cross-Sectional Study of Visible Minority Canadian Communities

The World Health Organization (WHO) defines vaccine hesitancy as reluctance or refusal to vaccinate despite availability. Contributing factors in visible minority populations include vaccine safety, effectiveness, mistrust, socioeconomic characteristics, vaccine development, information circulation, knowledge, perceived risk of COVID-19, and perceived benefit. Objectives: This study aimed to examine vaccine hesitancy in visible minority populations across Canadian regions. Methods: A survey was conducted among visible minority populations in Canadian regions, using 21 questions from the available literature via the Delphi method. The Canadian Hub for Applied and Social Research (CHASR) administered the survey to individuals 18 years or older who resided in Canada at the time of the survey and identified as visible minorities such as Asian, Black, and Latin American. After recruiting 511 participants, data analysis used Chi-square tests of association and 95% confidence intervals (CIs) to identify regional differences in vaccine choices, side effects, information sources, and reasons for vaccination. A weighted analysis extended the results to represent the visible minorities across provinces. Results: Higher rates of Pfizer were administered to participants in Ontario (73%), the Prairies (72%), British Columbia (71%), and Quebec (70%). British Columbia had the highest Moderna rate (59%). The most common side effect was pain at the injection site in Quebec (62%), Ontario (62%), BC (62%), and in the Atlantic (61%). Healthcare professionals and government sources were the most trusted information sources, with healthcare professionals trusted particularly in the Prairies (70%) and government sources similarly trusted in Quebec (65%) and Ontario (65%). In the Atlantic, 86% of refusals were due to side effects and 69% were due to prior negative vaccine experiences. Conclusions: Leveraging healthcare professionals' trust, community engagement, and flexible policies can help policymakers improve pandemic preparedness and boost vaccine acceptance.

Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong

BACKGROUND

The COVID-19 pandemic has had profound psychophysiological and socioeconomic effects worldwide. COVID-19 anxiety syndrome (CAS) is a specific cluster of maladaptive coping strategies, including perseveration and avoidance behaviours, in response to the perceived threat and fear of COVID-19. CAS is distinct from general COVID-19 anxiety. The level of CAS in the postpandemic era remained unknown. Despite extensive research on general COVID-19 anxiety and COVID-19 vaccine hesitancy (CVH), few studies have investigated the association between CAS and CVH. The present study aimed to assess the level of CAS and the prevalence of CVH and explore the association between CAS and CVH in the general population of Hong Kong.

METHODS

This cross-sectional study was conducted in Hong Kong. Participants were recruited using convenience and snowball sampling methods and completed an online or a paper-based questionnaire comprising two well-validated instruments. The COVID-19 Anxiety Syndrome Scale (C-19ASS), which includes the C-19ASS-P and C-19ASS-A subscales, was used to evaluate CAS in terms of perseveration and avoidance behaviours. The COVID-19 Vaccine Hesitancy Scale (CVHS) was used to determine the presence of CVH.

RESULTS

This study included 389 participants. The median C-19ASS-P and C-19ASS-A scores were 8 (Interquartile range (IQR) 5-13) and 3 (IQR 0-6), respectively. The CVHS scores revealed a CVH prevalence of 68.1%. A significantly larger proportion of participants with CVH rated "hesitant" compared with those without CVH across all the CVHS items. Furthermore, the median C-19ASS-P and C-19ASS-A scores were significantly higher for participants without CVH than for those with CVH.

CONCLUSIONS

Our findings revealed that CAS persists and CVH is common in the postpandemic era and that CAS is associated with CVH. Comprehensive interventions addressing both informational and psychological aspects are needed to increase the rate of vaccine acceptance and to mitigate the effect of CAS on public health outcomes.

Influenza vaccine hesitancy and its determinants among Lebanese public transportation drivers

Introduction

According to the National Institute for Occupational Safety and Health, ensuring influenza vaccination for public transportation drivers is considered a public health objective, given that these drivers are at high risk of contracting influenza. The main purpose of this cross-sectional study is, thus, to evaluate influenza vaccine hesitancy (VH) and its determinants among a representative sample of Lebanese public transportation drivers.

Methods

A survey questionnaire is conducted between January and March 2023, with the participation of a proportionate purposeful sample of 509 drivers from various regions in Lebanon. Study exposures include socio-demographics, health/work related variables, past experiences, knowledge and fatalistic views. VH and Vaccination Attitudes Examination (VAX) scales (score range 1 to 5 each) are used to measure study outcomes. Descriptive and bivariate statistical analyses, followed by ordinal and linear regression analyses are performed. Statistical significance is set at P < 0.025 (two sided).

Results

The vast majority of study participants (n = 499, 98 %) are males. Their age mean is 44.7 ± 12.6 years, while the mean duration of their work in public transportation is 11.5 ± 10.1 years. Results show vaccine hesitancy in terms of influenza risk calculation (3.27 ± 1.28), preference to natural immunity over influenza vaccines (3.23 ± 1.14) and vaccine constraints (2.83 ± 1.38). As for concerns regarding commercial profiteering behind influenza vaccines, the mean score of agreement with vaccines is 2.77 ± 1.10, while the mean score of lack of trust in vaccine safety is 2.70 ± 1.32.

Conclusions

Influenza VH among public transportation drivers in Lebanon is evident. Although a significant number of drivers are willing to be vaccinated, hesitancy often delays their decision. Study findings can inform influenza vaccination campaigns and syndicates regarding the need to raise awareness about influenza vaccine benefits among drivers and alleviate their hesitancies prior the upcoming flu season.

Validation of an Arabic tool for assessing vaccination literacy: A factor and Rasch analysis

Vaccine literacy is a significant part of health literacy. Although several tools have been developed to assess vaccine literacy, such tools are lacking in Arabic. Validating an Arabic version of a tool that evaluates vaccine literacy is critically important, as it would aid in understanding the decision-making process regarding vaccinations among individuals in Arabic-speaking countries. Therefore, the current study aimed to validate an Arabic tool for assessing vaccine literacy in adult vaccination. An online questionnaire was distributed to people throughout Jordan by sharing the questionnaire link via various social media platforms. The reliability and validity of the Arabic version of the vaccination literacy assessment tool (HLVa-Ar) were evaluated using factor analysis and Rasch analyses. The two-factor model generated fit indices were in the acceptable range (χ2/df = 2.48, RMSEA = 0.06, SRMR = 0.05, GFI = 0.94, CFI = 0.97, and TLI = 0.96). Cronbach's alpha for functional Vaccination literacy (VL) and interactive/critical VL were 0.91 and 0.88 respectively. The Rasch analysis indicated acceptable infit/outfit values and high item and person separation reliabilities for the two factors (0.852, 0.868, and 0.771, 0.818 respectively). Overall, the 420 participants displayed a good understanding of the general benefits and importance of vaccination. The HLVa-Ar was shown to be a valid and reliable tool that portrayed a wide range of vaccination literacy levels in the studied sample and provided valuable insights into participants' vaccination knowledge. The findings emphasize the need for developing targeted strategies to improve vaccination literacy and increase vaccination rates.

Vaccination coverage and access among children and adult migrants and refugees in the Middle East and North African region: a systematic review and meta-analysis

Background

The Middle East and North African (MENA) region is a major global hotspot for migration with more than 40 million migrants, who may be an under-vaccinated group because of barriers to vaccination within countries of origin, transit, and destination. We systematically synthesised the evidence on coverage, acceptance, drivers of uptake, and policies pertaining to vaccination for children and adult migrants in the region, in order to explore tailored interventions for these groups.

Methods

We searched six databases (including Medline, Embase) for peer-reviewed literature, and other websites (including WHO, IOM, ministries of health) for grey literature on coverage, acceptance, drivers of uptake and policies for any vaccination in migrants in the MENA region from between 2000 and 27 August 2024 in any language. We included studies reporting primary data on coverage, acceptance, and drivers of uptake, and any relevant articles on policies. We defined migrants as individuals who move away from their place of habitual residence, within or across international borders, temporarily or permanently. Studies without disaggregated migrant data were excluded. Primary outcomes were coverage (% individuals receiving ≥1 doses of any vaccine) and acceptance (% individuals accepting any vaccine). We separately synthesised data on children (<18 years) and adults (≥18). Estimates were pooled using a random-effects meta-analysis where possible or narratively synthesised, and drivers of uptake were synthesised using the WHO Behavioural and Social Drivers model. PROSPERO protocol: CRD42023401694.

Findings

We identified 6088 database and 282 grey literature records and included 55 studies and 1,906,975 migrants across 15 countries (including mostly refugees in the Middle East and expatriates in Gulf Cooperation Council countries). COVID-19 vaccination was reportedly provided free of charge to migrants in all countries whereas childhood vaccinations were reportedly provided to migrant children in seven countries. However, for adolescents and adults, there were wide variations across countries, and we found no policies relating to catch-up vaccination. Coverage for childhood vaccination amongst migrants was reportedly low, with only 36.0% of 589 migrant children fully vaccinated according to national schedules (95% CI 35.0%-43.0%, I 2 = 67%; data from migrants in Lebanon, Morocco, Sudan). Likewise, data on specific routine vaccines in children was generally low: measles containing vaccines (MCV): MCV dose 1 63.9%-66.9%; MCV dose 2 25.4%-85.6%; oral polio vaccine (OPV): OPV dose 3 65.1%-76.4%; diphtheria, tetanus and pertussis (DTP) containing vaccines: DTP dose 1 81.8%-86.7%; DTP dose 3 59.7%-76.6%). Drop-out rates across all routine vaccines for subsequent vaccine doses ranged from 12.4 to 38.5%, suggesting that migrants face a range of barriers to vaccine uptake beyond the first dose, that need to be better considered when designing interventions. For adults, we found eleven studies on coverage (including 9 on COVID-19) showing that COVID-19 vaccination coverage ranged 33.5-84.8% in migrants and 25.0-59.0% in host populations. Drivers of uptake of childhood vaccination in migrants included limited availability of vaccines and vaccination personnel, communication and administrative barriers, financial difficulties, lack of caregiver knowledge about services, and concerns expressed by caregivers around safety and benefits. For adults, drivers were mainly related to the COVID-19 vaccine and included concerns around safety, quality, side effects, and mistrust in vaccines and the systems that deliver them.

Interpretation

Migrants have unique risk factors for under-immunisation in the MENA region and have low vaccination coverage despite some level of entitlement to services. Data on vaccination coverage, drivers of uptake and policies for migrants in the MENA region is limited to small-scale studies among accessible groups, mostly focusing on COVID-19 compared to routine childhood and adult vaccination. There is an urgent need to strengthen data collection to better understand coverage across different migrant groups, ages, and MENA countries, especially on adult and catch-up vaccinations for routine immunisations, and develop innovative co-designed strategies to address specific drivers of vaccine uptake among this group.

Funding

La Caixa, LCF/PR/SP21/52930003.

COVID-19 vaccine hesitancy and attitudes toward routine vaccinations among Venezuelan migrants in Trinidad and Tobago: implications for a National Immunization Policy

Introduction

Vaccine hesitancy poses a threat to the prevention of COVID-19 and other vaccine-controlled diseases. In 2019, the Government of Trinidad and Tobago launched a policy outlining the scope of health services in the public sector available to registered Venezuelan migrants to include access to routine immunizations. Little is understood about immunization uptake among migrants, including the uptake of COVID-19 vaccinations in Trinidad and Tobago.

Method

Between July and October 2022, a survey was conducted using a sample of n = 507 Venezuelan migrants. We examined the relationship between COVID-19 vaccine hesitancy, migrant's attitudes toward past vaccinations, their beliefs and perceptions about COVID-19 disease, and health-service related factors. Descriptive statistics summarized the characteristics of these migrants. Odds ratios with 95% confidence intervals and multivariable logistic regression was used to examine factors and attitudes associated with COVID-19 vaccine hesitancy.

Results

Our findings showed that 89% of the migrants accessed publicly available health services while in Trinidad and Tobago, 72.4% reported that they did not refuse other vaccines in the past, and 23% reported being hesitant to take the COVID-19 vaccine. Females had higher odds of being COVID-19 vaccine hesitant compared to males, and participants expressing doubts about the source of vaccine information also had greater odds of vaccine hesitancy. Long waiting times at a public health clinic and costs associated with traveling to a clinic were associated with higher odds of COVID-19 vaccine hesitancy.

Conclusion

A National Immunization Policy inclusive of the unmet needs of vulnerable migrant populations is needed to ensure equitable access to vaccinations.

Exploring the factors influencing the adult population's reluctance to accept the COVID-19 vaccine in Tehran

BACKGROUND

While evidence of efficacy, safety, and technical feasibility is crucial when introducing a vaccine, it is equally important to consider the psychological, social, and political factors influencing vaccine acceptance. This study aims to identify the factors contributing to COVID-19 vaccine hesitancy among adults in Tehran, Iran.

METHODS

The study employed a descriptive and analytical cross-sectional design carried out from 2021 to 2022. It involved 260 eligible individuals residing in the catchment areas of Tehran and Shahid Beheshti Universities of Medical Sciences who declined to receive the COVID-19 vaccine, selected through systematic sampling. Data collection was accomplished through a researcher-developed questionnaire and analyzed using SPSS 26 software. The analysis utilized descriptive statistics and non-parametric tests including Mann-Whitney U, Kruskal-Wallis, and Multiple Linear Regression, to examine the relationships between variables.

RESULTS

The average scores (SD) across dimensions were as follows: the individual's health status and perceived risk, 15.53 (1.70); contextual and social effects, 17.68 (2.53); awareness, 14.81 (2.34); and beliefs and concerns. 14.91 (2.64), indicating a concerning situation regarding contextual and social impacts and a moderate status as to other areas. The primary reasons for vaccine refusal included fear, lack of belief in the vaccine, concerns about its reliability, illness, and lack of access or time. Acceptance of the vaccine was associated with education, occupation, marital status, number of children at home, and income reduction due to COVID-19.

CONCLUSION

The findings indicate that fear, lack of belief in the vaccine, concerns regarding its reliability, illness, and lack of access or time were the most important factors influencing reluctance to receive the vaccine. Health organizations should consider these factors when encouraging the population to receive the COVID-19 vaccine.

Dynamic factors associated with COVID-19 vaccine uptake in Cameroon between 2021 and 2022

Background

Little is known about attitudes towards COVID-19 vaccination in sub-Saharan Africa, where immunisation coverage is the lowest in the world.

Aim

The study aimed to identify factors associated with COVID-19 vaccine hesitancy and uptake in Cameroon, and assess changes in these factors over a period of time.

Setting

The study was conducted in the ten regions of Cameroon.

Methods

The authors conducted a two-phase cross-sectional survey in the 10 regions of Cameroon, from July 2021 to August 2021 (Phase one) and from August 2022 to September 2022 (Phase two). We analysed reasons for vaccine hesitancy descriptively and used logistic regression to assess factors associated with hesitancy.

Results

Overall, we enrolled 12 109 participants: 6567 (54.23%) in Phase one and 5542 (45.77%) in Phase two. Of these, 8009 (66.14%) were not interested in receiving the COVID-19 vaccine (n = 4176 in Phase one, n = 3833 in Phase two). The refusal rate increased significantly in the northern region from 27.00% in Phase 1 to 60.00% in Phase two. The leading contributor to COVID-19 vaccine hesitancy was fear that the vaccine was dangerous, which was significantly associated (95% confidence interval [CI], p < 0.05%) with vaccine refusal in both phases. Overall, 32.90% of participants (n = 2578) perceived the COVID-19 vaccine to be dangerous. Advanced age, male gender, Muslim religion and low level of education were associated with vaccine acceptance. Participants reported that healthcare workers were the most trusted source of information about the COVID-19 vaccine by 5005 (42.84%) participants.

Conclusion

Despite the investment of the Ministry of Health and its partners in community engagement, focussing on communication about the vaccine efficacy, tolerance and potential adverse events, fear of the vaccine remains high, likely leading to vaccine hesitancy in Cameroon between 2021 and 2022.

Contribution

The study highlight regional variations in COVID-19 vaccine acceptance in Cameroon, with factors age, gender, religion and education influencing willingness to vaccine. Trust in health workers was high, indicating that, tailored, community-led vaccination strategies are key for improving vaccine uptake, not only for COVID-19 but also for future epidemics.

A scoping review of COVID-19 vaccine hesitancy: refusal rate, associated factors, and strategies to reduce

Objective

This study aimed to investigate the evidence regarding vaccine hesitancy including refusal rate, associated factors, and potential strategies to reduce it.

Methods

This is a scoping review. Three main databases such as PubMed, Scopus, and Web of Science were searched from 1 January 2020 to 1 January 2023. All original studies in the English language that investigated one of our domains (vaccine hesitancy rate, factors associated with vaccine hesitancy, and the ways/interventions to overcome or decrease vaccine hesitancy) among the general population were included in this study. The data were charted using tables and figures. In addition, a content analysis was conducted using the 3C model of vaccine hesitancy (Confidence, Complacency, and Convenience) that was previously introduced by the WHO.

Results

Finally, 184 studies were included in this review. Of these, 165, 181, and 124 studies reported the vaccine hesitancy rate, associated factors, and interventions to reduce or overcome vaccine hesitancy, respectively. Factors affecting the hesitancy rate were categorized into 4 themes and 18 sub-themes (contextual factors, confidence barriers, complacency barriers, and convenience barriers).

Conclusion

Vaccine hesitancy (VH) rate and the factors affecting it are different according to different populations, contexts, and data collection tools that need to be investigated in specific populations and contexts. The need to conduct studies at the national and international levels regarding the reasons for vaccine refusal, the factors affecting it, and ways to deal with it still remains. Designing a comprehensive tool will facilitate comparisons between different populations and different locations.

Development and Evaluation of Methotrexate and Baicalin-Loaded Nanolipid Carriers for Psoriasis Treatment

Objectives

Psoriasis is a chronic inflammatory, T-lymphocyte immune-mediated skin disease. In this study, skin-permeating nanolipid carriers (NLCs) of Methotrexate (MTX) and Baicalin (BL) were formulated. This further gave formulation of nano-lipid encapsulated carriers for dual-drug delivery of the hydrophilic and hydrophobic drugs through the liposomal gel.

Materials and Methods

Optimization of the formulation of NLCs was performed and characterized by determining their particle size, drug permeation, skin irritation, drug loading capacity, stability, in vitro drug release behavior, and in vitro cellular viability. Ex vivo skin permeation and in vivo psoriatic efficiency were also evaluated and compared.

Results

Results revealed that the amount of MTX permeating the skin was 2.4 to 4.4 fold greater for dual-drug s than for single NLCs. The optimized dual-drug loaded NLCs had an average particle size (150.20 ± 3.57 nm) and polydispersity index (0.301 ± 0.01) and high entrapment (86.32 ± 2.78% w/w). The MTX nanoparticles exhibit a positive Zeta potential of 38.6 mV. The psoriasis area and severity index scoring showed the lowest skin erythema, skin thickness and scaling. MTX-BL NLCs were inhibited the expression of inflammatory cytokines (tumor necrosis factor-alpha, and interleukin-17) .

Conclusion

It can be concluded that newer targeting strategies for NLCs for dual-drug delivery of nano-lipid carriers could be administered topically for the treatment of psoriasis.

Predictors of COVID-19 vaccine acceptability among refugees and other migrant populations: A systematic scoping review

OBJECTIVE

This study aimed to map the existing literature to identify predictors of COVID-19 vaccine acceptability among refugees, immigrants, and other migrant populations.

METHODS

A systematic search of Medline, Embase, Scopus, APA PsycInfo and Cumulative Index of Nursing and Allied Health Literature (CINAHL) was conducted up to 31 January 2023 to identify the relevant English peer-reviewed observational studies. Two independent reviewers screened abstracts, selected studies, and extracted data.

RESULTS

We identified 34 cross-sectional studies, primarily conducted in high income countries (76%). Lower vaccine acceptance was associated with mistrust in the host countries' government and healthcare system, concerns about the safety and effectiveness of COVID-19 vaccines, limited knowledge of COVID-19 infection and vaccines, lower COVID-19 risk perception, and lower integration level in the host country. Female gender, younger age, lower education level, and being single were associated with lower vaccine acceptance in most studies. Additionally, sources of information about COVID-19 and vaccines and previous history of COVID-19 infection, also influence vaccine acceptance. Vaccine acceptability towards COVID-19 booster doses and various vaccine brands were not adequately studied.

CONCLUSIONS

Vaccine hesitancy and a lack of trust in COVID-19 vaccines have become significant public health concerns within migrant populations. These findings may help in providing information for current and future vaccine outreach strategies among migrant populations.

Barriers and Concerns that Contribute to Vaccine Hesitancy in Black, Indigenous, and People of Colour (BIPOC) Individuals in Ontario, Canada

BACKGROUND

Despite research demonstrating the effectiveness of COVID-19 vaccines, hesitancy is extremely common in minority communities. The purpose of this study was to identify key barriers and concerns that contribute to vaccine hesitancy in Black, Indigenous, and People of Colour (BIPOC) individuals and provide recommendations to address these barriers and concerns.

METHODS

The study was an online cross-sectional survey conducted among 1491 BIPOC and Caucasian adults, recruited using social media networks in August-September 2021. The questionnaire consisted of five sections that probed concerns and attitudes contributing to COVID-19 vaccine hesitancy.

RESULTS

Respondents were mostly Caucasian males (75.7%) and the average age was 29.1 years. A higher proportion of BIPOC respondents received both doses (50.6%) than Caucasian respondents (36.4%). Out of the unvaccinated, a higher percentage of BIPOC respondents did not plan on getting vaccinated (17.1%) compared to Caucasian respondents (4.2%). BIPOC respondents preferred the Pfizer-BioNTech (34.1%) vaccine whereas Caucasian respondents preferred AstraZeneca (29.3%). The biggest concern BIPOC and Caucasian respondents had with COVID-19 vaccines were side effects (56.6% vs 54.4%, respectively). BIPOC respondents identified dependability as the next biggest concern after side effects. A higher percentage of BIPOC respondents were against getting vaccinated against COVID-19 (16% vs 1.2%) compared to Caucasian respondents.

CONCLUSION

Among unvaccinated respondents, COVID-19 vaccine hesitancy was most evident in the BIPOC respondents compared to Caucasian respondents. Side effects, trustworthiness, and lack of information were identified as the three most common concerns surrounding vaccines in general. Increased accessibility to reliable and accurate vaccine information in various languages/dialects can raise awareness about COVID-19 vaccinations in BIPOC communities.

Predicting intention to vaccinate against COVID-19 in older Syrian refugees in Lebanon: Findings from a multi-wave study

BACKGROUND

COVID-19 vaccine acceptance among refugees in the Arab region remains low. This study aimed to examine the prevalence, reasons and predictors of intention to refuse the COVID-19 vaccine among older Syrian refugees in Lebanon.

METHODS

A nested cross-sectional study within a longitudinal study among older Syrian refugees in Lebanon. The sampling frame was a complete listing of beneficiary households of a humanitarian organization with at least one adult aged 50 years or older. Telephone surveys were completed at months 1 starting September 2020 (wave 1), months 2 (wave 2), months 5 (wave 3), months 6 (wave 4) and months 17 (wave 5) in March 2022. Logistic regression models were used to identify predictors of intention to refuse the COVID-19 vaccine. Models were internally validated using bootstrap methods and the models' calibration and discrimination were presented.

FINDINGS

Of 3167 Syrian refugees, 61.3% intended to receive the COVID-19 vaccine, 31.3% refused, and 7.4% were undecided. Reasons for vaccine refusal were: preference to follow preventive measures (27.4%) and belief that the vaccine is not essential (20.7%). Furthermore, 57.1% of participants registered to take the COVID-19 vaccine in wave 5. Irrespective of vaccination intention, reasons for not registering included: not wanting to receive the vaccine, and being unsure whether to take it. Predictors of intention to refuse the COVID-19 vaccine included: being a female, older age, having elementary education or above, living outside informal tented settlements, perceiving COVID-19 as not severe and vaccines as not safe or effective, and using social media for information on COVID-19. After adjusting for optimization, the final model showed moderate discrimination (C-statistic: 0.651 (95% CI:0.630-0.672)) and good calibration (C-slope: 0.93 (95% CI: 0.823-1.065)).

CONCLUSIONS

This study developed a predictive model for vaccination intention with a moderate discriminative ability and good calibration. Prediction models in humanitarian settings can help identify refugees at higher risk of not intending to receive the COVID-19 vaccine for public health targeting.

Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study

Background

Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar.

Methods

A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects.

Results

Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose.

Conclusion

The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.

Impact evaluation of a youth led intervention to increase COVID-19 vaccine uptake in Kwazulu-Natal, South Africa

BACKGROUND

COVID-19 vaccination rates in South Africa remain low at 51% of the adult population being fully vaccinated, defined as having two shorts of the COVID-19 vaccine with or without a booster. To improve vaccine uptake, a community-based intervention was tested in a high vaccine hesitancy community in South Africa. Trained community youths used social media, face to face interactions, door to door and neighbourhood outreach activities to deliver the intervention.

METHODS

To assess if the intervention had an impact, data was collected before the intervention and after the intervention in two districts, Wentworth an intervention site and Newlands East a control site. Both districts are in KwaZulu Natal Province, South Africa. The following outcomes, changes on perceptions and knowledge about COVID-19, intention to get vaccinated for those who were not fully vaccinated and vaccination uptake were assessed using difference-in-difference methods applied through Augmented Inverse-Probability Weighting and contrasts of Potential Outcome Means (POM).

RESULTS

One thousand, one hundred and fifty (1 150) participants agreed to take part in the study at baseline, and 916 (80%) were followed up after the 9-week intervention period. Intention to get vaccinated for COVID-19 was higher (difference-in-difference, DID 20%, 95% CI 6% - 35% higher), more people were fully vaccinated (DID 10%, 95% CI 0% - 20%) or partially vaccinated (DID 16%, 95% CI 6% - 26%) in Wentworth the intervention site compared to Newlands East, the control site. There were noticeable increases on the percentage of study participants indicating trust on the Government's COVID 19 programme, from 24% at baseline to 48% after the intervention in the intervention group than in the control group, 26% baseline and 29% at follow-up. There was a 10% (absolute) increase on the percentage of participants' saying they believed health care workers provided reliable information, 58% at baseline and 68% at follow-up in the intervention group, but there was little change in the control group 56% and 57% for baseline and follow-up respectively.

CONCLUSION

The youth-led intervention implemented in Wentworth, a community with a high rate of vaccine hesitancy, was effective in increasing vaccination uptake. Given the low COVID-19 vaccine coverage in South Africa and across the African region, as well as the new emerging variant of concern (XBB 1.5), there is an urgent need to scale up such intervention at the community level to address persistent misinformation and promote vaccine equality.

Behind Coronavirus Disease 2019 Vaccine Hesitancy of Filipino Nurses: A Thematic Approach

The study aimed to explore the reasons for nurses' coronavirus disease 2019 vaccine hesitancy in the Philippines. This study used descriptive, phenomenological qualitative research. The data were collected from 13 Filipino nurses using an unstructured interview questionnaire from June 2021 to October 2021. The six phases method of Braun and Clarke was used to analyze the data. The rigor or trustworthiness of the study was ensured by observing dependability, transferability, credibility, confirmability, and reflexivity. The study shows six significant themes; "being altruistic," "being circumspect," "vaccine brand distrust," "vaccine trauma," "perceived physical endurance," and "effects of religious belief and practice." In general, the reasons behind hesitancy on coronavirus disease 2019 vaccine were associated with their previous vaccine experiences, faith, vaccine brand distrust, altruistic behavior toward vaccines, and maintaining physical health among Filipino nurses. These are multifaceted yet exist in close relation. Therefore, these necessitate further understanding of its complexities, as they may contribute to society's outlook toward coronavirus disease 2019 vaccination.

Kubbara E, A. Bakarman M, Al Amri T, Eid R, Alyazidi N, Alkhamesi A, Alasslany A. Misconceptions about COVID-19 vaccine among adults in Saudi Arabia and their associated factors: A cross-sectional study conducted in 2021

Background

It is of utmost importance for the elements that influence public compliance with vaccination against COVID-19 to be assessed, including misconceptions, rumors, and conspiracy theories. Hence, in this study, we aimed to estimate the distribution of the most common misconceptions regarding COVID-19 vaccines and their predictors in Saudi Arabia.

Methods

We distributed an online questionnaire to participants aged 18 years or older. The survey included two sections. The first section comprised questions related to participants' demographic characteristics, level of education, and their sources of information about COVID-19. The second section assessed participants' perceptions regarding 11 of the most common misconceptions regarding COVID-19 vaccines, rated using a 5-point Likert scale. Using ordinal logistic regression, we conducted an evaluation of the relationships among different predictors including age, sex, educational level, and sources of information, as well as acceptance of misconceptions about vaccination.

Results

The most widely accepted misconception was that the COVID-19 vaccine had severe side effects, with 34.8% of participants believing this misinformation. Factors that were significantly associated with acceptance or non- acceptance of misconceptions were: 1) sex, with female respondents in this survey accepting rumors significantly more often than male respondents (p<0.001); 2) educational level, especially secondary school, was associated with a significantly lower acceptance of misconceptions (p=0.001). In total, 60.5% of participants used social media as their primary source of information, which was also a significant positive predictor of acceptance of misconceptions (p=0.034).

Conclusion

It is of critical importance to increase assurance regarding the safety of COVID-19 vaccines, the issue most likely to involve misconceptions, and to address the elements that affect belief in rumors among the population.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Acceptance of Annual Booster Doses of COVID-19 Vaccines Among Indian Healthcare Professionals: A Pan-India Cross-Sectional Survey

Introduction The emergence of coronavirus disease 2019 (COVID-19) posed significant challenges to global health, leading to the declaration of a pandemic by the World Health Organization. Vaccination efforts have effectively reduced severe outcomes and mortality, but breakthrough infections and new variants are of concern. In response, annual booster doses of COVID-19 vaccines are being considered to maintain immunity. Healthcare professionals, as frontline workers, play a pivotal role in vaccination campaigns. This study explores their attitudes toward and willingness to accept annual COVID-19 booster doses in India. Methods A pan-India cross-sectional survey was conducted among healthcare professionals, including faculty, resident doctors, interns, and nursing staff, across Indian medical and nursing colleges. Convenience sampling was used to collect responses via an online questionnaire. The questionnaire assessed demographics, vaccine status, attitudes toward COVID-19 vaccination, and willingness to accept annual booster doses. Multivariate analysis was performed to identify predictors of booster dose acceptance. Results A total of 535 participants responded from 28 states and 8 union territories of India. Most were 34.2 years (± 11.1 SD), and 372 (69.5%) had taken Covishield (Serum Institute of India, Pune, India) as their primary vaccine. While 525 (98.1%) had taken the first dose and 518 (96.8%) of them had taken the second dose, only 333 (62.2%) had received a booster. Around 318 (60%) of healthcare professionals were willing to accept an annual booster dose. The mean attitude score toward annual booster doses was 75.4 (range: 28-111). Healthcare professionals' trust in government recommendations and medical experts significantly influenced their willingness to accept annual booster doses. Conclusion This study provides insights into the attitudes of healthcare professionals in India toward annual COVID-19 booster doses. At the same time, a significant proportion showed a willingness to accept boosters.

The Impact of Social Media on Vaccination: A Narrative Review

Vaccine hesitancy poses a significant global health challenge, fueled by misinformation and anti-vaccination campaigns on social media platforms (SMPs). This study examines the influence of social media on coronavirus disease 2019 (COVID-19) and non-COVID-19 vaccination in Asia during the peri-pandemic period. Through a comprehensive analysis of available literature, we aim to elucidate the role of SMPs in shaping vaccination attitudes and behaviors. The findings highlight the detrimental impact of social media on vaccination efforts and provide insights into addressing vaccine hesitancy during this critical period. A narrative review was conducted by searching the PubMed, Scopus, and Google Scholar databases from inception to May 26, 2022. Only English-language articles involving human participants from Asian countries were included in this review. Out of the 228 articles identified through the database search, 14 articles were included in the final analysis. The prevalence of COVID-19 vaccine hesitancy or negative attitudes towards COVID-19 vaccines in Asian countries was found to be high, ranging from 20% to 55% across countries. Notably, reliance on SMPs for vaccine-related information was associated with a higher likelihood of COVID-19 vaccine hesitancy. This trend coincided with the proliferation of misinformation and conspiracy theories that portrayed COVID-19 vaccines as harmful during the pandemic. Similar patterns were observed for other types of vaccines, including polio, measles mumps and rubella, and diphtheria-tetanus-pertussis vaccines. The use of SMPs was also found to be associated with increased fear among caregivers in Asian countries, as well as a 3-4 times higher likelihood of delayed immunization. SMPs negatively impact vaccine intent in Asia due to misinformation and anti-vaccination campaigns during the pandemic. However, they can be a powerful tool for healthcare providers and policymakers to promote informed decision-making. Efforts should focus on leveraging SMPs to disseminate reliable information and combat hesitancy, fostering a well-informed and vaccinated population in Asia.

Defining drivers of under-immunization and vaccine hesitancy in refugee and migrant populations

BACKGROUND/OBJECTIVE

Some refugee and migrant populations globally showed lower uptake of COVID-19 vaccines and are also considered to be an under-immunized group for routine vaccinations. These communities may experience a range of barriers to vaccination systems, yet there is a need to better explore drivers of under-immunization and vaccine hesitancy in these mobile groups.

METHODS

We did a global rapid review to explore drivers of under-immunization and vaccine hesitancy to define strategies to strengthen both COVID-19 and routine vaccination uptake, searching MEDLINE, Embase, Global Health PsycINFO and grey literature. Qualitative data were analysed thematically to identify drivers of under-immunization and vaccine hesitancy, and then categorized using the 'Increasing Vaccination Model'.

RESULTS

Sixty-three papers were included, reporting data on diverse population groups, including refugees, asylum seekers, labour migrants and undocumented migrants in 22 countries. Drivers of under-immunization and vaccine hesitancy pertaining to a wide range of vaccines were covered, including COVID-19 (n = 27), human papillomavirus (13), measles or Measles-mumps-rubella (MMR) (3), influenza (3), tetanus (1) and vaccination in general. We found a range of factors driving under-immunization and hesitancy in refugee and migrant groups, including unique awareness and access factors that need to be better considered in policy and service delivery. Acceptability of vaccination was often deeply rooted in social and historical context and influenced by personal risk perception.

CONCLUSIONS

These findings hold direct relevance to current efforts to ensure high levels of global coverage for a range of vaccines and to ensure that marginalized refugee and migrant populations are included in the national vaccination plans of low-, middle- and high-income countries. We found a stark lack of research from low- and middle-income and humanitarian contexts on vaccination in mobile groups. This needs to be urgently rectified if we are to design and deliver effective programmes that ensure high coverage for COVID-19 and routine vaccinations.

Prevalence of COVID-19 vaccine acceptance among migrant and refugee groups: A systematic review and meta-analysis

OBJECTIVES

Understanding COVID-19 vaccine hesitancy among migrant and refugee groups is critical for achieving vaccine equity. Therefore, we aimed to estimate the prevalence of COVID-19 vaccine acceptance among migrant and refugee populations.

METHODS

A systematic review (PROSPERO: CRD42022333337) was conducted (December 2019-July 2022) using PubMed, Scopus, Web of Science, ProQuest and Google Scholar.

RESULTS

Nineteen studies from 12 countries were included. The pooled estimated prevalence of COVID-19 vaccine willingness among migrant and refugee groups was 70% (19 studies, 95% CI: 62.3-77.4%, I2: 99.19%, τ2: 0.03). Female and male participants did not differ significantly with each other (p = 0.64). Although no individual variable contributed statistically significantly in multivariable meta-regression analysis, the multivariable model that considered methodological quality, mean age of participants, participant group and country of origin explained 67% of variance.

DISCUSSION

Proportions of migrant/refugee groups receiving COVID-19 vaccinations approximated those observed among general populations. Additional studies are needed to examine factors relating to vaccine willingness to identify the most significant factors that may be targeted in interventions.

Hesitancy toward vaccination against COVID-19: A scoping review of prevalence and associated factors in the Arab world

Despite widespread availability of vaccines against SARS-CoV-2 virus, the cause of Coronavirus Disease 2019 (COVID-19), its uptake in many Arab countries is relatively low. This literature review aimed to scope evidence on COVID-19 vaccine hesitancy (VH) in the Arab world. A total of 134 articles reporting prevalence of COVID-19 VH and associated factors, conducted in any of the 22 Arab League countries, were reviewed. COVID-19 VH prevalence ranged from 5.4% to 83.0%. Female gender, young age, low education level and lack of previous influenza vaccine uptake were most commonly reported to be associated with COVID-19 VH. The most-reported personal concerns contributing toward VH were related to the rapid development, safety and side effects of vaccine, as well as an overall lack of trust in government policies toward pandemic control and widespread conspiracy theories. Tailored interventions to enable the distribution of trusted information and enhance public acceptance of immunization are warranted.

Does the Message Frame Promote People's Willingness to Vaccinate when they Worry about Side Effects from the COVID-19 Vaccine? Evidence from an Online Survey Experiment in China

Vaccination is an effective strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. However, worrying about side effects (WSE) from the COVID-19 vaccine is the leading concern making people hesitant to get vaccinated. Regrettably, there are few studies on alleviating the negative impacts of WSE on COVID-19 vaccination. This study aimed to assess whether message framing (gain- and loss-framed) can moderate the impacts of WSE on the willingness to vaccinate. We conducted an online self-administered survey experiment with three groups: control group (non-framed group), gain-framed groups, and loss-framed groups. In total, 981 participants were randomly assigned to one of the three groups, and their willingness to vaccinate themselves, their children, and elderly members was recorded. People with a higher level of WSE exhibited a lower willingness to vaccinate against COVID-19. However, the gain- and loss-framed messages increased people's willingness to vaccinate themselves, their children, and the elderly. Compared to the gain-framed messages, the loss-framed messages had a greater impact on enhancing people's willingness to self-vaccinate, but not on vaccinating their children and the elderly. Although the gain- and loss-framed messages weakened the negative impacts of WSE on the willingness to be vaccinated, their buffer effect was non-significantly different. The findings in this study suggest that a loss-framed messaging strategy could be a valuable tool in disseminating information on vaccination against COVID-19.

Access, acceptability, and uptake of the COVID-19 vaccine among global migrants: A rapid review

OBJECTIVE

To conduct a rapid review and determine the acceptability, access, and uptake of the COVID-19 vaccine among global migrants.

MATERIALS AND METHODS

A rapid review was conducted May 2022 capturing data collected from April 2020 to May 2022. Eight databases were searched: PubMed, Ovid Medline, EMBase, CINAHL, SCOPUS, Google Scholar, LILACS, and the Web of Science. The keywords "migrants" AND COVID-19" AND "vaccine" were matched with terms in MeSH. Peer-reviewed articles in English, French, Portuguese, or French were included if they focused on COVID-19 immunization acceptability, access, or uptake among global migrants. Two independent reviewers selected and extracted data. Extracted data was synthesized in a table of key characteristics and summarized using descriptive statistics.

RESULTS

The search returned 1,186 articles. Ten articles met inclusion criteria. All authors reported data on the acceptability of the COVID-19 vaccine, two on access, and one on uptake. Eight articles used quantitative designs and two studies were qualitative. Overall, global migrants had low acceptability and uptake, and faced challenges in accessing the COVID-19 vaccine, including technological issues.

CONCLUSIONS

This rapid review provides a global overview of the access, acceptability, and uptake of the COVID-19 vaccine among global migrants. Recommendations for practice, policy, and future research to increase access, acceptability, and uptake of vaccinations are discussed.

Knowledge, Beliefs, and Intention to Vaccinate against COVID-19 among the Seventh Day Adventists in Southeast Asia Region

Objective

The vaccine rollout in the Asian region was slower than in other countries. Factors such as lack of knowledge and skepticism towards the vaccine were noted. On the other hand, the influence of religious leaders on the congregation was enormous, including their intention to vaccinate. Guided by the Health Belief Model theory, this study aimed to explore the knowledge, belief and perceived susceptibility and severity of COVID, the perceived benefits and barriers of the vaccines, and the intention to vaccinate among the Seventh Day Adventists in Asia.

Methods

This was a descriptive study with respondents chosen through a multi-stage sampling method within the Asian region. A validated self-survey questionnaire, piloted among 40 respondents, was used using the Google online form. Data gathering was conducted for one month, from May until June 2021.

Results

Out of 400 questionnaires distributed, 396 responded with a return rate of 0.99%. The majority were aged 18-29 years (43.2%), men (61.4%), married (50.2%), completed a bachelors' degree (49.5%), currently working (65.4%), and have been a member of the church for 20 years (30.8%). The majority had excellent knowledge regarding the vaccine (mean 4.72, ± 1.33); despite having low belief in the vaccine (mean 2.18, ± 0.43), low perception of their susceptibility to acquiring COVID (mean 2.43, ± 0.34), low perception on the seriousness of COVID (mean 2.30, ±0.40), low perception on vaccine benefits (mean 2.27, ± 0.45), and perceived low barrier on being vaccinated (mean 2.27, ±.45). Most of them intend to vaccinate (67.3%).

Conclusion

The findings of this study suggest that the majority of Adventists intend to vaccinate. However, there is a need for health education to enhance their belief in the vaccine and change their negative perception about their susceptibility and severity of COVID.

Psychometric validation of the Korean versions of the Vaccine Hesitancy Scale and Vaccination Attitudes Examination Scale

PURPOSE

Strategies for reducing vaccine hesitancy and negative attitudes toward vaccination and measures to accurately assess them have been developed worldwide. The Vaccine Hesitancy Scale (VHS) and Vaccination Attitudes Examination Scale (VAX) are reliable and valid tools. This study evaluates the validity and reliability of the Korean versions of the Vaccine Hesitancy Scale (K-VHS) and Vaccination Attitudes Examination Scale (K-VAX).

METHODS

We translated the VHS and VAX into Korean using forward and backward translations and tested their psychometric attributes. We collected data from a sample of 2,292 Koreans, recruited in June 2021 from a large online panel using quotas for age and gender. We used content validity, construct validity with confirmatory factor analysis, concurrent validity, and convergent validity to assess the validity of the scales, and tested their reliability with evaluations of internal consistency and stability.

RESULTS

The K-VHS and K-VAX showed good model fits in the validity tests, with seven items for one factor and 12 items for four factors, respectively. The internal consistency (Cronbach's alpha = 0.94 for the K-VHS, and 0.86 for the K-VAX) and stability (ICC = 0.86 for the K-VHS, and 0.88 for the K-VAX) of the measures indicated that they are reliable.

CONCLUSIONS

Both tools are effective psychometric instruments for assessing vaccine hesitancy and vaccination attitudes in Korean adults. K-VHS and K-VAX would be useful for predicting vaccination behaviors in novel infectious disease contexts and communicating the evidence needed to develop related policies or programs.

COVID-19 Vaccine Hesitancy among the General Population: A Cross-Sectional Study

Hesitancy about receiving vaccines has been deemed a global danger to public health by WHO. The sociocultural backgrounds of the people have an impact on vaccine acceptance. The purpose of this study was to examine the effect of sociodemographic factors on COVID-19 vaccination hesitancy as well as to identify the factors that contributed to COVID-19 vaccine hesitancy.

METHODS

A cross-sectional study was carried out to determine the primary variables causing COVID-19 vaccination hesitancy among residents of Pune. The general population was sampled through simple random sampling. The minimum sample size was determined to be 1246. The questionnaire inquired about the individuals' sociodemographic information, vaccination status, and reasons for vaccine hesitancy.

RESULTS

In total, there were 5381 subjects, 1669 of whom were unvaccinated and 3712 of whom were partially vaccinated. Fear of adverse effects (51.71%), fear of losing a few days of work (43.02%), and inability to secure a vaccine slot online (33.01%) were the most frequently cited reasons. An older population (>60 years, p = 0.004), males (p = 0.032), those who were literate (p = 0.011), those of lower middle socioeconomic status (p = 0.001), and smokers were significantly associated with fear and mistrust of the COVID-19 vaccine, while mistrust of the vaccine was greatest among individuals from the upper and lower middle classes (p = 0.001).

CONCLUSION

Vaccine hesitancy due to concerns about the side effects and long-term complications was prevalent among the elderly, males, those from the lower middle class, and smokers. This study emphasizes the importance of communicating effectively about the vaccine's efficacy, its distribution, and vaccination sites.

COVID-19 vaccine hesitancy and attitudes in Pakistan: a cross-sectional phone survey of major urban cities

BACKGROUND

COVID-19 mass vaccination is the only hopeful savior to curb the pandemic. Vaccine distribution to achieve herd immunity is hindered by hesitance and negative attitude of the public against COVID-19 vaccination. This study aims to evaluate the vaccine hesitancy and attitudes in major cities in Pakistan as well as their determinants.

METHODS

A cross-sectional telephonic survey was conducted in June 2021 in major cities of Pakistan including Karachi, Lahore, Islamabad, Peshawar, and Gilgit, from unvaccinated urban population aged 18 years or older. Random Digit Dialing through multi-stage stratified random sampling was used to ensure representation of each target city and socio-economic classes. Questionnaire collected information on socio-demographics, COVID-19-related experiences, risk perception of infection, and receptivity of COVID-19 vaccination. Multivariate logistic regression analyses were performed to identify key determinants of vaccine hesitancy and acceptance.

RESULTS

The prevalence of vaccinated population in this survey was 15%. Of the 2270 respondents, 65% respondents were willing to vaccinate, while only 19% were registered for vaccination. Factors significantly associated with vaccine willingness were older age (aOR: 6.48, 95% CI: 1.94-21.58), tertiary education (aOR: 2.02, 95% CI: 1.36, 3.01), being employed (aOR: 1.34, 95% CI: 1.01, 1.78), perceived risk of COVID-19 (aOR: 4.38, 95% CI: 2.70, 7.12), and higher compliance with standard operating procedures (aOR: 1.72, 95% CI: 1.26, 2.35). The most common vaccine hesitancy reasons were 'no need' (n = 284, 36%) and concerns with 'vaccine safety and side effects' (n = 251, 31%), while most reported vaccine motivation reasons were 'health safety' (n = 1029, 70%) and 'to end the pandemic' (n = 357, 24%).

CONCLUSIONS

Although our study found 35% hesitancy rate of COVID-19 vaccine, there were noticeable demographic differences that suggest tailored communication strategy to address concerns held by most hesitant subpopulation. Use of mobile vaccination facilities particularly for less mobile and disadvantaged, and implementation and evaluation of social mobilization strategy should be considered to increase overall COVID-19 vaccination acceptance and coverage.

COVID-19 Vaccine Acceptance and Hesitancy among Migrants, Refugees, and Foreign Workers: A Systematic Review and Meta-Analysis

Despite the effectiveness of current vaccines in reducing the spread and severity of SARS-CoV-2 infections, many people, including migrants, refugees, and foreign workers, are hesitant to be vaccinated. This systematic review and meta-analysis (SRMA) was conducted to determine the pooled prevalence estimate of the acceptance and hesitancy rates of the COVID-19 vaccine among these populations. A comprehensive search of the peer-reviewed literature indexed in PubMed, Scopus, Science Direct, and Web of Science databases was conducted. Initially, 797 potential records were identified, of which 19 articles met the inclusion criteria. A meta-analysis of proportions using data from 14 studies revealed that the overall acceptance rate of COVID vaccination among 29,152 subjects was 56.7% (95% CI: 44.9-68.5%), while the prevalence of vaccine hesitancy among 26,154 migrants reported in 12 studies was estimated to be 31.7% (95% CI: 44.9-68.5%). The acceptance rate for the COVID-19 vaccination first declined from 77.3% in 2020 to 52.9% in 2021 and then slightly increased to 56.1% in 2022. The most frequent factors influencing vaccine hesitancy were worries about vaccine efficacy and safety. Intensive vaccination campaigns should be implemented to raise vaccination awareness among migrants, which will increase the acceptance rate for the COVID-19 vaccine and result in herd immunity.

Key Lessons from COVID-19: A Narrative Review Describing Qatar's Multifactorial Approach in Executing a Vaccination Campaign

Widespread vaccination programs have been implemented in many countries to curtail the COVID-19 pandemic, with varying success and challenges. To better understand the successes and challenges of the global COVID-19 response in the face of emerging new variants and epidemiologic data, we discuss how Qatar engaged the healthcare sector, governmental bodies, and the populace to combat COVID-19, with a focus on the country's vaccination strategy. This narrative provides the history and timeline of the Qatar COVID-19 vaccination campaign; factors that helped the vaccination campaign and the transferable lessons learned are discussed. Details regarding how Qatar responded to challenges, such as vaccine hesitancy and mitigation of misinformation, are highlighted. Qatar was one of the first countries to procure the BNT162b2 (Comirnaty^®; Pfizer-BioNTech, Pfizer Inc., New York, NY, USA) and mRNA-1273 (Spikevax^®; Moderna, Cambridge, MA, USA) COVID-19 vaccines. A relatively high vaccination rate and low case mortality rate (0.14% as of 4 January 2023) was observed in Qatar compared with other countries (global case mortality rate, 1.02%). Learnings will be carried forward as a basis for addressing this evolving pandemic and any future national emergencies in Qatar.

Knowledge and attitudes toward COVID-19 vaccination in Sudan: A cross-sectional study

Background

Vaccines are an essential part of public health interventions to mitigate the devastating health and non-health impacts of COVID-19 pandemic. Despite the fact that Sudan launched the COVID-19 vaccination program in March 2021, only 10% of the population received their two primary doses of vaccines by the end of May 2022. This delayed uptake of vaccines obviously warrants investigation. Therefore, we have conducted this study to evaluate the knowledge, attitude and acceptance of the general population in Sudan toward COVID-19 vaccines.

Methodology

A descriptive cross-sectional community-based study. The data were collected using an electronic questionnaire from 403 individuals living in Khartoum, Sudan. The data were processed using the Statistical Package for Social Sciences (SPSS), and data analysis was performed using appropriate tests.

Results

51% of the participants were found to have sufficient knowledge about the COVID-19 vaccine, and the knowledge level is higher among those educated beyond the secondary school and those who were employed. Among those unvaccinated, only 47% of the participants expressed their intention to take the vaccine when offered to them. The major reason for not trusting the vaccine is safety concerns expressed by 65.5% of the unvaccinated.

Conclusion

Higher education levels and employment were associated with an increase in sufficient knowledge about the vaccine in around half of the participants. However, most of participants had not taken the vaccine at the time of the study, and the trust in vaccines is not high. Effective interventions by the health authorities are needed to address these issues in order to accelerate the COVID-19 vaccination program in Sudan.

Acceptability and perception of COVID-19 vaccines among foreign medical students in China: A cross-sectional study

Background

Acceptability and perception of the COVID-19 vaccine among different social groups have been the subject of several studies. However, little is known about foreign medical students in Chinese universities.

Aim

This study, therefore, fills the literature gap using a focus group technique to assess the acceptance and perception of the COVID-19 vaccine among foreign medical students in China.

Methods

The study adopted an online cross-sectional survey method following the Chinese universities' lockdowns to collect the data between March and April 2022. A data collection questionnaire was developed, and then the link was shared with the respondents through key informants in different universities in China to obtain the data. The data collection process only included foreign medical students who were in China from May 2021 to April 2022. The authors received a total of 403 responses from the respondents. During data processing, we excluded 17 respondents since they were not in China while administering the questionnaire to enhance the data validity. The authors then coded the remaining 386 respondents for the estimation process. We finally applied the multilinear logistics regression technique to model the COVID-19 vaccine acceptance with the response or influencing factors, including the mediating factors among the foreign medical students in China.

Results

The data statistics show that 4.9% of the respondents were younger than 20 years, 91.5% were 20–40 years old, and 3.6% were older than 40 years; 36.3% of respondents were female subjects and 63.7% were male subjects. The results also show that the respondents are from six continents, including the African continent, 72.4%, Asia 17.4%, 3.1% from Europe, 2.8% from North America, 1.6% from Australia, and 2.3% from South America. The mediation analysis for the gender variable (β = 0.235, p = 0.002) suggests that gender is a significant channel in COVID-19 vaccine acceptance and perception among foreign medical students in China. Also, the main analysis shows that opinion on the safety of the vaccine (β = 0.081, p = 0.043), doses of the vaccine to receive (β = 0.175, p = 0.001), vaccine safety with some side effects (β = 0.15, p = 0.000), and the possibility of acquiring COVID-19 after vaccination (β = 0.062, p = 0.040) are all positive factors influencing vaccine acceptability and perception. Also, the home continent (β = −0.062, p = 0.071) is a negative factor influencing COVID-19 vaccine acceptance and perception. Furthermore, the finding shows that fear perceptions has affected 200 (51.81%) respondents. The medical students feared that the vaccines might result in future implications such as infertility, impotence, and systemic health conditions such as cardiovascular, respiratory, or deep vein thrombosis. In addition, 186 (48.19%) students feared that the vaccines were intended to shorten life expectancy.

Conclusion

COVID-19 vaccination acceptability and perception among medical students in China is high, most predominantly due to their knowledge of medicine composition formulation. Despite widespread acceptance by the general public and private stakeholders, we concluded that vaccination resistance remains a significant factor among medical students and trainees. The study further adds that in considering the COVID-19 vaccine, the factor of the home continent plays a significant role in vaccine hesitancy among foreign medical students. Also, knowledge, information, and education are important pillars confronting new medicine administered among medical trainees. Finally, there is a low rate of COVID-19 vaccine hesitancy among foreign medical students in China. The study, therefore, recommends targeted policy strategies, including sensitization, detailed public information, and education, especially for medical colleges and institutions on the COVID-19 vaccination, to achieve 100%. Furthermore, the study recommends that future researchers explore other factors influencing accurate information and education for successful COVID-19 vaccination implementation.

COVID-19 Vaccination Preferences among non-Chinese migrants in Hong Kong: A Discrete Choice Experiment

BACKGROUND

Studies has shown increase COVID-19 vaccination hesitancy among migrant populations in certain settings than the general population. Hong Kong (HK) has a growing migrant population with diverse ethnic backgrounds. Apart from individual level factors little is known about the migrants' preference related to COVID-19 vaccines.

OBJECTIVE

This study aimed to investigate which COVID-19 vaccine-related attributes combined to individual factors may lead to vaccine acceptance or refusal among the migrant population in HK.

METHODS

An online discrete choice experiment (DCE) was conducted among all adults, including Chinese people, non-Chinese Asians (South, South-East and North-East Asians), and non-Asians (Europeans, Americans and Africans) migrants in HK from 26 February to 26 April 2021. The participants were recruited by quota sampling and sent a link to web-survey. The vaccination attributes included in eight choice sets in each of the four blocks were vaccine brand, safety and efficacy, vaccine uptake by people around, professionals' recommendation, vaccination venue, and quarantine exemption for vaccinated travelers. Nested logistic model and latent-class logit (LCL) model were used for statistical analysis.

RESULTS

A total of 208 migrant participants were included with a response rate of 62.1%. Among migrants, participants with longer local residential years (27.7% for 10+ years, 20.6% for 7-9 years, 6.7% for 4-6 years, and 9.7% for below 3 years; P=.03), lower education level (28.3% vs 13.9%, P=.01) and lower income (25.2% vs 13.2%, P=.04) were more likely to refuse COVID-19 vaccination irrespective of vaccination attributes. BioNTech vaccine compared with Sinovac (adjusted odds ratio [AOR]: 1.75, 95% confidence interval [CI]: 1.14-2.68), vaccine with 90% (AOR: 1.44, 95%CI: 1.09-1.91) and 70% efficacy(AOR: 1.21, 95%CI: 1.03-1.44) compared with 50%, vaccine with fewer serious adverse events 1/100,000 compared with 1/10,000 (AOR: 1.12, 95%CI: 1.00-1.24) and quarantine exemption for cross-border travelers(AOR: 1.14, 95%CI: 1.01-1.30) were the vaccine attributes that could increase the likelihood of vaccination among migrants. For individual-level factors, the full-time housemakers (AOR: 0.44, 95%CI: 0.29-0.66), those with chronic conditions (AOR: 0.61, 95%CI: 0.41-0.91) and more children, and those frequently received vaccine-related information from workplace (AOR: 0.42, 95%CI: 0.31-0.57) were found reluctant to accept the vaccine. those with higher income (AOR: 1.79, 95%CI: 1.26-2.52), knowing anyone infected with COVID-19 (AOR: 1.73, 95%CI: 1.25-2.38), having greater perceived susceptibility of COVID-19 infection (AOR: 3.42, 95%CI: 2.52-4.64), received influenza vaccine (AOR: 2.15, 95%CI: 1.45-3.19), and frequently received information from social media (AOR: 1.52, 95%CI: 1.12-2.05) were more likely to accept the vaccine.

CONCLUSIONS

This study implies that migrants have COVID-19 vaccination preference heterogeneity and more targeted and tailored approaches are needed to promote vaccine acceptance for different subgroups of migrant population in Hong Kong. Vaccination promotion strategies are needed for low education and low income migrant groups, migrants with chronic diseases, working migrant population, housemakers and parents.

CLINICALTRIAL

Understanding COVID-19 vaccine hesitancy: A cross-sectional study in Malang District, Indonesia

Introduction

Vaccine hesitancy could undermine efforts to reduce incidence of coronavirus disease 2019 (COVID-19). Understanding COVID-19 vaccine hesitancy is crucial to tailoring strategies to increase vaccination acceptance. This study aims to investigate the prevalence of and the reasons for COVID-19 vaccine hesitancy in Malang District, Indonesia.

Methods

Data come from a cross-sectional study among individuals aged 17-85 years old (N = 3,014). Multivariate ordered logistic regression was used to identify factors associated with postponing or refusing COVID-19 vaccines. The Oxford COVID-19 vaccine hesitancy scale was used to measure vaccine hesitancy. A wide range of reasons for hesitancy, including coronavirus vaccine confidence and complacency, vaccination knowledge, trust and attitude in health workers and health providers, coronavirus conspiracy, anger reaction and need for chaos, populist views, lifestyle, and religious influence, was examined.

Results and discussion

The results show that 60.2% of the respondents were hesitant to receive the COVID-19 vaccine. Low confidence and complacency beliefs about the vaccine (OR = 1.229, 95% CI = 1.195-1.264) and more general sources of mistrust within the community, particularly regarding health providers (OR = 1.064, 95% CI = 1.026-1.102) and vaccine developers (OR = 1.054, 95% CI = 1.027-1.082), are associated with higher levels of COVID-19 vaccine hesitancy. Vaccine hesitancy is also associated with anger reactions (OR = 1.019, 95% CI = 0.998-1.040), need for chaos (OR = 1.044, 95% CI = 1.022-1.067), and populist views (OR = 1.028, 95% CI = 1.00-1.056). The findings were adjusted for socio-demographic factors, including age, sex, education, marital status, working status, type of family, household income, religious beliefs, and residency. The results suggest the need for an effective health promotion program to improve community knowledge of the COVID-19 vaccine, while effective strategies to tackle "infodemics" are needed to address hesitancy during a new vaccine introduction program.

COVID-19 Vaccine Hesitancy and Personality Traits; Results from a Large National Cross-Sectional Survey in Qatar

Attitudes to vaccination arise from a complex interplay of personal and environmental factors. This has been true for the COVID-19 vaccination attitudes too and understanding personal factors would help design immunisation strategies that help in infectious disease control. The five-factor model of personality has been established as a valid construct in exploring individual attitudes and traits. This institutional review board approved study explores the relationship between these five domains of personality and attitudes to COVID-19 vaccination in Qatar which has a migrant majority population. A cross-sectional survey was conducted in Qatar using an online survey link containing validated tools to measure vaccine hesitancy and personality traits. People from diverse ethnic and sociodemographic backgrounds, amounting to 5340 individuals, completed the self-report survey. After controlling for social and demographic variables, individuals scoring significantly higher on Conscientiousness were more likely to refuse the COVID-19 vaccination, while those scoring significantly lower on Openness to experience and Neuroticism were also more likely to refuse COVID-19 vaccination. Both groups of individuals scoring significantly higher and lower on Conscientiousness and Neuroticism, respectively, were more likely to trust their own research than trust endorsement of the COVID-19 vaccine from their doctor or healthcare organisation. The study highlights the highly complex and sometimes contradictory relationship between vaccine hesitancy and personality traits and makes a case for understanding this relationship better in order to inform successful immunisation strategies.

What attributes influence rural household's willingness to get vaccinated for COVID-19? Perspectives from six Chinese townships

Since the onset of the COVID-19 pandemic, vaccinations have been identified as the most effective mitigation strategy against the deadly virus. This has led developed nations to accelerate research and shorten the licensure process for COVID-19 vaccines, but these changes have caused widespread concerns about vaccine safety. Research literature has long indicated that citizens' perceptions of protective actions will determine their behaviors, and thus, the relationship between vaccine perception and vaccination intention needs to be assessed. To better understand vaccination willingness, especially in rural populations, this study surveyed 492 households from six townships in the Ya'an region of China's Sichuan Province in November 2020. The survey followed the Protective Action Decision Model (PADM) framework for collecting perceptions about the influenza and COVID-19 vaccines as protective actions, information sources, emergency preparedness, emotional response, and demographic characteristics. The results showed that influenza vaccine perceptions significantly affected people's COVID-19 vaccination perceptions and intentions. Unlike previous vaccination willingness and other COVID-19 studies, this study found that perceptions of resource-related attributes and health-related attributes both affected COVID-19 vaccination intentions, but the former were slightly stronger than the latter. Moreover, these effects were strongest among respondents who had the most positive perceptions of their influenza vaccine experience. This study's findings will benefit local authorities in designing appropriate policies and measures (e.g., hazard education, risk communication, vaccination convenience enhancement) for increasing vaccination compliance for the current and future pandemics.

How Message Frames Promote People’s Willingness to Get Vaccinated? The Mediation Role of Perceived Net Benefits

Objectives: This study aims to evaluate the association among framed messages (egoism-, altruism-, and loss-framed information), perceived net benefits (PNB), and willingness to receive a COVID-19 vaccine.

Methods: A between-subject survey experiment was designed to assess the above association. A total of 1,316 individuals were included in this study. The participants were randomly assigned to one control group (receiving non-framed information) and three experimental groups (receiving egoism-, altruism-, and loss-framed information). The participants then reported their vaccination willingness and perceived effectiveness and side effects of vaccination. PNB was determined by subtracting the perceived side effects from perceived effectiveness.

Results: Compared with the control group, participants in the experimental groups exhibited stronger vaccination willingness. Higher PNB levels were associated with enhanced vaccination willingness. However, only loss-framed messages indirectly affected vaccination willingness through PNB.

Conclusion: PNB can mediate the impact of message framing on vaccination willingness. However, the mediation effect of PNB was only found in the relationship between loss-framed messages and vaccination willingness.

The effect of altruism on COVID-19 vaccination rates

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.

COVID-19 Vaccination Hesitancy: A Review of the Literature and Recommendations

Vaccines are important to improve immunity against pathogens and diseases. The current COVID-19 disease is rapidly evolving and spreading among people; therefore, it is important to utilize a proper vaccination strategy against it. Currently, many approved vaccines are available and accessible; however, there is a reported hesitancy against taking them among the public and even the health care workers. Mainly, this is attributed to the fear of the possible side effects and complications. Moreover, inaccurate knowledge disseminated through the media/social media especially by those who lack the proper expertise, adds confusion and more fear that affects the vaccination decision. For such reasons, it is essential to find strategies to increase the acceptability of vaccines and enhance confidence in the vaccination process. This should be accompanied by sufficient efforts and proper clinical studies to confirm the value and the safety of the vaccines. Those strategies are important to avoid the further spread of the COVID-19 disease and abort the pandemic worldwide, especially when considering the likely approach towards a COVID-19 booster vaccination program, in which booster vaccines are re-taken along intervals to adequately contain the rapidly evolving nature of the virus. This review article highlights the factors influencing the acceptability of the COVID-19 vaccination and enrollment in clinical trials among the public and some specific populations. Furthermore, it summarizes the suggested strategies and recommendations to improve attitudes towards COVID-19 vaccination programs.

The Influence of Media Information Sources on Preventive Behaviors in China: After the Outbreak of COVID-19 Pandemic

Background

As announced by the World Health Organization (WHO), since March 2020, the COVID-19 pandemic has become a global pandemic. In order to prevent the spread of COVID-19, Chinese government carried out very strict prevention and control policy.

Objective

The study aimed to explore the effect of news reports on COVID-19 vaccine from traditional media and social media on COVID-19 preventive behaviors.

Methods

Adults aged between 18 and 58 years old completed an online survey reporting how they gathered media information sources regarding the COVID-19 vaccine, as well as any details relating to risk perception, vaccine efficacy, and preventive behaviors in COVID-19 pandemic.

Results

Our results showed that traditional and social media information sources both significantly and positively influenced people's COVID-19 preventive behaviors, with the former showing a stronger effect. COVID-19 contact risk perception and vaccine efficacy awareness of media audiences partly mediate this relationship. Audiences who reported more exposing news reports on COVID-19 vaccine from the media show stronger risk perception and vaccine efficacy awareness. This increases their COVID-19 preventive behaviors.

Conclusions

This study found that media information sources have an important impact on people's COVID-19 preventive behaviors. People believe more in the news information of the mainstream media about the COVID-19 pandemic. Moreover, much of the news information of social media is also from the important mainstream media. Media organizations should shoulder greater social responsibility, embed the health-related benefits of COVID-19 vaccination into the values and cultural order of the whole society, find and shape a common space of meaning, and produce forms of internal coupling and value identification.

Perceptions of, and Obstacles to, SARS-CoV-2 Vaccination Among Adults in Lebanon: Cross-sectional Online Survey

BACKGROUND

The COVID-19 pandemic is an additional burden on Lebanon's fragmented health care system and adds to its ongoing political, economic, and refugee crises. Vaccination is an important means of reducing the impact of the pandemic.

OBJECTIVE

Our study's aims were to (1) assess the prevalences of intention to vaccinate and vaccine hesitancy in Lebanon; (2) determine how vaccine hesitancy in Lebanon varies by sociodemographic, economic, and geographic characteristics; and (3) understand individuals' motivations for vaccinating as well as concerns and obstacles to vaccination.

METHODS

We performed a cross-sectional study from January 29, 2021, to March 11, 2021, using an online questionnaire of open- and closed-ended questions in Arabic via convenience "snowball" sampling to assess the perceptions of adults residing in Lebanon.

RESULTS

Of the 1185 adults who participated in the survey, 46.1% (95% CI: 43.2%-49.0%) intended to receive the SARS-CoV-2 vaccine when available to them, 19.0% (95% CI 16.8%-21.4%) indicated they would not, and 34.0% (95% CI 31.3%-36.8%) were unsure (with an additional 0.9% skipping this question). The most common reasons for hesitancy were concerns about safety, limited testing, side effects, and efficacy. Top motivations for vaccinating were to protect oneself, protect one's family and the public, and end the pandemic. Despite financial hardships in Lebanon, barriers to vaccine access were not frequently described as concerns. Established health care facilities, rather than new temporary vaccination centers, were most frequently selected as preferred vaccination sites.

CONCLUSIONS

Vaccine hesitancy appears to be high in Lebanon. Disseminating clear, consistent, evidence-based safety and efficacy information on vaccines may help reduce vaccine hesitancy, especially among the large proportion of adults who appear to be unsure about (rather than opposed to) vaccination.

Side Effects of COVID-19 Vaccines Primer Doses: Experience of Saudi Healthcare Workers Participating in CoVaST-SA

BACKGROUND

Side effects emerging after COVID-19 vaccines may adversely impact public confidence in vaccines. Therefore, this study was designed to explore the short-term side effects of COVID-19 vaccines as a part of the COVID-19 Vaccines Safety Tracking (CoVaST) study.

METHODS

A cross-sectional survey-based study was carried out to collect data from healthcare workers (HCWs) in Saudi Arabia. The study was initiated between June and December 2021. A validated questionnaire was used in this study consisting of four categories, including demographic characteristics and medical anamnesis of the participants, COVID-19-associated anamnesis, and side effects of vaccine uptake.

RESULTS

The study included 1039 participants, of which 70.2% were females, and their median age was 34. About 82.9% and 52.3% of the participants reported a minimum of both one local and systemic side effect, respectively. Females, young participants (≤34 years old), and non-obese participants had more potential to disclose post-vaccination side effects than their counterparts. Heterologous schedules and viral vector-based vaccines were linked with a greater rate of systemic side effects, whereas homologous vaccination schedules and mRNA-based vaccines were linked with a greater rate of local side effects.

CONCLUSION

Future studies on COVID-19 vaccines should focus on the role of BMI, previous infection, and vaccination schedule in terms of vaccine safety and reactogenicity.

Global COVID-19 vaccine acceptance rate: Systematic review and meta-analysis

Background

A vaccine against COVID-19 is a vital tool in managing the current pandemic. It is becoming evident that an effective vaccine would be required to control COVID-19. Effective use of vaccines is very important in controlling pandemics and paving the way for an acceptable exit strategy. Therefore, this systematic review and meta-analysis aims to determine the global COVID-19 acceptance rate that is necessary for better management of COVID-19 pandemic.

Methods

This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and considered the studies conducted on acceptance and/or hesitancy of COVID-19 vaccine. Articles were searched using electronic databases including PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. The quality of the study was assessed using the Joanna Briggs Institute (JBI) critical assessment tool to determine the relevance of each included article to the study.

Results

Of the 6,021 articles identified through the electronic database search, 68 articles were included in the systematic review and meta-analysis. The global pooled acceptance rate of the COVID-19 vaccine was found to be 64.9% [95% CI of 60.5 to 69.0%]. Based on the subgroup analysis of COVID-19 vaccine acceptance rate by the World Health Organization's region, the countries where the study was conducted, occupation, and survey period, the prevalence of COVID-19 vaccine acceptance rate was 60.8% [95% CI: 56.3, 65.2%], 61.9% [95% CI: 61.3, 62.4%], 81.6% [95% CI: 79.7, 83, 2%] and 64.5% [95% CI: 60.3, 68.5%], respectively.

Conclusions

This review revealed the variation in the level of COVID-19 vaccine acceptance rate across the world. The study found that the overall prevalence of COVID-19 vaccine acceptance was 64.9%. This finding indicated that even if the COVID-19 vaccine is developed, the issue of accepting or taking the developed vaccine and managing the pandemic may be difficult.

COVID-19 vaccination side effects among the child age group: a large cross-sectional online based survey in Saudi Arabia

BACKGROUND

Multiple vaccines have been tested in clinical trials for their efficacy and safety. In Saudi Arabia, Pfizer-BioNTech or Moderna were approved for children, however, previous studies to report their safety profile are limited. This research aims to understand the side effect of children's vaccination against SARS-CoV-2 infection in Saudi Arabia.

METHODS

This was an observational retrospective cross-sectional study was conducted using an online survey in Saudi Arabia from March to May 2022. The inclusion criteria were parents aged 18 years and above who live in Saudi Arabia and have vaccinated their children. The self-reported questionnaire was adopted from published studies to investigate the study objectives Descriptive statistics were used to describe patients' demographic characteristics, continuous data were reported as mean ± S.D., categorical data were reported as percentages (frequencies), and logistic regression was used to identify predictors of persistent post-COVID-19 symptoms.

RESULTS

This study had a total of 4,069 participants. Only 41.9% of the participants reported that their child(ren) had been infected with the coronavirus. 2.00 was the median number of children (IQR: 1.00-4.00). More than half of the study participants (64.2%) reported that a family member had been infected with the coronavirus. Both parents received COVID-19 vaccination, according to most participants (88.7%). Most participants (70.5%) stated that all children who met the vaccination criteria had received the vaccine. Most participants (83.5%) said their child or children had two doses of their vaccine, and about half (50.4%) of those who received the vaccine reported experiencing side effects. In addition, the majority (78.9%) reported that the side effects appeared within one day of receiving the vaccine, and nearly two-thirds (65.7%) reported that the side effects lasted between one and three. A total of 11,831 side effects cases were documented. Pain at the injection site, hyperthermia, and fatigue were the most reported side effects, accounting for 15.3%, 14.1%, and 13.2%, respectively.

CONCLUSION

It appears that the side effects of the COVID-19 vaccine for children are minor, tolerable, and like those described previously in clinical trials. Our data should encourage the public about the safety of receiving the COVID-19 vaccine for children.

Perception and Attitude Towards COVID-19 Vaccination Among the Elderly: A Community-Based Cross-Sectional Study

Introduction COVID-19 is one of the most formidable obstacles that humanity has encountered in this century. The death rate was high among the elderly in India; therefore, getting the elderly vaccinated was one of the most important things to do. Objective We conducted this study to assess the perception and attitude about the COVID-19 vaccines among the elderly population. Methods This cross-sectional study was conducted at Fatehpur Beri, New Delhi. We selected 108 participants using systematic random sampling. We used a semi-structured questionnaire to collect the data. Results Out of 108 participants, 52.8% were men. Among them, 9.3% of participants had tested positive before. The average number of days of illness among the participants was 5.3 (SD + 3.5). Males had a higher average day of illness (5.5, SD +3.7) than females (4.9, SD +3.3). Among those who had not been vaccinated, 73.3% of participants said they would receive the vaccine, 6.7% were unsure, and 20% were not willing to receive the vaccine. Conclusion COVID vaccination in an elderly population showed a relatively high vaccine acceptance rate, and the willingness to get the vaccine was also high among the unvaccinated.

COVID-19 vaccine hesitancy and acceptance among the public in the Gulf Cooperation Council countries: A review of the literature

Vaccine hesitancy has a significant impact on tackling infectious diseases as it has resulted in reemergence of vaccine-preventable diseases. This review aims to provide an up-to-date evaluation of COVID-19 vaccine hesitancy among the public in the Gulf Cooperation Council countries. We searched the PubMed and SCOPUS databases for manuscripts published on vaccine hesitancy and/or acceptance among the public in GCC countries up till April 1^st, 2022. Forty-nine studies met the inclusion criteria and were reviewed. The average vaccine hesitancy rate across GCC countries was 43%. Concerns about vaccine safety (n = 32) and effectiveness (n = 26) were most frequently associated with hesitancy. Being male (n = 25) and having positive behavior regarding the influenza vaccine or vaccines in general (n = 22) were most frequently associated with acceptance. Collaborative efforts of governments, academic bodies, and the media to provide evidence of vaccines' effectiveness throughout history and strictly manage the spread of the vaccine safety-related rumors are warranted.

Factors associated with COVID-19 vaccine hesitancy in Senegal: A mixed study

This study was an explanatory, sequential, mixed-methods design conducted in Senegal. We collected quantitative data from December 24, 2020, to January 16, 2021, and qualitative data from February 19 to March 30, 2021. We conducted a telephone survey among a marginal quota sample of 607 people over 18 years old. We performed descriptive, bivariate, and multivariate analyses with R software for the quantitative phase; and performed manual content analyses for the qualitative phase. We surveyed 607 people for the quantitative phase and interviewed 30 people for the qualitative phase. Individuals who hesitated or refused to be vaccinated represented 12.9% and 32.8%, respectively. Vaccine hesitancy was related to gender, living in large cities, having a poor attitude toward the vaccine, thinking that the vaccine would not help protect them from the virus, being influenced by people important to them, and lacking information from health professionals. Vaccine refusal was related to living in large cities, having a poor attitude toward the vaccine, thinking that the vaccine would not help protect them from the virus, thinking that the vaccine could endanger their health, trusting opinions of people who were important to them, and lacking information from health professionals. The results of the study show that the factors associated with COVID-19 vaccine hesitancy and refusal are diverse and complex. Addressing these factors will help to ensure better vaccination coverage. Governments and health authorities should intensify their efforts to promote vaccine confidence and reduce misinformation.

COVID-19 vaccine hesitancy between teachers and students in a college, a cross-sectional study in China

Studies have identified teacher effects on students' attitudes. This study explored the differences in and associations between teachers' and students' COVID-19 vaccine hesitancy, and the factors that affect it. A population-based self-administered online survey was conducted to evaluate the COVID-19 vaccine hesitancy of teachers and students in a college in Taizhou, China. A total of 835 valid questionnaires were obtained. All data were analyzed using IBM SPSS statistics 26.0 software. The proportions of COVID-19 vaccine hesitancy for teachers and students were 31.7%, and 23.8%, respectively. In the binary logistic regression analysis, teachers who perceived the safety of the COVID-19 vaccine as low (OR = 6.794 , 95%CI: 1.701-27.143), did not pay continuous attention to the vaccine news (OR = 3.498, 95%CI: 1.150-10.640), and suffered chronic diseases (OR = 2.659, 95%CI: 1.135-6.227) were more likely to hesitate to get vaccinated against COVID-19. The group of students who perceived the COVID-19 vaccine safety as being low (OR = 1.805, 95%CI: 1.094-2.979) were more hesitant to get the COVID-19 vaccine. While both teachers and students were hesitant about the COVID-19 vaccine, teachers were found to be more so. Perceptions regarding the safety of COVID-19 vaccines, attention to and awareness of vaccine news, and chronic medical conditions were the main factors that influenced the hesitation regarding COVID-19 vaccines. Therefore, students' vaccine hesitancy may depend largely on the perceptions of the vaccine's safety rather than teachers' vaccine hesitancy.