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Li X, Bai Y, Weng L, Bai Y, Gong W. COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study. Hum Vaccin Immunother 2024; 20:2315663. [PMID: 38439589 PMCID: PMC10936594 DOI: 10.1080/21645515.2024.2315663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.
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Affiliation(s)
- Xiaoyu Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yanping Bai
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lijun Weng
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunshan Bai
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
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Asupoto O, Li X, Hemberg JL, Emerson A, Black D, Geana MV, Wickliffe J, Glenn J, Ramaswamy M, Wurcel AG. COVID-19 and influenza vaccine uptake in women with criminal-legal system involvement. Vaccine 2024; 42:126176. [PMID: 39079808 DOI: 10.1016/j.vaccine.2024.126176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE Given their vulnerable health status and resource constraints, the perspectives of women with criminal-legal involvement (WCLI) are important but not usually represented in the literature on vaccine interest and vaccine hesitancy. This study aims to examine how the COVID-19 pandemic and vaccine affected the influenza vaccine uptake among WCLI. METHODS A cross-sectional secondary analysis was conducted using data collected from the Tri-City study, which followed WCLI in three U.S. cities from 2019 to 2023. We mapped the distribution of influenza vaccine uptake in 2019-2023 and developed a composite outcome that reflected participants' patterns of Y/N to influenza vaccine, which were categorized into four groups: Influenza Vaccine Supportive, Influenza Vaccine Adaptive, Influenza Vaccine Discontinued, and Influenza Vaccine Resistant. RESULTS Out of 507 people: 23.7% were Supportive, 8.5% Adaptive, 15.2% Discontinued and 38.3% Resistant. People who received the COVID vaccine had significantly lower odds of being identified as Discontinued (OR = 0.42, 95%CI = 0.20-0.87, p = .020) and Resistant (OR = 0.23, 95%CI = 0.13-0.43, p < .001), compared to the Supportive group. Mistrust toward COVID-19-related information was a significant independent predictor of being Adaptive (OR = 1.59, 95%CI = 1.08-2.35, p = .019), Discontinued (OR = 1.61, 95%CI = 1.15-2.25, p = .006), and Resistant (OR = 1.54, 95%CI = 1.19-2.00, p < .001) relative to Supportive. CONCLUSIONS Vaccine hesitancy poses significant challenges to public health efforts, with apparent dampening effect across vaccines. Public health messaging and clinical interactions informed by best practices in communication tailored to the lived experience of all people, including women with criminal-legal system involvement, will be necessary to inform future interventions aimed at increasing vaccine uptake.
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Affiliation(s)
- Olabimpe Asupoto
- Department of Medicine, Division of Geographic Medicine and Infectious Disease, Tufts Medicine, Boston, MA, USA.
| | - Xinyang Li
- Department of Population Health, the University of Kansas Medical Center, Kansas City, KS, USA
| | - Jordana L Hemberg
- Community Health and Implementation Research Program, RTI International, Berkeley, CA, USA
| | - Amanda Emerson
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Dominique Black
- Department of Medical/Clinical Psychology, University of Alabama at Birmingham, AL, USA
| | - Mugur V Geana
- William Allen White School of Journalism and Mass Communications, University of Kansas, Lawrence, KS, USA
| | - Joi Wickliffe
- Department of Population Health, the University of Kansas Medical Center, Kansas City, KS, USA
| | - Jason Glenn
- Department of History and Philosophy of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Megha Ramaswamy
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Alysse G Wurcel
- Department of Medicine, Division of Geographic Medicine and Infectious Disease, Tufts Medicine, Boston, MA, USA; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
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Archer H, McCoy SI, Sears D, Kwan A, Kuersten M, Lewnard JA, Bertozzi SM. Indirect vaccine effectiveness in an outbreak of Alpha B.1.1.7 variant in a California state Prison, May 2021. Vaccine 2024; 42:3057-3065. [PMID: 38584059 DOI: 10.1016/j.vaccine.2024.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
Incarcerated populations experienced high rates of SARS-CoV-2 infection and death during early phases of the COVID-19 pandemic. To evaluate vaccine effectiveness in the carceral context, we investigated the first outbreak of COVID-19 in a California state prison following widespread rollout of vaccines to residents in early 2021. We identified a cohort of 733 state prison residents presumed to be exposed between May 14 and June 22, 2021. 46.9 % (n = 344) were vaccinated, primarily with two doses of mRNA-1273 (n = 332, 93.6 %). In total, 92 PCR-positive cases were identified, of which 14 (14.5 %) occurred among mRNA-1273 vaccinated residents. No cases required hospitalization. All nine isolates collected belonged to the Alpha (B.1.1.7) variant. We used Cox proportional hazard regression to estimate vaccine effectiveness for at least one dose of any vaccine at the start of the outbreak. Vaccine effectiveness was 86 % (95 % CI: 75 %-97 %) against PCR-confirmed infection, with similar results for symptomatic infection. Higher rates of building-level vaccine uptake were associated with a lower overall rate of PCR-confirmed infection and symptomatic infection among unvaccinated residents. Among unvaccinated residents who lived in shared cells at the time of presumed exposure, exposure to a vaccinated cellmate was associated with a 38% (95% CI: 0.37, 1.04) lower hazard rate of PCR-confirmed infection over the study period. In this outbreak involving the Alpha SARS-CoV-2 variant, vaccination conferred direct and possibly indirect protection against SARS-CoV-2 infection and symptomatic COVID-19. Our results support the importance of vaccine uptake in mitigating outbreaks and severe disease in the prison setting and the consideration of community vaccination levels in policy and infection response.
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Affiliation(s)
- Helena Archer
- Division of Epidemiology, School of Public Health, University of California, Berkeley.
| | - Sandra I McCoy
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - David Sears
- Division of Infectious Diseases, Department of Medicine, University of California, San Francisco
| | - Ada Kwan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco
| | | | - Joe A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Stefano M Bertozzi
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley; School of Public Health, University of Washington, Seattle; Instituto Nacional de Salud Pública, Cuernavaca.
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Luisi M, Geana MV, Pei J. Pandemic antecedents - Exploring predictivity and relationships between COVID-19 vaccine uptake and influenza, shingles, and HPV vaccination. Vaccine 2024; 42:2455-2462. [PMID: 38461049 DOI: 10.1016/j.vaccine.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/16/2024] [Accepted: 03/02/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND A wealth of extant research focuses on identifying barriers to, and predictors of, COVID-19 vaccination. In addition to treating COVID-19 vaccination and related experiences as antecedents, this study analyzes the relationships between COVID-19 vaccination experiences and intent to receive the flu, shingles, and HPV vaccines. METHOD Analyses were performed on the responses from U.S. survey panel of 1,024 participants (n = 1,024), 530 (51.8 %) who received at least a dose of the COVID-19 vaccine and 494 (48.2 %) who had not. Descriptive and inferential statistics identify participant demographic characteristics, prior vaccination behavior, vaccination intentions, risk behavior assessment, vaccination attitudes and beliefs, and the predictivity of COVID-19 vaccination, when treated as an antecedent. RESULTS Receiving a first dose of the COVID-19 vaccine interacted with receiving a past influenza vaccine, predicting the future intention to receive a COVID-19 vaccine or booster. Vaccine hesitancy in parents is significantly related to vaccination behaviors for themselves and their children. Analyses also showed differences between the vaccinated group (VG) and the unvaccinated group (UVG) on hesitancy, beliefs, and attitudes toward the COVID-19 vaccine. CONCLUSION Experience with COVID-19 vaccination and the relationship of those experiences with other vaccinations provide useful insight on leveraging vaccine uptake. Healthcare professionals should improve the COVID-19 vaccination experience and use vaccination appointments to promote other vaccinations. Research should continue to compare vaccination experiences and how they may persuade or dissuade vaccination intent for other vaccinations.
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Affiliation(s)
- Monique Luisi
- School of Journalism, University of Missouri, 178 Gannett Hall, Columbia, MO 65211, USA.
| | - Mugur V Geana
- Center for Excellence in Health Communication to Underserved Populations, School of Journalism and Mass Communications, University of Kansas, 1000 Sunnyside Ave., Suite 2001, Lawrence, KS 66045, USA.
| | - Jun Pei
- Center for Excellence in Health Communication to Underserved Populations, School of Journalism and Mass Communications, University of Kansas, 1000 Sunnyside Ave., Suite 2001, Lawrence, KS 66045, USA.
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Qureshi NS, Miller LG, Judge SP, Tran NDT, Henderson SO. Characterizing predictors of COVID-19 vaccine refusal in an urban southern California jail population. Vaccine 2024; 42:777-781. [PMID: 38195263 DOI: 10.1016/j.vaccine.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Correctional populations have been disproportionately affected by COVID-19, and many large outbreaks have occurred in jails and prisons. Vaccination is a key strategy to reduce the SARS-CoV-2 transmission in carceral settings. Although implementation can be challenging due to vaccine hesitancy and medical mistrust, correctional settings provide largely equitable healthcare access and present a unique opportunity to identify potential predictors of vaccine hesitancy independent of access issues. METHODS We retrospectively analyzed electronic health record data for individuals offered COVID-19 vaccination at the Los Angeles County Jail between January 19, 2021, and January 31, 2023, and used multivariable logistic regression to determine predictors of COVID-19 vaccine refusal. RESULTS Of the 21,424 individuals offered COVID-19 vaccination, 2,060 (9.6 %) refused. Refusal was associated with male sex ([aOR] = 2.3, 95 % CI (1.9, 2.8)), age 18-34 ([aOR] = 1.2, 95 % CI (1.1, 1.4), referent group: age 45-54), Black race ([aOR] = 1.2, 95 % CI (1.1, 1.4)), reporting ever being houseless ([aOR] = 1.2, 95 % CI (1.1, 1.3)), and having a history of not receiving influenza vaccination while incarcerated ([aOR] = 2.4, 95 % CI (2.0, 2.8)). When analyzing male and female populations separately, male-specific trends reflected those seen in the overall population, whereas the only significant predictor of vaccine refusal in the female population was not receiving influenza vaccination while in custody ([aOR] = 6.5, 95 % CI (2.4, 17.6)). CONCLUSION Identifying predictors of vaccine refusal in correctional populations is an essential first step in the development and implementation of targeted interventions to mitigate vaccine hesitancy.
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Affiliation(s)
- Nazia S Qureshi
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA.
| | - Loren G Miller
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Stephen P Judge
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA; Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ngoc Dung T Tran
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
| | - Sean O Henderson
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
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Geana MV, Liu P, Pei J, Anderson S, Ramaswamy M. "A Friendly Conversation." Developing an eHealth Intervention to Increase COVID-19 Testing and Vaccination Literacy Among Women with Criminal and Legal System Involvement. JOURNAL OF HEALTH COMMUNICATION 2024; 29:131-142. [PMID: 38111197 PMCID: PMC10842808 DOI: 10.1080/10810730.2023.2293094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Many women leaving jails are ill-prepared to follow recommended COVID-19 mitigation practices, including testing and vaccination. Low COVID-19-related health literacy, exposure to disinformation, and mistrust in authorities put women at increased risk. Research on this population has shown significant use of mobile devices for communication and web access and public Wi-fi for the internet. Using inductive (formative empirical research with the community) and deductive (theory-based) practices, we designed, developed, and pilot-tested a multimedia, culturally tailored web-based electronic health (eHealth) application to increase COVID-19-specific health literacy and promote testing and vaccination among women with criminal and legal system involvement (CLSI). The intervention included a serialized animated multimedia component and a telenovela-style series, complementing each other and addressing knowledge needs identified in the formative research phase of the project. The eHealth intervention was pilot-tested with 13 CLSI women by using online activity logs and semi-structured telephone interviews. Findings confirmed that eHealth interventions employing multimodal information delivery had increased chances of engaging audiences, especially when developed with input from the target population and are culturally tailored. In addition, using a web-based delivery optimized for mobile made the intervention accessible on various devices and decreased the risk of technical problems.
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Affiliation(s)
- Mugur V. Geana
- Center for Excellence in Health Communication to Underserved Populations, School of Journalism and Mass Communications, University of Kansas, Lawrence, Kansas, USA
| | - Pan Liu
- Department of Media, Design, and Communication, Marian University, Indianapolis, Indiana, USA
| | - Jun Pei
- Center for Excellence in Health Communication to Underserved Populations, School of Journalism and Mass Communications, University of Kansas, Lawrence, Kansas, USA
| | - Sherri Anderson
- Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas, USA
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7
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Brody C, Szieff J, Abu-Alrub B. "If it wasn't forced upon me, I would have given it a second thought": Understanding COVID-19 vaccine hesitancy in an outlier county in the Bay Area, California. PLoS One 2023; 18:e0290469. [PMID: 38127963 PMCID: PMC10735040 DOI: 10.1371/journal.pone.0290469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/08/2023] [Indexed: 12/23/2023] Open
Abstract
While the San Francisco Bay Area counties rank very low in vaccine hesitancy and high in vaccination rates when compared to national numbers, Solano County has the most residents who are hesitant (6.3%) and the least who are fully vaccinated (51.6%) among Bay Area counties, according to the CDC. No studies to date have been able to provide the in-depth, localized information that would inform county-level public health interventions. This study aims to explore reasons and consequences for remaining unvaccinated in Solano County. Using a qualitative in-depth interview approach, we conducted 32 interviews with unvaccinated adults from Solano County. We used a grounded theory approach to our analysis. Using the socio-ecological model as a framework, we found that reasons for not getting vaccinated were primarily structural (mistrust of public information) and individual (bodily autonomy, personal choice) while consequences were primarily interpersonal (discrimination and stigma from friends, family, and employers). An overarching theme was that the vaccine rollout and messaging felt like an encroachment on personal choice and the feeling of being forced created more mistrust. Participants reported feeling like their decisions made them minorities among their colleagues, friends and family and that they were not persuaded by groupthink or by their relationships. Future public health responses to epidemics and pandemics might consider if a vaccine mandate is the best approach for reaching all county residents.
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Affiliation(s)
- Carinne Brody
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America
| | - Julian Szieff
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America
| | - Bilal Abu-Alrub
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, California, United States of America
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Newman PA, Dinh DA, Nyoni T, Allan K, Fantus S, Williams CC, Tepjan S, Reid L, Guta A. Covid-19 Vaccine Hesitancy and Under-Vaccination among Marginalized Populations in the United States and Canada: A Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01882-1. [PMID: 38117443 DOI: 10.1007/s40615-023-01882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of Covid-19 VH and under-vaccination among marginalized populations in the U.S. and Canada. METHODS Using the scoping review methodology developed by the Joanna Briggs Institute, we designed a search string and explored 7 databases to identify peer-reviewed articles published from January 1, 2020-October 25, 2022. We combine frequency analysis and narrative synthesis to describe factors influencing Covid-19 VH and under-vaccination among marginalized populations. RESULTS The search captured 11,374 non-duplicated records, scoped to 103 peer-reviewed articles. Among 14 marginalized populations identified, African American/Black, Latinx, LGBTQ+, American Indian/Indigenous, people with disabilities, and justice-involved people were the predominant focus. Thirty-two factors emerged as influencing Covid-19 VH, with structural racism/stigma and institutional mistrust (structural)(n = 71) most prevalent, followed by vaccine safety (vaccine-specific)(n = 62), side effects (vaccine-specific)(n = 50), trust in individual healthcare provider (social/community)(n = 38), and perceived risk of infection (individual)(n = 33). Structural factors predominated across populations, including structural racism/stigma and institutional mistrust, barriers to Covid-19 vaccine access due to limited supply/availability, distance/lack of transportation, no/low paid sick days, low internet/digital technology access, and lack of culturally- and linguistically-appropriate information. DISCUSSION We identified multilevel and complex drivers of Covid-19 under-vaccination among marginalized populations. Distinguishing vaccine-specific, individual, and social/community factors that may fuel decisional ambivalence, more appropriately defined as VH, from structural racism/structural stigma and systemic/institutional barriers to vaccination access may better support evidence-informed interventions to promote equity in access to vaccines and informed decision-making among marginalized populations.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Duy A Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kate Allan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Sophia Fantus
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | - Luke Reid
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor, ON, Canada
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Młoźniak I, Zwierczyk U, Rzepecka E, Kobryn M, Wilk M, Duplaga M. Manifestation of Health Denialism in Attitudes toward COVID-19 Vaccination: A Qualitative Study. Vaccines (Basel) 2023; 11:1822. [PMID: 38140226 PMCID: PMC10747861 DOI: 10.3390/vaccines11121822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Science denialism is characterized by the refusal to accept existing consensus and available evidence. Typical strategies denialists employ include spreading conspiracies, selective use of information, relying on fake experts, or general fallacies in logic. A flood of misinformation, fake news, and conspiracy theories accompanied the COVID-19 pandemic. Simultaneously, it was a subject of many denialistic opinions, from denying the existence of the epidemic challenge to claims that questioned the safety and effectiveness of the COVID-19 vaccines. This study's main aim was to assess the manifestations of denialism in attitudes toward the preventive measures recommended during the pandemic, with a special focus on vaccination. In-depth interviews were conducted with fifty representatives of the general population, demonstrating diversified opinions about COVID-19 vaccines and other preventive behaviors. The interviews were performed face to face in participants' houses or at other places they identified as convenient. Some of the interviewees preferred to do the interview via teleconference. The interviews were carried out from November 2022 to March 2023. The interviewees were recruited initially by convenience, and in further stages, the snowball technique was used. The interviewees were residents of four main administrative districts in Poland. Out of 50 participants, 26 were males, 29 were between 18-40, 16 were inhabitants of rural areas, and 28 had a university level of education. The interviews were based on a semi-structured guide that addressed, in addition to views about the origin of the new coronavirus, respondents' attitudes toward vaccination and sanitary recommendation, the health status of interviewees, their use of healthcare services, and their health behaviors. The interviews were transcribed and analyzed with MAXQDA Analytics Pro 2022 software (Release 22.7.0). Thematic analysis (TA) was applied to the content generated from the interviews. Based on the uptake of the COVID-19 vaccine, the participants were divided into three groups: unvaccinated, hesitant, and vaccinated (18, 4, and 28 interviewees, respectively). The main themes were established based on the TA of the interviews: attitudes toward COVID-19 vaccination, perception of sources of information, and the origin of the new coronavirus. The first theme decidedly drew the greatest attention of the interviewees. There was also a clear relationship between vaccination status and the presence of denialist thinking among interviewees. Interestingly, the role of experts as a key source of information about the pandemic was underlined by study participants. However, the criteria for being an expert differed. The subject of the origin of a new coronavirus was not interesting to interviewees. The analysis of the adherence to preventive measures revealed an interplay of diversified attitudes and motivations. Individuals presenting denialist views most frequently abstained from COVID-19 vaccination. However, such views were also present among those who hesitated or even among those who had been vaccinated. Furthermore, denialism was only one of the determinants of adherence to preventive measures.
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Affiliation(s)
- Iwona Młoźniak
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland; (I.M.); (U.Z.); (M.K.); (M.W.)
| | - Urszula Zwierczyk
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland; (I.M.); (U.Z.); (M.K.); (M.W.)
| | - Elżbieta Rzepecka
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland;
| | - Mateusz Kobryn
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland; (I.M.); (U.Z.); (M.K.); (M.W.)
| | - Marta Wilk
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland; (I.M.); (U.Z.); (M.K.); (M.W.)
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland; (I.M.); (U.Z.); (M.K.); (M.W.)
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10
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Sánchez-Recio R, Samper-Pardo M, Llopis-Lambán R, Oliván-Blázquez B, Cerdan-Bernad M, Magallón-Botaya R. Self-rated health impact of COVID 19 confinement on inmates in Southeastern of Europe: a qualitative study. BMC Public Health 2023; 23:2183. [PMID: 37936162 PMCID: PMC10631134 DOI: 10.1186/s12889-023-17088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic necessitated the implementation of various measures within closed institutions like prisons to control the spread of the virus. Analyzing the impact of these measures on the health of inmates is crucial from a public health perspective. This study aimed to explore inmates' subjective perception of the COVID-19 lockdown, the implemented measures, their physical self-perception, and their views on the vaccination process. METHOD Between April 2021 and January 2022, 27 semi-structured individual interviews and 1 focus group were conducted with inmates in a prison located in northwest Spain. The interviews were conducted in person and audio-recorded. Thematic content analysis was employed, utilizing methodological triangulation to enhance the coherence and rigor of the results. RESULTS The analysis revealed two main themes and nine subthemes. The first theme focused on inmates' perception of the implementation of protective measures against COVID-19 within the prison and its impact on their well-being. The second theme explored the pandemic's emotional impact on inmates. All participants reported negative consequences on their health resulting from the measures implemented by the institution to contain the pandemic. However, they acknowledged that measures like lockdowns and mass vaccination helped mitigate the spread of the virus within the prison, contrary to initial expectations. CONCLUSION COVID-19 and related measures have directly affected the health of inmates. To improve their health and minimize the impact of pandemic-induced changes, community participation and empowerment of individuals are essential tools, particularly within closed institutions such as prisons.
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Affiliation(s)
- Raquel Sánchez-Recio
- Research Group on Health Services in Aragon (GRISSA), Department of Preventive Medicine and Public Health, Faculty of Social and Labor Sciences, University of Zaragoza, C/ Violante de Hungría (23), Zaragoza, 50009, Spain
- Institute for Health Research in Aragon (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain
- Zaragoza Penitentiary Center, Autovía A-23, Km, 328, Zaragoza, Spain
| | - Mario Samper-Pardo
- Department of medicine, Facultad de Medicina Edificio A, University of Zaragoza, Zaragoza, 5009, Spain
| | | | - Bárbara Oliván-Blázquez
- Institute for Health Research in Aragon (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain.
- Department of Psychology and Sociology, University of Zaragoza, Calle de Violante de Hungría, 23, Zaragoza, 2009, Spain.
| | | | - Rosa Magallón-Botaya
- Institute for Health Research in Aragon (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain
- Department of medicine, Facultad de Medicina Edificio A, University of Zaragoza, Zaragoza, 5009, Spain
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11
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Bright AM, Higgins A, Grealish A. Nursing in a prison context: A focused mapping review and synthesis of international nursing literature. J Adv Nurs 2023; 79:4127-4136. [PMID: 37350161 DOI: 10.1111/jan.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/12/2023] [Accepted: 06/10/2023] [Indexed: 06/24/2023]
Abstract
AIM To provide a snapshot of the extent to which nursing and the prison context features in non-specialist/generic nursing journals. DESIGN Focused mapping review and synthesis. METHODS Relevant articles were examined for the extent to which they featured nursing and the prison context. A descriptive and contextual analysis of the data was carried out to provide a topography and synthesis of the key trends identified. DATA SOURCES Articles meeting criteria for nursing and the prison context in relevant non-specialized, generic nursing journals (n = 7) from January 2018 to December 2022. RESULTS Four thousand, nine hundred and twelve (n = 4912) articles were published during the review period of which (n = 14) met inclusion criteria. The key trends identified are presented under three headings: taking an advocacy approach for better health and well-being, examining self-determination and autonomy in prison populations and nursing in the prison context. CONCLUSION Nursing and the prison context features in non-specialized and generic nursing journals but sparsely and infrequently. There is a need for greater visibility of nursing and the prison context in nursing journals to help reduce stigma and marginalization of those working and those detained in prison. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE Nurses working in prison environments often manage extremely complex care needs. It is necessary to feature all nursing care environments in nursing journals so as to increase visibility and to act as a source of education for all. IMPACT (WHAT PROBLEM DID THE STUDY ADDRESS? MAIN FINDINGS? WHERE/WHOM WILL THE RESEARCH HAVE IMPACT ON): The findings of this review will have impact on all nurses engaged in practice and research as it highlights the extent to which nursing in a prison context is featured in non-specialized nursing journals and also speaks to the challenges faced by those working and detained in prison. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. This was a review of existing literature.
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Affiliation(s)
- Ann-Marie Bright
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Annmarie Grealish
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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12
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Martin P, Martin R, DeBritz AA, Kang AW. COVID-19 vaccination in correctional systems in the United States. J Public Health Policy 2023; 44:477-488. [PMID: 37542149 DOI: 10.1057/s41271-023-00426-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 08/06/2023]
Abstract
Overcrowding and limited ability to social distance contribute to high rates of COVID-19 outbreaks in correctional facilities. Despite the Centers for Disease Controls' recommendations, incarcerated persons and correctional staff report a high prevalence of vaccine-hesitance. We sought to identify reasons underlying COVID-19 vaccine hesitation and refusal in correctional systems. We used Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines to design the review. We searched PubMed abstracts and reviewed literature relevant to COVID-19 vaccine uptake and hesitancy in correctional systems of the United States (n = 23). Reasons for vaccine hesitancy among incarcerated people and correctional staff include efficacy, safety concerns, lack of information, and distrust. Findings reveal higher vaccine hesitancy among young and Black residents whereas facilities in close collaborations with state health departments exhibited higher vaccination rates. Correctional facilities must prioritize communication and education to improve the current state of vaccine hesitancy.
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Affiliation(s)
- Paige Martin
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Rosemarie Martin
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Audrey A DeBritz
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Augustine W Kang
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.
- Stanford University School of Medicine, Stanford, CA, USA.
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13
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Kollath-Cattano C, Hatteberg SJ, Petillo S, Giancaterini M. Correlates of and barriers to COVID-19 vaccine initiation and intention among US college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37437183 DOI: 10.1080/07448481.2023.2222843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/13/2023] [Accepted: 06/01/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE To examine correlates of and barriers to COVID-19 vaccine initiation and intention among college students. PARTICIPANTS 1,171 students attending a public university in the South. METHODS Multivariate logistic regression was used to assess the correlates of vaccine intention and initiation. Reasons for pursuing or foregoing vaccination were analyzed qualitatively using an inductive approach. RESULTS Among respondents, 44% had initiated vaccination, 38% intended to be vaccinated, and 18% were unsure about/unwilling to be vaccinated. Vaccine initiation and intention were both associated with 2019-2020 seasonal flu vaccination and political ideology, with conservative-leaning students having lower odds of vaccine initiation and of intention relative to liberal-leaning students. The most common reasons for vaccine initiation/intention and for vaccine hesitancy differed in frequency by political ideology. CONCLUSION The most effective vaccine promotion strategies may be those tailored to different social groups, virus-related beliefs/perceptions, and the specific concerns of vaccine hesitant students.
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Affiliation(s)
- Christy Kollath-Cattano
- Department of Health and Human Performance, College of Charleston, Charleston, South Carolina, USA
| | - Sarah J Hatteberg
- Department of Sociology and Anthropology, College of Charleston, Charleston, South Carolina, USA
| | - Samantha Petillo
- Department of Health and Human Performance, College of Charleston, Charleston, South Carolina, USA
| | - Morgan Giancaterini
- Department of Health and Human Performance, College of Charleston, Charleston, South Carolina, USA
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14
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Kramer C, Song M, Sufrin CB, Eber GB, Rubenstein LS, Saloner B. COVID-19 vaccination hesitancy and uptake: Perspectives from people released from the Federal Bureau of Prisons. Vaccine 2023; 41:1408-1417. [PMID: 36690558 PMCID: PMC9866228 DOI: 10.1016/j.vaccine.2023.01.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
People in United States (US) prisons and jails have been disproportionately impacted by the COVID-19 pandemic. This is due to challenges containing outbreaks in facilities and the high rates of health conditions that increase the risk of adverse outcomes. Vaccination is one strategy to disrupt COVID-19 transmission, but there are many factors impeding vaccination while in custody. We aimed to examine the perspectives of former residents in the Federal Bureau of Prisons (BOP) regarding COVID-19 vaccine hesitancy and acceptance. Between September-October 2021, we conducted semi-structured interviews with 21 recently released individuals who were incarcerated before and during COVID-19 and coded transcripts thematically. We assessed perceptions of the vaccine rollout and factors shaping vaccination uptake in custody and after release. The vaccine was available to seven participants in custody, of whom three were vaccinated. Interviewees had mixed attitudes about how vaccines were distributed, particularly with priority given to staff. Most were reluctant to get vaccinated in custody for varying reasons including observing staff declining to be vaccinated, lack of counseling to address specific questions about safety, and general lack of trust in the carceral system. By contrast, twelve got vaccinated post-release because of greater trust in community health care and stated they would not have done so while incarcerated. For residents in the BOP, COVID-19 vaccination was not simply a binary decision, instead they weighed the costs and benefits with most deciding against getting vaccinated. Institutions of incarceration must address these concerns to increase vaccine uptake as the pandemic continues.
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Affiliation(s)
- Camille Kramer
- Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, 4940 Eastern Ave., A101 Baltimore, MD 21224, USA.
| | - Minna Song
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA
| | - Carolyn B Sufrin
- Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, 4940 Eastern Ave., A101 Baltimore, MD 21224, USA; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD 21205, USA
| | - Gabriel B Eber
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, 624 N Broadway, Baltimore, MD 21205, USA
| | - Leonard S Rubenstein
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, 624 N Broadway, Baltimore, MD 21205, USA
| | - Brendan Saloner
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA
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15
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Riback LR, Dickson P, Ralph K, Saber LB, Devine R, Pett LA, Clausen AJ, Pluznik JA, Bowden CJ, Sarrett JC, Wurcel AG, Phillips VL, Spaulding AC, Akiyama MJ. Coping with COVID in corrections: a qualitative study among the recently incarcerated on infection control and the acceptability of wastewater-based surveillance. HEALTH & JUSTICE 2023; 11:5. [PMID: 36749465 PMCID: PMC9903258 DOI: 10.1186/s40352-023-00205-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Correctional settings are hotspots for SARS-CoV-2 transmission. Social and biological risk factors contribute to higher rates of COVID-19 morbidity and mortality among justice-involved individuals. Rapidly identifying new cases in congregate settings is essential to promote proper isolation and quarantine. We sought perspectives of individuals incarcerated during COVID-19 on how to improve carceral infection control and their perspectives on acceptability of wastewater-based surveillance (WBS) accompanying individual testing. METHODS We conducted semi-structured interviews with 20 adults who self-reported being incarcerated throughout the United States between March 2020 and May 2021. We asked participants about facility enforcement of the Centers for Disease Control and Prevention (CDC) COVID-19 guidelines, and acceptability of integrating WBS into SARS-CoV-2 monitoring strategies at their most recent facility. We used descriptive statistics to characterize the study sample and report on acceptability of WBS. We analyzed qualitative data thematically using an iterative process. RESULTS Participants were predominantly Black or multiple races (50%) and men (75%); 46 years old on average. Most received a mask during their most recent incarceration (90%), although only 40% received counseling on proper mask wearing. A quarter of participants were tested for SARS-CoV-2 at intake. Most (70%) believed they were exposed to the virus while incarcerated. Reoccurring themes included (1) Correctional facility environment leading to a sense of insecurity, (2) Perceptions that punitive conditions in correctional settings were exacerbated by the pandemic; (3) Importance of peers as a source of information about mitigation measures; (4) Perceptions that the safety of correctional environments differed from that of the community during the pandemic; and (5) WBS as a logical strategy, with most (68%) believing WBS would work in the last correctional facility they were in, and 79% preferred monitoring SARS-CoV-2 levels through WBS rather than relying on just individual testing. CONCLUSION Participants supported routine WBS to monitor for SARS-CoV-2. Integrating WBS into existing surveillance strategies at correctional facilities may minimize the impact of future COVID-19 outbreaks while conserving already constrained resources. To enhance the perception and reality that correctional systems are maximizing mitigation, future measures might include focusing on closer adherence to CDC recommendations and clarity about disease pathogenesis with residents.
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Affiliation(s)
- Lindsey R Riback
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
| | - Peter Dickson
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Keyanna Ralph
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lindsay B Saber
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rachel Devine
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lindsay A Pett
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Alyssa J Clausen
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jacob A Pluznik
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chava J Bowden
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer C Sarrett
- Center for the Study of Human Health, Emory University, Atlanta, GA, USA
| | | | | | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Matthew J Akiyama
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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16
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Cassarino N, Lodolo L, Smyth E, Ramaswamy M, Wurcel A. "The bottom line is that it is all about trust": Interviews with Health Services Administrators about perceived barriers and facilitators to vaccine administration in jails. J Clin Transl Sci 2023; 7:e50. [PMID: 37008613 PMCID: PMC10052395 DOI: 10.1017/cts.2022.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 01/24/2023] Open
Abstract
Background Compared to the general population, individuals incarcerated in jails and prisons are more vulnerable to infection and mortality from communicable diseases, such as COVID-19 and influenza. However, vaccination rates among incarcerated individuals as well as staff who work in jails and prisons remain disproportionately low. Healthcare administrators working in jails have first-hand experience about barriers to vaccine provision, but their perspectives are infrequently collected and analyzed. Methods We reached out to Health Services Administrators (HSAs) from all 14 Massachusetts (MA) county jails for qualitative in-depth interviews to understand how their personal and professional feelings about vaccination relate to the barriers and facilitators that surround administration of vaccines in jail. Results Eight people participated in the study (8/14 = 57% response rate). Key themes emerged, including 1) HSAs expressed divergent opinions on incarceration as the correct opportunity to vaccinate individuals, 2) HSAs' personal views on vaccines influenced their operationalization of vaccination in jail, and 3) opinions varied on whether their institutions' vaccine protocols needed modification. Conclusions Our findings highlight the critical need to leverage the feedback and influence of stakeholders such as HSAs in efforts to improve preventative healthcare delivery in carceral health systems.
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Affiliation(s)
| | - Laura Lodolo
- Tufts University School of Medicine, Boston, MA, USA
| | - Emma Smyth
- Department of Medicine, Division of Geographic Medicine, and Infectious Diseases, Tufts Medical Center, Boston, MA , USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Alysse Wurcel
- Tufts University School of Medicine, Boston, MA, USA
- Department of Medicine, Division of Geographic Medicine, and Infectious Diseases, Tufts Medical Center, Boston, MA , USA
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17
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González-Montalvo MDM, Dickson PF, Saber LB, Boehm RA, Phillips VL, Akiyama MJ, Spaulding AC. Opinions of former jail residents about self-collection of SARS-CoV-2 specimens, paired with wastewater surveillance: A qualitative study rapidly examining acceptability of COVID-19 mitigation measures. PLoS One 2023; 18:e0285364. [PMID: 37155633 PMCID: PMC10166543 DOI: 10.1371/journal.pone.0285364] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/21/2023] [Indexed: 05/10/2023] Open
Abstract
In year one of the COVID-19 epidemic, the incidence of infection for US carceral populations was 5.5-fold higher than that in the community. Prior to the rapid roll out of a comprehensive jail surveillance program of Wastewater-Based Surveillance (WBS) and individual testing for SARS-CoV-2, we sought the perspectives of formerly incarcerated individuals regarding mitigation strategies against COVID-19 to inform acceptability of the new program. In focus groups, participants discussed barriers to their receiving COVID-19 testing and vaccination. We introduced WBS and individual nasal self-testing, then queried if wastewater testing to improve surveillance of emerging outbreaks before case numbers surged, and specimen self-collection, would be valued. The participants' input gives insight into ways to improve the delivery of COVID-19 interventions. Hearing the voices of those with lived experiences of incarceration is critical to understanding their views on infection control strategies and supports including justice-involved individuals in decision-making processes regarding jail-based interventions.
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Affiliation(s)
| | - Peter F Dickson
- Department of Behavioral Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lindsay B Saber
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Rachel A Boehm
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Victoria L Phillips
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Matthew J Akiyama
- Department of Medicine, Montefiore Hospital, New York City, New York, United States of America
| | - Anne C Spaulding
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Department of Medicine, Emory School of Medicine, Atlanta, Georgia, United States of America
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18
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Shaw YP, Hustek S, Nguyen N, Starlin M, Wipfler K, Wallace BI, Michaud K. Rheumatic disease patient decision-making about COVID-19 vaccination: a qualitative analysis. BMC Rheumatol 2022; 6:76. [PMID: 36443813 PMCID: PMC9706890 DOI: 10.1186/s41927-022-00307-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although patients with rheumatic and musculoskeletal diseases (RMDs) are at increased risk for adverse outcomes of COVID-19 illness compared to healthy controls, they also have lower rates of willingness to be vaccinated. Previous research has identified reasons for vaccine hesitancy among patients with RMDs (such as concerns about side effects and flares), but little is known about what these reasons mean in the context of patients' lives, or how vaccine decision making is experienced from a patient perspective. Our objective was to describe decision-making about COVID-19 vaccination among RMD patients. METHODS Participants in a RMD registry were invited to complete monthly online surveys regarding COVID-19 vaccination from March-June 2021. We qualitatively analyzed comments from two open-ended survey questions reporting general experiences with vaccination and side effects. Comments were coded for attitudes towards COVID-19 vaccination, vaccine access, rheumatologic medication management around vaccination, and vaccine side effects. Themes were identified for the process and context of COVID-19 vaccine decisions, patient motivations for receiving or avoiding vaccination, and consistency of peri-vaccine medication management with current ACR guidelines. RESULTS We analyzed 710 comments from 537 respondents. Commenting respondents had a mean age of 64 years, were 87% female, 94% white, and 93% received/intended to receive ≥ 1 dose of a COVID-19 vaccine. Desire for protection and a return to normal routines motivated some commenters to get vaccinated, while concerns about vaccine side effects motivated others to delay or avoid vaccination. Several commenters reported disease flares following vaccination. Some commenters did not consult their providers about vaccination and failed to withhold immunomodulatory medications during vaccination, while others withheld medications more conservatively than recommended by current ACR guidelines, either on their own or directed by their provider. CONCLUSIONS While most commenters were vaccine-accepting, challenges to COVID-19 vaccine uptake in the RMD population may include fears of side effects, including worsened RMD symptoms, and perceptions that vaccination is unnecessary. Addressing these concerns and beliefs may be critical for promoting vaccination in this population.
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Affiliation(s)
- Yomei P Shaw
- FORWARD, The National Databank for Rheumatic Diseases, Wichita, KS, USA
| | - Sara Hustek
- University of Michigan Division of Rheumatology, Ann Arbor, MI, USA
| | - Nina Nguyen
- University of Michigan Division of Rheumatology, Ann Arbor, MI, USA
| | | | - Kristin Wipfler
- FORWARD, The National Databank for Rheumatic Diseases, Wichita, KS, USA
| | - Beth I Wallace
- University of Michigan Division of Rheumatology, Ann Arbor, MI, USA
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Kaleb Michaud
- FORWARD, The National Databank for Rheumatic Diseases, Wichita, KS, USA.
- University of Nebraska Medical Center, Omaha, NE, USA.
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19
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Williams S, Lee J, Halperin BA, Liao JM, Hsieh G, Reinecke K. Meta-summaries effective for improving awareness and understanding of COVID-19 vaccine safety research. Sci Rep 2022; 12:19987. [PMID: 36411340 PMCID: PMC9676710 DOI: 10.1038/s41598-022-24607-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022] Open
Abstract
Despite the efficacy, safety, and availability of COVID-19 vaccines, a lack of awareness and trust of vaccine safety research remains an important barrier to public health. The goal of this research was to design and test online meta-summaries-transparent, interactive summaries of the state of relevant studies-to improve people's awareness and opinion of vaccine safety research. We used insights from a set of co-design interviews (n = 22) to develop meta-summaries to highlight metascientific information about vaccine safety research. An experiment with 863 unvaccinated participants showed that our meta-summaries increased participants' perception of the amount, consistency, and direction of vaccine safety research relative to the U.S. Center for Disease Control (CDC) webpage, and that participants found them more trustworthy than the CDC page as well. They were also more likely to discuss it with others in the week following. We conclude that direct summaries of scientific research can be a useful communication tool for controversial scientific topics.
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Affiliation(s)
- Spencer Williams
- grid.34477.330000000122986657Department of Human-Centered Design and Engineering, University of Washington, Seattle, USA
| | - Joy Lee
- grid.34477.330000000122986657Department of Medicine, University of Washington, Seattle, USA
| | - Brett A. Halperin
- grid.34477.330000000122986657Department of Human-Centered Design and Engineering, University of Washington, Seattle, USA
| | - Joshua M. Liao
- grid.34477.330000000122986657Department of Medicine, University of Washington, Seattle, USA
| | - Gary Hsieh
- grid.34477.330000000122986657Department of Human-Centered Design and Engineering, University of Washington, Seattle, USA
| | - Katharina Reinecke
- grid.34477.330000000122986657Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, USA
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20
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Perrone C, Fiabane E, Maffoni M, Pierobon A, Setti I, Sommovigo V, Gabanelli P. Vaccination hesitancy: To be vaccinated, or not to be vaccinated, that is the question in the era of COVID-19. Public Health Nurs 2022; 40:90-96. [PMID: 36168152 PMCID: PMC9538072 DOI: 10.1111/phn.13134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/22/2022] [Accepted: 09/01/2022] [Indexed: 01/14/2023]
Abstract
COVID-19 vaccine hesitancy poses serious challenges in achieving adequate vaccine coverage in the general population. While most studies on vaccine hesitance determinants during the COVID-19 pandemic were quantitative, qualitative research on the reasons for vaccine resistance is still lacking. To fill this gap, this study aims to qualitatively investigate cognitive and emotional factors associated with COVID-19 vaccine hesitancy. This qualitative pilot study was conducted between October and November 2021 in Italy. A total of 40 COVID-19 vaccine-hesitant ("hesitant not vaccinated" or "hesitant but vaccinated") individuals completed anonymous questionnaires with open-ended questions. Data were analysed using the Interpretive Description approach. The central theme that emerged about vaccine hesitancy was the lack of control. This construct included four different sub-categories: distrust of the government, infodemic, influence of family, and general anti-vaccine opinions. The results also showed that the most important emotional and cognitive factors associated with hesitancy were anger related to a perceived sense of oppression; emotional avoidance to minimize risk; anxiety related to potential vaccine side effects. Identifying and understanding factors influencing COVID-19 vaccination hesitancy is crucial to improving communication strategies that will ultimately result in increased confidence and vaccine acceptance.
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Affiliation(s)
- Cecilia Perrone
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of Pavia InstitutePaviaItaly
| | - Elena Fiabane
- Istituti Clinici Scientifici MaugeriDepartment of Physical and Rehabilitation Medicine of Nervi InstituteGenovaItaly
| | - Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of MontescanoMontescanoItaly
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of MontescanoMontescanoItaly
| | - Ilaria Setti
- Department of Brain and Behavioural SciencesUnit of Applied PsychologyUniversity of PaviaPaviaItaly
| | - Valentina Sommovigo
- Department of PsychologyFaculty of Medicine and PsychologySapienza University of RomeRomaItaly
| | - Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCSPsychology Unit of Pavia InstitutePaviaItaly
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21
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Ismail N, Tavoschi L, Moazen B, Roselló A, Plugge E. COVID-19 vaccine for people who live and work in prisons worldwide: A scoping review. PLoS One 2022; 17:e0267070. [PMID: 36084037 PMCID: PMC9462803 DOI: 10.1371/journal.pone.0267070] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022] Open
Abstract
Overcrowding, poor conditions, and high population turnover make prisons highly susceptible to COVID-19. Vaccination is key to controlling COVID-19, yet there is disagreement regarding whether people who live and work in prisons should be prioritised in national vaccination programmes. To help resolve this, we critically examine the extent, nature, and quality of extant literature regarding prioritisation of COVID-19 vaccinations for people who live and work in prisons. Using a scoping review as our methodological framework, we conducted a systematic literature search of 17 databases. From 2,307 potentially eligible articles, we removed duplicates and screened titles and abstracts to retain 45 articles for review and quality appraisal. Findings indicated that while most countries recognise that prisons are at risk of high levels of COVID-19 transmission, only a minority have explicitly prioritised people who live and work in prisons for COVID-19 vaccination. Even among those that have, prioritisation criteria vary considerably. This is set against a backdrop of political barriers, such as politicians questioning the moral deservingness of people in prison; policy barriers, such as the absence of a unified international framework of how vaccine prioritisation should proceed in prisons; logistical barriers regarding vaccine administration in prisons; and behavioural barriers including vaccine hesitancy. We outline five strategies to prioritise people who live and work in prisons in COVID-19 vaccination plans: (1) improving data collection on COVID-19 vaccination, (2) reducing the number of people imprisoned, (3) tackling vaccine populism through advocacy, (4) challenging arbitrary prioritisation processes via legal processes, and (5) conducting more empirical research on COVID-19 vaccination planning, delivery, and acceptability. Implementing these strategies would help to reduce the impact of COVID-19 on the prison population, prevent community transmission, improve vaccine uptake in prisons beyond the current pandemic, foster political accountability, and inform future decision-making.
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Affiliation(s)
- Nasrul Ismail
- School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Babak Moazen
- Department of Health and Social Work, Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | | | - Emma Plugge
- UK Health Security Agency, London, United Kingdom
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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22
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Zhang H, Li Y, Peng S, Jiang Y, Jin H, Zhang F. The effect of health literacy on COVID-19 vaccine hesitancy among community population in China: The moderating role of stress. Vaccine 2022; 40:4473-4478. [PMID: 35710509 PMCID: PMC9174466 DOI: 10.1016/j.vaccine.2022.06.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 04/29/2022] [Accepted: 06/03/2022] [Indexed: 11/08/2022]
Abstract
Background The public’s hesitant attitude is a major subjective barrier in promoting vaccination against COVID-19 to build herd immunity. The current study aimed to address how individual factors such as health literacy and perceived stress affect people’s vaccine hesitancy of COVID-19 vaccine, and to provide insights for tailoring vaccine-promotion strategies. Methods With structured questionnaires, an online survey was conducted to address the relationship between the health literacy, perceived stress, and COVID-19 vaccine hesitancy among community population in mainland, China. Moderated analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of perceived stress. Results 560 responses were collected in total. 39.8% of the participants reported vaccine hesitancy, and this rate was higher among younger people and female. Moreover, people with higher level of health literacy showed reduced vaccine hesitancy, while this effect was only significant among those with low or moderate level of stress. For people with high level of stress, no significant effect of health literacy was found. Conclusions The findings suggest that increasing people’s health literacy could lead to reduced vaccine hesitancy in community sample. However, this effect disappeared when the stress level was high, suggesting other promotion services may need to be developed to increase the acceptance of COVID-19 vaccine. In conclusion, vaccine promotion strategies should be tailored for different populations, with taking account of individual’s health literacy and perceived stress.
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Affiliation(s)
- Huiqiao Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Yue Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Sihui Peng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China; Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Yue Jiang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Huihui Jin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China; Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China; Jinan University-BioKangtai Vaccine Institute, Jinan University, Guangzhou City, Guangdong Province, China.
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23
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Perceptions of and hesitancy toward COVID-19 vaccination in older Chinese adults in Hong Kong: a qualitative study. BMC Geriatr 2022; 22:288. [PMID: 35387602 PMCID: PMC8985396 DOI: 10.1186/s12877-022-03000-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/29/2022] [Indexed: 01/20/2023] Open
Abstract
Background COVID-19 vaccination is recommended for older adults by the World Health Organization. However, by July 15, 2021, only 26% of individuals over 60 years old in Hong Kong had received a first dose of the vaccine. The health belief model and the theory of planned behavior have been used to understand the determinants for COVID-19 vaccination in past literature. However, vaccination determinants can be complex and involve social and cultural factors that cannot be explained by micro-individual factors alone; hence, the health belief model and the theory of planned behavior cannot provide a complete understanding of vaccine hesitancy. Few studies on the barriers to, hesitancy toward, and motivations for COVID-19 vaccination among older Chinese adults have been performed. The aim of this study is to fill this gap by conducting a comprehensive analysis of this subject using the critical medical anthropology framework, extending the health belief model and the theory of planned behavior in understanding vaccination determinants among the older adult population. Methods Between November 2020 and February 2021, 31 adults (24 women and 7 men) over the age of 65 took part in semi-structured, one-on-one interviews. The data we gathered were then analyzed through a phenomenological approach. Results Two major themes in the data were examined: barriers to vaccination and motivations for vaccination. The participants’ perceptions of and hesitancy toward vaccination demonstrated a confluence of factors at the individual (trust, confidence, and social support networks), microsocial (stigma toward health care workers), intermediate-social (government), and macrosocial (cultural stereotypes, civic and collective responsibility, and economic considerations) levels according to the critical medical anthropology framework. Conclusions The decision to receive a COVID-19 vaccination is a complex consideration for older adults of low socioeconomic status in Hong Kong. Using the critical medical anthropology framework, the decision-making experience is a reflection of the interaction of factors at different layers of social levels. The findings of this study extend the health belief model and the theory of planned behavior regarding the understanding of vaccination perceptions and relevant behaviors in an older adult population.
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24
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Lessard D, Ortiz-Paredes D, Park H, Varsaneux O, Worthington J, Basta NE, MacDonald SE, Lebouché B, Cox J, Ismail SJ, Kronfli N. Barriers and facilitators to COVID-19 vaccine acceptability among people incarcerated in Canadian federal prisons: A qualitative study. Vaccine X 2022; 10:100150. [PMID: 35243324 PMCID: PMC8883835 DOI: 10.1016/j.jvacx.2022.100150] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/24/2022] [Accepted: 02/16/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Canadian correctional institutions have been prioritized for COVID-19 vaccination given the multiple outbreaks that have occurred since the start of the pandemic. Given historically low vaccine uptake, we aimed to explore barriers and facilitators to COVID-19 vaccination acceptability among people incarcerated in federal prisons. METHODS Three federal prisons in Quebec, Ontario, and British Columbia (Canada) were chosen based on previously low influenza vaccine uptake among those incarcerated. Using a qualitative design, semi-structured interviews were conducted with a diverse sample (gender, age, and ethnicity) of incarcerated people. An inductive-deductive analysis of audio-recorded interview transcripts was conducted to identify and categorize barriers and facilitators within the Theoretical Domains Framework (TDF). RESULTS From March 22-29, 2021, a total of 15 participants (n = 5 per site; n = 5 women; median age = 43 years) were interviewed, including five First Nations people and six people from other minority groups. Eleven (73%) expressed a desire to receive a COVID-19 vaccine, including two who previously refused influenza vaccination. We identified five thematic barriers across three TDF domains: social influences (receiving strict recommendations, believing in conspiracies to harm), beliefs about consequences (believing that infection control measures will not be fully lifted, concerns with vaccine-related side effects), and knowledge (lack of vaccine-specific information), and eight thematic facilitators across five TDF domains: environmental context and resources (perceiving correctional employees as sources of outbreaks, perceiving challenges to prevention measures), social influences (receiving recommendations from trusted individuals), beliefs about consequences (seeking individual and collective protection, believing in a collective "return to normal", believing in individual privileges), knowledge (reassurance about vaccine outcomes), and emotions (having experienced COVID-19-related stress). CONCLUSIONS Lack of information and misinformation were important barriers to COVID-19 vaccine acceptability among people incarcerated in Canadian federal prisons. This suggests that educational interventions, delivered by trusted health care providers, may improve COVID-19 vaccine uptake going forward.
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Affiliation(s)
- David Lessard
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trial in HIV, Research Institute of the McGill University Health Centre, Canada
| | - David Ortiz-Paredes
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
| | - Hyejin Park
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
| | | | | | - Nicole E. Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University of Alberta, Canada
- School of Public Health, University of Alberta, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trial in HIV, Research Institute of the McGill University Health Centre, Canada
- Department of Family Medicine, McGill University, Canada
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Canada
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Canada
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Canada
| | - Shainoor J. Ismail
- Division of Immunization Programs and Pandemic Preparedness, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Canada
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Canada
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25
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Hamilton K, Hagger MS. The Vaccination Concerns in COVID-19 Scale (VaCCS): Development and validation. PLoS One 2022; 17:e0264784. [PMID: 35286331 PMCID: PMC8920277 DOI: 10.1371/journal.pone.0264784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/16/2022] [Indexed: 01/01/2023] Open
Abstract
Vaccines are highly effective in minimizing serious cases of COVID-19 and pivotal to managing the COVID-19 pandemic. Despite widespread availability, vaccination rates fall short of levels required to bring about widespread immunity, with low rates attributed to vaccine hesitancy. It is therefore important to identify the beliefs and concerns associated with vaccine intentions and uptake. The present study aimed to develop and validate, using the AMEE Guide, the Vaccination Concerns in COVID-19 Scale (VaCCS), a comprehensive measure of beliefs and concerns with respect to COVID-19 vaccines. In the scale development phase, samples of Australian (N = 53) and USA (N = 48) residents completed an initial open-response survey to elicit beliefs and concerns about COVID-19 vaccines. A concurrent rapid literature review was conducted to identify content from existing scales on vaccination beliefs. An initial pool of items was developed informed by the survey responses and rapid review. The readability and face validity of the item pool was assessed by behavioral science experts (N = 5) and non-experts (N = 10). In the scale validation phase, samples of Australian (N = 522) and USA (N = 499) residents completed scaled versions of the final item pool and measures of socio-political, health beliefs and outcomes, and trait measures. Exploratory factor analysis yielded a scale comprising 35 items with 8 subscales, and subsequent confirmatory factor analyses indicated acceptable fit of the scale structure with the data in each sample and factorial invariance across samples. Concurrent and predictive validity tests indicated a theoretically and conceptually predictable pattern of relations between the VaCCS subscales with the socio-political, health beliefs and outcomes, and trait measures, and key subscales predicted intentions to receive the COVID-19 vaccine. The VaCCS provides a novel measure to assess beliefs and concerns toward COVID-19 vaccination that researchers and practitioners can use in its entirety or select specific sub-scales to use according to their needs.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Health Sciences Research Institute, University of California, Merced, California, United States of America
| | - Martin S Hagger
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Health Sciences Research Institute, University of California, Merced, California, United States of America
- Psychological Sciences, University of California, Merced, California, United States of America
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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26
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Ortiz-Paredes D, Varsaneux O, Worthington J, Park H, MacDonald SE, Basta NE, Lebouché B, Cox J, Ismail SJ, Kronfli N. Reasons for COVID-19 vaccine refusal among people incarcerated in Canadian federal prisons. PLoS One 2022; 17:e0264145. [PMID: 35263350 PMCID: PMC8906611 DOI: 10.1371/journal.pone.0264145] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vaccine uptake rates have been historically low in correctional settings. To better understand vaccine hesitancy in these high-risk settings, we explored reasons for COVID-19 vaccine refusal among people in federal prisons. METHODS Three maximum security all-male federal prisons in British Columbia, Alberta, and Ontario (Canada) were chosen, representing prisons with the highest proportions of COVID-19 vaccine refusal. Using a qualitative descriptive design and purposive sampling, individual semi-structured interviews were conducted with incarcerated people who had previously refused at least one COVID-19 vaccine until data saturation was achieved. An inductive-deductive thematic analysis of audio-recorded interview transcripts was conducted using the Conceptual Model of Vaccine Hesitancy. RESULTS Between May 19-July 8, 2021, 14 participants were interviewed (median age: 30 years; n = 7 Indigenous, n = 4 visible minority, n = 3 White). Individual-, interpersonal-, and system-level factors were identified. Three were particularly relevant to the correctional setting: 1) Risk perception: participants perceived that they were at lower risk of COVID-19 due to restricted visits and interactions; 2) Health care services in prison: participants reported feeling "punished" and stigmatized due to strict COVID-19 restrictions, and failed to identify personal benefits of vaccination due to the lack of incentives; 3) Universal distrust: participants expressed distrust in prison employees, including health care providers. INTERPRETATION Reasons for vaccine refusal among people in prison are multifaceted. Educational interventions could seek to address COVID-19 risk misconceptions in prison settings. However, impact may be limited if trust is not fostered and if incentives are not considered in vaccine promotion.
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Affiliation(s)
- David Ortiz-Paredes
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Hyejin Park
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nicole E. Basta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Shainoor J. Ismail
- Division of Immunization Programs and Pandemic Preparedness, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Metro City Medical Clinic, Edmonton, Alberta, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
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27
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Wang Y, Liu Y. Multilevel determinants of COVID-19 vaccination hesitancy in the United States: A rapid systematic review. Prev Med Rep 2022; 25:101673. [PMID: 34934611 PMCID: PMC8675390 DOI: 10.1016/j.pmedr.2021.101673] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/05/2021] [Accepted: 12/12/2021] [Indexed: 01/10/2023] Open
Abstract
Vaccine hesitancy is a challenge for the success and optimal implementation of COVID-19 immunization programs in the US. The objective of this study was to summarize multilevel determinants of COVID-19 vaccination intention in the US to inform future intervention opportunities. To this end, we conducted a rapid systematic review by searching published articles via PubMed published by October 5, 2021, following the PRISMA guidelines. One hundred and six articles were included. According to nationally representative studies, the overall COVID-19 acceptance rate ranges from 53.6% to 84.4%. Individual (demographics, health history, behaviors and health beliefs), interpersonal (having a close friend/family member impacted by COVID-19), healthcare and societal level factors (healthcare provider recommendations, source/credential of COVID-19 related information, and COVID-19 related conspiracy theories) all contributed to COVID-19 vaccine hesitancy in the US. This study demonstrates that the acceptance to COVID-19 vaccines is influenced by various factors, particularly the role of healthcare providers in enhancing public intent to vaccination. Potential interventions to mitigate people's concerns over the vaccines and address vaccine-related conspiracy/misinformation from social media are also critical to encourage vaccine uptake in the US.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, BOX 420644, Rochester, NY 14642, USA
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, BOX 420644, Rochester, NY 14642, USA
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28
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Yasmin F, Najeeb H, Moeed A, Naeem U, Asghar MS, Chughtai NU, Yousaf Z, Seboka BT, Ullah I, Lin CY, Pakpour AH. COVID-19 Vaccine Hesitancy in the United States: A Systematic Review. Front Public Health 2021; 9:770985. [PMID: 34888288 PMCID: PMC8650625 DOI: 10.3389/fpubh.2021.770985] [Citation(s) in RCA: 176] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
Vaccine hesitancy in the US throughout the pandemic has revealed inconsistent results. This systematic review has compared COVID-19 vaccine uptake across US and investigated predictors of vaccine hesitancy and acceptance across different groups. A search of PUBMED database was conducted till 17th July, 2021. Articles that met the inclusion criteria were screened and 65 studies were selected for a quantitative analysis. The overall vaccine acceptance rate ranged from 12 to 91.4%, the willingness of studies using the 10-point scale ranged from 3.58 to 5.12. Increased unwillingness toward COVID-19 vaccine and Black/African Americans were found to be correlated. Sex, race, age, education level, and income status were identified as determining factors of having a low or high COVID-19 vaccine uptake. A change in vaccine acceptance in the US population was observed in two studies, an increase of 10.8 and 7.4%, respectively, between 2020 and 2021. Our results confirm that hesitancy exists in the US population, highest in Black/African Americans, pregnant or breastfeeding women, and low in the male sex. It is imperative for regulatory bodies to acknowledge these statistics and consequently, exert efforts to mitigate the burden of unvaccinated individuals and revise vaccine delivery plans, according to different vulnerable subgroups, across the country.
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Affiliation(s)
- Farah Yasmin
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hala Najeeb
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdul Moeed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Unaiza Naeem
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Najeeb Ullah Chughtai
- Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Zohaib Yousaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Irfan Ullah
- Department of Community Medicine, Kabir Medical College, Peshawar, Pakistan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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