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Basholli FM, Berisha M, Scherzer M, Humolli I, Ramadani N, Habersaat KB, Kiss Z. "Using behavioral insights to inform the COVID-19 vaccine response in Kosovo [1]: Population perceptions and interventions". PEC INNOVATION 2024; 4:100279. [PMID: 38590340 PMCID: PMC11000163 DOI: 10.1016/j.pecinn.2024.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/23/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Objective Understand population perceptions in Kosovo[1] regarding COVID-19 vaccination to inform the pandemic response. Methods Five rounds of a cross-sectional survey in representative samples of adults during 2020-2021. Analysis includes descriptive statistics, hierarchical cluster analysis, segmentation and logistic regressions. Results Self-reported intention to vaccinate increased after the introduction of COVID-19 vaccines in Kosovo.[1] In less than one year, vaccination intentions increased from 36% to 66% of those unvaccinated. Predictors for vaccine intentions included gender, age, trust in health authorities. Segmentation analysis identified population segments that had high vaccine nintentions but low uptake, informing messages and campaign initiatives designed to translate intentions into behavior. Conclusion Identifying people's perceptions and behavior is essential to support evidence-based policy making, especially during outbreak response. Innovation BI is an innovative focus of research in Kosovo [1] where little BI data had been collected prior, and provided a unique understanding of population views, attitudes and behaviors related to COVID-19. These findings were not only essential for an evidence-based pandemic response but also laid the foundation for future broad application of BI to inform interventions that seek to enable, support and promote health-related behaviurs in Kosovo[1].
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Affiliation(s)
- Florie Miftari Basholli
- Medical Faculty, University of Pristina, Pristina, Kosovo
- Institute of Public Health of Kosovo, Pristina, Kosovo
| | - Merita Berisha
- Medical Faculty, University of Pristina, Pristina, Kosovo
- Institute of Public Health of Kosovo, Pristina, Kosovo
| | | | | | - Naser Ramadani
- Medical Faculty, University of Pristina, Pristina, Kosovo
- Institute of Public Health of Kosovo, Pristina, Kosovo
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Saville CWN, Mann R, Lockard AS, Bark-Connell A, Gabuljah SG, Young AM, Thomas DR. Covid and the common good: In-group out-group dynamics and Covid-19 vaccination in Wales and the United States. Soc Sci Med 2024; 352:117022. [PMID: 38850676 DOI: 10.1016/j.socscimed.2024.117022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
Vaccination is a social act, where benefits spill-over to third parties. How we approach such social decisions is influenced by whether likely beneficiaries share salient social identities with us. This study explores these dynamics using representative survey data from two contexts: national identity groups in Wales (N = 4187) and political partisans in America (N = 4864). In both cases, those in the minority in their local area were less likely to be vaccinated. In Wales, respondents who did not identify as Welsh were less likely to be vaccinated the greater the proportion of residents of their local area identified as Welsh. In America, the vaccination rate of Biden voters fell off more steeply than that of Trump voters as the proportion of Trump voters in their county increased. Results are robust to controlling for likely confounds and sensitivity analyses. In-group out-group dynamics help to shape important health decisions.
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Affiliation(s)
| | - Robin Mann
- School of History, Law, and Social Sciences, Bangor University, UK
| | | | | | | | - April M Young
- College of Public Health, University of Kentucky, USA
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Szászi ÁJ, Bíró-Nagy A. Controversies of COVID-19 vaccine promotion: lessons of three randomised survey experiments from Hungary. Public Health 2024; 229:192-200. [PMID: 38457939 DOI: 10.1016/j.puhe.2024.01.030] [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] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This study aimed to investigate vaccine promotion messages, examine the heterogeneous effects of these messages and provide experimental evidence to help evaluate the efficiency of COVID-19 vaccine promotion campaigns in Hungary. STUDY DESIGN This study presents the results of three randomised survey experiments that were embedded in cross-sectional, representative, public opinion studies of Hungarian adults based on in-person interviews. Simple randomisation and blinding were applied to assign participants into the control group (no message) or treatment groups (vaccine promotion messages). METHODS The first experiment (March 2021) aimed to test vaccination promotion messages from politicians (N = 331) and medical experts (N = 342) by comparing experimental groups' trust in vaccines and conspiratorial beliefs with the control group (N = 327). The second experiment (September 2022) tested the impact of two communication strategies ([1] highlighting the safety and effectiveness of vaccines, N = 104; and [2] highlighting the wide variety of vaccines available, N = 110) on increasing vaccine uptake among those who were still unvaccinated (control group, N = 89). The third experiment (September 2022) tested one message aiming to increase COVID-19 booster uptake among those who received only the first round of vaccination (N = 172; control group, N = 169). The outcome variable in the second and third experiments was intent to get vaccinated. Robust regressions, logit models, Mann-Whitney U-tests and model-based recursive partitioning were run. The inference criteria (p < 0.05) was set in pre-registration of the experiments. RESULTS All treatment effects were insignificant, but exploratory research found significant conditional treatment effects. Exposure to vaccine promotion by medical professionals was associated with a higher level of trust in Russian and Chinese COVID-19 vaccines in older age cohorts (weighted robust regressions, 50-59 years old, Russian vaccine: +0.769, interaction term [i.t.] p = 0.010; Chinese vaccine: +0.326, i.t. p = 0.044; and ≥60 years old, Russian vaccine +0.183, i.t. p = 0.040; Chinese vaccine +0.559, i.t. p = 0.010) and with a lower level of trust in these vaccines among younger adults (<30 years old, Russian vaccine: -1.236, i.t. p = 0.023; Chinese vaccine: -1.281, i.t. p = 0.022). Receiving a vaccine promotion message from politicians led to a higher level of trust in Chinese vaccines among the oldest respondents (≥60 years: +0.634, i.t. p = 0.035). CONCLUSIONS Short-term persuasion attempts that aimed to convince respondents about COVID-19 vaccination were ineffective. Booster hesitancy, similar to primary vaccine hesitancy, was resistant to vaccine promotion messages. Significant conditional effects suggest that COVID-19 vaccine promotion by medical experts and politicians may have had adverse effects for some demographic groups in Hungary.
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Affiliation(s)
- Á J Szászi
- HUN-REN Centre for Social Sciences, Institute for Political Science, Budapest, 1097, Tóth Kálmán u. 4., Hungary.
| | - A Bíró-Nagy
- HUN-REN Centre for Social Sciences, Institute for Political Science, Budapest, 1097, Tóth Kálmán u. 4., Hungary.
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Abebe D, Mengistu T, Demssie EA, Mesfin S. Corona virus vaccine hesitancy among higher education students in Adama City, Oromia, Ethiopia. Front Public Health 2024; 12:1364225. [PMID: 38590806 PMCID: PMC10999607 DOI: 10.3389/fpubh.2024.1364225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
Background Vaccination stands as the most efficient approach for managing the continued transmission of infections and preventing the emergence of novel variants. Coronavirus disease 2019 (COVID-19) vaccine hesitancy poses a significant burden in the fight to achieve herd immunity. Methods A cross-sectional study, based on institutional parameters, was conducted among a cohort of 530 higher education students, selected via a simple random sampling method. Study participants were selected using a systematic random sampling technique from February to March 2022. Structured questionnaire data were gathered and subsequently analyzed using SPSS version 21. The strength of the association between various factors and COVID-19 vaccine hesitancy was assessed using the odds ratio along with its 95% confidence interval. Statistical significance was deemed to be present at a p-value of < 0.05. Result The prevalence of coronavirus vaccine hesitancy was 47.5%. The factors that were found to be significantly associated with COVID-19 vaccine hesitancy were residential address (AOR = 2.398, 95% CI: 1.476-3.896); agreeing with leaders and groups that do not support COVID-19 vaccination (AOR = 2.292, 95% CI: 1.418-3.704); coming from a community whose leaders support COVID-19 vaccination for young adults (AOR = 0.598, 95% CI: 0.381-0.940), and believing that COVID-19 vaccines are safe (AOR = 0.343,95% CI: 0.168-0.701). Conclusion Approximately five out of 10 students who participated in this study were hesitant to get vaccinated against coronavirus. Incorporating messages and initiatives into local plans to specifically target the factors identified in this study is imperative for substantially increasing the COVID-19 vaccine uptake among students in higher education institutions.
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Affiliation(s)
- Dawit Abebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Tewodros Mengistu
- Department of Public Health, Adama General Hospital and Medical College, Adama, Ethiopia
| | - Enku Afework Demssie
- Department of Public Health, Adama General Hospital and Medical College, Adama, Ethiopia
| | - Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Nagase M. Factors associated with vaccine hesitancy against COVID-19 among adults in Europe: a descriptive study analysis applying socio-ecological framework. BMC Res Notes 2024; 17:84. [PMID: 38504304 PMCID: PMC10953226 DOI: 10.1186/s13104-024-06739-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/08/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE This study aimed to explore the factors associated with COVID-19 vaccine hesitancy in Europe among adults by using the Socio-Ecological Model. RESULTS This cross-sectional study used secondary data collected from respondents residing in 27 EU countries at the time of May 2021. The outcome was vaccine hesitancy against COVID-19, and the total sample size of 23,606 was analysed by binary logistic regression, as well as McKelvey and Zavonoia's R2. After adding each level of variables, the model found the significant and increased association with vaccine hesitancy in younger age groups (21-39 years and 40-60 years vs. 65 years+), who left full-time education at a young age (16-19 years), those with manual jobs, those with children at home, individuals residing in small towns, and beliefs related to the vaccine. Together, the levels explained 49.5% of the variance associated with vaccine hesitancy, and the addition to each variable layer increased the variance. This highlights the need to consider broad factors at multiple levels to enhance vaccine acceptance and uptake.
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Affiliation(s)
- Megumi Nagase
- Friede-Springer-Endowed Professorship for Global Child Health, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, Witten, Germany.
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Kumari G, Dey O. Can redistribution of vaccine improve global welfare? Lessons from COVID-19. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01665-9. [PMID: 38418652 DOI: 10.1007/s10198-023-01665-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/21/2023] [Indexed: 03/02/2024]
Abstract
The disparity in the distribution of COVID-19 vaccine has been recorded with more than 70% vaccination rate for high-income countries as compared to less than 40% for low-income countries. The low affordability of vaccines for the majority of low-income group invites the need for redistribution of vaccines. The disproportionate donation of vaccines across the globe motivates us to explore the incentive for the high-income group to redistribute. An exploratory analysis of cross-country COVID-19 vaccination distribution data shows that the countries which have received vaccines as donation has also contributed to vaccine wastage. This paper intends to provide a theoretical background for this counterintuitive observation using welfare analysis. We find that the market mechanism leads to a negative impact on global welfare due to redistribution. Only an invention with a defined redistribution mechanism may ensure an increase in global welfare. It is found that a critical value of redistribution mechanism reinforced by a minimum threshold level of income is essential to enhance welfare. The reduced form from the theoretical predictions is empirically validated with cross-country data on COVID-19 vaccination for all countries. As identified in theory, the internal support variables like political stability, government effectiveness, and health expenditure at the country level will impact global welfare. Therefore, when global cooperation is essential during a health crisis like COVID-19, improved internal coordination and intentions cannot be ignored.
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Affiliation(s)
- Gunjan Kumari
- Department of Economics, Indian Institute of Foreign Trade, Kolkata Campus, Kolkata, India
| | - Oindrila Dey
- Department of Economics, Indian Institute of Foreign Trade, Kolkata Campus, Kolkata, India.
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Veltri GA, Steinert JI, Sternberg H, Galizzi MM, Fasolo B, Kourtidis P, Büthe T, Gaskell G. Assessing the perceived effect of non-pharmaceutical interventions on SARS-Cov-2 transmission risk: an experimental study in Europe. Sci Rep 2024; 14:4857. [PMID: 38418636 PMCID: PMC10902314 DOI: 10.1038/s41598-024-55447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
We conduct a large (N = 6567) online experiment to measure the features of non-pharmaceutical interventions (NPIs) that citizens of six European countries perceive to lower the risk of transmission of SARS-Cov-2 the most. We collected data in Bulgaria (n = 1069), France (n = 1108), Poland (n = 1104), Italy (n = 1087), Spain (n = 1102) and Sweden (n = 1097). Based on the features of the most widely adopted public health guidelines to reduce SARS-Cov-2 transmission (mask wearing vs not, outdoor vs indoor contact, short vs 90 min meetings, few vs many people present, and physical distancing of 1 or 2 m), we conducted a discrete choice experiment (DCE) to estimate the public's perceived risk of SARS-CoV-2 transmission in scenarios that presented mutually exclusive constellations of these features. Our findings indicate that participants' perception of transmission risk was most influenced by the NPI attributes of mask-wearing and outdoor meetings and the least by NPI attributes that focus on physical distancing, meeting duration, and meeting size. Differentiating by country, gender, age, cognitive style (reflective or intuitive), and perceived freight of COVID-19 moreover allowed us to identify important differences between subgroups. Our findings highlight the importance of improving health policy communication and citizens' health literacy about the design of NPIs and the transmission risk of SARS-Cov-2 and potentially future viruses.
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Affiliation(s)
| | - Janina Isabel Steinert
- TUM School of Social Sciences and Technology & TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Henrike Sternberg
- TUM School of Social Sciences and Technology & TUM School of Management, Technical University of Munich, Munich, Germany
- Munich School of Politics and Public Policy & TUM School of Social Sciences and Technology & TUM School of Management, Technical University of Munich, Munich, Germany
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science and LSE Behavioural Lab, London School of Economics and Political Science, London, UK
| | - Barbara Fasolo
- Department of Management, London School of Economics and Political Science, London, UK
| | - Ploutarchos Kourtidis
- Department of Psychological and Behavioural Science and LSE Behavioural Lab, London School of Economics and Political Science, London, UK
| | - Tim Büthe
- TUM School of Social Sciences and Technology & TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Sanford School of Public Policy, Duke University, Durham, USA
| | - George Gaskell
- Department of Psychological and Behavioural Science and LSE Behavioural Lab, London School of Economics and Political Science, London, UK
- Department of Methodology, London School of Economics and Political Science, London, UK
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Gupta D, Rudisill C. Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination. HEALTH ECONOMICS REVIEW 2024; 14:16. [PMID: 38411764 DOI: 10.1186/s13561-024-00484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Time preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative health behavior timing in light of new health risks. Using the case of COVID-19, we examine factors affecting vaccination timing plans when vaccines were widely available in the European Union (EU). METHODS We use data from the Flash Eurobarometer 494 survey (May 21-26, 2021), which collected information on EU residents' attitudes towards COVID-19 vaccinations. We also use the 'Our World in Data' vaccination database for country-level COVID-19 vaccination rates. Probit regressions were conducted to determine how local vaccination rates, trust in information sources, social norms, vaccine safety beliefs, and risk understanding affected the probability of COVID-19 vaccination delay. RESULTS Of total participants (n = 26,106), 9,063 (34.7%) were vaccinated, 7,114 (27.3%) wanted to get vaccinated as soon as possible, 5,168 (19.8%) wanted to delay vaccination and 2,962 (11.4%) resisted vaccination. Participants were more likely to delay COVID-19 vaccination if they lived in a country with lower vaccination prevalence, trusted online social networks, family, friends, and colleagues for vaccination information, were eager to follow vaccination-related social norms, expressed vaccine safety concerns, and understood the risk of catching COVID-19 without a vaccine to be lower. CONCLUSIONS Results from the study contribute to understanding important factors that predict timing of vaccination plans. These findings can also contribute to the wider knowledge base about timing of preventive behavior uptake in novel risk contexts.
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Affiliation(s)
- Deeksha Gupta
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Felgendreff L, Siegers R, Otten L, Betsch C. Infographics on risks associated with COVID-19 and the willingness to get the AstraZeneca vaccine: two randomized online experiments. BMC Public Health 2024; 24:529. [PMID: 38378506 PMCID: PMC10880230 DOI: 10.1186/s12889-024-18057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Germans hesitated to get vaccinated with AstraZeneca in the COVID-19 pandemic after reports of blood clots. METHODS In two preregistered online experiments with stratified randomization (Study 1 N = 824, Study 2: N = 1,056), we tested whether providing evidence-based benefit-risk information reduces the perceived risk of the AstraZeneca vaccine and the perceived probability of blood clots due to the AstraZeneca vaccine and increases the vaccination intention. In Study 1, participants saw no infographic (control) or one of two infographics (low vs. high exposure risk varied by the underlying incidence rates). Study 2 additionally varied the infographic design displaying the risk information (presented as table, circle icons, or manikin-like icons). RESULTS The infographic decreased the risk perception of the vaccine compared to no infographic (Study 1: Cohens d = 0.31, 95% CI [0.14, 0.48]; Study 2: Cohens d = 0.34, 95% CI [0.06, 0.62]), but it did not influence the perceived probability of blood clots due to the AstraZeneca vaccine (Study 2: Cohens d = 0.05, 95% CI [-0.23, 0.33]). Also, the infographic design did not affect the perceived probability of blood clots (Study 2). The vaccination intention was not affected by viewing the infographic (Study 1: Cohens d = 0.04, 95% CI [-0.13, 0.21]; Study 2: Cohens d = 0.04, 95% CI [-0.24, 0.32]) nor the presented infection rate (Study 1: Cohens d = 0.07, 95% CI [-0.09, 0.24], Study 2: Cohens d = 0.01, 95% CI [-0.12, 0.15]) but by risk perceptions, sociodemographic characteristics, confidence in the AstraZeneca vaccine, and preference for alternative vaccines. CONCLUSIONS The evidence-based benefit-risk information helped putting the risk of vaccinations into perspective. Nevertheless, objective risk information alone did not affect vaccination intention that was low due to the preexisting lacking vaccine confidence.
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Affiliation(s)
- Lisa Felgendreff
- Institute for Planetary Health Behaviour, University of Erfurt, Nordhäuser Str. 63, Erfurt, 99089, Germany.
- Health Communication, BNITM Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
| | - Regina Siegers
- Data Literacy Project, Leibniz Institute for Educational Trajectories, Bamberg, Germany
| | - Leonie Otten
- Institute for Planetary Health Behaviour, University of Erfurt, Nordhäuser Str. 63, Erfurt, 99089, Germany
- Health Communication, BNITM Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cornelia Betsch
- Institute for Planetary Health Behaviour, University of Erfurt, Nordhäuser Str. 63, Erfurt, 99089, Germany
- Health Communication, BNITM Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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Robertson DA, Timmons S, Lunn PD. Behavioural evidence on COVID-19 vaccine uptake. Public Health 2024; 227:49-53. [PMID: 38104419 DOI: 10.1016/j.puhe.2023.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES The World Health Organization has declared that COVID-19 is no longer a public health emergency of international concern. Nevertheless, it remains a public health issue, and seasonal vaccinations, at the same time of year as influenza vaccinations, will be necessary. When the first vaccines were administered in 2020, decision-makers had to make assumptions about the best methods to communicate and administer vaccines to increase uptake. Now, a body of evidence can inform these decisions. STUDY DESIGN A narrative review written by three behavioural scientists who design research for policy. METHODS We searched the PubMed database for: (i) reviews of interventions to increase uptake of COVID-19 or influenza vaccines and (ii) empirical studies on uptake of COVID-19 and influenza vaccines. In addition, registered trials gathered by a Cochrane scoping review of interventions to increase uptake of COVID-19 vaccines were searched for updated results. RESULTS Results centre around two aspects of a vaccination campaign of interest to policymakers: communication and administration. Results suggest that communications highlighting the personal benefits of vaccination are likely to be more effective than those highlighting collective benefits. The efficacy of vaccination may be underestimated and stressing efficacy as a strong personal benefit may increase uptake. Keeping vaccines free, sending personalised messages, reminders and prebooked appointment times may also increase uptake. CONCLUSIONS There is now a body of evidence from behavioural science that suggests how vaccination campaigns for COVID-19 can be structured to increase uptake. These recommendations may be useful to policymakers considering seasonal vaccination campaigns and to researchers generating hypotheses for country-specific trials.
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Affiliation(s)
- D A Robertson
- Behavioural Research Unit, Economic and Social Research Institute, Dublin, Ireland; School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - S Timmons
- Behavioural Research Unit, Economic and Social Research Institute, Dublin, Ireland; School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - P D Lunn
- Behavioural Research Unit, Economic and Social Research Institute, Dublin, Ireland; Department of Economics, Trinity College Dublin, Dublin, Ireland
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Ferroni E, Gennaro N, Maifredi G, Leoni O, Profili F, Stasi C, Cacciani L, Calandrini E, di Napoli A, Petrelli A, Zorzi M. Access to SARS-CoV-2 vaccination in immigrants in Italy, by geographical area of origin. Vaccine 2024; 42:375-382. [PMID: 38097455 DOI: 10.1016/j.vaccine.2023.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/25/2023] [Accepted: 11/20/2023] [Indexed: 01/01/2024]
Abstract
OBJECTIVE Immigrants are commonly considered disadvantaged and at high risk of not receiving appropriate care, including vaccination. This study aimed to evaluate the access to SARS-CoV-2 vaccination in immigrants, by geographical area of origin, compared with Italian citizens. We also evaluated sex differences in vaccine's coverage by geographical area of origin. METHODS We performed a retrospective observational study in four Italian regions, including all resident subjects aged 5-69 years, and undergoing first dose SARS-CoV-2 vaccination in the period 28th December 2020- 3rd April 2022. We estimated cumulative coverage percentages, by age class and geographical area. To compare first-dose vaccine coverage by geographical area of origin, we estimated, through a Poisson analysis, Vaccine Coverage Ratios (VCR) with 95 % confidence intervals (95 %CI), adjusting for age and sex. RESULTS We included 16,294,785 Italian citizens and 2,534,351 immigrants aged 5-69 years and resident in the four regions considered. Regarding the geographical area of origin, 40.7 % of immigrants came from Eastern Europe, 13.5 % from North Africa and 13.1 % from Western Asia. A great variability in the first dose vaccine coverage emerged. We documented substantial heterogeneity in the first-dose vaccine coverage within immigrant's population, expressed with Italy as a reference, ranging from 0,768 (95 %CI: 0,766-0,769) in Eastern Europe countries to 1,013 (95 %CI: 1,009 - 1,018) in Eastern Asia. The chance of being vaccinated was found higher in males compared with females for African countries (VCR 1.07, 95 %CI 1.06-1.08) and Western Asian countries (VCR 1.08, 95 %CI 1.07-1.09). CONCLUSION We observed substantial heterogeneity in first-dose SARS-CoV-2 vaccination coverage in immigrants, suggesting a different propensity to vaccines according to the geographical area of origin. These data can help define appropriate and tailored strategies in order to improve vaccine coverage in some specific immigrant groups at the local health district level.
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Affiliation(s)
- Eliana Ferroni
- Epidemiological Department (SER), Azienda Zero of the Veneto Region, Padua, Italy.
| | - Nicola Gennaro
- Epidemiological Department (SER), Azienda Zero of the Veneto Region, Padua, Italy
| | | | - Olivia Leoni
- Directorate General for Health, Lombardy Region, Milan, Italy
| | | | - Cristina Stasi
- Epidemiology Unit, Tuscany Regional Health Agency, Florence, Italy
| | - Laura Cacciani
- Department of Epidemiology - Regional Health Service, ASL Roma 1, Rome, Italy
| | - Enrico Calandrini
- Department of Epidemiology - Regional Health Service, ASL Roma 1, Rome, Italy
| | - Anteo di Napoli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Alessio Petrelli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Manuel Zorzi
- Epidemiological Department (SER), Azienda Zero of the Veneto Region, Padua, Italy
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Tang S, Ji L, Bishwajit G, Guo S. Uptake of COVID-19 and influenza vaccines in relation to preexisting chronic conditions in the European countries. BMC Geriatr 2024; 24:56. [PMID: 38216899 PMCID: PMC10785450 DOI: 10.1186/s12877-023-04623-5] [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] [Received: 02/24/2023] [Accepted: 12/18/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND The suboptimal uptake of COVID-19 and influenza vaccines among those with non-communicable chronic diseases is a public health concern, because it poses a higher risk of severe illness for individuals with underlying health conditions, emphasizing the need to address barriers to vaccination and ensure adequate protection for this vulnerable population. In the present study, we aimed to identify whether people with chronic illnesses are more likely to get vaccinated against COVID-19 and influenza in the European Union. METHODS Cross-sectional data on 49,253 men (n = 20,569) and women (n = 28,684) were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe (June - August, 2021). The outcome variables were self-reported COVID-19 and influenza vaccine uptake status. The association between the uptake of the vaccines and six preexisting conditions including high blood pressure, high blood cholesterol, chronic lung disease, diabetes, chronic bronchitis, and asthma was estimated using binary logistic regression methods. RESULTS The vaccination coverage for COVID-19 ranged from close to 100% in Denmark (98.2%) and Malta (98.2%) to less than 50% in Bulgaria (19.1%) and Romania (32.7%). The countries with the highest percentage of participants with the influenza vaccine included Malta (66.7%), Spain (63.7%) and the Netherlands (62.5%), and those with the lowest percentage included Bulgaria (3.7%), Slovakia (5.8%) and Poland (9.2%). Participants with high blood pressure were 3% less likely [Risk difference (RD) = -0.03, 95% CI = -0.04, -0.03] to report taking COVID-19 and influenza [RD = -0.03, 95% CI= -0.04, -0.01] vaccine. Those with chronic lung disease were 4% less likely [RD = -0.04, 95% CI= -0.06, -0.03] to report taking COVID-19 and 2% less likely [RD= -0.02, 95% CI = -0.04, -0.01] to report taking influenza vaccine. Men and women with high blood pressure were 3% less likely to have reported taking both of the vaccines. CONCLUSIONS Current findings indicate a suboptimal uptake of COVID-19 and influenza vaccines among adult men and women in the EU countries. Those with preexisting conditions, including high blood pressure and chronic lung disease are less likely to take the vaccines.
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Affiliation(s)
- Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Lu Ji
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ghose Bishwajit
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Shuyan Guo
- National Institute of Hospital Administration, National Health Commission, Beijing, China.
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Moya C, Sattler S, Taflinger S, Sauer C. Examining double standards in layoff preferences and expectations for gender, age, and ethnicity when violating the social norm of vaccination. Sci Rep 2024; 14:39. [PMID: 38167903 PMCID: PMC10762145 DOI: 10.1038/s41598-023-48829-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Whether vaccination refusal is perceived as a social norm violation that affects layoff decisions has not been tested. Also unknown is whether ascribed low-status groups are subject to double standards when they violate norms, experiencing stronger sanctions in layoff preferences and expectations, and whether work performance attenuates such sanctioning. Therefore, we study layoff preferences and expectations using a discrete choice experiment within a large representative online survey in Germany (N = 12,136). Respondents chose between two employee profiles, each with information about ascribed characteristics signaling different status groups (gender, age, and ethnicity), work performance (work quality and quantity, and social skills), and whether the employees refused to vaccinate against COVID-19. We found that employees who refused vaccination were more likely to be preferred and expected to be laid off. Respondents also expected double standards regarding layoffs due to vaccination refusal, hence, harsher treatment of females and older employees. Nonetheless, their preferences did not reflect such double standards. We found little support that high work performance attenuates these sanctions and double standards, opening questions about the conditions under which social biases arise. Our results suggest detrimental consequences of vaccination refusal for individuals, the labor market, and acceptance of health policies.
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Affiliation(s)
- Cristóbal Moya
- Faculty of Sociology, Bielefeld University, 33615, Bielefeld, Germany
- DIW Berlin, 10117, Berlin, Germany
| | - Sebastian Sattler
- Faculty of Sociology, Bielefeld University, 33615, Bielefeld, Germany.
- Pragmatic Health Ethics Research Unit, Institut de Recherches Cliniques de Montréal, Montreal, H2W 1R7, Canada.
| | - Shannon Taflinger
- Faculty of Sociology, Bielefeld University, 33615, Bielefeld, Germany
- Institute of Sociology and Social Psychology, University of Cologne, 50931, Cologne, Germany
| | - Carsten Sauer
- Faculty of Sociology, Bielefeld University, 33615, Bielefeld, Germany
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Tran L, Dang T, Nguyen M, Kaufman J, Overmars I, Shrestha S, Abdi I, Nguyen T, Marahajan M, Chu T, Danchin M, Fox G, Nguyen TA. Behavioural and social drivers of COVID-19 vaccination in Vietnam: a scoping review. BMJ Open 2023; 13:e081134. [PMID: 38135311 DOI: 10.1136/bmjopen-2023-081134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Understanding of the behavioural and social drivers (BeSD) of vaccination is key to addressing vaccine hesitancy and accessibility issues. Vietnam's national COVID-19 vaccination programme resulted in high uptake of primary doses among adults, but lower booster doses for adults and primary doses for 5-11 years. This scoping review assessed BeSD influencing COVID-19 vaccine uptake in Vietnam to design interventions on reaching the national vaccination targets. METHOD We conducted a scoping review by searching PubMed, MedRxiv, LitCOVID, COVID-19 LOVE platform, WHO's COVID-19 research database and seven dominant Vietnamese language medical journals published in English or Vietnamese between 28 December 2019 and 28 November 2022. Data were narratively synthesised and summarised according to the four components of the WHO BeSD framework. The drivers were then mapped along the timeline of COVID-19 vaccine deployment and the evolution of the pandemic in Vietnam. RESULTS We identified 680 records, of which 39 met the inclusion criteria comprising 224 204 participants. Adults' intention to receive COVID-19 vaccines for themselves (23 studies) ranged from 58.0% to 98.1%. Parental intention to vaccinate their under 11-year-old children (six studies) ranged from 32.8% to 79.6%. Key drivers of vaccination uptake were perceived susceptibility and severity of disease, perceived vaccine benefits and safety, healthcare worker recommendation, and positive societal perception. Commonly reported COVID-19 vaccines' information sources (six studies) were social and mainstream media (82%-67%), television (72.7%-51.6%) and healthcare workers (47.5%-17.5%). Key drivers of COVID-19 uptake remained consistent for both adults and children despite changes in community transmission and vaccine deployment. CONCLUSION Key enablers of vaccine uptake for adults and children included perceived disease severity, perceived vaccine benefits and safety and healthcare worker recommendations. Future studies should assess vaccine communication targeted to these drivers, national policies and political determinants to optimise vaccine uptake.
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Affiliation(s)
- Luong Tran
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - Tho Dang
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - Mai Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
| | - Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Isabella Overmars
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Shiva Shrestha
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia
| | - Ikram Abdi
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Thao Nguyen
- Department of Health Communication, Government of Viet Nam Ministry of Health, Hanoi, Viet Nam
| | | | - Trang Chu
- United Nations Children's Fund, Hanoi, Viet Nam
| | - Margie Danchin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Gregory Fox
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Thu Anh Nguyen
- Woolcock Institute of Medical Research, Hanoi, Viet Nam
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Curzio O, Cori L, Bianchi F, Prinelli F, Galli M, Giacomelli A, Imiotti MC, Jesuthasan N, Recchia V, Adorni F. COVID-19 Vaccine Hesitancy among Unvaccinated Adults: A Cross-Sectional Exploratory Analysis of Vaccination Intentions in Italy Related to Fear of Infection. Vaccines (Basel) 2023; 11:1790. [PMID: 38140194 PMCID: PMC10747686 DOI: 10.3390/vaccines11121790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
From the initial COVID-19 outbreak, Italy was the first Western country to be seriously affected by the pandemic. Understanding vaccine hesitancy can help efforts to achieve broad vaccination coverage. The objectives of this research were to determine the extent of vaccine hesitancy in Italy and to understand the characteristics of those segments of the population with some hesitancy. Between January and February 2021, 41,473 subjects answered the second questionnaire delivered in phase II of the web-based EPICOVID19 survey. Among the included adult volunteers living in Italy, 4653 (11.2%) reported having previously received at least one dose of the COVID-19 vaccine. In the sample of 36,820 respondents, all not vaccinated (age 51.1 ± 13.5; 59.7% female; 63.6% high level of education), the comparison between hesitant and inclined participants was accompanied by percentages and odds ratios. A total of 2449 individuals were hesitant (6.7% of the unvaccinated ones). Hesitancy was higher among women (OR = 1.48; 95%CI: 1.36-1.62); it was highest in the 50-59 and 40-49 age groups and among those with a lower educational level. A higher level of education was associated with a lower proportion of hesitancy (5.54%) compared with 9.44% among respondents with a low level of education (OR = 0.56; 95%CI: 0.46-0.68). Hesitancy was most common in subjects who did not report fear of infection (12.4%, OR = 4.0; 95%CI: 3.46-4.61). The results can guide the design of tailored information and communication campaigns through considering objective and subjective characteristics.
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Affiliation(s)
- Olivia Curzio
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Liliana Cori
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Fabrizio Bianchi
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Federica Prinelli
- Institute of Biomedical Technologies of the National Research Council (ITB-CNR), 20154 Segrate, Italy; (F.P.); (N.J.)
| | - Massimo Galli
- Third Division of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy; (M.G.); (A.G.); (F.A.)
| | - Andrea Giacomelli
- Third Division of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy; (M.G.); (A.G.); (F.A.)
| | - Maria Cristina Imiotti
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Nithiya Jesuthasan
- Institute of Biomedical Technologies of the National Research Council (ITB-CNR), 20154 Segrate, Italy; (F.P.); (N.J.)
| | - Virginia Recchia
- Institute of Clinical Physiology of the National Research Council (IFC-CNR), 56124 Pisa, Italy; (O.C.); (F.B.); (M.C.I.); (V.R.)
| | - Fulvio Adorni
- Third Division of Infectious Diseases, Fatebenefratelli Sacco Hospital, 20157 Milan, Italy; (M.G.); (A.G.); (F.A.)
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Klaesson J, Lobo J, Mellander C. Social interactions and COVID-19 vaccine hesitancy: Evidence from a full population study in Sweden. PLoS One 2023; 18:e0289309. [PMID: 37983227 PMCID: PMC10659190 DOI: 10.1371/journal.pone.0289309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/14/2023] [Indexed: 11/22/2023] Open
Abstract
We investigate whether an individual's information milieu-an individual's residential neighborhood and co-workers-affects the decision to get a COVID-19 vaccine. The decision to accept or refuse a vaccine is intensely personal and involves the processing of information about phenomena likely to be unfamiliar to most individuals. One can thus expect an interplay between an individual's level of education and skills and the information processing of others whom with whom she can interact and whose decision she can probe and observe. Using individual-level data for adults in Sweden, we can identify the proportion of an individual's neighborhood and workplace who are unvaccinated as indicators of possible peer effects. We find that individuals with low levels of educational attainment and occupational skills are more likely to be unvaccinated when exposed to other unvaccinated individuals at work and in the residential neighborhood. The peer effects in each of these information milieus further increases the likelihood of not getting vaccinated-with the two acting as information channels that reinforce one another.
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Affiliation(s)
- Johan Klaesson
- Jönköping International Business School, Jönköping University, Jönköping, Sweden
- Institute of Retail Economics (HFI), Stockholm, Sweden
| | - José Lobo
- Arizona State University, Tempe, AZ, United States of America
| | - Charlotta Mellander
- Jönköping International Business School, Jönköping University, Jönköping, Sweden
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Klee B, Diexer S, Sarajan MH, Glaser N, Binder M, Frese T, Girndt M, Sedding D, Hoell JI, Moor I, Gekle M, Mikolajczyk R, Gottschick C. Regional Differences in Uptake of Vaccination against COVID-19 and Influenza in Germany: Results from the DigiHero Cohort. Vaccines (Basel) 2023; 11:1640. [PMID: 38005973 PMCID: PMC10674575 DOI: 10.3390/vaccines11111640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
During the COVID-19 pandemic in Germany, vaccination uptake exhibited considerable regional disparities. To assess the factors contributing to this variation, we examined the association of sociodemographic variables with COVID-19, COVID-19 booster, and influenza vaccination status within a cohort of 37,078 participants from 13 German federal states in the digital health cohort study commonly known as DigiHero. Our findings revealed variations in vaccination rates based on sociodemographic factors. However, these factors had limited explanatory power regarding regional differences in vaccine uptake. In contrast, we found substantial correlations between regional support of specific parties during the last local elections and the vaccination uptake at the level of each administrative district. In conclusion, sociodemographic factors alone did not suffice to explain the regional disparities in vaccine uptake. Political stances can play a major role, although the current investigation did not assess individual political orientations but rather used only an ecological approach.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Myka Harun Sarajan
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Nadine Glaser
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Haematology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany;
| | - Matthias Girndt
- Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Daniel Sedding
- Mid-German Heart Centre, Department of Cardiology and Intensive Care Medicine, University Hospital, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Jessica I. Hoell
- Paediatric Haematology and Oncology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Irene Moor
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany;
| | - Michael Gekle
- Julius-Bernstein-Institute of Physiology, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 6, 06110 Halle (Saale), Germany;
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
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Junghans C, Antonacci G, Williams A, Harris M. Learning from the universal, proactive outreach of the Brazilian Community Health Worker model: impact of a Community Health and Wellbeing Worker initiative on vaccination, cancer screening and NHS health check uptake in a deprived community in the UK. BMC Health Serv Res 2023; 23:1092. [PMID: 37821938 PMCID: PMC10568890 DOI: 10.1186/s12913-023-10084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Delays in preventative service uptake are increasing in the UK. Universal, comprehensive monthly outreach by Community Health and Wellbeing Workers (CHW), who are integrated at the GP practice and local authority, offer a promising alternative to general public health campaigns as it personalises health promotion and prevention of disease holistically at the household level. We sought to test the ability of this model, which is based on the Brazilian Family Health Strategy, to increase prevention uptake in the UK. METHODS Analysis of primary care patient records for 662 households that were allocated to five CHWWs from July 2021. Primary outcome was the Composite Referral Completion Indicator (CRCI), a measure of how many health promotion activities were received by members of a household relative to the ones that they were eligible for during the period July 2021-April 2022. The CRCI was compared between the intervention group (those who had received at least one visit) and the control group (allocated households that were yet to receive a visit). A secondary outcome was the number of GP visits in the intervention and control groups during the study period and compared to a year prior. RESULTS Intervention and control groups were largely comparable in terms of household occupancy and service eligibilities. A total of 2251 patients in 662 corresponding households were allocated to 5 CHWs and 160 households had received at least one visit during the intervention period. The remaining households were included in the control group. Overall service uptake was 40% higher in the intervention group compared to control group (CRCI: 0.21 ± 0.15 and 0.15 ± 0.19 respectively). Likelihood of immunisation uptake specifically was 47% higher and cancer screening and NHS Health Checks was 82% higher. The average number of GP consultations per household decreased by 7.4% in the intervention group over the first 10 months of the pilot compared to the 10 months preceding its start, compared with a 0.6% decrease in the control group. CONCLUSIONS Despite the short study period these are promising findings in this deprived, traditionally hard to reach community and demonstrates potential for the Brazilian community health worker model to be impactful in the UK. Further analysis is needed to examine if this approach can reduce health inequalities and increase cost effectiveness of health promotion approaches.
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Affiliation(s)
- Cornelia Junghans
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Grazia Antonacci
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
- Centre for Health Economics and Policy Innovation (CHEPI), Business School, Imperial College London, London, UK
| | - Alison Williams
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Matthew Harris
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3Rd Floor Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
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Ramasubramani P, Kar SS, Sarkar S. Association of Social Capital With Tuberculosis: A Community-Based Cross-Sectional Analytical Study in South India. Cureus 2023; 15:e46660. [PMID: 37942359 PMCID: PMC10628598 DOI: 10.7759/cureus.46660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Social capital denotes the relationships, networks, norms and values in the community. A high level of social capital positively improves health through a supportive social system. Illnesses affect health and social relationships. One such disease is tuberculosis (TB), known for its social stigma. India has the highest burden of morbidity and mortality due to TB. The assessment of social capital would highlight the importance of a supportive environment in reducing the disease burden and bringing better treatment outcomes. METHODS A cross-sectional exploratory analytical study was conducted in two primary health centers in Puducherry between February 2020 and March 2021. Considering the feasibility and resource constraints, we assessed the social capital between 50 newly diagnosed pulmonary tuberculosis (PTB) patients, their age- and gender-matched 50 household contacts (HHCs) and 50 PTB patients who completed treatment a year before. The HHC was either the marital partner or sibling of the newly diagnosed PTB patients selected for comparison as their exposure to infection would be similar to those diseased but did not develop the illness. Social capital and its domains were assessed using the World Bank's social capital questionnaire. Sociodemographic characteristics and social capital domains were compared using a chi-squared test. Mean standardized Z-scores of the domains were compared using one-way analysis of variance (ANOVA). A p-value of <0.05 is taken as significant. RESULTS Most participants from each group belonged to lower socioeconomic strata and were males (80%). The overall level of social capital was low among the newly diagnosed PTB patients, especially the group and network and trust and solidarity domains. The mean standardized Z-scores of social capital were the highest among the HHCs, followed by the treatment-completed PTB patients. There was no consistent pattern, but the trust and solidarity domain showed a statistically significant difference. CONCLUSION A low level of social capital and its domains were seen among the newly diagnosed PTB patients. However, better scores among the HHCs and the treatment-completed patients infer a negative association between social capital and TB. Thus, higher social capital preserves and improves health. Therefore, caregivers and disease-cured patients can be utilized as a social support system for current diseased patients and improve their health status.
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Affiliation(s)
- Premkumar Ramasubramani
- Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
| | - Sitanshu Sekhar Kar
- Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
| | - Sonali Sarkar
- Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
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Zhu DT, Serhan M, Mithani SS, Smith D, Ang J, Thomas M, Wilson K. The barriers, facilitators and association of vaccine certificates on COVID-19 vaccine uptake: a scoping review. Global Health 2023; 19:73. [PMID: 37759306 PMCID: PMC10537206 DOI: 10.1186/s12992-023-00969-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Globally, COVID-19 vaccines have proven to be instrumental for promoting population health by reducing illness from SARS-CoV-2. Vaccine certificates emerged as a potentially promising solution for encouraging vaccination and facilitating the safe reopening of society, however, they were controversial due to criticisms of infringing upon individual rights. While there is extensive literature describing the ethical, legal, and public health implications of vaccine certificates, there is currently a gap in knowledge about the association of vaccine certificates on vaccine uptake during the COVID-19 pandemic and barriers and facilitators to their use. OBJECTIVES The objectives of this scoping review are to (i) describe the existing literature on the association of vaccine certificates on the rates of COVID-19 vaccine uptake across several countries and (ii) describe the intrinsic and extrinsic barriers or facilitators that moderate this relationship. METHODS We conducted a scoping review based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched three bibliographic databases (APA PsychInfo, Embase Classic + Embase, OVID-Medline) and preprint severs during the first week of July 2023. Three reviewers independently screened the studies based on pre-specified eligibility criteria and performed quality assessments of the primary literature and data extraction. RESULTS Sixteen studies met the inclusion criteria. 14 or these were surveys and 2 were modelling studies. The majority documented that vaccine certificates were significantly associated with increased rates of COVID-19 vaccine uptake (n = 12), motivated by factors such as travel/employer requirements, influence from the government/peers, and trust in the safety, efficacy, and science behind COVID-19 vaccines. Three studies had non-significant or mixed findings. Only one study found a significant decrease in COVID-19 vaccine uptake, motivated by pervasive distrust in the QR code-based system of digital vaccine certificates in Russia. Quality of survey studies was generally high. CONCLUSION Our findings provide insights into the existing literature on vaccine certificates association with vaccine uptake in several different jurisdictions and barriers and facilitators to their uptake. This information can be used to guide future examinations of the implementation of vaccine certificates and more effective implementations.
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Affiliation(s)
- David T Zhu
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Medical Scientist Training Program, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Mohamed Serhan
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Salima S Mithani
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - David Smith
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Joyce Ang
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Maya Thomas
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kumanan Wilson
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Department of Medicine, University of Ottawa, Ottawa, Canada.
- Bruyère Research Institute, Ottawa, Canada.
- O'Neill Institute, Georgetown University, Washington DC, USA.
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Shivarov V, Grigorova D, Yordanov A. Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2594. [PMID: 37761791 PMCID: PMC10531457 DOI: 10.3390/healthcare11182594] [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: 08/27/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to millions of documented deaths worldwide, with diverse distribution among countries. Surprisingly, Bulgaria, a middle-income European Union member state, ranked highest in COVID-19 mortality. This study aims to assess whether Bulgarian cancer patients experienced a higher relative risk (RR) of death compared to the general Bulgarian population during the pandemic. MATERIALS AND METHODS Data from the Bulgarian National Statistical Institute and the Bulgarian National Cancer Registry were analyzed to estimate monthly RR of death in cancer patients compared to the general population before and during the first two years of the pandemic. The impact of the COVID-19 waves and predominant SARS-CoV-2 variants on RR was evaluated on various cancer types and age groups using a multiple linear regression approach. RESULTS During the COVID-19 waves, both the general population and cancer patients experienced a significant increase in mortality rates. Surprisingly, the RR of death in cancer patients was lower during pandemic waves. The results from the statistical modeling revealed a significant association between the COVID-19 waves and reduced RR for all cancer patients. Notably, the effect was more pronounced during waves associated with the Alpha and Delta variants. The results also showed varying impacts of the COVID-19 waves on RR when we analyzed subsamples of data grouped depending on the cancer type, age and sex. CONCLUSIONS Despite increased overall mortality in Bulgarian cancer patients during the pandemic, the RR of death was lower compared to the Bulgarian general population, indicating that protective measures were relatively effective in this vulnerable group. This study underscores the importance of implementing and encouraging preventive measures, especially in cancer patients, to mitigate the impact of future viral pandemics and reduce excess mortality.
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Affiliation(s)
- Velizar Shivarov
- Department of Experimental Research, Medical University Pleven, 5800 Pleven, Bulgaria
| | - Denitsa Grigorova
- Department of Probability, Operations Research and Statistics, Faculty of Mathematics and Informatics, Sofia University, 1504 Sofia, Bulgaria;
| | - Angel Yordanov
- Department of Gynaecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria;
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22
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Bakalova D, Nacheva I, Panchelieva T. Psychological Predictors of COVID-19-Related Anxiety in Vulnerable Groups. Eur J Investig Health Psychol Educ 2023; 13:1815-1830. [PMID: 37754471 PMCID: PMC10529974 DOI: 10.3390/ejihpe13090132] [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: 08/11/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
This study responds to the need to explore psychological predictors of COVID-19-related anxiety in vulnerable groups. An anonymous voluntary online survey was conducted (n = 520) with (a) working parents with young children (0-12 y.o.), (b) people with chronic physical conditions, (c) people with multiple vulnerability characteristics and (d) a control group (no self-reported vulnerability) in 2022. Findings showed that perceived stress of the parents and trait anxiety of the chronic sufferers were single weak positive predictors of COVID-19 anxiety. However, both psychological factors had a stronger effect on the pandemic-related anxiety for the group with multiple vulnerabilities. In the control group, trait resilience and optimistic expectations (combined with perceived stress) were moderate negative predictors of COVID-19 anxiety. The findings emphasize the importance of perceptions, expectations, trait anxiety as well as the need for intersectional research of vulnerability from multiple perspectives. Furthermore, they highlight the necessity of group-specific policies and interventions aimed both at handling the negative psychological tendencies of the vulnerable groups and at strengthening the positive tendencies of non-vulnerable groups, rather than tackling only emergent anxiety conditions in crisis times.
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Affiliation(s)
- Diana Bakalova
- Department of Psychology, Institute for Population and Human Studies, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
| | - Ilina Nacheva
- Department of Psychology, Institute for Population and Human Studies, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria;
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Anino CO, Wandera I, Masimba ZO, Kirui CK, Makero CS, Omari PK, Sanga P. Determinants of Covid-19 vaccine uptake among the elderly aged 58 years and above in Kericho County, Kenya: Institution based cross sectional survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001562. [PMID: 37698989 PMCID: PMC10497123 DOI: 10.1371/journal.pgph.0001562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023]
Abstract
Hesitancy to Covid-19 vaccine is a global challenge despite the compelling evidence of the value of vaccine in preventing disease and saving lives. It is suggested that context-specific strategies can enhance acceptability and decrease hesitancy to Covid-19 vaccine. Hence, the study determined uptake and determinants of Covid-19 vaccine following a sustained voluntary vaccination drive by Kenyan government. We conducted institution based cross-sectional survey of 1244 elderly persons aged 58 to 98 years in the months of January, February and March, 2022. A multinomial logistic regression analysis was used to investigate determinants of Covid 19 vaccine uptake. The predictor variables included socioeconomic and demographic characteristics, convenience and ease of access of the vaccine, collective responsibility, complacency and the three dimensions of confidence; trust in safety, trust in decision makers and delivery system. The findings are reported as the adjusted odd ratio (AOR) at 95% confidence interval (CI). Significant level was considered at p <0.05. The results from the multinomial logistic regression analysis indicated that advanced age and presence of chronic disease were associated with increased odds of doubt on Covid 19 vaccine, while long distance from vaccination centers was associated with increased odds of delay in vaccination. Overall, the findings of this study provided valuable insights into the factors influencing vaccine hesitancy among the elderly population in Kenya and will inform the development of targeted interventions to increase vaccine acceptance and uptake in this population.
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Backhaus A. Socio-demographic factors associated with COVID-19 vaccine uptake and refusal among Ugandan women. Global Health 2023; 19:68. [PMID: 37674181 PMCID: PMC10481614 DOI: 10.1186/s12992-023-00968-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 08/29/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND This paper analyzes associations of socio-demographic factors with the uptake of COVID-19 vaccines, the refusal to get vaccinated against COVID-19, and various reasons stated for refusing vaccination against COVID-19 among a representative sample of Ugandan women. METHODS This paper utilizes a representative cross-sectional survey collected among women aged 15-49 years in Uganda between September and November 2021. Regression analyses are used to study the associations of a broad range of socio-demographic characteristics with COVID-19 vaccine uptake, refusal of vaccination, and reasons for refusal among the respondents. RESULTS 4211 women were included in the analysis. 11% of them were vaccinated against COVID-19, 76% were willing to get vaccinated, 13% were unwilling to get vaccinated. Fear of side effects was the most commonly stated reason for refusing vaccination (69%). Factors significantly and positively associated with being vaccinated against COVID-19 were age, higher education, urban residency, having savings, partial instead of complete income loss during the pandemic, and usage of modern contraceptives. Factors significantly and positively associated with refusing vaccination against COVID-19 were urban residency and current pregnancy, while age, having savings, and using modern contraceptives were factors associated with a lower likelihood of refusing vaccination, albeit with varying statistical significance. Few factors were strongly related to the stated reasons for refusing the vaccines; the fear of side effects significantly increased with age, while having received negative information on the vaccines was significantly less common among women with higher education. CONCLUSIONS This study documents a low COVID-19 vaccination rate and a high willingness to get vaccinated among Ugandan women. Positive age and education gradients in vaccine uptake point to inequity in access to vaccination, potentially resulting from prioritizations of groups at particularly high risk. Refusal to be vaccinated was relatively low and systematic factors behind vaccine refusal were hardly to be found, even less so for particular reasons given for refusal.
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Affiliation(s)
- Andreas Backhaus
- Federal Institute for Population Research (BiB), Wiesbaden, Germany.
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25
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Sabat I, Neumann-Böhme S, Barros PP, Torbica A, van Exel J, Brouwer W, Stargardt T, Schreyögg J. Vaccine hesitancy comes in waves: Longitudinal evidence on willingness to vaccinate against COVID-19 from seven European countries. Vaccine 2023; 41:5304-5312. [PMID: 37460356 DOI: 10.1016/j.vaccine.2023.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/30/2023] [Accepted: 07/09/2023] [Indexed: 08/09/2023]
Abstract
AIM This paper investigates the prevalence and determinants of three main states of people's willingness to be vaccinated (WTBV) against COVID-19 - willing, unwilling and hesitant - and the occurrence and predictors of shifts between these states over time. Understanding the dynamics of vaccine intentions is crucial for developing targeted campaigns to increase uptake and emergency response preparedness. STUDY DESIGN A panel survey consisting of 9 quarterly waves of data collected between April 2020 and January 2022. Baseline data included 24 952 adults from Germany, UK, Denmark, the Netherlands, France, Portugal, and Italy recruited from online panels to construct census-matched nationally representative samples. METHODS AND MEASURES Self-reported COVID-19 vaccine intention was the main outcome. Multinomial logit random effects models were used to analyze the relationships of interest. All results reported as relative risk ratios (RRR). RESULTS Hesitancy to get vaccinated was the most unstable vaccine intention, with on average 42% of ever hesitant respondents remaining in this state through future waves, followed by the 'unwilling' (53%) and 'willing (82%). Following COVID-19 news, trust in information from the government, GPs and the WHO, risk preferences, risk perceptions, and confidence in vaccines (or lack thereof) predicted vaccination intention reversals. Risk preferences acted both as an impediment and as a facilitator for the vaccine uptake depending on the initial vaccine intention. CONCLUSIONS AND RELEVANCE This study revealed the dynamic nature of COVID-19 vaccine intentions and its predictors in 7 European countries. The findings provide insights to policymakers for designing more effective communication strategies, particularly targeted at hesitant and unwilling to vaccinate population groups, to increase vaccine uptake for future public health emergencies.
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Affiliation(s)
- Iryna Sabat
- Nova School of Business and Economics, R.Holanda 1, 2775-405 Carcavelos, Portugal; Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354 Hamburg, Germany.
| | - Sebastian Neumann-Böhme
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354 Hamburg, Germany; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands.
| | - Pedro Pita Barros
- Nova School of Business and Economics, R.Holanda 1, 2775-405 Carcavelos, Portugal.
| | - Aleksandra Torbica
- Centre for Research on Health and Social Care Management, CERGAS, Bocconi University, Via Röntgen n. 1, 20136 Milano, Italy.
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands; Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands.
| | - Werner Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands; Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands.
| | - Tom Stargardt
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354 Hamburg, Germany.
| | - Jonas Schreyögg
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354 Hamburg, Germany.
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Nanyonjo A, Nelson D, Sayers E, Lall P, Vernon-Wilson E, Tetui M, Grindrod K, Kane R, Gussy M, Siriwardena N. Community efforts to promote vaccine uptake in a rural setting: a qualitative interview study. Health Promot Int 2023; 38:daad088. [PMID: 37549195 PMCID: PMC10406424 DOI: 10.1093/heapro/daad088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Vaccine hesitancy has been identified as one of the top 10 threats to global health. The causes of low vaccine uptake are many and vary at micro and macro levels. However, rural and remote coastal areas in the UK experience unique vaccine inequalities due to high levels of deprivation and their unique and complex access-related problems. This study aimed to explore community efforts to promote vaccine uptake during the COVID-19 pandemic and understand how the COVID-19 vaccination campaign was experienced by the public. We conducted an exploratory descriptive qualitative study using semi-structured interviews with decision-makers, health professionals and community members in Lincolnshire, a predominantly rural county with a long coastline, a large population of white minority ethnicities, and those living in caravan and temporary housing. Data were analysed using conventional content analysis. Overcoming the various access barriers to vaccination uptake involved working with local media stations, local communities and local community groups, translation of information, bringing vaccines closer to the people through pop-up and mobile clinics and provision of transport and ensuring confidentiality. There is a need to employ inclusive targeted non-conventional care interventions whilst dealing with complex problems as occur in rural and remote coastal regions.
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Affiliation(s)
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
| | - Emma Sayers
- School of Health and Social Care, College of Social Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
| | - Priya Lall
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
| | - Elizabeth Vernon-Wilson
- School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, Ontario, N2G 1C5, Canada
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, Ontario, N2G 1C5, Canada
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, 10 Victoria St S A, Kitchener, Ontario, N2G 1C5, Canada
| | - Ros Kane
- School of Health and Social Care, College of Social Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
| | - Niro Siriwardena
- Community and Health Research Unit, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
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Scales D, Gorman S, Windham S, Sandy W, Gregorian N, Hurth L, Radhakrishnan M, Akunne A, Gorman JM. 'They've all endorsed it…but I'm just not there:' a qualitative exploration of COVID-19 vaccine hesitancy reported by Black and Latinx individuals. BMJ Open 2023; 13:e072619. [PMID: 37474192 PMCID: PMC10360437 DOI: 10.1136/bmjopen-2023-072619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE We sought to examine reasons for vaccine hesitancy among online communities of US-based Black and Latinx communities to understand the role of historical racism, present-day structural racism, medical mistrust and individual concerns about vaccine safety and efficacy. DESIGN A qualitative study using narrative and interpretive phenomenological analysis of online bulletin board focus groups. SETTING Bulletin boards with a focus-group-like setting in an online, private, chat-room-like environment. PARTICIPANTS Self-described vaccine hesitant participants from US-based Black (30) and Latinx (30) communities designed to reflect various axes of diversity within these respective communities in the US context. RESULTS Bulletin board discussions covered a range of topics related to COVID-19 vaccination. COVID-19 vaccine hesitant participants expressed fears about vaccine safety and doubts about vaccine efficacy. Elements of structural racism were cited in both groups as affecting populations but not playing a role in individual vaccine decisions. Historical racism was infrequently cited as a reason for vaccine hesitancy. Individualised fears and doubts about COVID-19 (short-term and long-term) safety and efficacy dominated these bulletin board discussions. Community benefits of vaccination were not commonly raised among participants. CONCLUSIONS While this suggests that addressing individually focused fear and doubts are central to overcoming COVID-19 vaccine hesitancy in Black and Latinx groups, addressing the effects of present-day structural racism through a focus on community protection may also be important.
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Affiliation(s)
- David Scales
- Division of General Internal Medicine, Weill Cornell Medical College, New York, New York, USA
- Critica, The Bronx, New York, USA
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28
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Angerer S, Glätzle-Rützler D, Lergetporer P, Rittmannsberger T. How does the vaccine approval procedure affect COVID-19 vaccination intentions? EUROPEAN ECONOMIC REVIEW 2023; 158:104504. [PMID: 37360583 PMCID: PMC10246308 DOI: 10.1016/j.euroecorev.2023.104504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/24/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
People's willingness to vaccinate is critical to combating the COVID-19 pandemic. We devise a representative experiment to study how the design of the vaccine approval procedure affects trust in newly developed vaccines and consequently public attitudes towards vaccination. Compared to an Emergency Use Authorization, choosing the more thorough Conditional Marketing Authorization approval procedure increases vaccination intentions by 13 percentage points. The effects of the increased duration of the approval procedure are positive and significant only for Emergency Use Authorization. Treatment effects do not differ between relevant subgroups, such as respondents who had (did not have) COVID-19, or between vaccinated and unvaccinated respondents. Increased trust in the vaccine is the key mediator of treatment effects on vaccination intentions.
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Affiliation(s)
- Silvia Angerer
- UMIT TIROL, Private University for Health Sciences and Health Technology, Hall in Tirol
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29
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Andreica I, Roman I, Redeker I, Baraliakos X, Braun J, Kiltz U. Facilitators and barriers for vaccination in patients with inflammatory rheumatic musculoskeletal diseases: a prospective cohort study. RMD Open 2023; 9:rmdopen-2022-002875. [PMID: 37295840 DOI: 10.1136/rmdopen-2022-002875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/02/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION To identify facilitators and barriers towards vaccination in general and specifically against pneumococci, influenza and SARS-CoV-2 in patients with rheumatic musculoskeletal diseases (RMD). METHODS Between February and April 2021, consecutive patients with RMD were asked to complete a structured questionnaire on general knowledge about vaccination, personal attitudes and perceived facilitators and barriers towards vaccination. General facilitators (n=12) and barriers (n=15) and more specific ones for vaccination against pneumococci, influenza and SARS-CoV-2 were assessed. Likert scales had four response options: from 1 (completely disagree) to 4 (completely agree). Patient and disease characteristics, their vaccination records and attitudes towards vaccination against SARS-CoV-2 were assessed. RESULTS 441 patients responded to the questionnaire. Knowledge about vaccination was decent in ≥70% of patients, but <10% of patients doubted its effectiveness. Statements on facilitators were generally more favourable than on barriers. Facilitators for SARS-CoV-2 vaccination were not different from vaccination in general. Societal and organisational facilitators were more often named than interpersonal or intrapersonal facilitators. Most patients indicated that recommendations of their healthcare professional would encourage them to be vaccinated-without preference for general practitioner or rheumatologists. There were more barriers towards SARS-CoV-2 vaccination than to vaccination in general. Intrapersonal issues were most frequently reported as a barrier. Statistically significant differences in response patterns to nearly all barriers between patients classified as definitely willing, probably willing and unwilling to receive SARS-CoV-2 vaccines were noted. DISCUSSION Facilitators towards vaccination were more important than barriers. Most barriers against vaccination were intrapersonal issues. Societal facilitators identified support strategies in that direction.
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Affiliation(s)
- Ioana Andreica
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Iulia Roman
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Imke Redeker
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Xenofon Baraliakos
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Juergen Braun
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Uta Kiltz
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
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30
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Sabatini S, Kaufmann M, Fadda M, Tancredi S, Noor N, Van Der Linden BWA, Cullati S, Frank I, Michel G, Harju E, Luedi C, Frei A, Ballouz T, Menges D, Fehr J, Kohler P, Kahlert CR, Scheu V, Ortega N, Chocano-Bedoya P, Rodondi N, Stringhini S, Baysson H, Lorthe E, Zufferey MC, Suggs LS, Albanese E, Vincentini J, Bochud M, D’Acremont V, Nusslé SG, Imboden M, Keidel D, Witzig M, Probst-Hensch N, von Wyl V. Factors Associated With COVID-19 Non-Vaccination in Switzerland: A Nationwide Study. Int J Public Health 2023; 68:1605852. [PMID: 37284510 PMCID: PMC10239801 DOI: 10.3389/ijph.2023.1605852] [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: 02/06/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives: We compared socio-demographic characteristics, health-related variables, vaccination-related beliefs and attitudes, vaccination acceptance, and personality traits of individuals who vaccinated against COVID-19 and who did not vaccinate by December 2021. Methods: This cross-sectional study used data of 10,642 adult participants from the Corona Immunitas eCohort, an age-stratified random sample of the population of several cantons in Switzerland. We used multivariable logistic regression models to explore associations of vaccination status with socio-demographic, health, and behavioral factors. Results: Non-vaccinated individuals represented 12.4% of the sample. Compared to vaccinated individuals, non-vaccinated individuals were more likely to be younger, healthier, employed, have lower income, not worried about their health, have previously tested positive for SARS-CoV-2 infection, express lower vaccination acceptance, and/or report higher conscientiousness. Among non-vaccinated individuals, 19.9% and 21.3% had low confidence in the safety and effectiveness of SARS-CoV-2 vaccine, respectively. However, 29.1% and 26.7% of individuals with concerns about vaccine effectiveness and side effects at baseline, respectively vaccinated during the study period. Conclusion: In addition to known socio-demographic and health-related factors, non-vaccination was associated with concerns regarding vaccine safety and effectiveness.
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Affiliation(s)
- Serena Sabatini
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marta Fadda
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Nazihah Noor
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | | | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Irene Frank
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- ZHAW Zurich University of Applied Sciences, School of Health Sciences, Winterthur, Switzerland
| | - Chantal Luedi
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Philipp Kohler
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Christian R. Kahlert
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
- Children’s Hospital of Eastern Switzerland, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Victor Scheu
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Natalia Ortega
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Patricia Chocano-Bedoya
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Center for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Hélène Baysson
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Maria Caiata Zufferey
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - L. Suzanne Suggs
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
- Institute of Communication and Public Policy, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Instutite of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Julia Vincentini
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Valérie D’Acremont
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Samira Gonseth Nusslé
- University Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Melissa Witzig
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health (TPH) Institute, Allschwil, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
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Vriens E, Tummolini L, Andrighetto G. Vaccine-hesitant people misperceive the social norm of vaccination. PNAS NEXUS 2023; 2:pgad132. [PMID: 37168670 PMCID: PMC10165803 DOI: 10.1093/pnasnexus/pgad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023]
Abstract
Vaccine hesitancy is one of the main threats to global health, as became clear once more during the COVID-19 pandemic. Vaccination campaigns could benefit from appeals to social norms to promote vaccination, but without awareness of the social norm in place any intervention relying on social norms may backfire. We present a two-step approach of social norm diagnosis and intervention that identifies both whether a vaccination norm exists or develops over time and corrects misperceptions. In two studies (N = 887 and N = 412 ) conducted in Rome, Italy from June to August 2021 (during the first COVID-19 vaccination campaign), we show that vaccine-hesitant people strongly underestimated vaccine acceptance rates for COVID-19 despite increases in region-wide vaccination rates. This suggests a false consensus bias on the social norm of vaccination. We presented a subgroup of vaccine-hesitant people with the accurate vaccine acceptance rates (both planned uptake and vaccine approval) and tested if this social information would lower their vaccine hesitancy. We do not find clear effects, most likely because of the introduction of the COVID-19 health certificate (the "green pass") that was implemented during our data collection. The green pass reduced both misperceptions in the social norm and vaccine hesitancy, thus undermining our treatment effect. We conclude that to alleviate misperceptions on the social norm of vaccination in early stages of the vaccination campaign governments and media should report not just the current vaccination rate, but also about vaccination intentions and approval.
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Affiliation(s)
- Eva Vriens
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
| | - Luca Tummolini
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
| | - Giulia Andrighetto
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
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Rando HM, Lordan R, Lee AJ, Naik A, Wellhausen N, Sell E, Kolla L, Gitter A, Greene CS. Application of Traditional Vaccine Development Strategies to SARS-CoV-2. mSystems 2023; 8:e0092722. [PMID: 36861991 PMCID: PMC10134813 DOI: 10.1128/msystems.00927-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Over the past 150 years, vaccines have revolutionized the relationship between people and disease. During the COVID-19 pandemic, technologies such as mRNA vaccines have received attention due to their novelty and successes. However, more traditional vaccine development platforms have also yielded important tools in the worldwide fight against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A variety of approaches have been used to develop COVID-19 vaccines that are now authorized for use in countries around the world. In this review, we highlight strategies that focus on the viral capsid and outwards, rather than on the nucleic acids inside. These approaches fall into two broad categories: whole-virus vaccines and subunit vaccines. Whole-virus vaccines use the virus itself, in either an inactivated or an attenuated state. Subunit vaccines contain instead an isolated, immunogenic component of the virus. Here, we highlight vaccine candidates that apply these approaches against SARS-CoV-2 in different ways. In a companion article (H. M. Rando, R. Lordan, L. Kolla, E. Sell, et al., mSystems 8:e00928-22, 2023, https://doi.org/10.1128/mSystems.00928-22), we review the more recent and novel development of nucleic acid-based vaccine technologies. We further consider the role that these COVID-19 vaccine development programs have played in prophylaxis at the global scale. Well-established vaccine technologies have proved especially important to making vaccines accessible in low- and middle-income countries. Vaccine development programs that use established platforms have been undertaken in a much wider range of countries than those using nucleic acid-based technologies, which have been led by wealthy Western countries. Therefore, these vaccine platforms, though less novel from a biotechnological standpoint, have proven to be extremely important to the management of SARS-CoV-2. IMPORTANCE The development, production, and distribution of vaccines is imperative to saving lives, preventing illness, and reducing the economic and social burdens caused by the COVID-19 pandemic. Vaccines that use cutting-edge biotechnology have played an important role in mitigating the effects of SARS-CoV-2. However, more traditional methods of vaccine development that were refined throughout the 20th century have been especially critical to increasing vaccine access worldwide. Effective deployment is necessary to reducing the susceptibility of the world's population, which is especially important in light of emerging variants. In this review, we discuss the safety, immunogenicity, and distribution of vaccines developed using established technologies. In a separate review, we describe the vaccines developed using nucleic acid-based vaccine platforms. From the current literature, it is clear that the well-established vaccine technologies are also highly effective against SARS-CoV-2 and are being used to address the challenges of COVID-19 globally, including in low- and middle-income countries. This worldwide approach is critical for reducing the devastating impact of SARS-CoV-2.
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Affiliation(s)
- Halie M. Rando
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ronan Lordan
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - Alexandra J. Lee
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amruta Naik
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nils Wellhausen
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth Sell
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - Likhitha Kolla
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - COVID-19 Review Consortium
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin—Madison, Madison, Wisconsin, USA
- Morgridge Institute for Research, Madison, Wisconsin, USA
- Childhood Cancer Data Lab, Alex’s Lemonade Stand Foundation, Philadelphia, Pennsylvania, USA
| | - Anthony Gitter
- Department of Biostatistics and Medical Informatics, University of Wisconsin—Madison, Madison, Wisconsin, USA
- Morgridge Institute for Research, Madison, Wisconsin, USA
| | - Casey S. Greene
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Childhood Cancer Data Lab, Alex’s Lemonade Stand Foundation, Philadelphia, Pennsylvania, USA
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Gori D, Capodici A, La Fauci G, Montalti M, Salussolia A, Soldà G, Di Valerio Z, Scognamiglio F, Fantini MP, Leask J, Larson HJ, Profeti S, Toth F, Lenzi J. COVID-19 Vaccine Refusal and Delay among Adults in Italy: Evidence from the OBVIOUS Project, a National Survey in Italy. Vaccines (Basel) 2023; 11:vaccines11040839. [PMID: 37112751 PMCID: PMC10141216 DOI: 10.3390/vaccines11040839] [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: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Vaccine hesitancy was defined by the World Health Organization (WHO) in 2019 as a major threat to global health. In Italy, reluctance to receive vaccines is a widespread phenomenon that was amplified during the COVID-19 pandemic by fear and mistrust in government. This study aims to depict different profiles and characteristics of people reluctant to vaccinate, focusing on the drivers of those who are in favor of and those who are opposed to receiving the COVID-19 vaccine. METHODS A sample of 10,000 Italian residents was collected. A survey on COVID-19 vaccination behavior and possible determinants of vaccine uptake, delay, and refusal was administered to participants through a computer-assisted web interviewing method. RESULTS In our sample, 83.2% stated that they were vaccinated as soon as possible ("vaccinators"), 8.0% delayed vaccination ("delayers"), and 6.7% refused to be vaccinated ("no-vaccinators"). In general, the results show that being female, aged between 25 and 64, with an education level less than a high school diploma or above a master's degree, and coming from a rural area were characteristics significantly associated with delaying or refusing COVID-19 vaccination. In addition, it was found that having minimal trust in science and/or government (i.e., 1 or 2 points on a scale from 1 to 10), using alternative medicine as the main source of treatment, and intention to vote for certain parties were characteristics associated with profiles of "delayers" or "no-vaccinators". Finally, the main reported motivation for delaying or not accepting vaccination was fear of vaccine side effects (55.0% among delayers, 55.6% among no-vaccinators). CONCLUSION In this study, three main profiles of those who chose to be vaccinated are described. Since those who are in favor of vaccines and those who are not usually cluster in similar sociodemographic categories, we argue that findings from this study might be useful to policy makers when shaping vaccine strategies and choosing policy instruments.
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Affiliation(s)
- Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Angelo Capodici
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Giusy La Fauci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Marco Montalti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Aurelia Salussolia
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Giorgia Soldà
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Zeno Di Valerio
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Francesca Scognamiglio
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
- Sydney Infectious Diseases Institute, Westmead, NSW 2145, Australia
| | - Heidi J Larson
- Institute for Health Metrics & Evaluation (IHME), University of Washington, Seattle, WA 98105, USA
- London School of Hygiene and Tropical Medicine (LSHTM), London WC1E 7HT, UK
| | - Stefania Profeti
- Department of Political and Social Sciences, University of Bologna, 40125 Bologna, Italy
| | - Federico Toth
- Department of Political and Social Sciences, University of Bologna, 40125 Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
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Fontán-Vela M, Gullón P, Bilal U, Franco M. Social and ideological determinants of COVID-19 vaccination status in Spain. Public Health 2023; 219:139-145. [PMID: 37178560 PMCID: PMC10080268 DOI: 10.1016/j.puhe.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES This study analysed the association between social and ideological determinants with COVID-19 vaccine accessibility and hesitancy in the Spanish adult population. STUDY DESIGN This was a repeated cross-sectional study. METHODS The data analysed are based on monthly surveys conducted by the Centre for Sociological Research between May 2021 and February 2022. Individuals were classified according to their COVID-19 vaccination status into (1) vaccinated (reference group); (2) willing to vaccinate but not vaccinated, proxy of lack of vaccine accessibility; and (3) hesitant, proxy of vaccine hesitancy. Independent variables included social (educational attainment, gender) and ideological determinants (voting in the last elections, importance attached to the health vs the economic impact of the pandemic, and political self-placement). We estimated odds ratio (OR) and 95% confidence interval (CI) conducting one age-adjusted multinomial logistic regression model for each determinant and then stratified them by gender. RESULTS Both social and ideological determinants had a weak association with the lack of vaccine accessibility. Individuals with medium educational attainment had higher odds of vaccine hesitancy (OR = 1.44, CI 1.08-1.93) compared with those with high educational attainment. People self-identified as conservative (OR = 2.90; CI 2.02-4.15) and those who prioritised the economic impact (OR = 3.80; CI 2.62-5.49) and voted for parties opposed to the Government (OR = 2.00; CI 1.54-2.60) showed higher vaccine hesitancy. The stratified analysis showed a similar pattern for both men and women. CONCLUSIONS Considering the determinants of vaccine uptake and hesitancy could help to design strategies that increase immunisation at the population level and minimise health inequities.
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Affiliation(s)
- M Fontán-Vela
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Instituto de Lengua, Literatura y Antropología, Centro Superior de Investigaciones Sociológicas, Ministerio de Ciencia e Innovación, Spain
| | - P Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - U Bilal
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - M Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-2217, USA
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Grignon M, Bai Y. A cross-sectional analysis of the association between social capital and willingness to get COVID-19 vaccine in Ontario, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:175-184. [PMID: 36752981 PMCID: PMC9907866 DOI: 10.17269/s41997-023-00746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE We examine the role of social capital in intention to take the vaccine at the end of the first wave of the COVID-19 pandemic. METHODS This study uses observational, cross-sectional data from the Ontario sample of the fall 2020 Canadian Community Health Survey (CCHS), a representative sample of the population with added questions relative to symptoms of COVID-19 and intentions to get vaccinated. Questions on social capital were asked to respondents from Ontario only, yielding a sample of 6516. Odds ratios (OR) and marginal effects at sample mean of an index of social capital (at the individual or aggregated level) on changes in intentions to get vaccinated are estimated from logistic regression models. RESULTS Individual-level social capital is associated with greater willingness to get vaccinated against COVID-19 (OR 1.09). Associations with aggregated-level social capital are less precisely estimated. Associations are the same for both males and females but vary across age categories: individual-level social capital is associated with higher willingness to get vaccinated among working-age respondents, but aggregate-level social capital is associated with higher willingness to get vaccinated among older adults. CONCLUSION Vaccine hesitancy is not a random phenomenon, nor is it explained by individual characteristics such as education or income only. It also reflects the state of the social environment in which individuals live and public health messaging should take this into account if it is to be successful.
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Affiliation(s)
- Michel Grignon
- Department of Economics, McMaster University, Hamilton, ON, Canada.
| | - Yihong Bai
- Department of Economics, McMaster University, Hamilton, ON, Canada
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Afshari P, Alavi SM, Abedi P, Beheshtinasab M, Dashtpayma S, Amiri H. Exploring the underlying factors of COVID-19 vaccination hesitancy in Ahvaz, Iran: a comprehensive cross-sectional study. Clin Exp Vaccine Res 2023; 12:127-133. [PMID: 37214142 PMCID: PMC10193107 DOI: 10.7774/cevr.2023.12.2.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Around 70% of the Iranian population had received two doses of coronavirus disease 2019 (COVID-19) vaccines by the end of 2021. In this study, we evaluated the reasons for vaccination refusal among people in Ahvaz, Iran. Materials and Methods In this cross-sectional study, 800 participants (400 vaccinated and 400 unvaccinated) were recruited. A demographic questionnaire was completed through interviews. The unvaccinated participants were asked about the reasons for their refusal. The Shapiro-Wilk test, independent t-test, chi-square test, and logistic regression were used for analyzing data. Results Older people were 1.018 times more likely to refrain from vaccination (95% confidence interval [CI], 1.001-1.039; p=043). People who were manual workers as well as those who were unemployed/housewives were 0.288 and 0.423 times less likely to receive vaccination, respectively. Those with high school education and married women were 0.319 and 0.280 times less likely to receive vaccination, respectively (95% CI, 198-0.515; p<0.001; 95% CI, 0.186-0.422; p<0.001). Participants who had hypertension or suffered from neurological disorders were more likely to receive the vaccination. Finally, people affected with severe COVID-19 infection were 3.157 times more likely to get vaccinated (95% CI, 1.672-5.961; p<0.001). Conclusion The results of this study showed that lower level of education and older age were contributed to reluctance for vaccination, while having chronic diseases or being already infected with severe COVID-19 infection were associated with more acceptance of vaccination.
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Affiliation(s)
- Poorandokht Afshari
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Alavi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Beheshtinasab
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shohreh Dashtpayma
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homayon Amiri
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Divergent COVID-19 vaccine policies: policy mapping of ten European countries. Vaccine 2023; 41:2804-2810. [PMID: 36967287 PMCID: PMC10030332 DOI: 10.1016/j.vaccine.2023.03.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
Background The COVID-19 pandemic highlighted the fragmented nature of governmental policy decisions in Europe. However, the extent to which COVID-19 vaccination policies differed in various European countries remains unclear. Here, we mapped the COVID-19 vaccination policies that were in force in January 2022 as well as booster regulations as of April 2022 in Austria, Denmark, England, France, Germany, Ireland, Italy, the Netherlands, Poland, and Spain. Methods National public health and health policy experts from these ten European nations developed and completed an electronic questionnaire. The questionnaire included a series of questions that addressed six critical components of vaccine implementation, including (1) authorization, (2) prioritization, (3) procurement and distribution, (4) data collection, (5) administration, and (6) mandate requirements. Results Our findings revealed significant variations in COVID-19 vaccination policies across Europe. We observed critical differences in COVID-19 vaccine formulations that were authorized for use as well as the specific groups that were provided with priority access. We also identified discrepancies in how vaccination-related data were recorded in each country and what vaccination requirements were implemented. Conclusion Each of the ten European nations surveyed in this study reported different COVID-19 vaccination policies. These differences complicated efforts to provide a coordinated pandemic response. These findings might alert policymakers in Europe of the need to coordinate their efforts to avoid fostering divergent and socially disruptive policies.
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Grignolio Corsini A, Zagarella RM, Adamo M, Caporale C. From COVID-19 vaccine candidates to compulsory vaccination: The attitudes of Italian citizens in the key 7-month of vaccination campaign. Vaccine 2023; 41:2582-2588. [PMID: 36925424 PMCID: PMC9981525 DOI: 10.1016/j.vaccine.2023.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
INTRODUCTION The aim of the study is to understand the evolution of COVID-19 vaccine acceptance over the key 7-month vaccine campaign in Italy, a period in which the country moved from candidate vaccines to products administered to the public. The research focus points to evaluate COVID-19 vaccine attitudes in adults and their children, propension towards compulsory vaccination, past and present adherence to anti-flu and anti-pneumococcal vaccines, and the reasons for trust/mistrust of vaccines. METHODS Italian residents aged 16->65 years were invited to complete an online survey from September 2020 to April 2021. The survey contained 13 questions: 3 on demographic data; 8 on vaccine attitudes; and 2 open-ended questions about the reasons of vaccine confidence/refusal. A preliminary word frequency analysis has been conducted, as well as a statistical bivariate analysis. RESULTS Of 21.537 participants, the confidence of those in favor of the COVID-19 vaccine increases of 50 % and the number of people who wanted more information decreases by two-third. Willingness to vaccinate their children against COVID-19 also increased from 51 % to 66.5 %. Only one-third of the strong vaccine-hesitant participants, i.e. 10 %, remained hostile. Compulsory vaccination showed a large and increasing favor by participants up to 78 %, in a way similar to their propensity for children's mandatory vaccination (70.6 %). Respondents' past and present adherence to anti-flu and anti-pneumococcal vaccines does not predict their intentions to vaccinate against COVID-19. Finally, a semantic analysis of the reasons of acceptance/refusal of COVID-19 vaccination suggests a complex decision-making process revealed by the participants' use of common words in pro-and-cons arguments. CONCLUSION The heterogeneity in the COVID-19 vaccine hesitancy, determinants and opinions detected at different ages, genders and pandemic phases suggests that health authorities should avoid one-size-fits-all vaccination campaigns. The results emphasize the long-term importance of reinforcing vaccine information, communication and education needs.
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Affiliation(s)
- Andrea Grignolio Corsini
- Interdepartmental Center for Research Ethics and Integrity, National Research Council, Rome, Italy; Faculty of Medicine & Surgery, Vita-Salute San Raffaele University, Milan, Italy.
| | | | - Massimiliano Adamo
- Institute for applied mathematics "Mauro Picone" (IAC), National Research Council, Rome, Italy.
| | - Cinzia Caporale
- Interdepartmental Center for Research Ethics and Integrity, National Research Council, Rome, Italy.
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Lim J, Moon KK. Political Ideology and Trust in Government to Ensure Vaccine Safety: Using a U.S. Survey to Explore the Role of Political Trust. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4459. [PMID: 36901469 PMCID: PMC10002444 DOI: 10.3390/ijerph20054459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/18/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Since early 2020, the rapid expansion of COVID-19 has raised concerns about vaccine safety and the government's handling of it. Particularly notable and concerning has been a growing number of people who oppose vaccines, as this opposition poses a threat to public health. Those for and against vaccination have become polarized along a political divide. Within this context, this study focuses on the role of political trust, exploring whether political ideology is associated with the perception that the government can ensure the safety of vaccines and whether there is a moderator that can alleviate the concerns of those who oppose the government's handling of vaccine safety on ideological grounds. This study relies on the 2021 U.S. General Social Survey (GSS) and employs an ordered probit method because the dependent variable is an ordered category. The ordered probit model includes a weight provided by the U.S. GSS to account for the population. The sample size was 473 because of the inclusion of all the variables relevant to this study. The results obtained are as follows: First, conservatives associate negatively with support for the government's handling of vaccine safety. Second, more importantly, conservatives exhibit a higher trust level toward the government to ensure vaccine safety if their level of political trust increases. The results point to important implications. Political ideology matters in how individuals view the government's handling of vaccine safety. Political trust plays a key role in helping individuals alter their views toward the government's handling of vaccine safety. This points to a need for the government to take political trust seriously and work hard to improve the public's trust in the government.
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Affiliation(s)
- Jaeyoung Lim
- Department of Public Administration and Social Welfare, Chosun University, Gwangju 61452, Republic of Korea
| | - Kuk-Kyoung Moon
- Department of Public Administration, Inha University, Incheon 22212, Republic of Korea
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Kaufman J, Steffens MS, Hoq M, King C, Marques MD, Mao K, Bullivant B, Danchin M. Effect of persuasive messaging about COVID-19 vaccines for 5- to 11-year-old children on parent intention to vaccinate. J Paediatr Child Health 2023; 59:686-693. [PMID: 36807943 DOI: 10.1111/jpc.16374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
AIM Uptake of COVID-19 vaccines for children aged 5-11 years old in Australia has plateaued. Persuasive messaging is an efficient and adaptable potential intervention to promote vaccine uptake, but evidence for its effectiveness is varied and dependent on context and cultural values. This study aimed to test persuasive messages to promote COVID-19 vaccines for children in Australia. METHODS A parallel, online, randomised control experiment was conducted between 14 and 21 January 2022. Participants were Australian parents of a child aged 5-11 years who had not vaccinated their child with a COVID-19 vaccine. After providing demographic details and level of vaccine hesitancy, parents viewed either the control message or one of four intervention texts emphasising (i) personal health benefits; (ii) community health benefits; (iii) non-health benefits; or (iv) personal agency. The primary outcome was parents' intention to vaccinate their child. RESULTS The analysis included 463 participants, of whom 58.7% (272/463) were hesitant about COVID-19 vaccines for children. Intention to vaccinate was higher in the community health (7.8%, 95% confidence interval (CI) -5.3% to 21.0%) and non-health (6.9%, 95% CI -6.4% to 20.3%) groups, and lower in the personal agency group (-3.9, 95% CI -17.7 to 9.9) compared to control, but these differences did not reach statistical significance. The effects of the messages among hesitant parents were similar to the overall study population. CONCLUSION Short, text-based messages alone are unlikely to influence parental intention to vaccinate their child with the COVID-19 vaccine. Multiple strategies tailored for the target audience should also be utilised.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kevin Mao
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
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Song I, Lee SH. COVID-19 vaccine refusal associated with health literacy: findings from a population-based survey in Korea. BMC Public Health 2023; 23:255. [PMID: 36747179 PMCID: PMC9900554 DOI: 10.1186/s12889-023-15182-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Poor health literacy is associated with lower utilization of preventable services. However, the relationship between health literacy and COVID-19 vaccine hesitancy remains controvertible. METHODS This study used data from 229,242 individuals who completed the Community Health Survey in Korea from August 16 to October 31 in 2021. To operationalize COVID-19 vaccine hesitancy, we measured vaccine refusal, which is defined as not having been vaccinated and not intending to get vaccinated against COVID-19. Health literacy is operationalized in two dimensions; the ability to understand spoken directions from health professionals and the ability to understand written information regarding health. Covariates include sex, age, educational level, marital status, employment status, basic living security pension status, and subjective health status. Two multivariable logistic regression models were run to determine factors associated with COVID-19 vaccine refusal. Model 1 included sociodemographic characteristics and subjective health status. Model 2 added two health literacy variables. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. RESULTS Only 3.9% of the Korean adult population were estimated to refuse COVID-19 vaccine. The most commonly cited reasons for COVID-19 vaccine refusal were concerns about vaccine adverse events (47.6%), followed by the assessment of one's own health status (29.5%). Individuals who found spoken directions very difficult to understand were more likely to refuse COVID-19 vaccine than those who found spoken directions very easy (OR = 1.55, 95% CI: 1.28-1.87, p < 0.001). People who did not pay attention to written information were more likely to refuse COVID-19 vaccine than those who reported it to be very easy to understand (OR = 1.28, 95% CI: 1.13-1.45, p < 0.001). People in all other categories of the literacy spectrum for either spoken or written information did not have an increased risk of COVID-19 vaccine refusal. CONCLUSION Health literacy was significantly associated with COVID-19 vaccine refusal. Health literacy programs could be beneficial to reduce vaccine refusal, particularly for the people who find spoken directions from health professionals very difficult to understand and those who do not pay attention to written information.
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Affiliation(s)
- Inmyung Song
- grid.411118.c0000 0004 0647 1065College of Nursing and Health, Kongju National University, 56 Gongjudaehak-Ro, 32588 Gongju-Si, Chungcheongnam-do Republic of Korea
| | - Soo Hyun Lee
- College of Nursing and Health, Kongju National University, 56 Gongjudaehak-Ro, 32588, Gongju-Si, Chungcheongnam-do, Republic of Korea.
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Marcinowicz L, Fejfer-Wirbal E, Dudzik A, Genowska A, Terlikowski S. Barriers and Facilitators to COVID-19 Vaccine Uptake among Polish Patients: A Qualitative Interview Study. Vaccines (Basel) 2023; 11:vaccines11010177. [PMID: 36680021 PMCID: PMC9861893 DOI: 10.3390/vaccines11010177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
The decision to receive a COVID-19 vaccine is influenced by a variety of individual and contextual factors. However, there are very few studies that analyse individual vaccination decisions using a qualitative methodology. To close this gap, we conducted a qualitative interview study to examine the opinions and experiences with the vaccine among patients previously hospitalized due to COVID-19, including barriers and facilitators to vaccine uptake. An exploratory qualitative study, using semi-structured telephone interviews, was conducted among 22 patients admitted for COVID-19 in Poland in 2022. Opinions of patients previously hospitalized with COVID-19 on vaccination were varied. Barriers to COVID-19 vaccine uptake stemmed from concerns about vaccine safety, patients' religious beliefs, and negative stories. High disease severity and anxiety over personal and family health were important arguments in favour of receiving the COVID-19 vaccine. The study findings indicated the need for ongoing health education by healthcare staff as well as coordination and integration of multi-sectoral institutional measures regarding COVID-19 prevention strategies as well as increased public health initiatives on social media and engagement of community leaders for awareness about vaccines and vaccination. It is crucial to build trust in COVID-19 vaccinations among the general public by disseminating reliable information through trustworthy and credible sources. However, it ought to be emphasised that, regardless of the measures taken, some individuals will remain unconvinced about receiving a COVID-19 vaccine.
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Affiliation(s)
- Ludmiła Marcinowicz
- Department of Obstetrics, Gynecology and Maternity Care, Medical University of Bialystok, 15-295 Bialystok, Poland
| | - Ewa Fejfer-Wirbal
- Department of Health Sciences, Prof. Edward F. Szczepanik State Vocational University in Suwalki, Noniewicza 10, 16-400 Suwalki, Poland
| | - Agnieszka Dudzik
- Department of Foreign Languages, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
- Correspondence:
| | - Sławomir Terlikowski
- Department of Obstetrics, Gynecology and Maternity Care, Medical University of Bialystok, 15-295 Bialystok, Poland
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Blaga Z, Czine P, Takacs B, Szilagyi A, Szekeres R, Wachal Z, Hegedus C, Buchholcz G, Varga B, Priksz D, Bombicz M, Szabo AM, Kiss R, Gesztelyi R, Romanescu DD, Szabo Z, Szucs M, Balogh P, Szilvassy Z, Juhasz B. Examination of Preferences for COVID-19 Vaccines in Hungary Based on Their Properties-Examining the Impact of Pandemic Awareness with a Hybrid Choice Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1270. [PMID: 36674026 PMCID: PMC9858986 DOI: 10.3390/ijerph20021270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has posed a huge challenge to the world in recent years. The development of vaccines that are as effective as possible and accessible to society offers a promising alternative for addressing the problems caused by this situation as soon as possible and to restore the pre-epidemic system. The present study investigated the preferences of residents in Hungary's second-largest city (Debrecen) for the COVID-19 vaccine. To achieve this aim, a discrete choice experiment was conducted with 1011 participants, and the vaccine characteristics included in the design of the experiment were determined by qualitative methods and a pilot survey: (1) country of origin; (2) efficiency; (3) side effect; and (4) duration of protection. During the data collection at three vaccination sites, respondents were asked to choose between three vaccine alternatives and one "no choice" option in eight decision situations. Discrete choice model estimations were performed using a random parameter logit (RPL) specification with the final model extended to include a latent variable measuring pandemic awareness. The results showed that the vaccine with a Chinese country of origin is the least preferred among the respondents, while the Hungarian and the European vaccines are the most preferred. Furthermore, the increase in the vaccine efficiency level increased the respondents' sense of utility for the vaccine; the short-term side effect was preferred to the long-term one; and the increase in the duration of protection provided by the vaccine increased the respondents' sense of utility for the vaccine. Based on the parameter estimated for the latent variable, it can be concluded that as the level of pandemic awareness (which is more positive among people with chronic diseases and less important among health workers) increases, the choice of a vaccine option becomes more preferred among respondents compared to the "no choice". The results of our investigation could contribute towards increasing compliance in the case of the vaccination-rejecting population, not only for COVID-19, but for any kind of vaccination procedure.
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Affiliation(s)
- Zsanett Blaga
- University Pharmacy, Clinical Centre, University of Debrecen, H-4032 Debrecen, Hungary
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Peter Czine
- Institute of Statistics and Methodology, University of Debrecen, H-4032 Debrecen, Hungary
| | - Barbara Takacs
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Anna Szilagyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Reka Szekeres
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Zita Wachal
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Csaba Hegedus
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Gyula Buchholcz
- University Pharmacy, Clinical Centre, University of Debrecen, H-4032 Debrecen, Hungary
| | - Balazs Varga
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Daniel Priksz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Mariann Bombicz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Adrienn Monika Szabo
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Rita Kiss
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Dana Diana Romanescu
- Department of Diabetology, Pelican Clinical Hospital, 410087 Oradea, Romania
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Zoltan Szabo
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Miklos Szucs
- Department of Urology and Andrology, Clinical Centre, Kenezy Gyula Campus, University of Debrecen, H-4001 Debrecen, Hungary
| | - Peter Balogh
- Institute of Statistics and Methodology, University of Debrecen, H-4032 Debrecen, Hungary
| | - Zoltan Szilvassy
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Bela Juhasz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
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Changes in Attitudes toward COVID-19 Vaccination and Vaccine Uptake during Pandemic. Vaccines (Basel) 2023; 11:vaccines11010147. [PMID: 36679992 PMCID: PMC9864985 DOI: 10.3390/vaccines11010147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
The epidemic control approach was based on non-pharmacological measures in the first year of the COVID-19 pandemic, followed by vaccine uptake in the second year. Vaccine uptake depends on the individual attitude toward vaccination. The aim was to assess the changes in attitudes regarding COVID-19 vaccine protection during the pandemic and to determine the vaccination uptake concerning these attitudes. A panel study on COVID-19 vaccine attitudes and vaccination against COVID-19 was conducted in Belgrade, Serbia. The first survey was carried out in May−June 2020, and the second survey was organized in August−September 2021. During the baseline testing performed in 2020, 64.4% of respondents believed that the future vaccine against COVID-19 could protect against the COVID-19 disease, while 9.7% thought that it could not, and 25.9% were unsure. One year later, in the second survey, the percentage of participants with positive attitudes was slightly lower (64.7% vs. 62.5%). However, negative attitudes turned positive in 34% of cases, and 28.9% became unsure about vaccine protection (p < 0.001). Out of the 390 participants included in the study, 79.7% were vaccinated against COVID-19 until follow-up. There is a statistically significant difference in vaccination uptake compared to the baseline attitude about the protection of the COVID-19 vaccine. The main finding of our study is that the majority of participants who were vaccine hesitant during the baseline testing changed their opinion during the follow-up period. Additionally, the baseline attitude about the protection of the COVID-19 vaccine has been shown to be a potential determinant of vaccination uptake.
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Ganem F, Folch C, Colom-Cadena A, Bordas A, Alonso L, Soriano-Arandes A, Casabona J. Determinants of COVID-19 vaccine hesitancy among students and parents in Sentinel Schools Network of Catalonia, Spain. PLoS One 2023; 18:e0282871. [PMID: 36893204 PMCID: PMC9997992 DOI: 10.1371/journal.pone.0282871] [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: 11/23/2022] [Accepted: 02/25/2023] [Indexed: 03/10/2023] Open
Abstract
Vaccine hesitancy is defined as a delay in acceptance of vaccines despite its availability, caused by many determinants. Our study presents the key reasons, determinants and characteristics associated with COVID-19 vaccine acceptability among students over 16 years and parents of students under 16 years and describe the COVID-19 vaccination among students in the settings of sentinel schools of Catalonia, Spain. This is a cross-sectional study that includes 3,383 students and the parents between October 2021 and January 2022. We describe the student's vaccination status and proceed a univariate and multivariate analysis using a Deletion Substitution Addition (DSA) machine learning algorithm. Vaccination against COVID-19 reached 70.8% in students under 16 years and 95.8% in students over 16 years at the end of the study project. The acceptability among unvaccinated students was 40.9% and 20.8% in October and January, respectively, and among parents was proportionally higher among students aged 5-11 (70.2%) in October and aged 3-4 (47.8%) in January. The key reason to not vaccinate themselves, or their children, were concern about side effects, insufficient research about the effect of the vaccine in children, rapid development of vaccines, necessity for more information and previous infection by SARS-CoV-2. Several variables were associated with refusal end hesitancy. For students, the main ones were risk perception and use of alternative therapies. For parents, the age of students, sociodemographic variables, socioeconomic impact related to the pandemic, and use of alternative therapies were more evident. Monitoring vaccine acceptance and refusal among children and their parents has been important to understand the interaction between different multilevel determinants and we hope it will be useful to improve public health strategies for future interventions in this population.
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Affiliation(s)
- Fabiana Ganem
- Centre d’Estudis Epidemiològics Sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Cinta Folch
- Centre d’Estudis Epidemiològics Sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail:
| | - Andreu Colom-Cadena
- Centre d’Estudis Epidemiològics Sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Anna Bordas
- Centre d’Estudis Epidemiològics Sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Lucia Alonso
- Institut d’Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Fundació Lluita Contra les Infeccions, Badalona, Spain
| | - Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Jordi Casabona
- Centre d’Estudis Epidemiològics Sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain
- Departament de Pediatria, d’Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d’Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Maietti E, Reno C, Sanmarchi F, Montalti M, Fantini MP, Gori D. Are psychological status and trust in information related to vaccine hesitancy during COVID-19 pandemic? A latent class and mediation analyses in Italy. Hum Vaccin Immunother 2022; 18:2157622. [PMID: 36573024 PMCID: PMC9891681 DOI: 10.1080/21645515.2022.2157622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Despite the recognized benefits of the COVID-19 vaccination, vaccine hesitancy (VH) remains one of the biggest challenges of the mass vaccination campaign. Most studies investigating VH determinants focused on socio-demographics and direct relationships. In this study, we aimed at: 1) identifying subgroups of people differently affected by the pandemic, in terms of psychological status; 2) investigating the role of psychological status and trust in information as possible mediators of the relationship between individual characteristics and VH. To this purpose, a latent class analysis (LCA) followed by a mediation analysis were carried out on data from a survey conducted in January 2021 on 1011 Italian citizens. LCA identified four different subgroups characterized by a differential psychological impact of the pandemic: the extremely affected (21.1%), the highly affected (49.1%), the moderately affected (21.8%) and the slightly affected (8%). We found that VH decreased with the increase of psychological impact (from 59.3% to 23.9%). In the mediation analysis, past vaccination refusal, age 45-54 years and lower-than-average income, were all indirectly related to higher VH through mistrust in COVID-19 information. Differently, the psychological impact counteracted the greater VH in females, the negative effect of social media among youngest (<35 years) and the negative effect of mistrust in the lower-than-average-income subgroup. Knowledge of psychological profile of hesitant individuals, their level of trust and the sources of information they access, together with their sociodemographic characteristics provides a more comprehensive picture of VH determinants that can be used by public health stakeholders to effectively design and adapt communication campaigns.
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Affiliation(s)
- Elisa Maietti
- Department of Biomedical and Nuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna, Italy
| | - Chiara Reno
- Department of Biomedical and Nuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna, Italy
| | - Francesco Sanmarchi
- Department of Biomedical and Nuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna, Italy,CONTACT Francesco Sanmarchi Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Via San Giacomo 12, Bologna, Italy
| | - Marco Montalti
- Department of Biomedical and Nuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Nuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna, Italy
| | - Davide Gori
- Department of Biomedical and Nuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna, Italy
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Surveillance of Severe Acute Respiratory Infection and Influenza Vaccine Effectiveness among Hospitalized Italian Adults, 2021/22 Season. Vaccines (Basel) 2022; 11:vaccines11010083. [PMID: 36679928 PMCID: PMC9861626 DOI: 10.3390/vaccines11010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Following an extremely low incidence of influenza during the first waves of the ongoing COVID-19 pandemic, the 2021/22 Northern Hemisphere winter season saw a resurgence of influenza virus circulation. The aim of this study was to describe epidemiology of severe acute respiratory infections (SARIs) among Italian adults and estimate the 2021/22 season influenza vaccine effectiveness. For this purpose, a test-negative case-control study was conducted in a geographically representative sample of Italian hospitals. Of 753 SARI patients analyzed, 2.5% (N = 19) tested positive for influenza, most of which belonged to the A(H3N2) subtype. Phylogenetic analysis showed that these belonged to the subclade 3C.2a1b.2a.2, which was antigenically different from the 2021/22 A(H3N2) vaccine component. Most (89.5%) cases were registered among non-vaccinated individuals, suggesting a protective effect of influenza vaccination. Due to a limited number of cases, vaccine effectiveness estimated through the Firth's penalized logistic regression was highly imprecise, being 83.4% (95% CI: 25.8-97.4%) and 83.1% (95% CI: 22.2-97.3%) against any influenza type A and A(H3N2), respectively. Exclusion of SARS-CoV-2-positive controls from the model did not significantly change the base-case estimates. Within the study limitations, influenza vaccination appeared to be effective against laboratory-confirmed SARI.
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Jang SH, Gerend MA, Youm S, Yi YJ. Understanding coronavirus disease 2019 (COVID-19) vaccine hesitancy: Evidence from the community-driven knowledge site Quora. Digit Health 2022; 8:20552076221145426. [PMID: 36544537 PMCID: PMC9761207 DOI: 10.1177/20552076221145426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Objective The present study aims to examine the threshold of coronavirus disease 2019 (COVID-19) vaccine hesitancy over time and public discourse around COVID-19 vaccination hesitancy. Methods We collected 3,952 questions and 66,820 answers regarding COVID-19 vaccination posted on the social question-and-answer website Quora between June 2020 and June 2021 and employed Word2Vec and Sentiment Analysis to analyze the data. To examine changes in the perceptions and hesitancy about the COVID-19 vaccine, we segmented the data into 25 bi-weekly sections. Results As positive sentiment about vaccination increased, the number of new vaccinations in the United States also increased until it reached a ceiling point. The vaccine hesitancy phase was identified by the decrease in positive sentiment from its highest peak. Words that occurred only when the positive answer rate peaked (e.g., safe, plan, best, able, help) helped explain factors associated with positive perceptions toward vaccines, and the words that occurred only when the negative answer rate peaked (e.g., early, variant, scientists, mutations, effectiveness) suggested factors associated with vaccine hesitancy. We also identified a period of vaccine resistance, where people who decided not to be vaccinated were unlikely to be vaccinated without further enforcement or incentive. Conclusions Findings suggest that vaccine hesitancy occurred because concerns about vaccine safety were high due to a perceived lack of scientific evidence and public trust in healthcare authorities has been seriously undermined. Considering that vaccine-related conspiracy theories and fake news prevailed in the absence of reliable information sources, restoring public trust in healthcare leaders will be critical for future vaccination efforts.
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Affiliation(s)
- Sou Hyun Jang
- Department of Sociology, Korea University,
Seoul, South Korea
| | - Mary A. Gerend
- Department of Behavioral Sciences and Social Medicine, College of
Medicine, Florida State University, Tallahassee, FL, USA
| | - Sangpil Youm
- Department of Computer & Information Science & Engineering,
Herbert Wertheim College of Engineering, University of
Florida, Gainesville, FL, USA
| | - Yong J Yi
- Department of Data Science, School of Global Convergence, College of
Computing & Informatics, Sungkyunkwan
University, Seoul, South Korea,Yong J Yi, Department of Data Science,
School of Global Convergence, College of Computing and Informatics, Sungkyunkwan
University, Seoul, South Korea.
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Bîrsanu SE, Plaiasu MC, Nanu CA. Informed Consent in Mass Vaccination against COVID-19 in Romania: Implications of Bad Management. Vaccines (Basel) 2022; 10:vaccines10111871. [PMID: 36366379 PMCID: PMC9693422 DOI: 10.3390/vaccines10111871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Informing patients and obtaining valid informed consent were significant challenges for the COVID-19 immunization program. In Romania, the authorities issued a strategy for activities regarding vaccination against COVID-19, including the informed consent procedure. The lack of legal preparedness was evident when the medical personnel at the vaccination centers were provided with informed consent forms that did not respect the existing legal requirements. In addition, the protocol for persons seeking vaccination stated that the patient was supposed to receive the informed consent form from the receptionist in order to read and sign it. We analyzed the legal implications and the malpractice litigation risk associated with this practice. Due to essential deficiencies and in the absence of an official enactment of new regulations, we conclude that the vaccination consent process did not comply with the legal requirements. Implications include medical personnel’s legal liability, loss of malpractice insurance coverage, and public mistrust that may have contributed to a low vaccination rate. Given the potential of future pandemics or other health crises, this may be a valuable lesson for developing better legal strategies.
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Affiliation(s)
- Sînziana-Elena Bîrsanu
- School of Advanced Studies of the Romanian Academy, 125 Calea Victoriei, 010071 Bucharest, Romania
| | - Maria Cristina Plaiasu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
- Correspondence: ; Tel.: +40-770-112-453
| | - Codrut Andrei Nanu
- Department No. 14 of Orthopedics, Anesthesia and Intensive Care, University of Medicine and Pharmacy “Carol Davila” Bucharest, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
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Rzymski P, Kasianchuk N, Sikora D, Poniedziałek B. COVID-19 vaccinations and rates of infections, hospitalizations, ICU admissions, and deaths in Europe during SARS-CoV-2 Omicron wave in the first quarter of 2022. J Med Virol 2022; 95:e28131. [PMID: 36068643 PMCID: PMC9537885 DOI: 10.1002/jmv.28131] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/11/2022] [Accepted: 09/04/2022] [Indexed: 01/11/2023]
Abstract
The vaccination campaigns brought hope to minimizing the coronavirus disease 2019 (COVID-19) burden. However, the emergence of novel, highly transmissible Omicron lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the waning of neutralizing antibodies a few months after vaccination has brought concerns over the vaccine efficacy. The present work analyzed the relationships between COVID-19 vaccine coverage (completion of primary course and booster dose intake) in the European Economic Area and rates of infection, hospitalizations, admissions to intensive care units (ICU), and deaths during the Omicron wave in the first quarter of 2022 (January-April). As demonstrated, infection rates were not correlated to vaccine coverage in any considered month. For January and February, the rates of hospitalizations, intensive care unit (ICU) admissions, and death due to COVID-19 were strongly negatively correlated (r =- 0.54 to -0.82) with the percentage of individuals who completed initial vaccination protocol and the percentage of those who received a booster dose. However, in March and April, the percentage of the population with primary vaccination course correlated negatively only with ICU admissions (r = -0.77 and -0.46, respectively). The uptake of boosters in March still remained in significant negative correlation with hospitalizations (r = -0.45), ICU admissions (r = -0.70) and deaths due to COVID-19 (r = -0.37), although in April these relationships were no longer observed. The percentage of individuals with confirmed SARS-CoV-2 infection did not correlate with the pandemic indices for any considered month. The study indicates that COVID-19 vaccination, including booster administration, was beneficial in decreasing the overwhelming of healthcare systems during the Omicron wave, but novel vaccine strategies may be required in the long term to enhance the effectiveness and durability of vaccine-induced protection during future waves of SARS-CoV-2 infections.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental MedicinePoznan University of Medical SciencesPoznańPoland,Integrated Science Association (ISA)Universal Scientific Education and Research Network (USERN)PoznańPoland
| | - Nadiia Kasianchuk
- Faculty of BiologyAdam Mickiewicz UniversityPoznańPoland,Faculty of PharmacyBogomolets National Medical UniversityKyivUkraine
| | - Dominika Sikora
- Department of Environmental MedicinePoznan University of Medical SciencesPoznańPoland,Doctoral SchoolPoznan University of Medical SciencesPoznańPoland
| | - Barbara Poniedziałek
- Department of Environmental MedicinePoznan University of Medical SciencesPoznańPoland
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