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Wong LP, Lee HY, Alias H, Zimet G, Liu T, Lin Y, Hu Z. Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review. Hum Vaccin Immunother 2024; 20:2313860. [PMID: 38359815 PMCID: PMC10877984 DOI: 10.1080/21645515.2024.2313860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.
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Affiliation(s)
- Li Ping Wong
- Department of Epidemiology and Health Statistics, Fujian Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hai Yen Lee
- Tropical Infectious Diseases Research & Education Centre (TIDREC), Universiti Malaya, Kuala Lumpur, Malaysia
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Gregory Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tongyu Liu
- Department of Gynecology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuzhou, Fujian, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, Fujian Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
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Ventonen M, Douglas-Smith N, Hatin B. Predicting the intention to receive the COVID-19 booster vaccine based on the health belief model. Acta Psychol (Amst) 2024; 246:104254. [PMID: 38631152 DOI: 10.1016/j.actpsy.2024.104254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/05/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
COVID-19 vaccine boosters are recommended because the protection provided by previous doses eventually decreases, posing a threat to immunity. Some people, however, remain hesitant or unwilling to get vaccinated. The present study sought to investigate factors associated with the intention to receive the COVID-19 booster vaccine based on (1) the constructs of the Health Belief Model, and (2) trust in healthcare workers and science. A sample of 165 adults with two doses of the COVID-19 vaccine were recruited using convenience sampling. Data was collected using an online survey from November 2021 to January 2022. The survey included questions about participants' socio-demographic details, health beliefs, trust, history of COVID-19 vaccination, and the intention to receive a third dose of the COVID-19 vaccine. Ordinal logistic regression analysis showed that higher perceived benefits, severity, and trust in healthcare workers, and lower perceived barriers predicted higher willingness to get a third dose of the vaccine whereas perceived susceptibility and trust in science did not. Understanding the factors and health beliefs that underlie vaccine hesitancy are vital when developing effective interventions with the aim of increasing uptake of COVID-19 booster vaccines.
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Affiliation(s)
- Milja Ventonen
- School of Education and Social Sciences, University of the West of Scotland, High St, Paisley PA1 2BE, United Kingdom.
| | - Nicola Douglas-Smith
- School of Education and Social Sciences, University of the West of Scotland, High St, Paisley PA1 2BE, United Kingdom.
| | - Bianca Hatin
- School of Education and Social Sciences, University of the West of Scotland, High St, Paisley PA1 2BE, United Kingdom.
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Beretzky Z, Brodszky V. Sociodemographic determinants of vaccination and willingness to pay for COVID-19 vaccines in Hungary, results of a cross-sectional online questionnaire. BMC Public Health 2024; 24:1320. [PMID: 38755599 PMCID: PMC11097570 DOI: 10.1186/s12889-024-18797-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: 02/15/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Several different coronavirus disease (COVID-19) vaccines were authorized and distributed all over the world, including Hungary, but vaccination rates and acceptance of the different vaccines varied through 2021 and subsequent years. In Hungary Western vaccines and the Chinese and Russian vaccines were available in early 2021. Understanding preference and willingness to pay (WTP) for the COVID-19 vaccine could provide information for policy decision making to control the COVID-19 pandemic. We aimed to assess the socio-demographic factors influencing the COVID-19 vaccination and to analyse individual preferences for the available COVID-19 vaccines in Hungary. METHODS A cross-sectional online questionnaire survey was conducted between 25-05-2021 and 08-06-2021 exploring the vaccine acceptance and WTP for vaccination in the Hungarian general population. To assess the preferences towards the different vaccines available in Hungary at the time of the study, we used a multi-step WTP task. RESULTS Altogether 2,000 respondents filled out our survey, with the average age of 49.1 (SD = 15.3), out of whom 370 respondents (18.5%) stated that they already had a COVID-19 infection. Age above 65 years, male gender, higher level of education, higher income and residence in the capital or county seats were associated with a higher probability of vaccination. The average WTP ranged from 14.2 to 30.3 EUR for the different vaccine types. CONCLUSIONS Males, respondents with higher education and income stated a higher WTP value for all vaccines. Better socioeconomic status increased both vaccination coverage and willingness to pay for vaccines.
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Affiliation(s)
- Zsuzsanna Beretzky
- Department of Health Policy, Corvinus University of Budapest, Fővám Tér 8, 1093, Budapest, Hungary.
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, Fővám Tér 8, 1093, Budapest, Hungary
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Achore M. Correlates of COVID-19 vaccine uptake among the forcibly displaced: evidence from Libya. Arch Public Health 2024; 82:70. [PMID: 38741160 DOI: 10.1186/s13690-024-01306-4] [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: 11/27/2023] [Accepted: 05/04/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Vaccine hesitancy and refusal can hinder the control of infectious diseases such as coronavirus disease 2019 (COVID-19). Although forcibly displaced individuals are at high risk of contracting COVID-19, evidence shows that they are less likely to accept the COVID-19 vaccine. Given their predicament, the factors influencing vaccine uptake in the general population might differ vastly from those in displaced populations. Given the limited evidence on vaccine uptake from humanitarian settings, the current study examined the determinants of COVID-19 vaccine uptake among the forcibly displaced in Libya. METHODS Data were extracted from the World Bank/United Nations High Commissioner for Refugees (UNHCR) microdata repository. Data were collected between April and July 2021 after the rollout of the first dose of the COVID-19 vaccine in Libya. Percentages, means, and standard deviations were used to quantify the distribution of the sample population. Logistic regression models were employed to identify factors influencing COVID-19 vaccine uptake. RESULTS Odds ratios (ORs) with p values are used to present the regression analysis results. The study revealed that people unaffected by COVID-19 were less likely (OR = .71, 95%CI = 0.67-0.89) to accept the vaccine. Similarly, individuals with access to free COVID-19 vaccines were more likely to be vaccinated than those without free vaccines (OR = 38, 95%CI = 0.19-0.28). Finally, the results indicated that individuals were six times more likely to be vaccinated at mass vaccination sites ((OR = 6.31, 95%CI = 5.46- 7.94) and 1.92 times more likely to be vaccinated at local health centers (OR = 1.92, 95%CI = 0.1.72-3.11) than they were at hospitals and distant health facilities. CONCLUSION Implementing comprehensive mass vaccination venues, public education initiatives, and awareness campaigns regarding the importance of vaccination can decrease vaccine hesitancy among the forcibly displaced.
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Affiliation(s)
- Meshack Achore
- Department of Population Health, 220 Hofstra University, 101 Hofstra Dome, Hempstead, NY, 11549-2200, USA.
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DeBeck DP, Scudder JN. An Integrated Health Belief Model: Predicting Uptake of the First COVID-19 Booster Vaccine. HEALTH COMMUNICATION 2024; 39:1102-1112. [PMID: 37128817 DOI: 10.1080/10410236.2023.2204583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Public health campaigns have turned to the Health Belief Model (HBM) as a guiding framework for the past six decades. Carpenter's 2010 HBM meta-analysis revealed important shortcomings as well as a path forward that has largely been ignored by recent COVID-19 research using this framework. Consistent with Carpenter's recommendations, this study on the uptake of the first COVID-19 booster vaccine focused on the overlooked interactional processes of the original HBM founders. Our study used SEM and Hayes's PROCESS 4.1 to explore the possibilities of the interdependent nature of the core three beliefs to form a model that is integrated. The study indicated that the core variables of the original HBM were significant predictors of the intent to take the first COVID-19 booster vaccine when considered in an interactional process framework. Our study results have implications for those designing public health advocacy campaigns regarding COVID-19 as it enters an endemic stage with future vaccines and medications.
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Bouloukaki I, Christodoulakis A, Papageorgakopoulou S, Tsiligianni I. The Prevalence and Determinants of Hesitancy for Regular COVID-19 Vaccination among Primary Healthcare Patients with Asthma or COPD in Greece: A Cross-Sectional Study. Vaccines (Basel) 2024; 12:414. [PMID: 38675796 PMCID: PMC11054093 DOI: 10.3390/vaccines12040414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The emergence of novel coronavirus mutations and signs of the waning immunity provided by COVID-19 vaccines underscore the importance of regular vaccination. This study aimed to investigate the prevalence of regular COVID-19 vaccination hesitancy and the factors that influence it among patients with asthma or chronic obstructive pulmonary disease (COPD) who visited primary care centers. The cross-sectional study was conducted in six primary healthcare centers in Crete, Greece (October-December 2023). Participants completed a questionnaire, which included questions about socio-demographic characteristics, health status, previous COVID-19 booster vaccination, attitudes, and beliefs about COVID-19 vaccination. Multivariate logistic regression was used to identify the factors that influenced vaccine hesitancy. Of the 264 participants, 65% exhibited hesitancy towards COVID-19 booster vaccination. Female gender, middle age, lower educational attainment, depression diagnosis, concerns about vaccine side effects, lack of confidence in vaccine efficacy, and reliance on media information were positively associated to vaccine hesitancy. Conversely, those having a cardiovascular disease or type 2 diabetes, those generally adhering to the recommendations of the treating physician, and those having previously received the flu vaccine or more than three COVID-19 vaccine doses were positively associated with regular COVID-19 vaccinations. Consequently, our findings could help develop strategies that could potentially reduce regular vaccination hesitancy among patients with asthma or COPD.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Stavroula Papageorgakopoulou
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (S.P.); (I.T.)
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Yang T, Tang D, Zhan Y, Seyler BC, Li F, Zhou B. SARS-CoV-2 vaccination and semen quality: a study based on sperm donor candidate data in southwest China. Transl Androl Urol 2024; 13:80-90. [PMID: 38404555 PMCID: PMC10891393 DOI: 10.21037/tau-23-395] [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: 07/28/2023] [Accepted: 11/20/2023] [Indexed: 02/27/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has been a global health crisis and continues to pose risk to population health at the present. Vaccination against this disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has become a public health priority worldwide. Yet, limited information is available on the potential impact of such vaccines on human fertility. Methods To examine the relationship between COVID-19 vaccination and male fertility, we conducted an observational study on sperm donor candidates in China who received Chinese COVID-19 vaccines between January 1, 2020 to December 31, 2021. Results A total of 2,955 semen samples from 564 individuals were assessed along with vaccination information. Statistical analyses were conducted on both the entire study population and the subgroup of individuals who provided repeated semen samples before and after vaccination. While motility related parameters [progressive rate, curvilinear velocity (VCL), average path velocity (VAP), straight-line velocity (VSL), wobble (WOB), straightness (STR), linearity (LIN), amplitude of lateral head displacement (ALH), beat-cross frequency (BCF)] exhibited statistically significant difference before and after vaccination based on Welch two-sample test, mixed effects regression results based on repeated measures from the same individuals indicated that vaccination was not statistically associated with sperm quality parameters except for VCL, VAP, and VSL. Individual variability was the key determinant of sperm quality variance, with contribution ranging from 19% to 82%. Conclusions Findings from our study could help to enhance current understanding of male reproductive health in the context of the global pandemic.
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Affiliation(s)
- Tingting Yang
- Department of Andrology/Human Sperm Bank of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Die Tang
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Barnabas C. Seyler
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Fuping Li
- Department of Andrology/Human Sperm Bank of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Bin Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
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Abate BB, Tilahun BD, Yayeh BM. Global COVID-19 vaccine acceptance level and its determinants: an umbrella review. BMC Public Health 2024; 24:5. [PMID: 38166750 PMCID: PMC10759439 DOI: 10.1186/s12889-023-17497-4] [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: 07/22/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The COVID-19 vaccination is essential for reducing disease burden on a worldwide scale. The success of this strategy will largely depend on how well vaccines are received. Previous reviews had produced contradictory results, and there had been no umbrella review. Therefore, the objective of this umbrella review was to combine the contradictory data regarding the COVID-19 vaccination's global acceptance rate and its contributing factors. METHODS Using PRISMA guideline, PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Scopus and Google Scholar which reported COVID-19 vaccine acceptance and/or its determinants were searched. The quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR). A weighted inverse variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias and sensitivity analysis were also assessed. RESULT Twenty-two SRM with 10,433,306 study participants were included. The pooled COVID-19 vaccine acceptance rate globally is found to be 60.23 (95% CI: 58.27, 62.18). In low-income countries, the pooled level of COVID-19 vaccine acceptance was found to be 54.07(50.31, 57.83) while this magnitude is 64.32 (62.24,66.40) among studies across the globe. Higher level of education (AOR =1.96; 95% CI:1.20, 2.73), good level of knowledge (2.20; 95% CI:1.36, 3.03), favourable attitude (AOR =4.50; 95% CI:2.89, 6.12), previous history of COVID-19 infection (AOR =3.41; 95% CI:1.77, 5.06), male sex (AOR =1.62; 95% CI:1.47, 1.77), and chronic disease (AOR =1.54; 95% CI:1.18, 1.90) were predictors of COVID-19 vaccine acceptance. CONCLUSION The pooled level of COVID-19 vaccine acceptance highly varied and found to be unacceptably low particularly in low-income countries. Higher level of education, good level of knowledge, favourable attitude, previous history of COVID-19, male sex, and chronic disease were factors of COVID-19 vaccine acceptance rate. A collaborative effort of stakeholders such as policymakers, and vaccine campaign program planners is needed to improve the acceptance rate of COVID-19 vaccine.
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Affiliation(s)
- Biruk Beletew Abate
- Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Befkad Derese Tilahun
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Berihun Mulu Yayeh
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Gazibara T, Cvjetkovic S, Milic M, Dotlic J, Maksimovic N, Jovanovic V, Jeremic Stojkovic V. Preferences of COVID-19 Vaccines in the General Population in Belgrade, Serbia: A Qualitative Study. Behav Med 2024; 50:16-25. [PMID: 35672260 DOI: 10.1080/08964289.2022.2085652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/02/2022]
Abstract
Few countries provided multiple COVID-19 vaccines for their citizens right from the start of mass immunization. In Serbia, four vaccines were available. Circumstances in which people had several options to choose from are unique. The purpose of this study was to identify motivators behind COVID-19 vaccination and the choice of COVID-19 vaccine among people who were immunized against COVID-19. Qualitative interviews with 35 vaccinated people aged > 18 years were conducted in May 2021 at the Institute of Public Health of Serbia, a reference institution for vaccination. Interviews were audio-recorded, transcribed and data were analyzed using qualitative content analysis. Four topics emerged: 1) Decision to receive COVID-19 vaccine; 2) Sources of information about the vaccine; 3) Choice of the COVID-19 vaccine and 4) Anti-vaccination sentiment around the vaccinated people. Participants were classified in two groups: those who were determined to receive the vaccine and those who were hesitant. People who were hesitant decided to receive the vaccine after reviewing the information collected from various sources, especially physicians. Although some participants accepted any vaccine regardless of their characteristics, there were others who had explicit preferences. These preferences stemmed mainly from their beliefs about particular vaccine's efficacy and safety, COVID-19 status (previous infection), living or lifestyle circumstances (residence or travel abroad), doctor's recommendation (underlying health status) or trust in expertise of that particular manufacturer's country of origin. Opting for appropriate vaccine was motivated by reasons specific to various individuals, which enabled them to make choices in line with their preferences and values.
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Affiliation(s)
- Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Smiljana Cvjetkovic
- Department of Humanities, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Milic
- Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Maksimovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Verica Jovanovic
- Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
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Huang CL, Chen JY, Lin XQ, Deng JS, Tung TH, Zhu JS. Parents' willingness to pay for their children's COVID-19 vaccine in Taiwan, China: A cross-sectional study. Hum Vaccin Immunother 2023; 19:2168936. [PMID: 36683206 PMCID: PMC9980450 DOI: 10.1080/21645515.2023.2168936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Most COVID-19 studies aim to assess factors influencing willingness to pay for vaccines between the public and medical staff. However, few studies focus on parents' willingness to pay for their children's COVID-19 vaccine. The current study aimed to assess parents' willingness to pay for their children's vaccination against COVID-19 and its influencing factors. This population-based cross-sectional study used a self-administered questionnaire. The inclusion criterion was parents with at least one child younger than 18 years. The final analysis included 384 valid data points. A total of 89.1% of the parents indicated that they are willing to pay for their children's vaccination against COVID-19. Among them, both fathers' and mothers' willingness to pay for their children's COVID-19 vaccine was 89.6%. The mean and median willingness to pay were% would pay for their children. Excluding other confounding factors, willingness to pay for the COVID-19 vaccine for themselves and hesitation to vaccinate their children were significantly associated with parents' willingness to pay for their children's COVID-19 vaccine. We found that 89.1% of the parents in Taiwan would pay for their children's COVID-19 vaccine. Parents' willingness to pay for themselves and hesitation to vaccinate their children were associated with willingness to pay. Reducing hesitation about vaccines and developing policies for vaccine payment may have a positive impact on willingness to pay for vaccines and promoting COVID-19 vaccination.
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Affiliation(s)
- Chun-Lian Huang
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, Taiwan
| | - Jing-Shan Deng
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, Taiwan
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, Taiwan
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Qin C, Du M, Wang Y, Liu Q, Yan W, Tao L, Liu M, Liu J. Assessing acceptability of the fourth dose against COVID-19 among Chinese adults: A population-based survey. Hum Vaccin Immunother 2023; 19:2186108. [PMID: 36892289 PMCID: PMC10026929 DOI: 10.1080/21645515.2023.2186108] [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] [Indexed: 03/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe for approximately three years. Vaccination is a key factor to ending this pandemic, but its protective effect diminishes over time. A second booster dose at the right time is needed. To explore the willingness to receive the fourth dose of the COVID-19 vaccine and its influencing factors, we commenced a national, cross-sectional and anonymous survey in mainland China among people aged 18 and above from October 24 to November 7, 2022. A total of 3,224 respondents were eventually included. The acceptance rate of the fourth dose was 81.1% (95% CI: 79.8-82.5%), while it was 72.6% (95% CI: 71.1-74.2%) for a heterologous booster. Confidence in current domestic situation and the effectiveness of previous vaccinations, and uncertainty about extra protection were the main reasons for vaccine hesitancy. Perceived benefit (aOR = 1.29, 95% CI: 1.159-1.40) and cues to action (aOR = 1.73, 95% CI: 1.60-1.88) were positively associated with the vaccine acceptance, whereas perceived barriers (aOR = 0.78, 95% CI: 0.72-0.84) and self-efficacy (aOR = 0.79, 95% CI: 0.71-0.89) were both negatively associated with it. Additionally, sex, age, COVID-19 vaccination history, time for social media, and satisfaction with the government's response to COVID-19 were also factors affecting vaccination intention. Factors influencing the intention of heterologous booster were similar to the above results. It is of profound theoretical and practical significance to clarify the population's willingness to vaccinate in advance and explore the relevant influencing factors for the subsequent development and promotion of the fourth-dose vaccination strategies.
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Affiliation(s)
- Chenyuan Qin
- School of Public Health, Peking University, Beijing, China
| | - Min Du
- School of Public Health, Peking University, Beijing, China
| | - Yaping Wang
- School of Public Health, Peking University, Beijing, China
| | - Qiao Liu
- School of Public Health, Peking University, Beijing, China
| | - Wenxin Yan
- School of Public Health, Peking University, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Min Liu
- School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Peking University, Beijing, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China
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12
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Biswas MR, Shah Z. Extracting factors associated with vaccination from Twitter data and mapping to behavioral models. Hum Vaccin Immunother 2023; 19:2281729. [PMID: 38013461 PMCID: PMC10760324 DOI: 10.1080/21645515.2023.2281729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023] Open
Abstract
Social media platform, particularly Twitter, is a rich data source that allows monitoring of public opinions and attitudes toward vaccines.Established behavioral models like the 5C psychological antecedents model and the Health Belief Model (HBM) provide a well-structured framework for analyzing shifts in vaccine-related behavior. This study examines if the extracted data from Twitter contains valuable insights regarding public attitudes toward vaccines and can be mapped to two behavioral models. This study focuses on the Arab population, and a search was carried out on Twitter using: ' تلقيحي OR تطعيم OR تطعيمات OR لقاح OR لقاحات' for two years from January 2020 to January 2022. Then, BERTopicmodeling was applied, and several topics were extracted. Finally, the topics were manually mapped to the factors of the 5C model and HBM. 1,068,466 unique users posted 3,368,258 vaccine-related tweets in Arabic. Topic modeling generated 25 topics, which were mapped to the 15 factors of the 5C model and HBM. Among the users, 32.87%were male, and 18.06% were female. A significant 55.77% of the users were from the MENA (Middle East and North Africa) region. Twitter users were more inclined to accept vaccines when they trusted vaccine safety and effectiveness, but vaccine hesitancy increased due to conspiracy theories and misinformation. The association of topics with these theoretical frameworks reveals the availability and diversity of Twitter data that can predict behavioral change toward vaccines. It allows the preparation of timely and effective interventions for vaccination programs compared to traditional methods.
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Affiliation(s)
- Md. Rafiul Biswas
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Zubair Shah
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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13
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Stefanizzi P, Bianchi FP, Moscara L, Martinelli A, Di Lorenzo A, Gesualdo L, Simone S, Rendina M, Tafuri S. Determinants of compliance to influenza and COVID-19 vaccination in a cohort of solid organ transplant patients in Puglia, Southern Italy (2017-2022). Hum Vaccin Immunother 2023; 19:2266932. [PMID: 37842986 PMCID: PMC10580794 DOI: 10.1080/21645515.2023.2266932] [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: 07/30/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Influenza and Coronavirus Disease 2019 (COVID-19) vaccination are recommended in both solid organ transplant (SOT) candidates and recipients. In Puglia, Southern Italy, an active vaccination offer program has been activated targeting these patients. This study aims at investigating vaccination coverage (VC) for both vaccines in a SOT patients' cohort, as well as at identifying the vaccination compliance determinant. This is a retrospective, population-based study. The study population consists of the SOT patients who accessed Bari's "Policlinico" General Hospital during 2017-2022. Patients were contacted and, after providing their consent, asked their immunization status regarding influenza and COVID-19 and whether they had already undergone transplant or were waiting to do so. Regression models were fitted to investigate the determinants of VCs for influenza vaccination (2021/22 and 2022/23 seasons) and for COVID-19 vaccination (three-dose base cycle, first and second booster doses). Three-hundred and ten SOT patients were identified; 85.2% (264/310) had already undergone SOT. VCs were suboptimal, especially for constant yearly influenza vaccination (17.7%) and COVID-19 vaccination's second booster (1.94%). Logistic regression highlighted that influenza VCs are higher for SOT recipients than SOT candidates, as well as for older patients, although when considering both vaccination seasons only age significantly impact the vaccination uptake. Older age was the only influential variable for COVID-19 VC. VCs for SOT patients seem to be unsatisfying. Stronger interventions are required.
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Affiliation(s)
- Pasquale Stefanizzi
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Paolo Bianchi
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Lorenza Moscara
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Martinelli
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Di Lorenzo
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Simona Simone
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Maria Rendina
- Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Silvio Tafuri
- Hygiene Unit – Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
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Lv L, Wu XD, Yan HJ, Zhao SY, Zhang XD, Zhu KL. The disparity in hesitancy toward COVID-19 vaccination between older individuals in nursing homes and those in the community in Taizhou, China. BMC Geriatr 2023; 23:828. [PMID: 38066433 PMCID: PMC10709861 DOI: 10.1186/s12877-023-04518-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Older individuals are priority coronavirus disease 2019 (COVID-19) vaccine recipients. Our aim was to investigate the prevalence of and factors influencing vaccine hesitancy in older individuals living in nursing homes and communities. METHODS A self-administered COVID-19 vaccine hesitancy survey was conducted from September 2021 to December 2021 among people aged ≥ 60 years in eight nursing homes (382 participants) and the community (112 participants) in Taizhou, China. The response rate was 72.1% (382/530) for older adults in nursing homes and 68.7% (112/163) for older adults in the community. RESULTS We found that 58.1% of the older individuals in nursing homes and 36.6% of those in the community were hesitant to receive the COVID-19 vaccine and that there was a statistically significant difference (P < 0.001). Multiple logistic regression results indicated that the main factors influencing hesitation among the older individuals in nursing homes were being male (Odds Ratio (OR) = 1.67, 95% Confidence Interval (CI): 1.01-2.76); their cognitive level, including having a high perceived risk of COVID-19 infection (OR = 3.06, 95% CI: 1.73-5.43) or the perception of low vaccine safety (OR = 3.08, 95% CI: 1.545- 6.145); anxiety (OR = 3.43, 95% CI: 1.96-5.99); and no previous influenza vaccination (OR = 1.82, 95% CI: 1.13-2.93); whereas those for older individuals in the community were comorbid chronic diseases (OR = 3.13, 95% CI: 1.11- 8.78) and community workers not recommending the vaccine (OR = 8.223, 95% CI: 1.77-38.27). CONCLUSION The proportion of older individuals in nursing homes who were hesitant to receive the COVID-19 vaccine was significantly higher than for older individuals in the community. Targeted measures should be implemented to reduce vaccine hesitancy and improve vaccination rates in response to the special environment of nursing homes and the characteristics of this population.
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Affiliation(s)
- Li Lv
- The Affiliated People's Hospital of Ningbo University, Ningbo, 315040, Zhejiang Province, China
| | - Xu-Dong Wu
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Huan-Jun Yan
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Shuang-Ying Zhao
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Xiao-Dong Zhang
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Ke-Lei Zhu
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China.
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15
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An JX, Lin XQ, Xie BJ, Tung TH, Zhu JS. Relationship between COVID-19 vaccine hesitancy and willingness to pay for the booster dose of COVID-19 vaccine of oncology patients in Taizhou, China. Ann Med 2023; 55:672-679. [PMID: 36840655 PMCID: PMC9970222 DOI: 10.1080/07853890.2023.2165705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/28/2022] [Accepted: 01/02/2023] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVE This population-based study aimed to determine the hesitancy and willingness to pay (WTP) for the booster dose of a coronavirus disease (COVID-19) vaccine among patients with cancer in Taizhou, China. PATIENTS AND METHODS A self-administered online questionnaire was administered to patients with cancer in Taizhou, China. The chi-square test, binary logistic regression model were used to evaluate the WTP for the booster dose of a COVID-19 vaccine. The minimum sample size was 218, determined by G*Power software (latest ver. 3.1.9.7). A total of 354 patients received the survey, and 256 (72.3%) patients responded. RESULTS Overall, 69.9% (179/256) of respondents were willing to pay for the booster dose, and 78.8% (141/179) of these patients were willing to pay 1-99 CNY. Furthermore, 50.4% (129/256) of respondents were hesitant to receive a COVID-19 vaccine. Being unhesitant was significantly associated with WTP for the booster dose (aOR: 3.040; 95% CI: 1.669-5.540). CONCLUSION Hesitant patients with cancer had a lower WTP for the booster dose against COVID-19 than non-hesitant participants. These results imply that further health education programmes are essential to decrease the hesitancy of patients with cancer and enhance booster dose vaccination rates for public health improvements.KEY MESSAGESOur research showed that 70% of patients with cancer are willing to pay for the booster dose of the COVID-19 vaccine, and most are willing to pay less than 100 CNY, and this result reflects the economic value and affordability of the third dose of vaccination.COVID-19 vaccine-hesitant patients with cancer had a lower willingness to pay for a booster dose against COVID-19 than non-hesitant participants and few patients are still unwilling to pay among patients do not hesitate to receive the third dose.Therefore, promoting willingness to pay among oncology patients and addressing vaccine hesitancy remains key.
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Affiliation(s)
- Jia-Xiang An
- Department of Surgical Oncology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Bo-Jian Xie
- Department of Surgical Oncology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
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16
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Deng JS, Ying CQ, Lin XQ, Huang CL, Zhang MX, Tung TH, Zhu JS. Impact of household decision makers' hesitancy to vaccinate children against COVID-19 on other household members: A family-based study in Taizhou, China. SSM Popul Health 2023; 24:101517. [PMID: 37767519 PMCID: PMC10520923 DOI: 10.1016/j.ssmph.2023.101517] [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: 06/03/2023] [Revised: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Background Vaccination is the most effective means of preventing outbreaks of infectious diseases, and family ;decision makers play an important role in decision-making regarding family matters and may influence other family members to take an active role in vaccinating children against COVID-19. Purpose This study examined the influence of family decision makers on the hesitation of other family members to vaccinate their children against COVID-19. Methods A population-based, self-administered online questionnaire was administered in Taizhou, China, from September 1, 2021, to September 15, 2021. The questionnaire included demographic information, knowledge, attitudes, and perceptions about the COVID-19 vaccine as well as hesitation regarding the use of the COVID-19 vaccination in children. In total, 490 respondents were included in this study. Logistic regression was used to assess the factors associated with vaccine hesitancy. Results In total, 490 respondents from 190 households were interviewed. Of the 190 family decision makers, 43.7% (83/190) were hesitant to vaccinate their children against COVID-19. When family decision makers were hesitant to vaccinate children against COVID-19, 65.1% (82/126) of the other family members expressed similar hesitancy regarding vaccination. When family decision makers were not hesitant to vaccinate children, only 21.3% (37/174) of other family members were hesitant to do so. In the regression analysis, family decision makers' hesitation to vaccinate their children was associated with other family members' hesitation (OR=6.264, 95% CI:3.132-12.526). In addition, decision makers' perceptions of the safety of the vaccine (OR=0.422, 95% CI:0.215-0.826) and hesitation to vaccinate themselves (OR=8.967, 95% CI:4.745-16.948) influenced their hesitation to vaccinate their children. Conclusion The present study found that family decision makers' hesitation to vaccinate children against COVID-19 influenced other family members' hesitation to vaccinate children. In addition, family decision makers' perceptions of the safety of the vaccine and their hesitation to vaccinate themselves influenced other family members' hesitation to vaccinate their children.
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Affiliation(s)
- Jing-Shan Deng
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chen-Qian Ying
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Chun-Lian Huang
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Mei-Xian Zhang
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, China
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Yoda T, Iwasaki N, Katsuyama H. Willingness to Pay for COVID-19 Vaccines in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7044. [PMID: 37998275 PMCID: PMC10671273 DOI: 10.3390/ijerph20227044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/14/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
More than 80% of the Japanese population had received the coronavirus disease 2019 (COVID-19) vaccination by the end of April 2023; however, this vaccination rate continues to decline along with the need for booster shots. Further, the vaccines may not permanently be available free of charge. This study conducted a survey to determine the public's willingness to pay for the COVID-19 vaccine in Japan. Using an internet research panel, the questionnaire collected data on various sociodemographic variables and the respondents' willingness to pay for COVID-19 vaccines. Descriptive statistics and logistic regression analysis were used to evaluate the respondents' answers. The results showed that of 1100 respondents, 55.2% would not want to receive the vaccine if it was paid for. A total of 44.8% respondents expressed willingness to pay, with most (170 respondents) willing to pay for 1000-1999 JPY (7.1-14.2 USD). Logistic regression analysis revealed that age, educational status, history of contracting COVID-19, and COVID-19 vaccination frequency were significantly associated with those who were willing to receive the COVID-19 vaccine if it was free (p < 0.05). These findings provide valuable insights for the Japanese government in determining appropriate pricing strategies to promote COVID-19 vaccination effectively.
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Affiliation(s)
- Takeshi Yoda
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan; (N.I.); (H.K.)
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan
| | - Nagisa Iwasaki
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan; (N.I.); (H.K.)
| | - Hironobu Katsuyama
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan; (N.I.); (H.K.)
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18
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Gianfredi V, Berti A, Stefanizzi P, D’Amico M, De Lorenzo V, Moscara L, Di Lorenzo A, Venerito V, Castaldi S. COVID-19 Vaccine Knowledge, Attitude, Acceptance and Hesitancy among Pregnancy and Breastfeeding: Systematic Review of Hospital-Based Studies. Vaccines (Basel) 2023; 11:1697. [PMID: 38006029 PMCID: PMC10675759 DOI: 10.3390/vaccines11111697] [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: 09/16/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
The risk of unfavourable outcomes for SARS-CoV-2 infection is significant during pregnancy and breastfeeding. Vaccination is a safe and effective measure to lower this risk. This study aims at reviewing the literature concerning the anti-SARS-CoV-2 vaccine's acceptance/hesitancy among pregnant and breastfeeding women attending hospital facilities. A systematic review of literature was carried out. Hospital-based observational studies related to vaccination acceptance, hesitancy, knowledge and attitude among pregnant and breastfeeding women were included. Determinants of acceptance and hesitancy were investigated in detail. Quality assessment was done via the Johann Briggs Institute quality assessment tools. After literature search, 43 studies were included, 30 of which only focused on pregnant women (total sample 25,862 subjects). Sample size ranged from 109 to 7017 people. Acceptance of the SARS-CoV-2 vaccine ranged from 16% to 78.52%; vaccine hesitancy ranged between 91.4% and 24.5%. Fear of adverse events for either the woman, the child, or both, was the main driver for hesitancy. Other determinants of hesitancy included religious concerns, socioeconomic factors, inadequate information regarding the vaccine and lack of trust towards institutions. SARS-CoV-2 vaccine hesitancy in hospitalized pregnant women appears to be significant, and efforts for a more effective communication to these subjects are required.
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Affiliation(s)
- Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Alessandro Berti
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (L.M.); (A.D.L.)
| | - Marilena D’Amico
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Viola De Lorenzo
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
| | - Lorenza Moscara
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (L.M.); (A.D.L.)
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70121 Bari, Italy; (L.M.); (A.D.L.)
| | - Vincenzo Venerito
- Rheumatology Unit, Department of Precision and Regenerative Medicine, Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy; (V.G.); (A.B.); (M.D.); (V.D.L.); (S.C.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milan, Italy
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Opoku MP, Belbase S, Nsowah FA, Yeboah K, Nketsia W, Mohamed A, Agyei-Okyere E, Amponteng M, Saah R, Safi M. Coronavirus Disease Vaccination Among Persons With Disabilities: Understanding Vaccine Perceptions and Hesitancy in Ghana. LINACRE QUARTERLY 2023; 90:452-471. [PMID: 37974567 PMCID: PMC10638957 DOI: 10.1177/00243639231178626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The effects of coronavirus disease 2019 (COVID-19) have been felt globally and in all spheres of life. Developing vaccines was an important milestone in ensuring the protection of lives, but there are concerns about vaccine availability in sub-Saharan African (SSA) countries. The living conditions of persons with disabilities, in particular, in SSA societies have been described as deplorable and unsustainable, and they are at risk of discrimination. Such persons appear to be already struggling to obtain other basic services, and the extent of vaccine accessibility to this population remains unknown. This study aimed to assess the perceptions of persons with disabilities in Ghana of COVID-19 vaccines. Between July 2021 and December 2021, 336 persons with disabilities (hearing, visual, and physical) were recruited from two regions in Ghana. The attitude toward the COVID-19 vaccination scale was adapted for this study. The results showed that persons with disabilities were ambivalent toward vaccination, and differences were observed between participant groups. The background variables found to influence attitude were age, place of residence, educational qualification, gender, and COVID-19 acquisition status. The study concludes with a clarion call to policymakers to expedite public education for persons with disabilities.
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Affiliation(s)
- Maxwell Peprah Opoku
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Shashidhar Belbase
- Curriculum and Method of Instruction, United Arab Emirates University, Al-Ain, United Arab Emirates
| | | | - Kwame Yeboah
- Department of Special Education, University of Cape Coast, Cape Coast, Ghana
| | - William Nketsia
- School of Education, Western Sydney University, Sydney, Australia
| | - Ahmed Mohamed
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Elvis Agyei-Okyere
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Reuben Saah
- Library Section, Abetifi Presbyterian College of Education, Abetifi, Ghana
| | - Mohammed Safi
- Department of Speech and Language Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Ngamchaliew P, Kaewkuea N, Nonthasorn N, Vonnasrichan T, Rongsawat N, Rattanachai L, Chaipipattanakij W, Kamolnawin S, Vichitkunakorn P. Acceptance of COVID-19 vaccination and vaccine confidence levels in Thailand: A cross-sectional study. Vaccine 2023; 41:6589-6598. [PMID: 37743117 DOI: 10.1016/j.vaccine.2023.09.018] [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: 06/08/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Vaccination is considered effective for minimising the impact of COVID-19. Pandemic control depends on high vaccination rates and confidence levels among the population. This study determined COVID-19 vaccine acceptance and confidence levels among vaccinated Thai participants. METHODS An online cross-sectional study was conducted between 13 September 2021 and 14 January 2022 among individuals ≥ 18 years. An online questionnaire was distributed via social media platforms and posters in public places in Thailand. It included four components (demographic characteristics, COVID-19 vaccine regimens, vaccine acceptance, and confidence). Statistical analyses included a chi-squared test, Wilcoxon signed-rank test, and multivariate logistic regressions. RESULTS Approximately 88.4% of the participants accepted the vaccine. Almost half had confidence in 'unconcerned about vaccine side effects' (48.2%), 'trust in vaccine effectiveness' (44.3%) and 'trust in government vaccine policy' (43.4%). Multiple logistic regression indicated that males and high education significantly correlated with vaccine acceptance. Higher age (45-59 years and ≥ 60 years) and low monthly income (≤5,000 THB) were significantly associated with trust in government vaccine policy. The 1stCoronaVac/2ndCoronaVac/3rdBNT162b2 regimen group was significantly associated with unconcern about vaccine side effects compared to the 1stAZD1222/2ndAZD1222 regimen group. CONCLUSIONS Over half of vaccinated participants indicated concern about COVID-19 vaccine side effects and distrust in vaccine effectiveness and government policy; nonetheless, almost all took the COVID-19 vaccine. Participants who received the 1stCoronaVac/2ndCoronaVac/3rdBNT162b2 regimen were unconcerned about vaccine side effects. Some socio-demographic factors were associated with vaccine acceptance and high confidence, which should be sought while designing interventions to improve COVID-19 vaccination rates.
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Affiliation(s)
- P Ngamchaliew
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - N Kaewkuea
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - N Nonthasorn
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - T Vonnasrichan
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - N Rongsawat
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - L Rattanachai
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - W Chaipipattanakij
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - S Kamolnawin
- Medical Student, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - P Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
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Bikorimana JP, Thellmann C, Mulugeta T, Wonde D, Tsegaye A, Ali Bashir Alnoor Ahmed B, Bayisenge U, Pocock J. Doctoral research, COVID-19, and political crisis in Ethiopia, Sudan, Rwanda, and the UK: challenges, responses, and recommendations. NIHR OPEN RESEARCH 2023; 3:53. [PMID: 37994318 PMCID: PMC10663879 DOI: 10.3310/nihropenres.13470.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 11/24/2023]
Abstract
Background Conducting doctoral research is a challenging endeavour, a challenge which as the growing literature on the subject has shown, the COVD-19 pandemic has made even more so. For some doctoral researchers, however, the pandemic has also been accompanied by political unrest and military conflict, putting them and their networks at risk and making their research especially difficult to sustain. Methods We have used a collaborative auto-ethnography, and we, a group of seven doctoral researchers based in Ethiopia, Rwanda, Sudan and UK have written our experiences. Results Drawing upon the results of a collaborative auto-ethnography (CAE), this article records and discusses the experiences of a group of doctoral researchers who with the support of their organisation, the Social Science for Severe Stigmatised Skin Diseases (5S) Foundation, have been attempting to cope with both the pandemic and internal instability and strife. After firstly setting the context, the article explains why for the purposes of this paper CAE was adopted as our method, and then documents and discusses the experiences of seven doctoral researchers based in Ethiopia, Sudan, Rwanda, and the UK, doing so in terms of four different themes: New Ways of Working and Its Impact, Change and Delay, Mental Health and Well-Being Impact, and Qualities and Capacities. Conclusion What these experiences tell us is that this group of doctoral researchers have found themselves in extremely challenging situations, which have placed exceptionally high demands on them and their support networks, and this has had an impact on their health and well-being although also been the catalyst for some more positive development. Given their lived experiences, the article finishes with a series of recommendations for future research projects of this kind.
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Affiliation(s)
- Jean Paul Bikorimana
- Social Sciences for Severe Stigmatising Skin Diseases (5S) Foundation, Center for Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Corinna Thellmann
- Social Sciences for Severe Stigmatising Skin Diseases (5S) Foundation, Center for Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Tseganesh Mulugeta
- College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dereje Wonde
- Social Sciences for Severe Stigmatising Skin Diseases (5S) Foundation, Center for Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Addisu Tsegaye
- Social Sciences for Severe Stigmatising Skin Diseases (5S) Foundation, Center for Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Badraldeen Ali Bashir Alnoor Ahmed
- Social Sciences for Severe Stigmatising Skin Diseases (5S) Foundation, Center for Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Ursin Bayisenge
- Social Sciences for Severe Stigmatising Skin Diseases (5S) Foundation, Center for Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Jeffrey Pocock
- ThinkWrite, 18 Rosewood Ave, Alveston, Bristol, BS35 3PP, UK
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22
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Wang X. Putting Emotions in the Health Belief Model: The Role of Hope and Anticipated Guilt on the Chinese's Intentions to Get COVID-19 Vaccination. HEALTH COMMUNICATION 2023; 38:2491-2500. [PMID: 35658753 DOI: 10.1080/10410236.2022.2078925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
When promoting COVID-19 vaccination, the media and public figures often mention hope to return to normalcy and sometimes try to elicit guilt by asking people to get vaccinated to protect themselves and others. Situated within the health belief model, the present research aimed to investigate whether hope and anticipated guilt were related to vaccine uptake intent. It postulated that hope and anticipated guilt mediated the relationships between risk perceptions/perceived benefits and vaccine uptake intent. The data were collected via an online survey of 460 Chinese participants in March 2021 and were analyzed using Hayes' PROCESS MACRO. The results revealed that perceived susceptibility and perceived benefits, but not perceived severity, predicted the Chinese's vaccine uptake intent. Furthermore, hope positively predicted vaccine uptake intent and partially mediated the relationship between perceived benefits and vaccination intent and between perceived severity and vaccination intent. Anticipated guilt was a significant, but weak predictor of vaccination intent. Both theoretical and practical implications are discussed.
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Affiliation(s)
- Xiao Wang
- School of Communication, Rochester Institute of Technology
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23
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Kumar R, Singh S, Chawla R, Balhara K, Dhar L. COVID-19 vaccination: Immune response in healthcare workers-A study with review of literature. INDIAN J PATHOL MICR 2023; 66:758-763. [PMID: 38084528 DOI: 10.4103/ijpm.ijpm_126_22] [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] [Indexed: 11/17/2022] Open
Abstract
Background As the world has been going through a pandemic of coronavirus disease 2019 (COVID-19) for the past two years, a safe and effective vaccine was urgently needed. Vaccination against the disease was launched in India on January 16, 2021 with healthcare workers, frontline workers, and the elderly above 60 years being the first beneficiaries. Vaccines being used in India are Covishield and Covaxin. Materials and Methods Fifteen healthcare workers (HCWs) who were vaccinated with Covishield or Covaxin were included in the study, and T cell, B cell and antibody response of the HCWs were analyzed. Blood samples collected from every subject were sent for antibody analysis, hematological workup for cell counts, and flow cytometry was performed for various subsets of lymphocytes. Hematological variables in naïve HCWs (who never had any natural infection) and recovered HCWs (those recovered from natural infection) were compared. Results Antibody index among recovered HCWs was significantly higher than the naïve HCWs. All the leucocyte parameters showed a higher median value in the recovered group except total leucocyte count (TLC), T helper cell count (Th cell), T helper cell to T cytotoxic cell (Th cell: CTL) ratio and natural killer (NK) cell. But only Th: CTL ratio showed a statistically significant difference. Conclusion This study shows that the antibody index among individuals who had both vaccination and COVID-19 infection is significantly higher than those who just had vaccination. T helper cell to T cytotoxic cell ratio is lowered in the recovered HCWs as compared to the naïve HCWs and this finding is statistically significant.
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Affiliation(s)
- Rabish Kumar
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Sarika Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Rohit Chawla
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
| | - Kirti Balhara
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Lity Dhar
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
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24
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Ba Z, Yang A, Zhu S, Li Y, Ma J, Zhang Y, Li Z, Chen F. Comprehensive evaluation of the effect of inactivated SARS-CoV-2 vaccination on female fertility: A retrospective cohort study. J Med Virol 2023; 95:e29161. [PMID: 37814968 DOI: 10.1002/jmv.29161] [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: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
Fear of possible negative effects of coronavirus disease 2019 (COVID-19) vaccine on fertility is the main reason for vaccine hesitancy among the public especially women of childbearing age. Despite the high coverage of COVID-19 vaccination in China, more scientific evidence is still needed to address their concerns and guide fertility counseling and management in the future. Herein, we performed a retrospective cohort study at a single large center for reproductive medicine in China between August 2020 and May 2023. Patients aged 20-42 years with no history of laboratory-confirmed COVID-19 were included and categorized into different groups according to their vaccination status. The serum sex hormone levels, anti-Müllerian hormone concentrations, embryo quality, and pregnancy outcomes were evaluated and compared among them. We found there were no significant differences in the concentrations of follicle-stimulating hormone, luteinizing hormone and progesterone between the unvaccinated, first-dose, second-dose, and booster vaccinated groups. However, the estradiol showed a highly significant increase in the one-dose vaccinated group compared with its levels in other groups. Among unvaccinated and either vaccinated patients, anti-Müllerian hormone levels were comparable (p = 0.139). The number of oocytes retrieved, fertilization rate and good-quality embryo rate were all similar between each group of in vitro fertilization and intracytoplasmic sperm injection. No significant differences were observed regarding other laboratory parameters. Moreover, the vaccination status of infertile couples did not exert any adverse effect on the pregnancy outcomes in all assisted reproductive technologies cycles. In short, we comprehensively evaluated the reproductive safety of inactivated severe acute respiratory syndrome coronavirus 2 vaccine and found any dose of vaccination wouldn't negatively affect female fertility parameters such as sex hormone levels and ovarian reserve. Moreover, this is the first study to complete the live birth follow-up of the cohort after receiving inactivated severe acute respiratory syndrome coronavirus 2 vaccine, further dispelling the misconception and providing reassurance for decision-making by clinicians.
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Affiliation(s)
- Zaihua Ba
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Aijun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Shiheng Zhu
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Yuqi Li
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Jiao Ma
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Yingze Zhang
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Zewu Li
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
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25
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Ibrahim FM, Fadila DE, Elmawla DAEA. Older adults' acceptance of the COVID-19 vaccine: Application of the health belief model. Nurs Open 2023; 10:6989-7002. [PMID: 37485792 PMCID: PMC10495744 DOI: 10.1002/nop2.1954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/17/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023] Open
Abstract
AIMS To determine the prevalence of COVID-19 vaccination acceptance among older adults and the factors that independently predict vaccine acceptance using the Health Belief Model (HBM). DESIGN This was a cross-sectional, descriptive study. METHODS Consenting older adults aged 60 years and older (n = 384) from Primary Health Care Centers in rural and urban areas of Mansoura District, Egypt, who could interact adequately with researchers participated in the study. The data were collected through an electronic questionnaire that included socio-demographic data, health-related characteristics, and health beliefs based on the HBM framework. RESULTS Overall, 46.9% were willing to receive the COVID-19 vaccine, 19.5% declined, and 33.6% were undecided. Higher perceptions of COVID-19 severity, vaccine benefits, and action cues were associated with vaccine acceptance (p = 0.05). PUBLIC CONTRIBUTION Vaccination campaigns that highlight the benefits of immunization should be prioritized by policymakers. In addition, vaccinated peoples should use social media to spread awareness about the advantages and challenges of vaccination. Nurse leaders should apply the HBM to forecast health-related behaviors, especially vaccination attitudes.
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Affiliation(s)
- Fatma M. Ibrahim
- Gerontological Nursing, Faculty of NursingMansoura UniversityMansouraEgypt
| | - Doaa E Fadila
- Gerontological Nursing, Faculty of NursingMansoura UniversityMansouraEgypt
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26
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Mohamed AA, Bocher TF, Magan MA, Siameja C, Mohamoud SA. Hesitancy in COVID-19 Vaccine Uptake and Its Correlated Factors Using Multi-Theory Model among Adult Women: A Cross-Sectional Study in Three States of Somalia. Vaccines (Basel) 2023; 11:1489. [PMID: 37766165 PMCID: PMC10534331 DOI: 10.3390/vaccines11091489] [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: 01/29/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND In developing countries, access to information, awareness, and availability of COVID-19 vaccines are key challenges. Somalia launched the COVID-19 vaccination in March 2021; however, the uptake of the vaccination is slow, which creates fear of further loss of life in the country unless intentional and organized campaigning and efforts are made to improve both the availability of the vaccine and its acceptance by the community. This study aimed to understand the current level of awareness, accessibility, trust, and hesitancy toward the COVID-19 vaccine among women in Somalia. METHODS To assess COVID-19 vaccine uptake, acceptance, community awareness, and hesitancy rates in Somalia, we carried out a cross-sectional mixed methods study in three regions of Somalia that were selected randomly out of the 18 regions of Somalia. A multi-theory model (MTM) was developed to identify correlated factors associated with the hesitancy or non-hesitancy toward COVID-19 vaccination among women of all ages (18 years and above). RESULTS A total of 999 eligible women (333 in each district) of 18-98 years old were interviewed in March 2022. About two-thirds (63.76%) of participants reported hesitancy about receiving the COVID-19 vaccine. The theory model initiation construct indicated that behavioral confidence in the vaccine (b = 0.476, p < 0.001), participatory dialogue (at b = 0.136, p < 0.004), and changes in the physical environment (b = 0.248, p = 0.015) were significantly associated with COVID-19 vaccine acceptance among women who were not hesitant to take the vaccine. CONCLUSIONS The availability of COVID-19 vaccines may not translate into their uptake. The decision to get the vaccine was determined by multiple factors, including the perceived value of the vaccination, previous experience with the vaccine, perceived risk of infection, accessibility and affordability, and trust in the vaccine itself. Public health education programming and messaging must be developed to encourage vaccine uptake among women with varying levels of vaccine hesitancy.
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Affiliation(s)
- Adam A. Mohamed
- Save the Children International, Mogadishu P.O. Box 39664-00623, Somalia
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27
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Kahlenberg H, Williams D, van Tilburg MAL, Jiroutek MR. Vaccine hesitancy for COVID19: what is the role of statistical literacy? Front Public Health 2023; 11:1230030. [PMID: 37744510 PMCID: PMC10513463 DOI: 10.3389/fpubh.2023.1230030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Vaccination is an important measure used to control the spread of COVID19. The estimation of risk versus benefit of vaccination is based on the understanding of information about the vaccine. Statistics are frequently part of communications about COVID19. Individuals that do not have an adequate foundation of statistical knowledge may not be able to properly assess associated risks and benefits. This study aims to assess the association between statistical literacy and hesitation to receive the COVID19 vaccine. Methods A nationally representative sample of 2,138 adults, recruited through CINT United States, Inc., (Lawrenceville, NJ; http://www.cint.com), completed an internet survey in the summer of 2021. This survey collected demographic measures and information about COVID19 vaccination status. The competency of respondents on various basic statistical concepts was assessed along with the corresponding confidence of respondents in their answers. A multivariable logistic regression model was constructed to assess the relationship between vaccine hesitancy and statistical literacy while controlling for covariates of interest. Results Statistical literacy was found to have a negligible association with COVID19 vaccine hesitancy (OR 1.01; 95% CI 1.00-1.02). In addition, differences in the proportion receiving the COVID19 vaccine between political affiliations, income levels, race groups, and ethnicities were observed. Discussion The statistical knowledge of the general American public is not commensurate with the need to be literate in basic statistical concepts in the data-driven world in which we live. An effective way to stem vaccine hesitancy may rely on increased statistical knowledge to not be biased by preconceived beliefs shaped by misinformation.
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Affiliation(s)
- Halle Kahlenberg
- Department of Pharmaceutical & Clinical Sciences, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, United States
| | - Delaney Williams
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Buies Creek, NC, United States
| | - Miranda A. L. van Tilburg
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Buies Creek, NC, United States
- Cape Fear Valley Health, Fayetteville, NC, United States
- Marshall University, Huntington, WV, United States
| | - Michael R. Jiroutek
- Department of Pharmaceutical & Clinical Sciences, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, United States
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28
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Liang W, Fu X, Li R, Yang L, Liu P, Guo X, Jia Q, Wang Z, Xie Y. Effect of domestic COVID-19 vaccine on the plasma D-dimer levels of early pregnant women in China. Front Med (Lausanne) 2023; 10:1219502. [PMID: 37727754 PMCID: PMC10505705 DOI: 10.3389/fmed.2023.1219502] [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: 05/16/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Objective To investigate the effect of COVID-19 vaccination on plasma D-dimer levels in early pregnant women. Methods A total of 834 early pregnant women(gestational age ≤ 13 weeks), who visited Northwest Women and Children's Hospital between December 2020 and April 2022, were selected. There were 696 women in the healthy group (group A) and 138 in the group with a history of adverse pregnancy and childbirth (group B). The plasma D-dimer levels of all participants were tested, and the COVID-19 vaccine history of all participants was collected using a survey questionnaire. Results The plasma D-dimer levels did not differ between group A and the group B (p = 0.1327). In the group A, 470 were vaccinated and 226 were unvaccinated. The D-dimer levels of vaccinated individuals were lower than those of unvaccinated individuals (p = 0.0047). In the group B, 84 were vaccinated and 54 were unvaccinated; no difference in D-dimer levels was found between the vaccinated and unvaccinated individuals (p = 0.0542). In the group A, the D-dimer levels of the unvaccinated group were not different from those of women vaccinated with one dose (p = 0.208), but they were higher than those who received two doses (p = 0.019) or three doses (p = 0.003). And, no significant difference in D-dimer levels was found among women who received different vaccine brands and with different vaccination times. Conclusion This study preliminarily indicates that COVID-19 vaccination does not increase D-dimer levels in early pregnant women.
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Affiliation(s)
- Wenjuan Liang
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
| | - Xin Fu
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
| | - Rui Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Liu Yang
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
| | - Peng Liu
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
| | - Xuan Guo
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
| | - Qinliang Jia
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
| | - Ziran Wang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yun Xie
- Medical Laboratory Center, Northwest Women’s and Children’s Hospital, Xi'an, China
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29
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Mubarak S, A'aqoulah A, AlGhawrie H, Albalas S, Innab N. Assessing the acceptability of COVID-19 vaccine and its booster dose. Immun Inflamm Dis 2023; 11:e950. [PMID: 37773710 PMCID: PMC10521373 DOI: 10.1002/iid3.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/26/2023] [Accepted: 07/08/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Coronavirus disease of 2019 (COVID-19) vaccinations are essential to control the pandemic and prevent severe COVID-19 infections. This study aims to assess the acceptability of the COVID-19 vaccine and the factors that impact the intention to take the COVID-19 vaccine and its booster dose. METHODS A cross-sectional study was conducted in Saudi Arabia and Jordan. The study used a self-administered web-based survey (questionnaire) for data collection that was distributed via social media platforms from May 2022 to July 2022. RESULTS In this study, among 518 participants, 54.4% had already received two doses of the COVID-19 vaccine, and out of the participants who didn't receive the booster dose, 19.9% declared a definite willingness to receive it, while 42% had already taken a booster dose, which indicated good acceptance. After adjustment for significant background characteristics, a significant association between the country and receiving the COVID-19 vaccine, the intention to get the vaccine, and infection with COVID-19 were found, in addition to a significant association between the country and the participants' opinion that electronic applications helped them to follow their vaccine schedule were found (p < .001). Also, the results showed that participants' attitudes were significantly associated with educational level and age groups (p ≤ .001, p = .032, respectively). There was a significant association between the intention to receive the vaccine booster dose and the country (p < .001). The Saudi participants were willing to get the booster dose seven times more than the Jordanians, furthermore, there was a significant association between taking the vaccine booster dose in the country, as well as age group, working in the medical field, previous COVID-19 infection, and the intention to vaccinate the children (p < .001, p = .030, .031, .025, < .001, respectively). CONCLUSION Overall, our results emphasize a positive response and a positive attitude toward COVID-19 vaccination. In addition, define the groups to be targeted with effective communication regarding the COVID-19 vaccine and its booster dose.
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Affiliation(s)
- Sawsan Mubarak
- Infection Control Program, King Hussein Cancer Center, Amman, Jordan
| | - Ashraf A'aqoulah
- Department of Health Systems Management, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hadeel AlGhawrie
- Infection Control Program, King Hussein Cancer Center, Amman, Jordan
| | - Samir Albalas
- Department of Health Services Administration, Faculty of Economics and Administrative Sciences, Yarmouk University, Irbid, Jordan
| | - Nisreen Innab
- Department of Computer Science and Information Systems, College of Applied Sciences, AlMaarefa University, Saudi Arabia
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30
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Zhao T, Wang C, Zhang S, Chen L, Han B, Liu H, Xie M, Cai X, Zhang S, Zhou Y, Li G, Liu B, Du J, Zeng J, Liu Y, Lu Q, Cui F. What Causes the Discrepancy in SARS-CoV-2 Vaccine Between Parental Hesitancy for Themselves and for Their Children During Lockdown Period? J Epidemiol Glob Health 2023; 13:422-434. [PMID: 37378822 PMCID: PMC10468446 DOI: 10.1007/s44197-023-00122-3] [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: 08/29/2022] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Parents are usually the decision-makers for vaccinations of children. Therefore, it is important to understand parental beliefs and attitudes toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine for themselves and their children when it was approved for children age 3-17. METHOD A cross-sectional survey based on an anonymous online questionnaire for parents was conducted in seven provinces of China, and demographic information, vaccination history, parental decision motives, and health belief model toward themselves and their children were collected, respectively. RESULTS The overall parental hesitancy rate toward themselves was 20.30%, and that toward their children was 7.80%. More parental concerns on disease severity (odd ratio [OR] = 1.11, 95% confidence interval [CI]: 1.01-1.61) and susceptibility (OR = 1.29, 95% CI: 1.01-1.63) of children could be the causes of discrepancy in hesitancy for themselves and for their children. Parents who hesitated to vaccinate themselves might also be hesitated to vaccinate their children (β = 0.077, P < 0.001). CONCLUSION Threat perception may lead to inconsistencies in parental vaccination decisions toward themselves and toward their children. Correcting misinformation and strengthening education about COVID-19 are of great significance in addressing vaccine hesitancy among parents and children.
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Affiliation(s)
- Tianshuo Zhao
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Chao Wang
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Linyi Chen
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Bingfeng Han
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Hanyu Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Mingzhu Xie
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Xianming Cai
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Shanshan Zhang
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Yiguo Zhou
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Guoxing Li
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Puyang Center for Disease Control and Prevention, Henan, 457005, People's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Juan Du
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Jing Zeng
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Qingbin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, 100191, People's Republic of China.
- Vaccine Research Center, School of Public Health, Peking University, Beijing, 100191, People's Republic of China.
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Lan X, Su B, Liang S, Yu M, Qiao Y, Wang L, Song M, Wang Y, Xu J. Willingness of people living with HIV to receive a second COVID-19 booster dose: a multicenter cross-sectional study in China. Front Public Health 2023; 11:1227277. [PMID: 37680268 PMCID: PMC10480566 DOI: 10.3389/fpubh.2023.1227277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 09/09/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has significantly affected the global population, with People Living with HIV (PLWH) being particularly vulnerable due to their compromised immune systems. Although vaccination is a crucial preventative measure against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, little is understood about the willingness of PLWH to receive a second COVID-19 booster dose and the factors that may influence this decision. This study investigates the willingness of PLWH in China to receive a second COVID-19 booster dose and its influencing factors, comparing these with a group of healthy individuals. Methods A multicenter cross-sectional study was conducted across five Chinese cities, namely, Beijing, Tianjin, Zhengzhou, Hohhot, and Harbin. Participants were recruited through five community-based organizations. Data were collected via participant self-administered questionnaires included demographic information, willingness to receive a second COVID-19 booster dose, and knowledge about HIV and COVID-19 vaccination. Factors influencing vaccination willingness were identified using multivariable logistic regression analyzes. Results A total of 156 PLWH and 151 healthy individuals were included in the study. After adjusting for potential confounders, it was found that PLWH demonstrated a lower willingness to receive a second COVID-19 booster dose compared to healthy individuals (77.6% vs. 88.7%, p = 0.009). Lower willingness was associated with HIV positive status (Adjusted Odds Ratio [AOR]: 0.39, 95%CI: 0.20, 0.75), perceived barriers (AOR: 0.05, 95%CI: 0.01, 0.26), and perceived severity (AOR: 0.32, 95%CI: 0.12, 0.90). Conclusion PLWH in China demonstrated a lower willingness to receive a second COVID-19 booster dose compared to healthy individuals. The findings suggest that perceptions and understanding of the COVID-19 vaccination and its necessity for protection against SARS-CoV-2 could influence this willingness. Efforts should be made to strengthen and disseminate knowledge about HIV and COVID-19 vaccinations among this population. In addition, developing interventions and policies that target specific subgroups and address misconceptions about vaccination could be instrumental in improving vaccination rates among PLWH.
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Affiliation(s)
- Xinquan Lan
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Shijie Liang
- Department of Infection, Zhengzhou Center for Disease Control and Prevention, Zhengzhou, China
| | - Maohe Yu
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Ying Qiao
- Department of Infection, The Second Hospital of Hohhot, Hohhot, China
| | - Li Wang
- Department of Infection, Heilongjiang Provincial Hospital, Harbin, China
| | - Moxin Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Yuxiao Wang
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
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Xie Z, Lau JTF, Liang Y, Ouyang Q, Chen J, Lin S, Yao K, Hu X, Lin H, Yu Y, Zeng D. Prevalence and factors of COVID-19 vaccine refusal among solid cancer patients in China: an application of the health belief model. Front Public Health 2023; 11:1236376. [PMID: 37601174 PMCID: PMC10435902 DOI: 10.3389/fpubh.2023.1236376] [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: 06/07/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction It is essential to protect cancer patients from contracting COVID-19 through vaccination. A majority of cancer patients are recommended by international health authorities to take up the vaccines. COVID-19 vaccine refusal among cancer patients during the pandemic period is under-researched. This study investigated factors of vaccine refusal based on the Health Belief Model (HBM). Methods A cross-sectional study was conducted among female breast cancer patients, male/female thyroid cancer patients, and gynecological cancer patients in Shantou, China from April to August 2022 (n = 1,115). Multinomial logistic regression analysis adjusted for socio-demographics was conducted to test factors of COVID-19. Adjusted odds ratios of the two models comparing vaccine refusal vs. "vaccine non-refusal" and vaccine refusal vs. ever-vaccination were derived and presented. Results Of all the participants, the prevalence of vaccine refusal, "vaccine non-refusal," and ever-vaccination was 25.9, 22.2, and 51.8%, respectively. In both multinomial logistic regression models, significant factors of vaccine refusal included socio-demographics (age, education level, employment status, monthly household income, cancer type, duration since cancer diagnosis, current treatment status) and some vaccine-related HBM (perceived benefits, perceived barriers, cue to action, and self-efficacy). Perceived severity of COVID-19 was significant only in the vaccine refusal vs. ever-vaccination model. In neither model, perceived susceptibility to contract COVID-19 was statistically significant. Conclusion About ¼ of the participants expressed vaccine refusal. Interventions are warranted. Future longitudinal studies are needed to verify this study's findings. Pilot interventions should also be launched to test effectiveness of interventions modifying the significant HBM factors found in this study.
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Affiliation(s)
- Zhaomin Xie
- School of Public Health, Shantou University, Shantou, China
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Joseph Tak-Fai Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuanke Liang
- Department of Thyroid and Breast Surgery, Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China
| | | | - Junjia Chen
- Shantou University Medical College, Shantou, China
| | - Si Lin
- Shantou University Medical College, Shantou, China
| | - Kaitao Yao
- Shantou University Medical College, Shantou, China
| | - Xuanyin Hu
- Shantou University Medical College, Shantou, China
| | - Haoyu Lin
- Department of Thyroid and Breast Surgery, Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China
| | - Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - De Zeng
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
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Ford A, Heidke P, Kurup C, Wirihana L, Kroll J, Calleja P. Factors influencing Australian nursing and midwifery students COVID-19 vaccination intentions. Vaccine X 2023; 14:100352. [PMID: 37519775 PMCID: PMC10372303 DOI: 10.1016/j.jvacx.2023.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
Background Vaccination for COVID-19 has become a cornerstone management plan for many countries. Australian state governments made vaccinations mandatory for all healthcare workers. Despite evidence on the important role vaccines hold in preventing or decreasing serious disease, there have been many nurses and midwives who have demonstrated vaccine hesitancy. This hesitancy has also been present in undergraduate nursing and midwifery students. The aim of this study was to explore factors influencing Australian nursing and midwifery students' intentions towards receiving the COVID-19 vaccine; identify the barriers and facilitators to obtaining the COVID-19 vaccine; and understand students' perceptions of mandating the COVID-19 vaccine and identify any impact on their studies.. Methods Cross-sectional mixed method study utilising an online survey platform. Data were analysed using binomial and multinomial logistic regression through Statistical Package for the Social Sciences. A content analysis was completed for the qualitative data. Results There were 715 participants and 556 who completed the survey in full. Nurses made up the majority of participants (n = 409), 133 participants were midwives and 30 were in dual nursing/midwifery programs. Education and communication were identified as two major factors that facilitate vaccine acceptance. Conclusions Vaccines are integral in the prevention of contracting COVID-19 or reducing the severity of the symptoms. However, many nursing and midwifery students have shown reluctance towards getting vaccinated. The mandate to be vaccinated to attend clinical placement has led to the inability of some students to complete their course. The findings from this study are valuable in informing the future COVID-19 vaccination strategies and improving vaccine acceptance. COVID-19 remains a global health risk and therefore further research is needed of vaccine acceptance amongst the future health workforces. It is crucial knowledge for policy makers and healthcare services as they plan for any future pandemics and implement Australia's national vaccine strategy.
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Affiliation(s)
- Abigail Ford
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Penny Heidke
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Chanchal Kurup
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Lisa Wirihana
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Jeremy Kroll
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
- Motivation of Health Behaviours Lab, Appleton Institute, CQUniversity Psychology Wellness Centre, 554-700 Yaamba Road, Norman Gardens, 4701, Building 32/Lower Ground 32, Australia
| | - Pauline Calleja
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
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Alshagrawi SS. Examining health sciences students' intention to uptake COVID-19 vaccination using the theory of planned behavior. Hum Vaccin Immunother 2023; 19:2256044. [PMID: 37694723 PMCID: PMC10496529 DOI: 10.1080/21645515.2023.2256044] [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: 06/21/2023] [Revised: 08/24/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023] Open
Abstract
To examine the association between the theory of planned behavior (TPB) constructs and Health Sciences students' intentions to receive COVID-19 vaccination. A cross-sectional study was conducted in Saudi Arabia by recruiting Health Sciences students as participants. Using Structural Equation Modeling (SEM), the proposed TPB model was evaluated. The sample of 505 individuals consisted of more males (n = 275; 54.5%) than females and was relatively young (88% were between the ages of 18 and 30). The suggested TPB model explained 78.2% of the variation in intention to get COVID-19 immunization. We found that greater levels of perceived behavioral control (β = 1.58, p < .001) and attitude (β = .44, p < .001) strongly predicted increased vaccination intentions. The subjective norm construct was not a significant predictor of vaccination intentions (β = 0.06, p = .34). The findings of this study indicate that the TPB can be utilized effectively to obtain insight into the factors associated with COVID-19 adherence and help in the development of effective COVID-19 intervention strategies.
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Affiliation(s)
- Salah S. Alshagrawi
- College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
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35
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Apuke OD, Asude Tunca E. Modelling the Factors That Predict the Intention to Take COVID-19 Vaccine in Nigeria. JOURNAL OF ASIAN AND AFRICAN STUDIES 2023; 58:664-680. [PMID: 37461427 PMCID: PMC10345828 DOI: 10.1177/00219096211069642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
This study developed a model that predicted factors that prompt the intention to take the COVID-19 vaccine among Nigerians. Data were collected from 385 respondents across Nigeria using snowball sampling technique with online questionnaire as instrument. Results indicated that cues to action, health motivation, subjective norms, and perceived behavioural control positively predicted the intention to take COVID-19 vaccine in Nigeria. However, perceived susceptibility, severity, and COVID-19 vaccine benefits did not predict the intention to take the COVID-19 vaccine. Further findings showed that COVID-19 vaccine barrier and attitude was negatively associated with the intention to take the COVID-19 vaccine.
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Affiliation(s)
- Oberiri Destiny Apuke
- Oberiri Destiny Apuke, Faculty of Communication and Media Studies, Taraba State University, PMB 1167 Jalingo, Nigeria.
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Adiyoso W, Wilopo W, Mondry, Nurbaiti B, Suprapto FA. The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia. Vaccine X 2023; 14:100297. [PMID: 37063303 PMCID: PMC10081936 DOI: 10.1016/j.jvacx.2023.100297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 03/02/2023] [Accepted: 03/30/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND SARS-COV-2 (COVID-19) has severely impacted people's health worldwide. Vaccines are one of the health measures taken to reduce the impact of COVID-19, but recent reports have revealed that some people are reluctant to be vaccinated against COVID-19. Understanding the factors underlying an individual's decision to take the COVID-19 vaccine is critical to designing an immunisation programme. This study examines factors that influence the intention to take a COVID-19 vaccine using the modified Health Belief Model (HBM) framework and analysing demographic factors. METHOD A cross-sectional online survey was conducted from 10 January to 20 January 2021. Five hundred thirty-seven respondents above 17 years old and residing in Indonesia voluntarily completed an online survey. Survey questions addressed sociodemographic factors; perception of susceptibility, severity, benefits and barriers; cues to action; and intention to take the COVID-19 vaccine. A Structural Equation Modelling (SEM) approach with SmartPLS software was used to analyse the measurements and model construct. FINDINGS The results showed that the perception of susceptibility, severity, benefits and barriers, as well as cues to action, predicted people's intention to take a COVID-19 vaccine. Model structure explained a large proportion of variance in people's intention to be vaccinated against COVID-19 (R2 = 66.8 %). Some demographic factors affected the key variables of the HBM. People with low and middle income negatively influence feeling severity, beneficial and barrier in intending to take vaccine. Other demographic factors such as sex, age, marriage and living areas did not affect the components of the HBM, except for females influencing severity and people living in urban areas associated with benefits variable. These findings imply that COVID-19 vaccination programmes should focus on providing accurate information about the severity of COVID-19 and the benefits of taking the vaccine. Building people's confidence in their ability to eliminate barriers to taking the vaccine and involving family members and community and religious leaders will increase COVID-19 vaccine uptake. CONCLUSION Despite limitations to the study, such as respondent demographics that are unrepresentative of the wider Indonesian population, inadequate survey timing and an exclusive focus on vaccine intention as the outcome variable, the present study contributes to explaining individuals' intentions to take a COVID-19 vaccine in a Eastern country context. This study is valuable to providing public health policy recommendations that focus on effectively designing immunisation programme interventions.
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Affiliation(s)
- Wignyo Adiyoso
- National Development Planning Agency/BAPPENAS, Jl. Proklamasi No. 70, Jakarta Pusat, Indonesia
| | - Wilopo Wilopo
- Research Centre for Conflict and Policy (RCCP), Faculty of Administrative Science, Brawijaya University, Jl. MT. Haryono 163, Malang, East Java, Indonesia
| | - Mondry
- Faculty of Social and Political Science, Brawijaya University, Jl. Veteran, Malang, East Java, Indonesia
| | - Beti Nurbaiti
- Bhayangkara Jakarta Raya University, Bekasi, West Java, Indonesia
| | - Firre An Suprapto
- Regional and Rural Development Planning Department, Faculty of Economics and Management, IPB University, Jl. Raya Dramaga, Bogor, West Java, Indonesia
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Unger JB, Herzig E, Rodriguez V, Soto D, Lee R, Sood N. Application of Protection Motivation Theory to COVID-19 vaccination among a predominantly Hispanic sample of adolescents. Prev Med Rep 2023; 34:102245. [PMID: 37252067 PMCID: PMC10197527 DOI: 10.1016/j.pmedr.2023.102245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 03/01/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023] Open
Abstract
Despite the efficacy and widespread availability of COVID-19 vaccines, vaccine uptake has been relatively low in U.S. Hispanic communities, especially among adolescents. This study examined vaccination status among 444 high school students in predominantly Hispanic neighborhoods of Los Angeles County, California in May-June 2022 (mean age = 15.74 years, 55% female, 93% Hispanic). Guided by Protection Motivation Theory, we hypothesized that the odds of being fully vaccinated (at least 2 vaccine doses) would be significantly associated with higher levels of perceived severity, perceived vulnerability, response efficacy, and self-efficacy. 79% of the respondents were fully vaccinated. Binary logistic regression analyses found that response efficacy (belief in the effectiveness of the COVID-19 vaccine) and self-efficacy to get vaccinated were significantly associated with the likelihood of being fully vaccinated. Perceived severity of COVID-19 and perceived vulnerability to COVID-19 were not associated with the likelihood of being fully vaccinated. Results indicate that health communications are needed to convince Hispanic adolescents and their parents that the COVID-19 vaccine is effective, and outreach efforts are needed to remove barriers to vaccination among this population.
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Affiliation(s)
- Jennifer B Unger
- University of Southern California Keck School of Medicine, United States
| | - Emma Herzig
- University of Southern California Keck School of Medicine, United States
| | - Viviana Rodriguez
- University of Southern California Keck School of Medicine, United States
| | - Daniel Soto
- University of Southern California Keck School of Medicine, United States
| | - Ryan Lee
- University of Southern California Keck School of Medicine, United States
| | - Neeraj Sood
- University of Southern California Sol Price School of Public Policy, United States
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Kaliba AR, Andrews DR. The Impact of Meso-Level Factors on SARS-CoV-2 Vaccine Early Hesitancy in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6313. [PMID: 37444159 PMCID: PMC10341526 DOI: 10.3390/ijerph20136313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
The extant literature on the U.S. SARS-CoV-2 virus indicates that the vaccination campaign was lagging, insufficient, and uncoordinated. This study uses the spatial model to identify the drivers of vaccine hesitancy (in the middle of the pandemic), one of the critical steps in creating impactful and effective interventions to influence behavioral changes now and in the future. The applied technique accounted for observed and unobserved homogeneity and heterogeneity among counties. The results indicated that political and religious beliefs, quantified by Cook's political bipartisan index and the percentage of the population affiliated with the main Christian groups, were the main drivers of the SARS-CoV-2 vaccine hesitancy. The past vaccination experience and other variables determining the demand and supply of vaccines were also crucial in influencing hesitancy. The results imply that vaccination campaigns require engaging community leaders at all levels rather than depending on politicians alone and eliminating barriers to the supply and demand of vaccines at all levels. Coordination among religious and community leaders would build a practical institutional arrangement to facilitate (rather than frustrate) the vaccination drives.
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Affiliation(s)
- Aloyce R. Kaliba
- College of Business, Southern University and A&M, Baton Rouge, LA 70813, USA
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Akintunde TY, Chen JK, Ibrahim E, Isangha SO, Sayibu M, Musa TH. Factors associated with COVID-19 vaccine uptake among foreign migrants in China. Heliyon 2023; 9:e17567. [PMID: 37533745 PMCID: PMC10292914 DOI: 10.1016/j.heliyon.2023.e17567] [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: 11/01/2022] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Background/Purpose The COVID-19 outbreak created unique policy challenges for vaccinating special groups like migrants. As part of sustainable development goals, the equitable distribution of the COVID-19 vaccine can contribute to ensuring health for all. This study examined COVID-19 vaccine uptake among foreign migrants in China based on sociodemographics, cultural beliefs, past vaccine behaviors, and psychosocial factors. Design An online cross-sectional survey was conducted among foreign migrants in mainland China via social media platforms from 21 November through 20 December 2021. Bivariate (unadjusted odd-ratio) and multivariate logistic regression analyses were performed to establish the correlates of COVID-19 vaccine uptake. Result Surveyed foreign migrants that are culture neutral (AOR: 2.5, CI: 95%, 1.02-5.90, p = 0.044), willing to pay for vaccination (AOR: 2.27, CI: 95%, 1.18-3.98, p = 0.012), believe in vaccine efficacy (AOR: 3.00, CI: 95%, 1.75-5.16, p < 0.000), have poor psychological health (AOR: 1.96, CI: 95%, 1.14-3.38, p = 0 0.014), and have higher perceived seriousness of COVID-19 (AOR: 2.12, CI: 95%, 1.26-3.57, p = 0.005) are more likely to receive COVID-19 vaccine. Those migrants with a history of declining vaccination (AOR: 0.34, CI: 95%, 0.18-0.65, p = 0.000) and middle-income earners $1701-3500 (AOR: 0.43, CI: 95%, 0.23-0.82, p = 0.010) are less likely to receive the COVID-19 vaccine. Conclusion This study brings a unique perspective to understanding vaccine behavior among international migrants in China. There is an urgent call from the World Health Organization and countries for complete vaccination and efforts to improve vaccine coverage. However, fewer studies have been conducted globally on the vaccination of migrant populations. The current study provides empirical information to increase the knowledge of the correlates of vaccine behavior among immigrants in countries around the globe. Future studies should conduct cross-country comparisons to understand the factors associated with increasing vaccination rates among immigrant populations to formulate a strong policy to increase vaccine coverage among immigrant populations across countries.
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Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, China
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Elhakim Ibrahim
- Department of Demography, College for Health, Community and Policy, The University of Texas, San Antonio, TX, United States
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, College of Liberal Art and Social Sciences, City University of Hong Kong, Hong Kong
| | - Muhideen Sayibu
- Department of Sci-Tech Communication and Policy, University of Science and Technology of China, Anhui, Hefei, China
| | - Taha Hussein Musa
- Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Su Y, Li S, Xue J, Li A, Zhu T. Measuring the importance of influencing factor for COVID-19 vaccination intention in China. Front Public Health 2023; 11:1191401. [PMID: 37441653 PMCID: PMC10335563 DOI: 10.3389/fpubh.2023.1191401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023] Open
Abstract
Background Vaccination is considered an effective approach to deter the spread of coronavirus disease (COVID-19). However, vaccine hesitancy is a common issue that makes immunization programs more challenging. To promote vaccination in a targeted and efficient way, this study aims to develop and validate a measurement tool for evaluating the importance of influencing factors related to COVID-19 vaccination intention in China, and to examine the demographic differences. Methods In study 1, we developed a Factor Importance Evaluation Questionnaire (FIEQ) based on semi-structured interview results and used exploratory factor analysis (EFA) to explore its factor structure. In study 2, we verified the four-factor structure of FIEQ by confirmatory factor analysis (CFA). We then administered FIEQ to Chinese participants and conducted a student t-test and analysis of variance to examine the differences in the importance evaluation of factors based on gender and educational level. Results In study 1, we developed a four-factor construct and retained 20 items after EFA (N = 577), with acceptable reliability (alpha = 0.87) and validity. In study 2, we found that the model fit was good (χ2 = 748.03 (162), p < 0.001, GFI = 0.949, RMSEA = 0.049, SRMR = 0.048, AGFI = 0.934), and reliability was acceptable (alpha = 0.730) (N = 1,496). No gender difference was found in factor importance. However, individuals with different educational levels reported significantly different importance evaluations of three factors, including perceived benefits and social norms (F = 3.786, p = 0.005), perceived influences from reference groups (F = 17.449, p < 0.001), and perceived risks (F = 2.508, p = 0.04). Conclusion This study developed and validated FIEQ for measuring the importance of influencing factors related to the COVID-19 vaccination intention in Chinese participants. Moreover, our findings suggest that the educational level may play a role in how individuals evaluate the importance of factors. This study provides insights into the concerns that individuals have regarding vaccination and offers potentially effective and targeted strategies for promoting COVID-19 vaccination.
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Affiliation(s)
- Yue Su
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Sijia Li
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jia Xue
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Faculty of Information, University of Toronto, Toronto, ON, Canada
| | - Ang Li
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Tingshao Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Rahayuwati L, Mutyara K, Nugraha RR, Khatiwada M, Dochez C, Kartasasmita C. COVID-19 Vaccine Perspective Among University Lecturers and Students: A Qualitative Study of Pre Implementation of Vaccination. J Multidiscip Healthc 2023; 16:1619-1629. [PMID: 37325125 PMCID: PMC10266379 DOI: 10.2147/jmdh.s416123] [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: 04/21/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023] Open
Abstract
Background The determinants of vaccine preferences and hesitancy varied by time and place. Objective The aim of this study was to assess the perspective of a COVID-19 vaccine among university-based groups. Methodology This qualitative research involved lecturers and students, and a selection of online focused group discussion was conducted based on the following criteria, including representatives of the health and non-health faculties, with at least 8 attendees in lecturer groups, and 8 participants in student groups. Results This study is described in 8 themes covering various issues about COVID-19 vaccine, such as views on COVID-19 vaccine, fake news, vaccine implementation by government. Conclusion The assessment of vaccine perspective shows that although awaited by some people, it also creates contradictions. This is due to the massive amount of information available regarding the vaccine descriptions. The role of the government as the main policy maker is to provide the right information and to make the right decisions about vaccines and vaccination implementation.
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Affiliation(s)
- Laili Rahayuwati
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, 45363, Indonesia
| | - Kuswandewi Mutyara
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, 45363, Indonesia
| | | | - Madan Khatiwada
- Network for Education and Support in Immunisation (NESI), University of Antwerp, Antwerp, 2610, Belgium
| | - Carine Dochez
- Network for Education and Support in Immunisation (NESI), University of Antwerp, Antwerp, 2610, Belgium
| | - Cissy Kartasasmita
- Department of Pediatric, Hasan Sadikin Hospital, Bandung, 40161, Indonesia
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Sobierajski T, Rzymski P, Wanke-Rytt M. Impact of the COVID-19 Pandemic on Attitudes toward Vaccination: Representative Study of Polish Society. Vaccines (Basel) 2023; 11:1069. [PMID: 37376458 DOI: 10.3390/vaccines11061069] [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: 05/05/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
The study explored the association between individuals' attitudes toward vaccination and their actual vaccination behavior. We also examined the impact of the coronavirus disease 2019 (COVID-19) pandemic and the ongoing vaccination debate on changing attitudes towards vaccination, specifically within different demographic groups. The survey was conducted among a representative sample of Poles (N = 805) using computer-assisted web interview (CAWI) technology. As demonstrated, those who identified themselves as strong vaccine supporters were statistically significantly more frequently to be vaccinated with COVID-19 booster doses, to follow a physician's recommendation on any vaccine without hesitation, and to be strengthened in their confidence in vaccines during the COVID-19 pandemic (p < 0.001 for all). However, over half of the responders declared themselves as moderate vaccine supporters/opponents, the groups whose further attitudes are likely to be affected by (mis)communication. Importantly, more than half of moderate vaccine supporters declared that their vaccine confidence was weakened during the COVID-19 pandemic, while 43% were not vaccinated against COVID-19. In addition, the study demonstrated that older and better-educated individuals were more likely to be COVID-19-vaccinated (p < 0.001 and p = 0.013, respectively). The results of this study imply that, in order to improve vaccine acceptance, it is essential to strengthen public health communication and avoid communication errors conducted during the COVID-19 pandemic.
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Affiliation(s)
- Tomasz Sobierajski
- Center of Sociomedical Research, Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 26/28 Krakowskie Przedmieście Str., 00-927 Warsaw, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland
- Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznan, Poland
| | - Monika Wanke-Rytt
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 63a Żwirki i Wigury Str., 02-091 Warsaw, Poland
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Salah H, Sinan I, Alsamani O, Abdelghani LS, ElLithy MH, Bukamal N, Jawad H, Hussein RRS, Elgendy MO, Rabie ASI, Khalil DM, Said ASA, AlAhmad MM, Khodary A. COVID-19 Booster Doses: A Multi-Center Study Reflecting Healthcare Providers' Perceptions. Vaccines (Basel) 2023; 11:1061. [PMID: 37376450 DOI: 10.3390/vaccines11061061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/22/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: During 2019, the COVID-19 pandemic was threatening healthcare services and workers, and acquiring immunity was an option to stop or limit the burden of this pandemic. Herd immunity was a top priority worldwide as the virus was spreading rapidly. It was estimated that 67% of the total global population should be immunized against COVID-19 to achieve herd immunity. The aim of the current study is to investigate different perceptions of healthcare workers in the Kingdom of Bahrain and Egypt using an online survey in an attempt to evaluate their awareness and concerns regarding new variants and booster doses. (2) Methods: This study conducted a survey on healthcare workers in the Kingdom of Bahrain and Egypt about their perception and concerns on the COVID-19 vaccines. (3) Results: The study found that out of 389 healthcare workers 46.1% of the physicians were not willing to take the booster doses (p = 0.004). Physicians also did not support taking the COVID-19 vaccine as an annual vaccine (p = 0.04). Furthermore, to assess the association between the type of vaccine taken with the willingness of taking a booster vaccine, healthcare workers beliefs on vaccine effectiveness (p = 0.001), suspension or contact with patients (p = 0.000), and infection after COVID-19 vaccination (p = 0.016) were significant. (4) Conclusion: Knowledge about vaccine accreditation and regulation should be dispersed more widely to ensure that the population has a positive perception on vaccine safety and effectiveness.
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Affiliation(s)
- Hager Salah
- Pharmaceutical Services Department, King Hamad University Hospital, Al Sayh 24343, Bahrain
| | - Israa Sinan
- Education and Proficiency Centre, King Hamad University Hospital, Al Sayh 24343, Bahrain
| | - Omar Alsamani
- Pharmaceutical Services Department, King Hamad University Hospital, Al Sayh 24343, Bahrain
- Pharmacy Program, Allied Health Department, College of Health Sciences, University of Bahrain, Manama 32038, Bahrain
| | | | - May Hassan ElLithy
- Pharmaceutical Services Department, King Hamad University Hospital, Al Sayh 24343, Bahrain
| | - Nazar Bukamal
- Cardiothoracic ICU and Anesthesia Department, Mohammed Bin Khalifa Specialist Cardiac Center, Awali 183261, Bahrain
| | - Huda Jawad
- Allied Health Department, College of Health Sciences, University of Bahrain, Manama 32038, Bahrain
| | - Raghda R S Hussein
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, Egypt
- Department of Clinical Pharmacy, Faculty of Pharmacy, October 6 University, 6th October City 12511, Egypt
| | - Marwa O Elgendy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62521, Egypt
- Department of Clinical Pharmacy, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt
| | - Al Shaimaa Ibrahim Rabie
- Clinical Pharmacy Department, Faiyum Oncology Center, Fayium 63511, Egypt
- Clinical Nutrition Department, Fayium Health Insurance Authority, Fayium 63511, Egypt
| | - Doaa Mahmoud Khalil
- Public Health and Community Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62514, Egypt
| | - Amira S A Said
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, Egypt
- Clinical Pharmacy Department, College of Pharmacy, Al Ain University, Abu Dhabi P.O. Box 112612, United Arab Emirates
| | - Mohammad M AlAhmad
- Clinical Pharmacy Department, College of Pharmacy, Al Ain University, Abu Dhabi P.O. Box 112612, United Arab Emirates
| | - Azza Khodary
- Mental Health Department, Faculty of Education, Helwan University, Helwan 11795, Egypt
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Wei L, Zeng W, Huang Y, Ye G, Chen Y, Yang L, Cai Y. COVID-19 vaccination coverage and its cognitive determinants among older adults in Shanghai, China, during the COVID-19 epidemic. Front Public Health 2023; 11:1163616. [PMID: 37333561 PMCID: PMC10272832 DOI: 10.3389/fpubh.2023.1163616] [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: 02/11/2023] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives This study aimed to examine the coverage of coronavirus disease 2019 (COVID-19) vaccination and its cognitive determinants among older adults. Methods A cross-sectional study was conducted using a questionnaire to conduct a survey among 725 Chinese older adults aged 60 years and above in June 2022, 2 months after the mass COVID-19 outbreak in Shanghai, China. The questionnaire covered demographic characteristics, COVID-19 vaccination status, internal risk perception, knowledge, and attitude toward the efficacy and safety of COVID-19 vaccines. Results The vaccination rate was 78.3% among the surveyed individuals. Self-reported reasons for unwillingness to get vaccinated (multiple selections) were "concerns about acute exacerbation of chronic diseases after vaccination (57.3%)" and "concerns regarding vaccine side effects (41.4%)." Compared to the unvaccinated group, the vaccinated group tended to have a higher score in internal risk perception (t = 2.64, P < 0.05), better knowledge of COVID-19 vaccines (t = 5.84, P < 0.05), and a more positive attitude toward the efficacy and safety of COVID-19 vaccines (t = 7.92, P < 0.05). The path analysis showed that the cognitive effect on vaccination behavior is relatively large, followed by the internal risk perception, and then the attitude toward COVID-19 vaccines. The more knowledgeable the participants were about COVID-19 vaccines, the more likely they were to receive the COVID-19 vaccines. In the multivariate logistic regression, the increased coverage of COVID-19 vaccination was associated with reduced age (OR = 0.53 95% CI 0.43-0.66, P < 0.001), being a resident in other places than Shanghai (OR = 0.40, 95% CI 0.17-0.92, P < 0.05), a shorter time of lockdown (OR = 0.33, 95% CI 0.13-0.83, P < 0.05), a history of other vaccines (OR = 2.58, 95% CI 1.45-4.60, P < 0.01), a fewer number of chronic diseases (OR = 0.49, 95% CI 0.38-0.62, P < 0.001), better knowledge about COVID-19 vaccines (OR = 1.60, 95% CI 1.17-2.19, P < 0.01), and a positive attitude toward COVID-19 vaccines (OR = 9.22, 95% CI 4.69-18.09, P < 0.001). Conclusion Acquiring accurate knowledge and developing a positive attitude toward COVID-19 vaccines are important factors associated with COVID-19 vaccination. Disseminating informed information on COVID-19 vaccines and ensuring efficacious communication regarding their efficacy and safety would enhance awareness about COVID-19 vaccination among older adults and consequently boost their vaccination coverage.
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Affiliation(s)
- Lu Wei
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Zeng
- Department of Global Health, School of Health, Georgetown University, Washington, DC, United States
| | - Yangyang Huang
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoxin Ye
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Chen
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Yang
- Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Geriatrics, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Pundhir A, Jaiswal A, Kushwaha P, Goel AD, Gahlot A, Singh L, Kaur M. A cross-sectional study on COVID-19 vaccine hesitancy in peri-urban areas in Kanpur, Uttar Pradesh, India. Monaldi Arch Chest Dis 2023; 94. [PMID: 37259812 DOI: 10.4081/monaldi.2023.2577] [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: 05/10/2023] [Indexed: 06/02/2023] Open
Abstract
Vaccination is a potential public health solution for the prevention of infection. It reduces the severity of symptoms in the case of COVID-19. Despite the availability of vaccines, some people are hesitant to be vaccinated. The objectives of this study were to measure the proportion of vaccine hesitancy among the peri-urban population and identify its determinants. An adult population of 303 from two peri-urban areas in the field practice area of the Urban Health Training Center, Rama Medical College, was interviewed from February 22 to March 25, 2021. Epicollect 5 was used for collecting data, and STATA 16 was used for analysis. Multivariable logistic regression was applied to compute the adjusted odds ratio (AOR) (95% confidence interval) to find out the determinants of vaccine hesitancy. The 3Cs model-guided tools were used for data collection and analysis. More than one-fourth (28%) of the participants were vaccine-hesitant, whereas 34.6% had no confidence in the vaccine. Other reasons were complacency (40.6%) and convenience (35.9%). Vaccine hesitancy was significantly associated with gender [AOR=2.40 (1.12-5.16)] and trust in government [AOR=0.18 (0.08-0.45)], but there was no association with age group, political affiliation, or source of information about the vaccine. It is important to build people's trust in vaccines, make them convenient, and resolve the issues that are making them complacent. The health system needs to involve non-governmental organizations to reach out to those for whom there are issues of availability and approach.
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Affiliation(s)
- Ashish Pundhir
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani.
| | - Abhishek Jaiswal
- Center for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
| | - Poonam Kushwaha
- Department of Community Medicine, Rama Medical College Hospital and Research Center, Kanpur, Uttar Pradesh.
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan.
| | - Anju Gahlot
- Department of Community Medicine, Rama Medical College Hospital and Research Center, Kanpur, Uttar Pradesh.
| | - Lakshmi Singh
- Department of Community Medicine, Rama Medical College Hospital and Research Center, Kanpur, Uttar Pradesh.
| | - Manmeet Kaur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh.
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Kumar G, Jena S, Snigdha NT, Basha S, Narayanan JK, Luke AM. Acceptance of COVID-19 Vaccines in India: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11050964. [PMID: 37243068 DOI: 10.3390/vaccines11050964] [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: 04/03/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
This systematic review and meta-analysis sought to evaluate the acceptability levels for COVID vaccine(s) in various states in India. Published articles in PubMed/Scopus/Cochrane/DOAJ/the Web of Science that focused on assessing COVID-19 vaccine hesitation/vaccine acceptance using a survey/questionnaire were included. After extensive research, 524 records were found, and after screening on the basis of eligibility criteria, only 23 papers were added to this review. Increased vaccine assumption percentage (>70%) among the population was found in two surveys nationwide (92.8%) and in Delhi (79.5%). For pooled estimates of COVID-19 vaccine acceptance and heterogeneity, twenty-three studies (23) consisting of 39,567 individuals reported for acceptance of COVID 19 vaccine in India.. Out of these, 26,028 individuals accepted the COVID-19 vaccine, giving a pooled estimate of 62.6% (95% CI: 55.6-69.4) with considerable heterogeneity (χ2 = 3397.3, p < 0.0001; I2 = 99.40%). The results of this study give a brief insight into the percentage acceptance and hesitancy among the Indian population regarding COVID-19 vaccine immunisation. Future research and vaccine education initiatives can be steered by the findings of this work as a starting point.
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Affiliation(s)
- Gunjan Kumar
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to Be University, Patia, Bhubaneswar 751024, Odisha, India
| | - Samikshya Jena
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to Be University, Patia, Bhubaneswar 751024, Odisha, India
| | - Niher Tabassum Snigdha
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Sakeenabi Basha
- Department of Community Dentistry, Faculty of Dentistry, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Jayaraj Kodangattil Narayanan
- Medical and Dental Sciences Department, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman P.O. Box 346, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman P.O. Box 346, United Arab Emirates
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Aslan S, Ozkara A, Kasım I, Aksoy H. Why Turkish Parents Refuse Childhood Vaccination? A Qualitative Study. ARCHIVES OF IRANIAN MEDICINE 2023; 26:267-274. [PMID: 38301090 PMCID: PMC10685866 DOI: 10.34172/aim.2023.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/08/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Anti-vaccination is spreading among parents. In 2017, 23000 families in Turkey refused vaccinations for their children. Meanwhile an increase in infectious diseases was observed, which might be caused by vaccination rejection. The reasons why families do not vaccinate their children may be very different, such as side effects, or advocation for "healthy life" by gurus. However, the real reasons for vaccine refusal are unknown. Our aim is to determine the reasons for anti-vaccination in Turkey. METHODS In order to reveal the real reasons for not taking the vaccine, we planned to conduct interviews with the representatives of the vaccine rejection group using qualitative research methodology with the "grounded theory" method. We searched some anti-vaccination blogs to find candidates for interviews. Within the scope of our study, parental concerns about vaccinations were classified by analyzing the data obtained from semi-structured questions and interviews recorded with voice recorders in face-to-face interviews with 21 parents in 13 cities of Turkey. RESULTS The obtained findings were classified under the headings of ''mistrust'', ''vaccine efficacy-importance'', ''decision-making processes - bases'', and ''law-ethics''. Mistrust was the main theme, almost singularly, as the most important reason for vaccine rejection. The salient reasons for mistrusts were: Companies which produce vaccines especially international companies because of conspiratory beliefs; health authorities, because of the belief about non-transparency in epidemiologic data, immunization council etc. and healthcare professionals, because of their non-communicative and non-concerned attitude. CONCLUSION Mistrust is hard to overcome. The beliefs of the patients cannot be easily changed. As a result of our study, we made some recommendations for health authorities, healthcare professionals, companies and other related stakeholders.
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Affiliation(s)
- Salih Aslan
- Evren Integrated Health Center, Ankara, Türkiye
| | - Adem Ozkara
- Department of Family Medicine University of Health Sciences,, Ankara City Hospital, Ankara, Türkiye
| | - Ismail Kasım
- Department of Family Medicine University of Health Sciences,, Ankara City Hospital, Ankara, Türkiye
| | - Hilal Aksoy
- Department of Family Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Pourrazavi S, Fathifar Z, Sharma M, Allahverdipour H. COVID-19 vaccine hesitancy: A Systematic review of cognitive determinants. Health Promot Perspect 2023; 13:21-35. [PMID: 37309435 PMCID: PMC10257562 DOI: 10.34172/hpp.2023.03] [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: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 06/14/2023] Open
Abstract
Background: Although mass vaccination is considered one of the most effective public health strategies during the pandemic, in the COVID-19 era, many people considered vaccines unnecessary and, or doubted the effectiveness of the COVID-19 vaccine. This review aimed to tabulate cognitive causes of COVID-19 vaccination hesitancy, which may help public health policymakers overcome the barriers to mass vaccinations in future pandemics. Methods: For this systematic review, studies pertaining to COVID-19 vaccine hesitancy published up to June 2022 were retrieved from six online databases (Cochrane Library, Google Scholar Medline through PubMed, Scopus, and Web of Science). Inclusion criteria were the studies conducted on people who had a delay in accepting or refusing COVID-19 vaccines, reported the impact of cognitive determinants on vaccine hesitancy, and were written in English in the timeframe of 2020-2022. Results: This systematic review initially reviewed 1171 records. From these 91 articles met the inclusion criteria. The vaccination hesitation rate was 29.72% on average. This systematic review identified several cognitive determinants influencing vaccination hesitancy. Lack of confidence and complacency were the most frequent factors that predicted vaccine hesitancy. Conclusion: The identified prevailing cognitive determinants for COVID-19 vaccine hesitancy indicated that using initiative and effective communication strategies would be a determinant factor in building people's trust in vaccines during the pandemic and mass vaccinations.
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Affiliation(s)
- Sara Pourrazavi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Health Education & Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Fathifar
- Department of Library, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manoj Sharma
- Department of Social and Behavioral Health, University of Nevada, Las Vegas (UNLV), Las Vegas, NV 89119, USA
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89154, USA
| | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Health Education & Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran
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Wang D, Shi ZH. Do psychological distress and digital sports influence the willingness to take the vaccine and precautionary saving? Empirical evidence from Shanghai. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-13. [PMID: 37361311 PMCID: PMC10119833 DOI: 10.1007/s10389-023-01915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/05/2023] [Indexed: 06/28/2023]
Abstract
Aim The COVID-19 epidemic has caused risk and uncertainty. This study answers whether and how psychological distress and digital sports influence willingness to take the vaccine and precautionary savings. Subject and methods We conducted a cross-sectional study with an online survey sample of 1016 Shanghai residents who live and work there and are aged between 16-60. All of them experienced the COVID-19 lockdown in Shanghai. We used logistic regressions to examine the relationships between the variables of interest. Results Three findings were demonstrated. First, psychologically distressed individuals are less inclined to take the vaccine. Second, those engaged in fitness activities via digital media platforms are more willing to get vaccinated. Third, psychologically distressed individuals and digital video-based physical exercisers are more likely to precautionary save. Conclusions This study contributes to the literature by documenting how people changed their life from the perspective of finance and health during the lockdown and providing practical implications.
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Affiliation(s)
- Di Wang
- School of Management, Shanwei Institute of Technology, Shanwei, Guangdong China
| | - Zhong-hua Shi
- School of Education, Shanwei Institute of Technology, Shanwei, Guangdong China
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50
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Wu J, Xia Q, Miao Y, Yu C, Tarimo CS, Yang Y. Self-perception and COVID-19 vaccination self-efficacy among Chinese adults: A moderated mediation model of mental health and trust. J Affect Disord 2023; 333:313-320. [PMID: 37084973 PMCID: PMC10116156 DOI: 10.1016/j.jad.2023.04.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Optimal COVID-19 vaccination coverage is necessary to achieve community protection, and self-efficacy independently predict vaccination behavior. The current study examined the effect of self-perception on COVID-19 vaccination self-efficacy as well as potential mechanisms among Chinese adults. METHODS A cross-sectional survey was conducted from four cities in China (n = 6781). Models 4 and 8 in Hayes' PROCESS macro were used to test models. RESULTS Self-perception (β = 0.128, 95 % CI: 0.093-0.163) and self-perception ∗ mental health (β = 0.009, 95 % CI: 0.003-0.014) were positively associated with trust in doctors and vaccine developers, while mental health was negatively related to trust in doctors and vaccine developers (β = -0.483, 95 % CI: -0.629-0.337). Self-perception (β = 0.149, 95 % CI: 0.138-0.161), trust in doctors and vaccine developers (β = 0.185, 95 % CI: 0.177-0.194) and self-perception ∗ mental health (β = 0.003, 95 % CI: 0.002-0.005) were positively associated with COVID-19 vaccination self-efficacy. Mental health was negatively related to COVID-19 vaccination self-efficacy (β = -0.101, 95 % CI: -0.151-0.051). LIMITATIONS This cross-sectional study collected data through online questionnaires. CONCLUSIONS Our results demonstrated that the relationship between self-perception and COVID-19 vaccination self-efficacy was partially mediated by trust in doctors and vaccine developers. Both the correlation between self-perception and COVID-19 vaccination self-efficacy, and the relationship between self-perception and trust in doctors and vaccine developers were moderated by mental health. Findings confirm that increasing COVID-19 vaccination self-efficacy would be facilitated by improvements in self-perception, mental health, and trust in doctors and vaccine developers.
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Affiliation(s)
- Jian Wu
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Qingyun Xia
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Yudong Miao
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Chengcheng Yu
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Clifford Silver Tarimo
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China
| | - Yinmei Yang
- Department of Health management, College of Public Health, Zhengzhou University, 100 Kexue Road, Gaoxin district, Zhengzhou 450001, China.
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