Conspiracy beliefs and vaccination intent for COVID-19 in an infodemic

Path analysis of perceived disease vulnerability, COVID-19 fear, and lower vaccine hesitancy within the context of protection motivation theory

COVID-19 vaccinations have demonstrated effectiveness in reducing severe infections. However, vaccine hesitancy posed a major public health hurdle to combat the COVID-19 pandemic. Online spread of vaccine conspiracy beliefs generated unwarranted mistrust and resistance to vaccines. While numerous studies have explored the factors influencing vaccine hesitancy, there remains a lack of comprehensive understanding regarding the interplay between perceived disease vulnerability, COVID-19 fear, and vaccine hesitancy. Protection motivation theory posits citizens will evaluate perceived threats and take actions to mitigate potential harm. With a large U.S. sample, path analysis demonstrated individuals' perceived disease vulnerability was associated with lower vaccine hesitancy. Greater perceived disease vulnerability was associated with higher COVID-19 fear. Greater COVID-19 fear was associated with lower vaccine hesitancy. Greater vaccine conspiracy beliefs associated with higher vaccine hesitancy. However, in the presence of perceived vulnerability to disease, vaccine conspiracy beliefs associated with higher fear of COVID-19 and thereby lower vaccine hesitancy. We found under circumstances of higher perceived vulnerability to disease and fear of COVID-19, vaccine conspiratorial believers were less vaccine hesitant. We discuss how public health messaging can highlight personal risks to contracting COVID-19 to appeal to those who self-identify as disease prone, but may have reservations about vaccines because of misinformation. Successfully combating diseases entails reaching and gaining cooperation from misbelievers because misinformation is expected to continue in the digital age. By understand individual differences to vaccine hesitancy, it can help increase vaccinations and prevent severe illnesses in the post COVID-19 pandemic era.

Promoter or barrier? Assessing how social media predicts Covid-19 vaccine acceptance and hesitancy: A systematic review of primary series and booster vaccine investigations

RATIONALE

Prior research indicates that social media is primarily a negative contributor to Covid-19 vaccine outcomes.

OBJECTIVE

The current systematic review of Covid-19 primary series and booster vaccine investigations provides a more nuanced and comprehensive assessment of this association by exploring a) how distinct social media judgments and actions predict different vaccine-related outcomes - perceptions and intentions/uptake, b) both primary series and booster findings, c) types of social media, and d) comparisons across different populations.

METHOD

We conducted a systematic review of published research examining the link between social media and COVID-19 vaccine outcomes - judgments, intentions, and uptake. Overall, we identified 113 published articles.

RESULTS

The findings reveal complex associations between distinct social media predictors and these outcomes. The most consistent negative relationships emerge within studies looking at 'social media as an information source,' 'trust', and 'general social media use/passive exposure' as predictors of less favorable vaccine judgments and intentions/uptake. Conversely, studies focused on 'information seeking' indicate more mixed results. Among the few booster investigations, there are more positive than negative associations between social media predictors and Covid-19 vaccine intentions. Across different social media platforms and sample populations, social media was a less robust/consistent negative predictor of COVID-19 judgments and intentions.

CONCLUSIONS

While social media can contribute to more negative COVID-19 vaccine judgments and motivations, the consistency of this relationship may vary across populations, the platforms users access, and the nature of exposure. Overall, social media campaigns promoting COVID-19 vaccines should employ distinct strategies to target those individuals that value social media as an information resource.

Relationship Between Fear of COVID-19, Conspiracy Beliefs About Vaccines and Intention to Vaccinate Against COVID-19: A Cross-National Indirect Effect Model in 13 Latin American Countries

The present study explored the predictive capacity of fear of COVID-19 on the intention to be vaccinated against COVID-19 and the influence in this relationship of conspiracy beliefs as a possible mediating psychological variable, in 13 Latin American countries. A total of 5779 people recruited through non-probabilistic convenience sampling participated. To collect information, we used the Fear of COVID-19 Scale, Vaccine conspiracy beliefs Scale-COVID-19 and a single item of intention to vaccinate. A full a priori Structural Equation Model was used; whereas, cross-country invariance was performed from increasingly restricted structural models. The results indicated that, fear of COVID-19 positively predicts intention to vaccinate and the presence of conspiracy beliefs about COVID-19 vaccines. The latter negatively predicted intention to vaccinate against COVID-19. Besides, conspiracy beliefs about COVID-19 vaccines had an indirect effect on the relationship between fear of COVID-19 and intention to vaccinate against COVID-19 in the 13 countries assessed. Finally, the cross-national similarities of the mediational model among the 13 participating countries are strongly supported. The study is the first to test a cross-national mediational model across variables in a large number of Latin American countries. However, further studies with other countries in other regions of the world are needed.

Attitudes and practices toward COVID-19 precautionary measures: A comparative study of health professionals and public

BACKGROUND

Containment of the COVID-19 pandemic has been impaired by the denial and defiance of preventive recommendations.

AIMS

We aimed to study the attitudes toward COVID-19 social measures among laypersons and healthcare professionals.

METHODS

We conducted a cross-sectional study in the United Arab Emirates using a self-administered online questionnaire. Both healthcare workers and laypersons were actively recruited. In addition to sociodemographic variables, the questionnaire included questions on anxiety, knowledge, and defiance related to COVID-19.

RESULTS

A total of 615 individuals with a mean age of 32 years (SD, 12) participated. Females comprised 69% and healthcare workers constituted 60% of the study sample. Among laypersons, over 42% reported having social gatherings at home, and 44% admitted to visiting crowded places. More than half of the respondents felt increased anxiety. Previous COVID-19 infection did not affect attitudes or anxiety levels. Knowledge about COVID-19 was higher among those who were more educated (r = .21). Healthcare workers had lower anxiety than laypersons (p = .002). COVID-19 anxiety was higher among older persons and did not decrease with more knowledge. COVID-19 defiance was higher among younger male respondents from larger households and did not correlate with knowledge. Multivariate analysis showed more defiant attitudes at younger ages.

CONCLUSIONS

Anxiety-related to the COVID-19 pandemic is more common in older individuals, whereas younger persons were more likely to deny and defy prevention recommendations despite having knowledge of viral transmission. Voluntary compliance by young individuals requires an engaging communication strategy to generate more compassionate attitudes.

The Impact of Social Media on Vaccination: A Narrative Review

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

Who chooses alternative sources of information about childhood vaccinations? A cross-sectional study

Introduction

Vaccine hesitancy can lead to problematic outcomes in terms of public health. A factor playing a fundamental role in this dynamic is the source of information considered by parents in the decision-making progress that leads to the acceptance or refusal of childhood vaccinations. This study aims to investigate the sources of information considered by the parents of children attending primary and secondary schools in two large Italian cities and to identify predictors that led to choosing alternative sources of information.

Methods

An online questionnaire was administered to the parents of students attending elementary, middle, and high schools in Rome and Turin. Two validated tools were used: the Parent Attitudes about Childhood Vaccines Survey and the Vaccine Health Literacy of adults in Italian. Sources of information about vaccinations, trust toward the healthcare system, hesitancy and attitudes about COVID-19 vaccinations, were also investigated. A multivariable logistic regression model was built to identify predictors of the preferred sources of information on the topic.

Results

Totally, 2,301 answers to the survey were collected from June to October 2021. Of these, 1,127 came from parents in Rome (49%) and 1,174 from parents based in Turin (51%) with a mean age of 47.7 years (±6.4). The majority of the respondents were mothers (81%), married (73%), with two or more children (70.5%). The multivariable logistic regression model results showed that fathers were more inclined than mothers to use alternative sources of information (OR 1.48, 95% CI 1.29-2.00). Moreover, a higher level of vaccine hesitancy was a strong predictor for choosing alternative sources of information (OR 2.45, 95% CI 1.73-3.46). The HLVa-it scores show that parents with a lower Vaccine Literacy (VL) were more inclined to use alternative sources of information.

Discussion

Addressing health literacy issues and changing the official forms of communication could help improving vaccine acceptance. This study shows the importance of rebuilding a trusting relationship between patients and health care providers, which is fundamental in the fight against vaccine hesitancy.

COVID-19 vaccine hesitancy among pregnant women in an antenatal clinic in Durban, South Africa

Background

Mass administration of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most efficient intervention against the coronavirus disease 2019 (COVID-19) pandemic. Recently, vaccinations were shown to be safe and effective during pregnancy. However, vaccination rates are low in low- and middle-income countries, and vaccine hesitancy is a major limiting factor.

Objectives

To investigate the rate of COVID-19 vaccine hesitancy among pregnant women.

Method

A cross-sectional questionnaire-based investigation of 313 unvaccinated pregnant women attending an antenatal clinic in Durban, South Africa (SA). The questionnaire included clinical and socio-demographic data, and reasons for vaccine hesitancy were recorded and evaluated.

Results

Of 313 women participating, 126 (40.3%) were vaccinated against COVID-19, 21/313 = 6.7%; for those unvaccinated, 21/187 (13.9%) were planning to be vaccinated. However, most unvaccinated women, 174 of 187 (93%), showed COVID-19 vaccine hesitancy.

Conclusion

The COVID-19 vaccination hesitancy among pregnant women in Durban, SA, is exceptionally high. This requires urgent attention by the relevant health authorities (both professional health organisations and the SA Department of Health) as many countries experience different waves of the variants of SARS-CoV-2 and herd immunity may not have been achieved.

Contribution

This study showed a high vaccine acceptance hesitancy rate among pregnant women in SA.

The Roles of Social Media Use and Medical Mistrust in Black Americans' COVID-19 Vaccine Hesitancy: The RISP Model Perspective

The COVID-19 pandemic has brought unprecedented challenges to healthcare and public health messaging in the United States. One area of focus has been vaccination uptake among Black Americans, who have experienced COVID-19 deaths disproportionate to their share of the United States population, raising questions about the processes involved in vaccination perceptions and behaviors. Guided by the Risk Information Seeking and Processing model, this study explored the roles of medical mistrust and social media as a source of risk information in Black Americans' vaccine hesitancy. Survey results from a YouGov panel sample of Black Americans (n = 1,136; 53.5% female) showed that social media use and medical mistrust were positively associated with belief in misinformation related to the COVID-19 vaccine, which, in turn, was positively related to vaccine hesitancy through perceived information insufficiency and information seeking intentions. Furthermore, we found that belief in misinformation and subjective norms toward anti-vaccination also serially mediated the association between social media use and medical mistrust with vaccine hesitancy. Theoretical and practical implications are discussed.

Determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon: a scoping review of the literature

BACKGROUND

Vaccination is essential to protect from influenza and recently from COVID-19, yet uptake in Lebanon is suboptimal. Several factors determine uptake including knowledge, attitude and policies. We conducted a scoping review of the literature to explore the determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, thirty one peer reviewed studies indexed in six databases Pub Med, EMBASE, Scopus, CINAHL, Medline, and the Cochrane Library were screened. Two students, a senior Librarian and an Associate Professor in nursing searched for eligible studies. The library search strategy followed a combination of three broad concepts (viral influenzas; vaccines; Lebanon). The search timeframe was up till December 31, 2022. Determinants of influenza and COVID-19 vaccine intent or uptake were categorized following the constructs of the Theory of Planned Behavior.

RESULTS

Nine studies investigated influenza vaccine intent or uptake among the public community, parents and healthcare workers. Twenty one studies investigated COVID-19 vaccine intent or uptake among the public community, older refugees, university students, patients with cancer, dentists, and social media users. One study investigated both types of vaccines. A conceptual model of the determinants of vaccine intent and uptake within the Lebanese context was developed. Various determinants included environmental factors, norms, knowledge, perceptions, attitudes, past experiences, behavioral control and hesitancy.

CONCLUSIONS

Research on vaccine intent and uptake in Lebanon is still in its infancy, while that of COVID-19 is on the rise. Multifaceted reasons behind the low vaccination rates were observed yet few attempts were made to target vulnerable groups. Further research studies are needed to target vulnerable groups.

Vaccine Hesitancy and the Concept of Trust: An Analysis Based on the Israeli COVID-19 Vaccination Campaign

This paper examines the trust relations involved in Israel's COVID-19 vaccination campaign, focusing on vaccine hesitancy and the concept of 'trust'. The first section offers a conceptual analysis of 'trust'. Instead of analyzing trust in the vaccination campaign as a whole, a few objects of trust are identified and examined. In section two, the Israeli vaccination campaign is presented, and the focus is placed on vaccine hesitancy. In section three, different trust relations are examined: public trust in the Israeli government and health institutions, interpersonal trust in healthcare professionals and experts, trust in the pharmaceutical companies that make the COVID-19 vaccine, the US FDA, and trust in the new vaccine and the new technology. Through this complexity of trust relations, I argue that it is impossible to completely separate the trust that the vaccine is safe and effective from social aspects of mistrust. Additionally, practices of silencing and censoring the concerns of vaccine hesitaters - both experts and among the public, are pointed out. I contend that these cases further minimize vaccine hesitaters' trust in vaccine-related entities. In contrast, in section four, I suggest the 'trust-based approach': since vaccine hesitancy is not solely the result of knowledge deficiency but also a lack of trust relations, any campaign that addresses vaccine hesitancy should also focus on trust. The advantages of this approach are spelled out. For governments, a discussion based on trust is, ultimately, the best democratic way to encourage hesitaters to take the plunge and get vaccinated.

Conspiracy beliefs, COVID-19 vaccine uptake and adherence to public health interventions during the pandemic in Europe

BACKGROUND

Conspiracy beliefs can be a major hindrance causing a lack of compliance with public health measures, including vaccination. We examined the relationship between individual attitudes, socio-demographic factors, conspiracy beliefs, COVID-19 vaccine hesitancy and preferences about pandemic policies in Europe.

METHODS

We used data from the 10th round of the European Social Survey, conducted in 2021-22 in 17 European countries. Both a conspiracy index and a personal attitude index for each participant were built by using a Latent Class Analysis model. Then, we used a multilevel regression model to investigate the relationship between a personal attitudes index, socio-demographic factors and country of residence, and a conspiracy index. We descriptively analyse the relationship between the conspiracy index and four main items related to COVID-19.

RESULTS

We found that a higher probability of believing in conspiracy theories was associated with male gender, middle age, lower levels of education, unemployment, lower levels of trust and satisfaction and right-wing political orientation. The country of residence was a contextual factor, with eastern European countries having higher levels of conspiracy beliefs. Individuals who expressed conspiracy beliefs had lower COVID-19 vaccine uptake, were less satisfied with the way health services coped with the pandemic and less supportive of governmental restrictions.

CONCLUSIONS

This study provides valuable insights into the factors associated with conspiracy beliefs and their potential impact on public health. The findings highlight the need for effective strategies to address the underlying factors driving conspiracy beliefs, reduce vaccine hesitancy and promote acceptance of public health interventions.

Are We Facing a Tsunami of Vaccine Hesitancy or Outdated Pandemic Policy in Times of Omicron? Analyzing Changes of COVID-19 Vaccination Trends in Poland

In this study, we analyzed Polish COVID-19 vaccination data until January 2023 from the European Centre for Disease Prevention and Control to understand individual decision making during the milder Omicron wave. Our findings show a general decline in subsequent vaccine uptake. As the number of government-provided doses increased, completion rates among certain low-risk groups dropped to less than 1%. Elderly individuals, especially those aged 70–79, showed greater adherence but also exhibited decreased interest in subsequent boosters. Healthcare workers exhibited a dramatic shift in their attitude, disregarding the recommended schedule. The overwhelming majority opted out of receiving the second boosters, while the remaining individuals adjusted their timing based on infection trends or the availability of updated boosters. Two factors positively influenced vaccination decisions: societal influence and the availability of updated boosters. Lower-risk individuals were more likely to postpone vaccination until updated boosters were available. Our findings highlight that while Polish policy aligns with international guidelines, it fails to garner significant adherence from the Polish population. Previous studies have shown that vaccinating low-risk groups resulted in more sick days due to adverse events following immunization than the days gained by preventing infection. Consequently, we advocate for the official abandonment of this policy, as its practical abandonment has already taken place, and persisting in pretending otherwise only serves to erode public trust. Therefore, we propose a shift toward treating COVID-19-like influenza with vaccination for vulnerable individuals and those who have close contact with them before the season.

Are We Facing a Tsunami of Vaccine Hesitancy or Outdated Pandemic Policy in Times of Omicron? Analyzing Changes of COVID-19 Vaccination Trends in Poland

In this study, we analyzed Polish COVID-19 vaccination data until January 2023 from the European Centre for Disease Prevention and Control to understand individual decision making during the milder Omicron wave. Our findings show a general decline in subsequent vaccine uptake. As the number of government-provided doses increased, completion rates among certain low-risk groups dropped to less than 1%. Elderly individuals, especially those aged 70-79, showed greater adherence but also exhibited decreased interest in subsequent boosters. Healthcare workers exhibited a dramatic shift in their attitude, disregarding the recommended schedule. The overwhelming majority opted out of receiving the second boosters, while the remaining individuals adjusted their timing based on infection trends or the availability of updated boosters. Two factors positively influenced vaccination decisions: societal influence and the availability of updated boosters. Lower-risk individuals were more likely to postpone vaccination until updated boosters were available. Our findings highlight that while Polish policy aligns with international guidelines, it fails to garner significant adherence from the Polish population. Previous studies have shown that vaccinating low-risk groups resulted in more sick days due to adverse events following immunization than the days gained by preventing infection. Consequently, we advocate for the official abandonment of this policy, as its practical abandonment has already taken place, and persisting in pretending otherwise only serves to erode public trust. Therefore, we propose a shift toward treating COVID-19-like influenza with vaccination for vulnerable individuals and those who have close contact with them before the season.

COVID-19 Vaccine Acceptance Behavior among Hispanics/Latinxs in Nevada: A Theory-Based Analysis

Hesitancy toward the COVID-19 vaccine has hindered its rapid uptake among the Hispanic and Latinx populations. The study aimed to use the Multi-Theory Model (MTM) for health behavior change to explain the intention of initiating and sustaining the behavior of COVID-19 vaccination among the Hispanic and Latinx populations that expressed and did not express hesitancy towards the vaccine in Nevada. Using a quantitative cross-sectional and survey-based research study design, data were collected using a 50-item questionnaire and analyzed using multiple linear regression modeling. Of 231 respondents, participatory dialogue (b = 0.113, p < 0.001; b = 0.072, p < 0.001) and behavioral confidence (b = 0.358, p < 0.001; b = 0.206, p < 0.001) displayed significant associations with the initiation of COVID-19 vaccine acceptance among vaccine-hesitant and non-vaccine-hesitant individuals. Emotional transformation (b = 0.087, p < 0.001; b = 0.177, p < 0.001) displayed a significant association with the sustenance of COVID-19 vaccine acceptance among vaccine-hesitant and non-vaccine-hesitant individuals. Results from this study provide evidence that the MTM is a useful tool in predicting COVID-19 vaccine acceptance behavior among Hispanics and Latinxs in Nevada, and it should be used in intervention designs and messaging to promote vaccine uptake.

Undergraduate Students' Knowledge, Attitudes and Willingness to Receive COVID-19 Vaccines: A Survey of Convenience Sample in Namibia

Introduction

The global consequences of the COVID-19 pandemic cannot be overstated. Vaccinations are one of the leading strategies to protect against the virus, and it is likely that students' understanding and desire to be vaccinated can be major factors in helping contain the pandemic. Nonetheless, no studies looked into the vaccine attitude, knowledge and willingness in Namibia.

Objectives

To assess and describe the association between knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines in the school of education, nursing and economics and management science at the university campus in Namibia.

Methods

The study employed a cross-sectional descriptive study from 200 undergraduate university students using a convenience sampling. Data analysis was done using SPSSv28 and descriptive statistics were used to depict trends in data while a Pearson's correlation determined the relationship between the study variables.

Results

The data showed that 54.2% (1.54  ±  0.49) of the participants had adequate knowledge concerning the vaccine, while 57.1% and 58.6% had a negative outlook and were unwilling to get vaccinated. A moderate positive correlation was observed between attitudes and willingness to take COVID-19 vaccines (r  =  .546, P  =<.001), while a negative relation existed between knowledge and attitudes (r  =  -.017, P  =>.001).

Conclusions

This study has provided valuable insight into the knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines. Despite more than half of the participants having appropriate knowledge, they had an unfavourable outlook toward COVID-19 vaccination. It is recommended that further studies focus on how factors such as incentives, religion and cultural values affect their desires to be vaccinated.

"I'm luckier than everybody else!": Optimistic bias, COVID-19 conspiracy beliefs, vaccination status, and the link with the time spent online, anticipated regret, and the perceived threat

The catastrophic wave in the fall of 2021 drove Romania to the top of the list of dangerous COVID-19 infections, with the highest mortality rate in Europe. At the same time, Romania had one of the lowest vaccination rates. In this context, the present research aimed to explore the link between vaccination intention/status, optimistic bias, COVID-19 conspiracy beliefs, the time spent online, and vaccination (anticipated) regret. Our convenience sample was formed by 408 adults aged 18-63 years (M = 22.11, SD = 6.18, 69.9 % females), who were distributed into four groups: (1) non-vaccinated who definitely refused COVID-19 vaccination, (2) non-vaccinated who considered COVID-19 vaccination, (3) non-vaccinated who reported their absolute willingness to COVID-19 vaccination, and (4) people who were COVID-19 vaccinated. We conducted our analyses separately, depending on these groups (i.e., vaccination intentions/status). Data were collected using an online questionnaire between November 10, 2021, and January 03, 2022. In our cross-sectional approach, following correlation and ANOVA analyses, among the observed patterns were (1) the significant negative relation between optimism bias and the perceived COVID-19 threat; (2) the positive link between anticipated regret, post-vaccination regret, age, and conspiracy beliefs. We discuss our findings considering their contribution to health policies and practices.

A mediation model of the relationship between university students' news media literacy and xenophobia: The role of intellectual humility, perceived threat, and blind patriotism

The dissemination of misinformation and disinformation has increased the need for news media literacy. This study administered a self-developed questionnaire to measure the relationship between news media literacy and xenophobia among college students in China (N = 430). The questionnaire measured five variables: news media literacy, xenophobia, blind patriotism, perceived threat, and intellectual humility. Confirmatory factor analysis (CFA) was used to validate this five-variable survey, and the analyses indicated satisfactory construct validity. Results from structural equation modeling indicated that intellectual humility was a significant predictor of news media literacy, and blind patriotism and perceived threat mediated the relationship between news media literacy and xenophobia. This study provides insights for researchers and instructors who are promoting news media literacy education in schools.

To Vaccinate or Not to Vaccinate-Reasons of Willingness and Reluctance of Students against SARS-CoV-2 Vaccination-An International Experience

Despite the vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being reported to be safe and effective, the unwillingness to vaccinate and doubts are still common. The aim of this international study was to assess the major reasons for the unwillingness to vaccinate in a group of students from Poland (n = 1202), Bangladesh (n = 1586), India (n = 484), Mexico (n = 234), Egypt (n = 566), Philippines (n = 2076), Pakistan (n = 506), Vietnam (n = 98) and China (n = 503). We conducted an online cross-sectional study that aimed to assess (1) the percentage of vaccinated and unvaccinated students and (2) the reasons associated with willingness/unwillingness to the vaccine. The study included 7255 respondents from 9 countries with a mean age of 21.85 ± 3.66 years. Only 22.11% (n = 1604) of students were vaccinated. However, the majority (69.25%, n = 5025) expressed a willingness to be vaccinated. More willing to vaccinate were students in informal relationships who worked mentally, used psychological/psychiatric services before the pandemic, and studied medicine. There are cultural differences regarding the reasons associated with the unwillingness to vaccinate, but some 'universal' might be distinguished that apply to the whole group.

COVID-19 vaccine hesitancy among young adults in Canada

OBJECTIVES

Vaccine hesitancy is a multifaceted decision process that encompasses various factors for which an individual may choose to get vaccinated or not. We aimed to identify the relationship between COVID-19 conspiracy theories, general attitudes towards vaccines, current COVID-19 vaccine factors, and COVID-19 vaccine hesitancy.

METHODS

The present research is a multi-province cross-sectional study design. Survey data were collected in May and June 2021 (n=4905) in the Canadian provinces of Alberta, Ontario, and Quebec. Multivariate ordinal regression models were used to assess the association between vaccine hesitant profiles and COVID-19 conspiracy theories, general attitudes towards vaccines, and specific factors pertaining to COVID-19 vaccines.

RESULTS

Participants were aged 18 to 40 years and 59% were women. Individuals with low income, with low educational attainment, and/or who are unemployed were more likely to be vaccine hesitant. COVID-19 conspiracy theory beliefs and general attitudes towards vaccines are significantly associated with greater hesitancy for the COVID-19 vaccine. Vaccine factors including pro-vaccine actions and opinions of friends and family and trust in scientists and government as well as the country in which a vaccine is manufactured are associated with less vaccine hesitancy.

CONCLUSION

Conspiracy theories are distinct from criticism and concerns regarding the vaccine. Nevertheless, poverty, low level of education, and distrust towards the government are associated with higher odds of being vaccine hesitant. Results suggest it is imperative to deliver transparent and nuanced health communications to address legitimate distrust towards political and scientific actors and address the societal gap regarding general attitudes towards vaccines as opposed to focusing solely on COVID-19.

Pseudoscience and fraudulent products for COVID-19 management

As of now, the COVID-19 pandemic has become uncontrolled and is spreading widely throughout the world. Additionally, new variants of the mutated viral variants have been found in some countries that are more dangerous than the original strain. Even vaccines cannot produce complete protective immunity against the newer strains of SARS-CoV-2. Due to such a dreadful situation, lots of fear and depression have been created among the public. People are looking for the treatment of the disease at any cost and there is a race in the market to provide treatment and make money, whether it is effective or not! In such a condition, many fraud products, remedies, and myths have come into the market, which is falsely claimed to be effective for the disease and can harm the patients. Hence, FDA has banned such products and remedies. In this review, we have compiled all such fraudulent and pseudosciences identified for COVID-19. Currently, in the pandemic time, health agencies are approving the repurposed medicines based on the small-scale clinical data for emergency uses that become ineffective (most of the cases) after large randomized clinical studies. Proper vigilance strategies need to be defined by the regulatory agencies of the nation and routine awareness programs shall be arranged for educating the people and healthcare workers on routine updates.

Therapeutic strategies to address monkeypox

Introduction

Monkeypox is a viral zoonosis, with symptoms similar to those seen in smallpox patients, although the clinical presentation may be less severe. Until recently, human monkeypox infection was rare, and primarily occurred in Central and West Africa.

Areas covered

An international outbreak began in May 2022, and monkeypox has now been detected on every continent except Antarctica. The first recognized case from the current outbreak was confirmed in the United Kingdom on 6 May 2022, in an adult with travel links to Nigeria, but it has been suggested that cases had been spreading in Europe for months. On 23 July 2022 the Director-General of the World Health Organization declared the monkeypox outbreak a public health emergency of international concern.

Expert opinion

There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, and therapeutics developed to combat smallpox may be used to treat monkeypox. This manuscripts reviews what is known about these potential treatments, including tecovirimat and brincidofovir, based on a literature search of PubMed through 9 August 2022, and explores how these therapeutics may be used in the future to address the expanding monkeypox pandemic.

Psychological impact of COVID-19: Assessing the COVID-19-related anxiety, individual’s resilience and conspiracy beliefs on attitudes to COVID-19 vaccination

It has been 2 years since the first outbreak of the COVID-19 virus, and continuous efforts and measures have been exerted and implemented to halt its spread, such as the introduction of vaccination programs. However, as with the consumption of other products and services, some people hold different beliefs, consequently affecting their attitudes toward COVID-19 vaccination. Thus, vaccine unwillingness and hesitancy remain an enormous concern for many countries. This paper explores the effects of anxiety, individual resilience, and conspiracy beliefs on attitudes toward COVID-19 vaccines among the population of Malaysia—with a focus on Muslim individuals. We used survey data from 438 respondents (205 male, 233 female) to assess the research model. To conduct the multi-group analysis, we used partial least square structural equation modeling in SmartPLS 3. The results suggest that anxiety is positively associated with COVID-19 vaccination attitudes, whereas conspiracy beliefs have an inverse effect on vaccination attitudes, while an individual’s resilience is also positively associated with vaccination attitudes. Furthermore, it is found that the relationship between conspiracy beliefs and vaccination attitudes is weakened for an individual with a higher level of resilience. The findings also reveal the differences and similarities between males and females. To the best of our knowledge, this study is the first to simultaneously explore and demonstrate the effects of COVID-19-related anxiety, conspiracy beliefs and resilience with people’s attitudes toward COVID-19 vaccines and to examine the homogeneity of both males and females—especially among Malaysia’s Muslim population—thereby offering a valuable contribution to the literature.

COVID-19 Misinformation and Social Network Crowdfunding: Cross-sectional Study of Alternative Treatments and Antivaccine Mandates

BACKGROUND

Crowdfunding is increasingly used to offset the financial burdens of illness and health care. In the era of the COVID-19 pandemic and associated infodemic, the role of crowdfunding to support controversial COVID-19 stances is unknown.

OBJECTIVE

We sought to examine COVID-19-related crowdfunding focusing on the funding of alternative treatments not endorsed by major medical entities, including campaigns with an explicit antivaccine, antimask, or antihealth care stances.

METHODS

We performed a cross-sectional analysis of GoFundMe campaigns for individuals requesting donations for COVID-19 relief. Campaigns were identified by key word and manual review to categorize campaigns into "Traditional treatments," "Alternative treatments," "Business-related," "Mandate," "First Response," and "General." For each campaign, we extracted basic narrative, engagement, and financial variables. Among those that were manually reviewed, the additional variables of "mandate type," "mandate stance," and presence of COVID-19 misinformation within the campaign narrative were also included. COVID-19 misinformation was defined as "false or misleading statements," where cited evidence could be provided to refute the claim. Descriptive statistics were used to characterize the study cohort.

RESULTS

A total of 30,368 campaigns met the criteria for final analysis. After manual review, we identified 53 campaigns (0.17%) seeking funding for alternative medical treatment for COVID-19, including popularized treatments such as ivermectin (n=14, 26%), hydroxychloroquine (n=6, 11%), and vitamin D (n=4, 7.5%). Moreover, 23 (43%) of the 53 campaigns seeking support for alternative treatments contained COVID-19 misinformation. There were 80 campaigns that opposed mandating masks or vaccination, 48 (60%) of which contained COVID-19 misinformation. Alternative treatment campaigns had a lower median amount raised (US $1135) compared to traditional (US $2828) treatments (P<.001) and a lower median percentile of target achieved (11.9% vs 31.1%; P=.003). Campaigns for alternative treatments raised substantially lower amounts (US $115,000 vs US $52,715,000, respectively) and lower proportions of fundraising goals (2.1% vs 12.5%) for alternative versus conventional campaigns. The median goal for campaigns was significantly higher (US $25,000 vs US $10,000) for campaigns opposing mask or vaccine mandates relative to those in support of upholding mandates (P=.04). Campaigns seeking funding to lift mandates on health care workers reached US $622 (0.15%) out of a US $410,000 goal.

CONCLUSIONS

A small minority of web-based crowdfunding campaigns for COVID-19 were directed at unproven COVID-19 treatments and support for campaigns aimed against masking or vaccine mandates. Approximately half (71/133, 53%) of these campaigns contained verifiably false or misleading information and had limited fundraising success.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1001/jamainternmed.2019.3330.

Time-Series Associations between Public Interest in COVID-19 Variants and National Vaccination Rate: A Google Trends Analysis

The emergence of a constantly mutating novel virus has led to considerable public anxiety amid the COVID-19 pandemic. Information seeking is a common strategy to cope with pandemic anxiety. Using Google Trends analysis, this study investigated public interest in COVID-19 variants and its temporal associations with the disease-prevention measure of vaccination during the initial COVID-19 vaccine rollout period (13 December 2020 to 25 September 2021). Public interest was operationalized as the relative search volume of online queries of variant-related terms in the countries first affected by the Alpha, Beta, and Delta variants: the UK, South Africa, and India, respectively. The results show that public interest in COVID-19 variants was greater during the Delta-variant-predominant period than before this period. The time-series cross-correlation analysis revealed positive temporal associations (i.e., greater such public interest was accompanied by an increase in national vaccination rate) tended to occur more frequently and at earlier time lags than the negative temporal associations. This study yielded new findings regarding the temporal changes in public interest in COVID-19 variants, and the between-country variations in these public interest changes can be explained by differences in the rate and pace of vaccination among the countries of interest.

Factors Influencing Willingness to Be Vaccinated against COVID-19 in Nigeria

Vaccines have been historically used to address some pressing health problems in the world. COVID-19 presents no exception, although vaccine hesitancy remains a major bottleneck in some countries. This study analyzed the factors influencing willingness to be vaccinated against COVID-19 in Nigeria. The data are from the 10th wave of COVID-19 National Longitudinal Phone Survey (COVID-19 NLPS) that was conducted in 2021. The data were analyzed with Logit regression. The result showed that the national acceptance rate of COVID-19 vaccine was 85.29%. The North East had the highest acceptance rate (96.14%), while the South East (71.80%) had the lowest value. Rural areas had higher vaccine acceptance rates of 87.80% as compared against 81.41% for urban areas. Logit regression result showed that urban residents in the South East zone and the South South zone were not too worried about contracting COVID-19 or not worried at all about contracting COVID-19, saw COVID-19 as not much of a threat to household finance or COVID-19 as not a threat at all to households’ finances, which significantly reduced the log odds of residents’ willingness to be vaccinated against COVID-19 (p < 0.05). However, age, the COVID-19 preventive compliance index and needing medical services significantly increased the log odds of the willingness to be vaccinated against COVID-19 vaccines (p < 0.05). Addressing the COVID-19 pandemic in Nigeria through vaccination requires significant interventions for ensuring regional and sectoral balances in vaccine acceptability through interventions and programmes for promoting individuals’ perception of health risk and vulnerability.

Social media and attitudes towards a COVID-19 vaccination: A systematic review of the literature

BACKGROUND

Vaccine hesitancy continues to limit global efforts in combatting the COVID-19 pandemic. Emerging research demonstrates the role of social media in disseminating information and potentially influencing people's attitudes towards public health campaigns. This systematic review sought to synthesize the current evidence regarding the potential role of social media in shaping COVID-19 vaccination attitudes, and to explore its potential for shaping public health interventions to address the issue of vaccine hesitancy.

METHODS

We performed a systematic review of the studies published from inception to 13 of March2022 by searching PubMed, Web of Science, Embase, PsychNET, Scopus, CINAHL, and MEDLINE. Studies that reported outcomes related to coronavirus disease 2019 (COVID-19) vaccine (attitudes, opinion, etc.) gathered from the social media platforms, and those analyzing the relationship between social media use and COVID-19 hesitancy/acceptance were included. Studies that reported no outcome of interest or analyzed data from sources other than social media (websites, newspapers, etc.) will be excluded. The Newcastle Ottawa Scale (NOS) was used to assess the quality of all cross-sectional studies included in this review. This study is registered with PROSPERO (CRD42021283219).

FINDINGS

Of the 2539 records identified, a total of 156 articles fully met the inclusion criteria. Overall, the quality of the cross-sectional studies was moderate - 2 studies received 10 stars, 5 studies received 9 stars, 9 studies were evaluated with 8, 12 studies with 7,16 studies with 6, 11 studies with 5, and 6 studies with 4 stars. The included studies were categorized into four categories. Cross-sectional studies reporting the association between reliance on social media and vaccine intentions mainly observed a negative relationship. Studies that performed thematic analyses of extracted social media data, mainly observed a domination of vaccine hesitant topics. Studies that explored the degree of polarization of specific social media contents related to COVID-19 vaccines observed a similar degree of content for both positive and negative tone posted on different social media platforms. Finally, studies that explored the fluctuations of vaccination attitudes/opinions gathered from social media identified specific events as significant cofactors that affect and shape vaccination intentions of individuals.

INTERPRETATION

This thorough examination of the various roles social media can play in disseminating information to the public, as well as how individuals behave on social media in the context of public health events, articulates the potential of social media as a platform of public health intervention to address vaccine hesitancy.

FUNDING

None.

The Impact of COVID-19 Vaccination in Changing the Adherence to Preventive Measures: Evidence from Italy

The objectives of the survey were to explore any changes in the adherence to the three main COVID-19 preventive measures (social distancing, washing hands, wearing face-masks) among 795 individuals who received the COVID-19 vaccine booster dose in Italy and to identify the predictors associated. The concern of contracting COVID-19 before the vaccination, after the primary COVID-19 vaccine series, and after the booster dose resulted with a mean value of 7.7, 4.6, and 4.2, respectively. Females, those who had a lower mean self-perceived health status, who perceived COVID-19 as a very serious health problem, who decided to receive the booster dose because they perceived to be at risk of getting COVID-19, and who expressed interest in acquiring more information regarding the COVID-19 vaccine booster dose were more likely to report a higher concern of contracting COVID-19 after the booster dose. Over two-thirds were willing to respect the three main COVID-19 preventive measures following the booster dose. The multinomial logistic regression analysis showed that those who had used all three main preventive measures before and after the second or single dose were less likely to perceive COVID-19 as a serious illness. Those who had used them irregularly were less likely to have used official government organizations and scientific journals as sources of information. This survey provided an understanding regarding the adherence to COVID-19 preventive measures that may help to target policy interventions needed to reduce the spread of SARS-CoV-2.