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Baumer-Mouradian SH, Hofstetter AM, O'Leary ST, Opel DJ. Vaccine Confidence as Critical to Pandemic Preparedness and Response. Pediatr Clin North Am 2024; 71:499-513. [PMID: 38754938 DOI: 10.1016/j.pcl.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Vaccine confidence is a belief that vaccines work, are safe, and are part of a trustworthy medical system. The COVID-19 pandemic exposed the fragility of the public's confidence in vaccines and the vaccine enterprise, limiting the public health impact of vaccination. In this review, we examine the critical nature of vaccine confidence to pandemic preparedness and response.
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Affiliation(s)
- Shannon H Baumer-Mouradian
- Department of Pediatrics, Medical College of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI 53226, USA
| | - Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine and Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S CURE-4, PO Box 5371, Seattle, WA 98145, USA
| | - Sean T O'Leary
- Department of Pediatrics and Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, 1890 North Revere Court, Aurora, CO 80045, USA
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine and Treuman Katz Center for Pediatric Bioethics and Palliative Care, Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S: JMB-6; 1900 Ninth Avenue, Seattle, WA 98101, USA.
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Salmon DA, Chen RT, Black S, Sharfstein J. Lessons learned from COVID-19, H1N1, and routine vaccine pharmacovigilance in the United States: a path to a more robust vaccine safety program. Expert Opin Drug Saf 2024; 23:161-175. [PMID: 38343204 DOI: 10.1080/14740338.2024.2305707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Vaccine pharmacovigilance is an essential component of vaccine safety programs. Vaccine pharmacovigilance refers to detecting uncommon adverse events following immunization (AEFI), determining whether they are due to the vaccine or are only a coincidence, and, for those AEFI considered related to vaccination, characterizing them further. When AEFI are due to vaccination, it is important to characterize the attributable risk and ascertain the biological mechanism causing the adverse reaction to inform efforts to prevent or mitigate the risk. A robust post-authorization safety system is necessary for vaccine decision-making, clinical recommendations, vaccine compensation, and vaccine communication and confidence. AREAS COVERED This paper describes the key characteristics of vaccine pharmacovigilance programs, reviews US vaccine pharmacovigilance for routine vaccination programs, COVID-19, and H1N1, and makes recommendations for improving future vaccine safety systems. EXPERT OPINION The key characteristics of vaccine pharmacovigilance programs include passive surveillance, active surveillance, clinical investigation and special studies, and causality assessment. Recent examples illustrate the strengths of US pharmacovigilance systems, including systems for passive and active surveillance, as well as areas for improvement, including study of pathogenesis, consistent funding, and leadership. We make recommendations that would, if implemented, further strengthen the vaccine safety system for future routine and pandemic immunizations.
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Affiliation(s)
- Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert T Chen
- Brighton Collaboration, A program of the Task Force for Global Health, Decatur, GA, USA
| | - Steve Black
- Global Vaccine Data Network, Auckland, New Zealand
| | - Joshua Sharfstein
- Department of Health, Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Albert K, Gray G. Keeping up with COVID-19 information: Capacity issues and knowledge uncertainty early in the pandemic. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2023; 60:594-615. [PMID: 37661698 DOI: 10.1111/cars.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
This article examines the relationship between information consumption and mental health during the early stages of the COVID-19 pandemic. Adopting a qualitative approach, we interviewed 39 people in British Columbia, Canada between October and December 2020. Interestingly, half of the participants did not want to seek out new information on COVID-19, making their early insights and initial confusion salient. While some individuals did desire up-to-date information on outbreaks and new risks, many expressed confusion over what was perceived to be an evolving landscape of public health policy and practice. Overall, our research found that capacity issues, information overload/fatigue, politics, distrust, and competing sources of news all contributed to a culture of confusion towards public health information. As a consequence, this confusion resulted in knowledge uncertainty about the virus, vaccinations, and the pandemic itself. Our findings highlight the need for a host of future projects that examine how citizens experience disempowerment and limited agency towards compliance with health and safety initiatives.
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Affiliation(s)
- Katelin Albert
- Department of Sociology, University of Victoria, Victoria, Canada
| | - Garry Gray
- Department of Sociology, University of Victoria, Victoria, Canada
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Lun P, Ning K, Wang Y, Ma TSW, Flores FP, Xiao X, Subramaniam M, Abdin E, Tian L, Tsang TK, Leung K, Wu JT, Cowling BJ, Leung GM, Ni MY. COVID-19 Vaccination Willingness and Reasons for Vaccine Refusal. JAMA Netw Open 2023; 6:e2337909. [PMID: 37856125 PMCID: PMC10587797 DOI: 10.1001/jamanetworkopen.2023.37909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/22/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Hong Kong was held as an exemplar for pandemic response until it recorded the world's highest daily COVID-19 mortality, which was likely due to vaccine refusal. To prevent this high mortality in future pandemics, information on underlying reasons for vaccine refusal is necessary. Objectives To track the evolution of COVID-19 vaccination willingness and uptake from before vaccine rollout to mass vaccination, to examine factors associated with COVID-19 vaccine refusal and compare with data from Singapore, and to assess the population attributable fraction for vaccine refusal. Design, Setting, and Participants This cohort study used data from randomly sampled participants from 14 waves of population-based studies in Hong Kong (February 2020 to May 2022) and 2 waves of population-based studies in Singapore (May 2020 to June 2021 and October 2021 to January 2022), and a population-wide registry of COVID-19 vaccination appointments. Data were analyzed from February 23, 2021, to May 30, 2022. Exposures Trust in COVID-19 vaccine information sources (ie, health authorities, physicians, traditional media, and social media); COVID-19 vaccine confidence on effectiveness, safety, and importance; COVID-19 vaccine misconceptions on safety and high-risk groups; political views; and COVID-19 policies (ie, workplace vaccine mandates and vaccine pass). Main Outcomes and Measures Primary outcomes were the weighted prevalence of COVID-19 vaccination willingness over the pandemic, adjusted incidence rate ratios, and population attributable fractions of COVID-19 vaccine refusal. A secondary outcome was change in daily COVID-19 vaccination appointments. Results The study included 28 007 interviews from 20 waves of longitudinal data, with 1114 participants in the most recent wave (median [range] age, 54.2 years [20-92] years; 571 [51.3%] female). Four factors-mistrust in health authorities, low vaccine confidence, vaccine misconceptions, and political views-could jointly account for 82.2% (95% CI, 62.3%-100.0%) of vaccine refusal in adults aged 18 to 59 years and 69.3% (95% CI, 47.2%-91.4%) of vaccine refusal in adults aged 60 years and older. Workplace vaccine mandates were associated with 62.2% (95% CI, 9.9%-139.2%) increases in daily COVID-19 vaccination appointments, and the Hong Kong vaccine pass was associated with 124.8% (95% CI, 65.9%-204.6%) increases in daily COVID-19 vaccination appointments. Conclusions and Relevance These findings suggest that trust in health authorities was fundamental to overcoming vaccine hesitancy. As such, engendering trust in health care professionals, experts, and public health agencies should be incorporated into pandemic preparedness and response.
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Affiliation(s)
- Phyllis Lun
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ke Ning
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yishan Wang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tiffany S. W. Ma
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Francis P. Flores
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Xiao
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Linwei Tian
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tim K. Tsang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Kathy Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Joseph T. Wu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Benjamin J. Cowling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Urban System Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Eyal K, Njozela L, Köhler T, Ingle K, Brophy T, Buttenheim A, Maughan-Brown B. Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey. BMC Public Health 2023; 23:1767. [PMID: 37697314 PMCID: PMC10494356 DOI: 10.1186/s12889-023-16584-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/22/2023] [Indexed: 09/13/2023] Open
Abstract
INTRODUCTION Despite a high number of recorded COVID-19 infections and deaths in South Africa, COVID-19 vaccine coverage remained low in March 2022, ten months into the national vaccine roll-out. This study provides evidence on the correlates of vaccine intentions, attitudes towards vaccination and opinions about mandates. METHODS We used data from the second COVID-19 Vaccine Survey (CVACS), a telephone survey conducted February-March 2022 among 3,608 South African adults who self-reported not being vaccinated against COVID-19. The survey instrument was designed in consultation with government, policymakers, and civil society; and segmented the sample into four distinct groups with different vaccine intentions (synonymous with vaccine hesitancy levels). Kruskal-Wallis and Mann-Whitney tests were used to examine the sociodemographic characteristics, attitudes and behaviours associated with the different vaccination intentions groups. Thematic coding of responses to open-ended questions elicited insights on reasons for not being vaccinated and attitudes towards mandates. RESULTS Intentions to get vaccinated were greater among individuals with lower socio-economic status (Mann-Whitney Z = -11.3, p < 0.001); those believing the vaccine protects against death (Kruskal-Wallis Χ2 = 494, p < 0.001); and those who perceived themselves at risk of COVID-19-related illness (Χ2 = 126, p < 0.01). Vaccine intentions were lower among individuals who believed that the vaccine causes death (Χ2 = 163, p < 0.001); believed that the vaccine is unsafe for the babies of pregnant/breastfeeding mothers, or the chronically ill (Χ2 = 123, p < 0.01); those not trusting government health information about COVID-19 and the COVID-19 vaccine (Kendall's τ = -0.41, p < 0.01); and those in opposition to mandates (τ = 0.35, p < 0.001). Only 25% supported mandates, despite 48% thinking mandates would work well, with 54% citing individual rights as their main reason for mandate opposition. CONCLUSION The profile of individuals not vaccinated against COVID-19 as of March 2022 varied markedly by self-reported vaccination intentions, underscoring the importance of tailored demand-creation efforts. This paper highlights several factors which differ significantly across these groups. These findings could inform the design of future vaccination campaigns, potentially increasing their likelihood of success. This is an important policy objective given widespread vaccine hesitancy, and further work is required on this topic. Mandates remain an option to increase coverage but need to be carefully considered given extensive opposition.
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Affiliation(s)
- Katherine Eyal
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa.
| | - Lindokuhle Njozela
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| | - Timothy Köhler
- Development Policy Research Unit, University of Cape Town, Cape Town, South Africa
| | - Kim Ingle
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| | - Timothy Brophy
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
| | - Alison Buttenheim
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 416 Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Brendan Maughan-Brown
- Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa
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Dudley MZ, Squires GK, Petroske TM, Dawson S, Brewer J. The Use of Narrative in Science and Health Communication: A Scoping Review. PATIENT EDUCATION AND COUNSELING 2023; 112:107752. [PMID: 37068426 DOI: 10.1016/j.pec.2023.107752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many people deny science and reject health recommendations despite widely distributed facts and statistics. Didactic science and health communication is often dry, and relies on the false assumption that people make purely evidence-based decisions. Stories can be a powerful teaching tool by capturing attention and evoking emotion. OBJECTIVE We explore the impact and appeal of, and describe best practices for, using narrative (storytelling) versus didactic methods in science and health communication. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS We searched PubMed and Web of Science for articles either: assessing effectiveness of narrative science/health communication; assessing acceptability of (or preference for) narrative science/health communication; giving advice on how best to use narrative; and/or providing science-based explanations for how/why narrative succeeds. RESULTS Narrative science/health communication is effective and appealing for audiences across a variety of topics and mediums, with supporting evidence across fields such as epidemiology, neuroscience, and psychology. Whether narrative or didactic messaging is most effective depends on the topic, audience, and objective, as well as message quality. However, combining narrative with didactic methods is likely to be more effective than using either strategy alone. DISCUSSION Narrative science/health communication merits wider implementation and further research. Narrative communication creates openness to information by delaying the formulation of counterarguments. PRACTICAL VALUE Science and health communicators should collaborate with cultural and storytelling experts, work directly with their target audiences throughout the message development and testing processes, and rely on popular story elements (e.g., first-person point of view, relatable protagonists) to improve the comprehension, engagement, and thoughtful consideration of their intended audience. FUNDING This work was funded by Thirty Meter Telescope, with which two authors (GKS and SD) were affiliated. Otherwise, the funding organization had no role in the study and/or submission.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA.
| | - Gordon K Squires
- California Institute of Technology / IPAC, 1200 E California Blvd, 315 Keith Spalding, Pasadena, CA 91125, USA
| | | | - Sandra Dawson
- Thirty Meter Telescope International Observatory, Pasadena, CA, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA
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Salmon DA, Dudley MZ, Brewer J, Shaw J, Schuh HB, Proveaux TM, Jamison AM, Forr A, Goryn M, Breiman RF, Orenstein WA, Kao LS, Josiah Willock R, Cantu M, Decea T, Mowson R, Tsubata K, Bucci LM, Lawler J, Watkins JD, Moore JW, Fugett JH, Fugal A, Tovar Y, Gay M, Cary AM, Vann I, Smith LB, Kan L, Mankel M, Beekun S, Smith V, Adams SD, Harvey SA, Orton PZ. LetsTalkShots: personalized vaccine risk communication. Front Public Health 2023; 11:1195751. [PMID: 37457264 PMCID: PMC10348877 DOI: 10.3389/fpubh.2023.1195751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Vaccine hesitancy is a global health threat undermining control of many vaccine-preventable diseases. Patient-level education has largely been ineffective in reducing vaccine concerns and increasing vaccine uptake. We built and evaluated a personalized vaccine risk communication website called LetsTalkShots in English, Spanish and French (Canadian) for vaccines across the lifespan. LetsTalkShots tailors lived experiences, credible sources and informational animations to disseminate the right message from the right messenger to the right person, applying a broad range of behavioral theories. Methods We used mixed-methods research to test our animation and some aspects of credible sources and personal narratives. We conducted 67 discussion groups (n = 325 persons), stratified by race/ethnicity (African American, Hispanic, and White people) and population (e.g., parents, pregnant women, adolescents, younger adults, and older adults). Using a large Ipsos survey among English-speaking respondents (n = 2,272), we tested animations aligned with vaccine concerns and specific to population (e.g., parents of children, parents of adolescents, younger adults, older adults). Results Discussion groups provided robust feedback specific to each animation as well as areas for improvements across animations. Most respondents indicated that the information presented was interesting (85.5%), clear (96.0%), helpful (87.0%), and trustworthy (82.2%). Discussion Tailored vaccine risk communication can assist decision makers as they consider vaccination for themselves, their families, and their communities. LetsTalkShots presents a model for personalized communication in other areas of medicine and public health.
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Affiliation(s)
- Daniel A. Salmon
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Matthew Z. Dudley
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Janesse Brewer
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jana Shaw
- Department of Public Health and Preventive Medicine, State University of New York, Upstate Medical University, Syracuse, NY, United States
- Department of Pediatrics, State University of New York, Upstate Medical University, Syracuse, NY, United States
| | - Holly B. Schuh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Tina M. Proveaux
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Amelia M. Jamison
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Amanda Forr
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Michelle Goryn
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Robert F. Breiman
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Walter A. Orenstein
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Robina Josiah Willock
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, United States
| | - Michelle Cantu
- Department of Immunization, National Association of County and City Health Officials, Washington, DC, United States
| | - Tori Decea
- Department of Immunization, National Association of County and City Health Officials, Washington, DC, United States
| | - Robin Mowson
- Department of Immunization, National Association of County and City Health Officials, Washington, DC, United States
| | | | | | | | - James D. Watkins
- Williams County Combined Health District, Montpelier, OH, United States
| | - Jamie W. Moore
- Guilford County Division of Public Health, Greensboro, NC, United States
| | - James H. Fugett
- Guilford County Division of Public Health, Greensboro, NC, United States
| | - Adriele Fugal
- Monongalia County Health Department, Morgantown, WV, United States
| | - Yazmine Tovar
- Monongalia County Health Department, Morgantown, WV, United States
| | - Marie Gay
- Orange County Department of Health, Goshen, NY, United States
| | - Aleen M. Cary
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Iulia Vann
- Utah County Health Department, Provo, UT, United States
| | - Lee B. Smith
- Guilford County Division of Public Health, Greensboro, NC, United States
| | - Lilly Kan
- Department of Immunization, National Association of County and City Health Officials, Washington, DC, United States
| | - Magda Mankel
- Border Studies Program, Earlham College, Tucson, AZ, United States
| | - Sumayya Beekun
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Indigenous Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Victoria Smith
- Williams County Combined Health District, Montpelier, OH, United States
| | | | - Steven A. Harvey
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Peter Z. Orton
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Wang Y, Willis E, Yeruva VK, Ho D, Lee Y. A case study of using natural language processing to extract consumer insights from tweets in American cities for public health crises. BMC Public Health 2023; 23:935. [PMID: 37226165 DOI: 10.1186/s12889-023-15882-7] [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: 08/05/2022] [Accepted: 05/11/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic was a "wake up" call for public health agencies. Often, these agencies are ill-prepared to communicate with target audiences clearly and effectively for community-level activations and safety operations. The obstacle is a lack of data-driven approaches to obtaining insights from local community stakeholders. Thus, this study suggests a focus on listening at local levels given the abundance of geo-marked data and presents a methodological solution to extracting consumer insights from unstructured text data for health communication. METHODS This study demonstrates how to combine human and Natural Language Processing (NLP) machine analyses to reliably extract meaningful consumer insights from tweets about COVID and the vaccine. This case study employed Latent Dirichlet Allocation (LDA) topic modeling, Bidirectional Encoder Representations from Transformers (BERT) emotion analysis, and human textual analysis and examined 180,128 tweets scraped by Twitter Application Programming Interface's (API) keyword function from January 2020 to June 2021. The samples came from four medium-sized American cities with larger populations of people of color. RESULTS The NLP method discovered four topic trends: "COVID Vaccines," "Politics," "Mitigation Measures," and "Community/Local Issues," and emotion changes over time. The human textual analysis profiled the discussions in the selected four markets to add some depth to our understanding of the uniqueness of the different challenges experienced. CONCLUSIONS This study ultimately demonstrates that our method used here could efficiently reduce a large amount of community feedback (e.g., tweets, social media data) by NLP and ensure contextualization and richness with human interpretation. Recommendations on communicating vaccination are offered based on the findings: (1) the strategic objective should be empowering the public; (2) the message should have local relevance; and, (3) communication needs to be timely.
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Affiliation(s)
- Ye Wang
- Department of Communication and Journalism, University of Missouri-Kansas City, 202 Haag Hall, 5120 Rockhill Road, 816-235-2735, Kansas City, MO, 64110, USA.
| | - Erin Willis
- Department of Advertising, Public Relations & Media Design, University of Colorado Boulder, 478 UCB, 1511 University Avenue, Boulder, CO, 80309-0200, USA
| | - Vijaya K Yeruva
- Division of Computing, Analytics, and Mathematics, University of Missouri-Kansas City, 801 E51st St, Kansas City, MO, 64110, USA
| | - Duy Ho
- Division of Computing, Analytics, and Mathematics, University of Missouri-Kansas City, 801 E51st St, Kansas City, MO, 64110, USA
| | - Yugyung Lee
- Division of Computing, Analytics, and Mathematics, University of Missouri-Kansas City, 801 E51st St, Kansas City, MO, 64110, USA
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Salmon DA, Plotkin S, Navar AM. Vaccine Decision-making in a Time of Conflicting Recommendations: A Call to Go Beyond Politics. Pediatr Infect Dis J 2023; 42:e138-e139. [PMID: 36854117 PMCID: PMC10097467 DOI: 10.1097/inf.0000000000003892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 03/02/2023]
Affiliation(s)
- Daniel A. Salmon
- From the Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Ann Marie Navar
- University of Texas Southwestern Medical Center, Dallas, Texas
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Rando HM, Lordan R, Lee AJ, Naik A, Wellhausen N, Sell E, Kolla L, Gitter A, Greene CS. Application of Traditional Vaccine Development Strategies to SARS-CoV-2. mSystems 2023; 8:e0092722. [PMID: 36861991 PMCID: PMC10134813 DOI: 10.1128/msystems.00927-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Over the past 150 years, vaccines have revolutionized the relationship between people and disease. During the COVID-19 pandemic, technologies such as mRNA vaccines have received attention due to their novelty and successes. However, more traditional vaccine development platforms have also yielded important tools in the worldwide fight against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A variety of approaches have been used to develop COVID-19 vaccines that are now authorized for use in countries around the world. In this review, we highlight strategies that focus on the viral capsid and outwards, rather than on the nucleic acids inside. These approaches fall into two broad categories: whole-virus vaccines and subunit vaccines. Whole-virus vaccines use the virus itself, in either an inactivated or an attenuated state. Subunit vaccines contain instead an isolated, immunogenic component of the virus. Here, we highlight vaccine candidates that apply these approaches against SARS-CoV-2 in different ways. In a companion article (H. M. Rando, R. Lordan, L. Kolla, E. Sell, et al., mSystems 8:e00928-22, 2023, https://doi.org/10.1128/mSystems.00928-22), we review the more recent and novel development of nucleic acid-based vaccine technologies. We further consider the role that these COVID-19 vaccine development programs have played in prophylaxis at the global scale. Well-established vaccine technologies have proved especially important to making vaccines accessible in low- and middle-income countries. Vaccine development programs that use established platforms have been undertaken in a much wider range of countries than those using nucleic acid-based technologies, which have been led by wealthy Western countries. Therefore, these vaccine platforms, though less novel from a biotechnological standpoint, have proven to be extremely important to the management of SARS-CoV-2. IMPORTANCE The development, production, and distribution of vaccines is imperative to saving lives, preventing illness, and reducing the economic and social burdens caused by the COVID-19 pandemic. Vaccines that use cutting-edge biotechnology have played an important role in mitigating the effects of SARS-CoV-2. However, more traditional methods of vaccine development that were refined throughout the 20th century have been especially critical to increasing vaccine access worldwide. Effective deployment is necessary to reducing the susceptibility of the world's population, which is especially important in light of emerging variants. In this review, we discuss the safety, immunogenicity, and distribution of vaccines developed using established technologies. In a separate review, we describe the vaccines developed using nucleic acid-based vaccine platforms. From the current literature, it is clear that the well-established vaccine technologies are also highly effective against SARS-CoV-2 and are being used to address the challenges of COVID-19 globally, including in low- and middle-income countries. This worldwide approach is critical for reducing the devastating impact of SARS-CoV-2.
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Affiliation(s)
- Halie M. Rando
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ronan Lordan
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - Alexandra J. Lee
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amruta Naik
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nils Wellhausen
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth Sell
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - Likhitha Kolla
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - COVID-19 Review Consortium
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin—Madison, Madison, Wisconsin, USA
- Morgridge Institute for Research, Madison, Wisconsin, USA
- Childhood Cancer Data Lab, Alex’s Lemonade Stand Foundation, Philadelphia, Pennsylvania, USA
| | - Anthony Gitter
- Department of Biostatistics and Medical Informatics, University of Wisconsin—Madison, Madison, Wisconsin, USA
- Morgridge Institute for Research, Madison, Wisconsin, USA
| | - Casey S. Greene
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Health AI, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA
- Childhood Cancer Data Lab, Alex’s Lemonade Stand Foundation, Philadelphia, Pennsylvania, USA
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11
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An equity-focused approach to improving access to COVID-19 vaccination using mobile health clinics. HEALTHCARE (AMSTERDAM, NETHERLANDS) 2023; 11:100690. [PMID: 36996736 PMCID: PMC10033254 DOI: 10.1016/j.hjdsi.2023.100690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 03/25/2023]
Abstract
This article describes the implementation of an equity-focused strategy to increase the uptake of COVID-19 vaccination among communities of color and in traditionally underserved geographic areas using mobile health clinics (MHCs). The MHC Vaccination Program was implemented through a large integrated healthcare system in North Carolina using a grassroots development and engagement strategy along with a robust model for data-informed decision support to prioritize vulnerable communities. Several valuable lessons from this work can replicated for future outreach initiatives and community-based programming: •Health systems can no longer operate under the assumption that community members will come to them, particularly those experiencing compounding social and economic challenges. The MHC model had to be a proactive outreach to community members, rather than a responsive delivery mechanism. •Barriers to access included financial, legal, and logistical challenges, in addition to mistrust among historically underserved and marginalized communities. •A MHC model can be adaptable and responsive to data-informed decision-making approaches for targeted service delivery. •A MHC model is not a one-dimensional solution to access, but part of a broader strategy to create diverse points of entry into the healthcare system that fall within the rhythm of life of community members.
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12
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Johnson AK, Smith CS, Hunt B, Jacobs J, Roesch P. Chicago's Citywide COVID-19 Vaccine Equity Program: Protect Chicago Plus. Public Health Rep 2023; 138:218-222. [PMID: 36633366 PMCID: PMC9843141 DOI: 10.1177/00333549221143093] [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] [Indexed: 01/13/2023] Open
Abstract
Vaccination is one of the most effective strategies to control the spread of COVID-19 and reduce morbidity and mortality; however, rapid and equitable vaccine distribution is required to achieve such outcomes. We conducted a basic interrupted time-series analysis to examine the short-term impacts of a citywide vaccine equity plan, the Protect Chicago Plus (PCP) plan. We compared vaccine coverage in zip codes in Chicago with high COVID-19 vulnerability, as identified from the Chicago COVID-19 Community Vulnerability Index, with coverage in all other zip codes in Chicago. From our analysis, we observed that implementation of PCP coincided with reduced vaccination disparities between Chicago communities with low and high vulnerability indexes over time. In our analysis of vaccination coverage before program implementation, vaccination coverage climbed nearly twice as fast among non-PCP zip codes (0.19% per day) than among PCP zip codes (0.10% per day) or by 0.09 percentage points (P < .001). In model analysis after program implementation, zip codes prioritized for the program had 0.42% additional coverage per day as compared with 0.27% per day for non-PCP zip codes. Our findings suggest that such programs may improve vaccine equity, but additional research is needed to better understand the longer-term effects of citywide vaccination strategies on vaccine uptake.
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Affiliation(s)
- Amy K. Johnson
- Division of Adolescent and Young Adult
Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL,
USA
- Feinberg School of Medicine,
Northwestern University, Chicago, IL, USA
| | - C. Scott Smith
- Chaddick Institute for Metropolitan
Development, DePaul University, Chicago, IL, USA
- Cook County Department of Public
Health, Chicago, IL, USA
- C. Scott Smith, PhD, DePaul University,
Chaddick Institute for Metropolitan Development, 14 E Jackson, Ste 1600,
Chicago, IL 60604, USA.
| | - Bijou Hunt
- Sinai Urban Health Institute, Chicago,
IL, USA
- Sinai Infectious Disease Center,
Chicago, IL, USA
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13
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Johnson BB. Factors in intention to get the COVID-19 vaccine change over time: Evidence from a two-wave U.S. study. HEALTH, RISK & SOCIETY 2023. [DOI: 10.1080/13698575.2023.2173727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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14
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Touchton M, Wampler B. Democratizing Public Health: Participatory Policymaking Institutions, Mosquito Control, and Zika in the Americas. Trop Med Infect Dis 2023; 8:tropicalmed8010038. [PMID: 36668945 PMCID: PMC9865320 DOI: 10.3390/tropicalmed8010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
The Zika virus is a mosquito-borne virus spread primarily by Aedes mosquitoes. Zika cases have been detected throughout the mosquito's range, with an epidemic occurring from 2015 to 2017 in Brazil. Many Zika cases are mild or asymptomatic, but infections in pregnant women can cause microcephaly in children, and a small percentage of cases result in Guillan-Barré syndrome. There is currently little systematic information surrounding the municipal spread of the Zika Virus in Brazil. This article uses coarsened exact matching with negative binomial estimation and ordinary least squares estimation to assess the determinants of Zika incidence across the ~280,000 cases confirmed and recorded by Brazil's Ministry of Health in 2016 and 2017. These data come from Freedom of Information Act (FOIA) requests in Brazil and have not been published. We use data on the universe of individual Zika cases in Brazil and Geographic Information Systems (GIS) software to examine the virus at the municipal level across 5570 municipalities and construct a unique, unusually rich dataset covering daily Zika transmission. Additionally, our dataset includes corresponding local data on democratic governance, mosquito control efforts, and environmental conditions to estimate their relationship to Zika transmission. The results demonstrate that the presence of subnational democratic, participatory policymaking institutions and high levels of local state capacity are associated with low rates of Zika contraction. These models control for local healthcare spending and economic conditions, among other factors, that also influence Zika contraction rates. In turn, these findings provide a better understanding of what works for local health governance and mosquito control and makes important data public so that scholars and practitioners can perform their own analyses. Stronger models of Zika transmission will then inform mosquito abatement efforts across the Global South, as well as provide a blueprint for combatting Dengue fever, which is also transmitted by Aedes mosquitoes.
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Affiliation(s)
- Michael Touchton
- Department of Political Science, University of Miami, Coral Gables, FL 33146, USA
- Faculty Lead for Global Health, Institute for Advanced Studies of the Americas, University of Miami, Coral Gables, FL 33146, USA
- Correspondence:
| | - Brian Wampler
- President’s Office of Public Engagement, Boise State University, Boise, ID 83725, USA
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15
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Michelle Driedger S, Capurro G, Tustin J, Jardine CG. "I won't be a guinea pig": Rethinking public health communication and vaccine hesitancy in the context of COVID-19. Vaccine 2023; 41:1-4. [PMID: 36460532 PMCID: PMC9691450 DOI: 10.1016/j.vaccine.2022.11.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
At the beginning of 2021, when Canada started distribution of COVID-19 vaccines, the unprecedented scope and severity of the pandemic led to very high levels of public awareness and attention, with Canadians actively seeking information. We argue that while there was continuous public health communication about COVID-19 and the newly available vaccines, these messages did not address the specific anxieties elicited by the novel vaccines, even as vaccination guidelines changed. Instead, public health messages about COVID-19 vaccines resembled those aimed at reducing vaccine hesitancy for routine immunization and did not sufficiently address the constant changes to COVID-19 vaccine recommendations. In a context of heightened public concern and significant public attention, it is crucial for communicators to acknowledge that hesitancy is vaccine-specific, and that novel diseases and new vaccines produce specific concerns. Long-term strategies should address the novelty of the technology and of the risk, thoroughly explain the reasons for shifting vaccination guidelines, and leverage trusted sources, such as community leaders. Further, as COVID-19 vaccines become less effective against some of the more recent variants of the virus, vaccine messaging needs to be tailored to evolve with shifting realities to not lose productive gains in the COVID-19 vaccination campaign to date.
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Affiliation(s)
- S. Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, MB R3E 0W3, Canada,Corresponding author
| | - Gabriela Capurro
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, MB R3E 0W3, Canada
| | - Jordan Tustin
- School of Occupational and Public Health, Toronto Metropolitan University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Cindy G. Jardine
- Faculty of Health Sciences, University of Fraser Valley, 45190 Caen Ave, Chilliwack, BC V2R 0N3, Canada
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16
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Nahofti Kohneh J, Amirdadi M, Teimoury E. An optimization framework for COVID-19 vaccine allocation and inventory management: A case study. Appl Soft Comput 2023; 132:109801. [PMID: 36407088 PMCID: PMC9651993 DOI: 10.1016/j.asoc.2022.109801] [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: 12/13/2021] [Revised: 09/04/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
As the novel coronavirus pandemic wreaked havoc globally, governments have implemented massive vaccination programs to tackle it. However, since the pandemic's emergence moves beyond the second year, some issues have stymied vaccination programs, including vaccine hesitancy, vaccine distribution inequality, new strains of the virus, and a possibility that the virus enters a stage of a requirement for cyclical vaccination. These challenges highlight the need for an appropriate mass COVID-19 vaccination program. Therefore, we attempt to address this problem by developing a bi-objective integrated vaccine allocation and inventory management framework. The goal is to minimize the system costs while maximizing the vaccination service level. Several important factors, such as multiple types of vaccines, the vaccines' perishability concept, demand uncertainty, and motivational strategy, have been addressed using dynamic planning. Besides that, the model development mechanism is carried out to be compatible and applicable to the current general vaccination program policies, forcing few strategic changes. Then, a case study concerning the vaccination program of the city of Mashhad in Iran is applied to the model. The results demonstrated significant advantages in total cost, vaccine shortage, and wastage compared to the current policy. Finally, the Lagrangian relaxation method is implemented on the model to strengthen further its capacity to handle larger-scale problems.
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Affiliation(s)
- Jamal Nahofti Kohneh
- Glenn Department of Civil Engineering, Clemson University, 135 Lowry Hall, Clemson, SC 29634, United States
| | - Masoud Amirdadi
- Department of Civil Engineering, Lassonde School of Engineering, York University, Toronto, Ontario, Canada
| | - Ebrahim Teimoury
- School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
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17
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Choi Y, Fox AM. Mistrust in public health institutions is a stronger predictor of vaccine hesitancy and uptake than Trust in Trump. Soc Sci Med 2022; 314:115440. [PMID: 36332532 PMCID: PMC9557136 DOI: 10.1016/j.socscimed.2022.115440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/27/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022]
Abstract
STUDY GOAL This study examines the sources of COVID-19 vaccine hesitancy and refusal in Americans by decomposing different forms of government trust/mistrust including trust in Trump and mistrust in public health institutions. METHODS Using linear panel regression models with data from 5,446 US adults (37,761 responses) from the Understanding America Survey, the likelihoods of vaccine hesitancy, uptake, and trust in various information sources were examined. RESULTS AND CONCLUSION We find that the likelihoods of hesitancy and having negative perceptions of COVID-19 vaccines were consistently much higher among PHI mistrusters, showing even a stronger hesitancy than Trump trusters. This tendency has persisted over time, resulting in only 49% of PHI mistrusters having been vaccinated in the most recent survey wave. However, a large portion of PHI mistrusters still trusted physicians, family, and friends. These findings suggest that mistrust in PHIs is a salient predictor of vaccine hesitancy and reduced uptake on its own, which is compounded by trust in Trump.
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Affiliation(s)
- Yongjin Choi
- Corresponding author. 135 Western Avenue, Albany, NY, 12203, USA
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18
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Zhu W, Zou H, Song Y, Ren L, Xu Y. Understanding the impact process of vaccine adoption for COVID-19. Hum Vaccin Immunother 2022; 18:2099166. [PMID: 35905384 DOI: 10.1080/21645515.2022.2099166] [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: 12/15/2022] Open
Abstract
Vaccination for the novel coronavirus disease 2019 (COVID-19) provides an effective approach for the general improvement of social safety and individual health. To date, few studies have analyzed the adoption of COVID-19 vaccines from an entire impact process perspective. Using the health belief model (HBM) and the valence theory, this research evaluates the impact process of vaccine adoption for COVID-19. The respondents in this study were individuals who have been vaccinated in China. The effective sample included 595 individuals. Four valuable and novel findings are identified through this research. First, neither perceived susceptibility nor perceived severity has a statistically significant impact on the benefits from vaccination, threats from vaccination and self-efficacy. Second, benefits from vaccination produce a significant positive effect on self-efficacy and vaccine adoption. Third, threats from vaccination produce a significant negative effect on self-efficacy and vaccine adoption. Fourth, both self-efficacy and cues to adoption produce a significantly positive impact on vaccine adoption. Our theoretical model, which is the main contribution of this research, indicates that individual vaccine adoption is simply a process that leads from behavioral cognition to behavioral intention, rather than from psychological perception to behavioral cognition and then from behavioral cognition to behavioral intention.
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Affiliation(s)
- Wenlong Zhu
- Business School, Qingdao University of Technology, Qingdao, China
| | - Hao Zou
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Song
- Business School, Qingdao University of Technology, Qingdao, China
| | - Lili Ren
- Business School, Qingdao University of Technology, Qingdao, China
| | - Yingjie Xu
- Central Laboratory, Qingdao Stomatological Hospital, Qingdao, China
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19
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Dudley MZ, Omer SB, O'Leary ST, Limaye RJ, Ellingson MK, Spina CI, Brewer SE, Bednarczyk RA, Chamberlain AT, Malik F, Frew PM, Church-Balin C, Riley LE, Ault KA, Orenstein WA, Halsey NA, Salmon DA. MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial. BMC Public Health 2022; 22:2134. [PMID: 36411403 PMCID: PMC9676851 DOI: 10.1186/s12889-022-14498-7] [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: 06/23/2022] [Accepted: 10/13/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Many pregnant women and parents have concerns about vaccines. This analysis examined the impact of MomsTalkShots, an individually tailored educational application, on vaccine attitudes of pregnant women and mothers. METHODS MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomizing at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia between June 2017 and July 2018. All participants (n = 2087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and two follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1041) were randomly assigned to receive educational videos through MomsTalkShots, algorithmically tailored to their vaccine intentions, attitudes, and demographics. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots regardless of the practice/provider intervention. RESULTS By 1 month post-birth, MomsTalkShots increased perceived risk of maternal influenza disease (61% among MomsTalkShots recipients vs 55% among controls; Odds Ratio: 1.61, 95% Confidence Interval: 1.23-2.09), confidence in influenza vaccine efficacy (73% vs 63%; OR: 1.97, 95%CI: 1.47-2.65), and perceived vaccine knowledge (55% vs 48%; OR: 1.39, 95%CI: 1.13-1.72). Among those intending not to vaccinate at baseline, MomsTalkShots increased perceived risk of maternal influenza disease (38% vs 32%; OR: 2.07, 95%CI: 1.15-3.71) and confidence in influenza vaccine efficacy (44% vs 28%; OR: 2.62, 95%CI: 1.46-4.69). By 1 year post-birth, MomsTalkShots increased perceived vaccine knowledge (62% vs 50%; OR: 1.74, 95%CI: 1.36-2.24) and trust in vaccine information from obstetricians and pediatricians (64% vs 55%; OR: 1.53, 95%CI: 1.17-2.00). Among those uncertain about vaccinating at baseline, MomsTalkShots increased perceived vaccine knowledge (47% vs 12%; OR: 6.89, 95%CI: 1.52-31.25) and reduced infant vaccine safety concerns (71% vs 91%; OR: 0.24, 95%CI: 0.06-0.98). CONCLUSIONS MomsTalkShots improved pregnant women's and mothers' knowledge and perceptions of maternal and infant vaccines and the diseases they prevent, and offers a scalable tool to address vaccine hesitancy. TRIAL REGISTRATION Registered at Clinicaltrials.gov on 13/09/2016 (registration number: NCT02898688).
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA.
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Saad B Omer
- Yale Institute for Global Health, Yale School of Medicine, New Haven, USA
- Department of Infectious Diseases, Yale School of Medicine, New Haven, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, USA
| | - Sean T O'Leary
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, 80045, USA
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Mallory K Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA
| | - Christine I Spina
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
| | - Sarah E Brewer
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 1890 N Revere Ct. Mailstop F443, Aurora, CO, 80045, USA
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Allison T Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Fauzia Malik
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-0834, USA
| | - Paula M Frew
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- School of Public Health; School of Medicine; Population Health & Health Equity Initiative, Office of Research and Economic Development, University of Nevada, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA
- Present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed), NJ, Kenilworth, USA
| | - Cathy Church-Balin
- Center for Communication Programs, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA
| | - Kevin A Ault
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Walter A Orenstein
- Emory Vaccine Center, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
- Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Dr, Atlanta, GA, 30322, USA
| | - Neal A Halsey
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, W5041, Baltimore, MD, 21205, USA
- Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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20
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Lowe M, Harmon SHE, Kholina K, Parker R, Graham JE. Public health communication in Canada during the COVID-19 pandemic. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:34-45. [PMID: 36329358 PMCID: PMC9633012 DOI: 10.17269/s41997-022-00702-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Communication is central to the implementation and effectiveness of public health measures. Informed by theories of good governance, COVID-19 pandemic public health messaging in 3 Canadian provinces is assessed for its potential to encourage or undermine public trust and adherence. METHODS This study employed a mixed-methods constant comparative approach to triangulate epidemiological COVID-19 data and qualitative data from news releases, press briefings, and key informant interviews. Communications were analyzed from January 2020 to October 2021 in Nova Scotia, Ontario, and Alberta. Interview data came from 34 semi-structured key informant interviews with public health actors across Canada. Team-based coding and thematic analysis were conducted to analyze communications and interview transcripts. RESULTS Four main themes emerged as integral to good communication: transparency, promptness, clarity, and engagement of diverse communities. Our data indicate that a lack of transparency surrounding evidence and public health decision-making, delays in public health communications, unclear and inconsistent terminology and activities within and across jurisdictions, and communications that did not consider or engage diverse communities' perspectives may have decreased the effectiveness of public health communications and adherence to public health measures throughout the COVID-19 pandemic. CONCLUSION This study suggests that increased federal guidance with wider jurisdictional collaboration backed by transparent evidence could improve the effectiveness of communication practices by instilling public trust and adherence with public health measures. Effective communication should be transparent, supported by reliable evidence, prompt, clear, consistent, and sensitive to diverse values. Improved communication training, established engagement infrastructure, and increased collaborations and diversity of decision-makers and communicators are recommended.
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Affiliation(s)
- Maya Lowe
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, NS Canada ,Technoscience & Regulation Research Unit, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Shawn H. E. Harmon
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, NS Canada ,Technoscience & Regulation Research Unit, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Ksenia Kholina
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, NS Canada ,Technoscience & Regulation Research Unit, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Rachel Parker
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, NS Canada ,Technoscience & Regulation Research Unit, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Janice E. Graham
- Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, NS Canada ,Technoscience & Regulation Research Unit, Faculty of Medicine, Dalhousie University, Halifax, NS Canada
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21
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Shea L, Bushen J, Ahmad N, Geonnotti G, LaMori J, Terrey S, Gonzalez P, Shuman J. Development and implementation of an online community as a strategy for mixed methods research during a pandemic. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:47. [PMID: 36064454 PMCID: PMC9442570 DOI: 10.1186/s40900-022-00383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
Conducting mixed methods research is critical for healthcare researchers to understand attitudes, behaviors, and experiences on health-related topics, such as vaccine acceptance. As the COVID-19 pandemic has made it difficult to employ traditional, face-to-face qualitative methodologies, this paper describes the use of a virtual platform to conduct person-centered research. To overcome these challenges and better understand the attitudes and behaviors of vaccine-eligible individuals in the United States, an online health community called the Virtual Engagement Research Community (VERC) was designed and implemented. Using the Health Belief Model as a framework, the VERC employed a mixed methods approach to elicit insights, which included discussion topics, rapid polls, and surveys. Throughout the initial enrollment period of April-October 2021, continuous improvement efforts were made to bolster recruitment and member engagement. This agile research strategy was successful in utilizing mixed methods to capture community sentiments regarding vaccines. While this community focused on vaccination, the methodology holds promise for other areas of health research such as obesity, HIV, mental health disorders, and diabetes.
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Affiliation(s)
- Lisa Shea
- Janssen Scientific Affairs, LLC, 800 Ridgeview Drive, Horsham, PA, 19044, USA.
| | | | - Nina Ahmad
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Gabrielle Geonnotti
- Janssen Scientific Affairs, LLC, 800 Ridgeview Drive, Horsham, PA, 19044, USA
| | - Joy LaMori
- Janssen Scientific Affairs, LLC, 800 Ridgeview Drive, Horsham, PA, 19044, USA
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22
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Shearer RD, Vickery KD, Bodurtha P, Drawz PE, Johnson S, Jeruzal J, Waring S, Chamberlain AM, Kharbanda AB, Leopold J, Harrison B, Hiler H, Khazanchi R, Rossom R, Margolis KL, Rai NK, Muscoplat MH, Yu Y, Dudley RA, Klyn NAM, Winkelman TNA. COVID-19 Vaccination Of People Experiencing Homelessness And Incarceration In Minnesota. HEALTH AFFAIRS (PROJECT HOPE) 2022; 41:846-852. [PMID: 35666963 DOI: 10.1377/hlthaff.2021.02030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We used data from a statewide public health-health system collaboration to describe trends in COVID-19 vaccination rates by racial and ethnic groups among people experiencing homelessness or incarceration in Minnesota. Vaccination completion rates among the general population and people incarcerated in state prisons were substantially higher than those among people experiencing homelessness or jail incarceration.
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Affiliation(s)
- Riley D Shearer
- Riley D. Shearer, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | - Josh Leopold
- Josh Leopold, Minnesota Department of Health, Saint Paul, Minnesota
| | | | - Hattie Hiler
- Hattie Hiler, Minnesota Housing, Saint Paul, Minnesota
| | - Rohan Khazanchi
- Rohan Khazanchi, University of Nebraska, Omaha, Nebraska; University of Minnesota; Hennepin Healthcare Research Institute
| | - Rebecca Rossom
- Rebecca Rossom, HealthPartners Institute, Bloomington, Minnesota
| | | | | | | | | | | | | | - Tyler N A Winkelman
- Tyler N. A. Winkelman, Hennepin Healthcare, Minneapolis, Minnesota; Hennepin Healthcare Research Institute
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23
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Heinrich CJ, Camacho S, Binsted K, Gale S. An audit test evaluation of state practices for supporting access to and promoting Covid-19 vaccinations. Soc Sci Med 2022; 301:114880. [PMID: 35364564 PMCID: PMC8917647 DOI: 10.1016/j.socscimed.2022.114880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/26/2022] [Accepted: 03/04/2022] [Indexed: 10/26/2022]
Abstract
A field experiment, using a paired audit testing design with testers of different racial and language profiles, was conducted to document and evaluate individual encounters in inquiring about COVID-19 vaccinations in the U.S. states. Testers communicated with state health department and major vaccination site staff about obtaining the COVID-19 vaccine and assessed the extent to which evidence-informed communication tactics for encouraging take-up were employed. The audit testers included individuals representing Latinx identities, given research showing they face greater hardships in navigating vaccine infrastructure and place less trust in public immunization efforts. Data were collected in phone and electronic communications between mid-June and mid-August of 2021. Empirical analyses confirmed that states vary considerably in how clearly officials communicate vaccination requirements and procedures, and in what they ask of individuals before providing the opportunity to receive the COVID-19 vaccine. The Spanish-speaking tester was more likely to encounter negative or racialized language-primarily implicit in nature-such as calls abruptly ended (vs. attempting to secure language support) and requests for additional identification or personal information before continuing with vaccination registration. Examples of overtly negative or racist encounters included condescending comments about Latinx testers' identification (or perceived undocumented status) and the Spanish-speaking tester's communication in Spanish. Analysis of an index of good practices constructed from the audit data revealed that very few strategies for promoting vaccinations were regularly implemented. In regression analyses, an additional point on the good practices index predicted a 0.133 percentage point increase in the percent of the population receiving the first vaccine dose, suggesting the lack of implementation of these good practices may represent a missed opportunity to increase COVID-19 vaccination rates. We identified exemplars in the communications that the federal government could disseminate to rapidly improve state practices and the accessibility of accurate information on COVID-19 vaccination opportunities.
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Affiliation(s)
- Carolyn J Heinrich
- Department of Leadership, Policy and Organizations, Vanderbilt University, 202 Payne Hall, PMB 414, 230 Appleton Place, Nashville, TN, 37203, USA.
| | - Sayil Camacho
- Department of Leadership, Policy and Organizations, Vanderbilt University, USA
| | - Kaitlin Binsted
- Department of Leadership, Policy and Organizations, Vanderbilt University, USA
| | - Shadlan Gale
- Department of Leadership, Policy and Organizations, Vanderbilt University, USA
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24
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Breckenridge LA, Burns D, Nye C. The use of motivational interviewing to overcome COVID-19 vaccine hesitancy in primary care settings. Public Health Nurs 2022; 39:618-623. [PMID: 34716618 PMCID: PMC8661599 DOI: 10.1111/phn.13003] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022]
Abstract
Vaccine hesitancy is not a new phenomenon. However, the COVID-19 pandemic has highlighted the impact of political, racial, and health disparities on vaccine hesitancy at a global level. With the creation of the COVID-19 vaccine, a resurgence of vaccine hesitancy has emerged and many are reluctant to receive the vaccination. The reluctance varies from concerns about government interference in vaccine development, to the speed of vaccine development, to long-term health outcomes and potential side effects. Health care professionals need to consider evidence-based approaches that are effective in assisting patients with health care decision-making regarding vaccine uptake. Motivational Interviewing (MI) is an effective technique to positively impact behavior change. Definitions and examples of MI techniques are provided to illustrate how MI can be used to support patient autonomy and provide a safe and trusting environment, with the goal of increasing COVID-19 vaccination uptake.
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Affiliation(s)
| | - Dana Burns
- Clinical Assistant Professor, Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Carla Nye
- Clinical Assistant Professor, Virginia Commonwealth UniversityRichmondVirginiaUSA
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25
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Liu J, Yang X, Lu Y, Zheng X. The Joint Effects of Social Norm Appeals and Fear Appeals in COVID-19 Vaccine Campaign Posters on Self-Perceived Communication Quality and Vaccination Intention. Front Psychol 2022; 13:760146. [PMID: 35418898 PMCID: PMC8997576 DOI: 10.3389/fpsyg.2022.760146] [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: 08/17/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
To understand how different types of cues in vaccine education messages affect attitude toward campaign messages and vaccination intention, this study examined the impact of the presence of social norm appeals (individual vs. group cues) and the presence of fear appeals in coronavirus disease 2019 (COVID-19) vaccine campaign posters on perceived communication quality and vaccination intention. A 2 (social norm appeal: individual cue vs. group cue) × 2 (fear appeal: absence vs. presence) × 3 (repetition) within-subject factorial design experiment was conducted in China. Findings demonstrated that the presence of fear appeals in COVID-19 vaccine campaign posters elicited lower levels of perceived communication quality and vaccination intention than those without fear appeals. The interactive effect of fear appeals and social norm appeals was also found to be significant. Specifically, positive-framed messages (i.e., absence of fear appeals) with group cues and fear appeal messages with individual cues elicited higher perceived information quality and stronger vaccination intention than other types of messages. Understanding how these cues function jointly in COVID-19 vaccine campaign messages will help public health practitioners create more effective intervention strategies.
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Affiliation(s)
- Jiawei Liu
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Xiaobing Yang
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Yanqin Lu
- School of Media and Communication, Bowling Green State University, Bowling Green, OH, United States
| | - Xia Zheng
- The Media School, Indiana University, Bloomington, IN, United States
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26
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Thorpe A, Fagerlin A, Drews FA, Butler J, Stevens V, Riddoch MS, Scherer LD. Communications to Promote Interest and Confidence in COVID-19 Vaccines. Am J Health Promot 2022; 36:976-986. [PMID: 35411819 PMCID: PMC9008475 DOI: 10.1177/08901171221082904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Communicating about COVID-19 vaccine side effects and efficacy is crucial for promoting transparency and informed decision-making, but there is limited evidence on how to do so effectively. DESIGN A within-subjects experiment. SETTING Online survey from January 21 to February 6, 2021. SUBJECTS 596 US Veterans and 447 non-Veterans. INTERVENTION 5 messages about COVID-19 vaccine side effects and 4 messages about COVID-19 vaccine efficacy. MEASURES COVID-19 vaccine interest (1 = "I definitely do NOT want the vaccine" to 7 = "I definitely WANT the vaccine" with the midpoint 4 = "Unsure"). Confidence about COVID-19 vaccine efficacy (1= "Not at all confident," 2 = "Slightly confident," 3 = "Somewhat confident," 4 = "Moderately confident," 5 = "Extremely confident"). RESULTS Compared to providing information about side effects alone (M = 5.62 [1.87]), messages with additional information on the benefits of vaccination (M = 5.77 [1.82], P < .001, dz = .25), reframing the likelihood of side effects (M = 5.74 [1.84], P < .001, dz = .23), and emphasizing that post-vaccine symptoms indicate the vaccine is working (M = 5.72 [1.84], P < .001, dz = .17) increased vaccine interest. Compared to a vaccine efficacy message containing verbal uncertainty and an efficacy range (M = 3.97 [1.25]), messages conveying verbal certainty with an efficacy range (M = 4.00 [1.24], P = .042, dz=.08), verbal uncertainty focused on the upper efficacy limit (M = 4.03 [1.26], P < .001, dz = .13), and communicating the point estimate with certainty (M = 4.02 [1.25], P < .001, dz = .11) increased confidence. Overall, Veteran respondents were more interested (MVeterans = 5.87 [1.72] vs MNonVeterans = 5.45 [2.00], P < .001, d = .22) and confident (MVeterans = 4.13 [1.19] vs MNonVeterans = 3.84 [1.32], P < .001, d = .23) about COVID-19 vaccines than non-Veterans. CONCLUSIONS These strategies can be implemented in large-scale communications (e.g., webpages, social media, and leaflets/posters) and can help guide healthcare professionals when discussing vaccinations in clinics to promote interest and confidence in COVID-19 vaccines.
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Affiliation(s)
- Alistair Thorpe
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
| | - Angela Fagerlin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Frank A Drews
- Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA.,University of Utah College of Social and Behavioral Science, Salt Lake City, UT, USA
| | - Jorie Butler
- University of Colorado School of Medicine, Aurora, CO, USA.,VA Denver Center for Innovation, Denver, CO, USA
| | - Vanessa Stevens
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Marian S Riddoch
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
| | - Laura D Scherer
- University of Colorado School of Medicine, Aurora, CO, USA.,VA Denver Center for Innovation, Denver, CO, USA
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27
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Glenton C, Carlsen B, Winje BA, Eilers R, Wennekes MD, Hoffmann TC, Lewin S. Using qualitative research to develop an elaboration of the TIDieR checklist for interventions to enhance vaccination communication: short report. Health Res Policy Syst 2022; 20:31. [PMID: 35305651 PMCID: PMC8934130 DOI: 10.1186/s12961-022-00833-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/28/2022] [Indexed: 12/05/2022] Open
Abstract
Background The COVID-19 pandemic has led to an increased interest in communication with the public regarding vaccination. Our recent Cochrane qualitative evidence synthesis points to several factors that could influence the implementation and success of healthcare worker communication with older adults about vaccination. However, it is often difficult to assess whether factors identified as potentially important in qualitative studies have been considered in randomized trials because of poor trial reporting. We therefore decided to use our qualitative evidence synthesis findings to encourage better reporting of vaccination communication interventions in trials by developing an elaboration of the TIDieR (Template for Intervention Description and Replication) checklist for intervention reporting. Methods We examined the findings from our Cochrane qualitative evidence synthesis on healthcare workers’ perceptions of and experiences with communicating about vaccination with adults over the age of 50 years. We identified factors that could influence the implementation and uptake, and thereby the effectiveness, of vaccination communication interventions. We then drafted a list of the information elements we would need from trial reports to assess whether these factors had been considered in the development of the interventions evaluated in these trials. Finally, we compared our list of information elements to the TIDieR checklist items. We were able to align all of our information elements with the TIDieR items. However, for several of the TIDieR items, we developed a more detailed description to ensure that relevant information would be captured sufficiently in trial reports. Results We developed elaborations for the following TIDieR items: “Why” (item 2), “What—materials” (item 3), “Who provided” (item 5), “How” (item 6), “Where” (item 7) and “Tailoring” (item 9). Conclusions Both qualitative research and trials of intervention effectiveness are critical to furthering our understanding of what works, where, for whom and through which mechanisms. However, a key ingredient for developing this understanding is adequate reporting of intervention design, content and implementation in randomized trials. We hope that this elaboration of the TIDier checklist will improve reporting of interventions in trials focused on vaccine communication with older adults, and thereby enhance the usability of this research for developing future communication strategies.
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28
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McGrath E, Secord E. Politics, Patience, and Pediatrics in the COVID-19 Pandemic. Clin Pediatr (Phila) 2022; 61:93-94. [PMID: 35132904 DOI: 10.1177/00099228221075096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Berardi C, Lee ES, Wechtler H, Paolucci F. A vicious cycle of health (IN)equity: Migrant inclusion in light of COVID-19. HEALTH POLICY AND TECHNOLOGY 2022; 11:100606. [PMID: 35194550 PMCID: PMC8853963 DOI: 10.1016/j.hlpt.2022.100606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives Methods Results Conclusions
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Affiliation(s)
- Chiara Berardi
- Newcastle Business School, University of Newcastle, 409 Hunter Street, Newcastle, NSW, Australia
| | - Eun Su Lee
- Newcastle Business School, University of Newcastle, 409 Hunter Street, Newcastle, NSW, Australia
| | - Heidi Wechtler
- Newcastle Business School, University of Newcastle, 409 Hunter Street, Newcastle, NSW, Australia
| | - Francesco Paolucci
- Newcastle Business School, University of Newcastle, 409 Hunter Street, Newcastle, NSW, Australia
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30
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Washburn KJ, LeBrón AM, Reyes AS, Becerra I, Bracho A, Ahn E, Urzúa AS, Foo MA, Zárate S, Tanjasiri SP, Boden-Albala B. Orange County, California COVID-19 Vaccine Equity Best Practices Checklist: A Community-Centered Call to Action for Equitable Vaccination Practices. Health Equity 2022; 6:3-12. [PMID: 35112040 PMCID: PMC8804261 DOI: 10.1089/heq.2021.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has exacerbated longstanding inequities throughout the United States, disproportionately concentrating adverse social, economic, and health-related outcomes among low-income communities and communities of color. Inequitable distribution, prioritization, and uptake of COVID-19 vaccines due to systemic and organizational barriers add to these disproportionate impacts across the United States. Similar patterns have been observed within Orange County, California (OC). Methods: In response to COVID-19 vaccine inequities unfolding locally, the Orange County Health Equity COVID-19 community-academic partnership generated a tool to guide a more equitable vaccine approach. Contents of the OC vaccine equity best practices checklist emerged through synthesis of community-level knowledge about vaccine inequities, literature regarding equitable vaccination considerations, and practice-based health equity guides. We combined into a memo: the checklist, a written explanation of its goals and origins, and three specific action steps meant to further strengthen the focus on vaccine equity. The memo was endorsed by partnership members and distributed to county officials. Discussion: Since the initial composition of the checklist, the local vaccine distribution approach has shifted, suggesting that equitable pandemic responses require continual re-evaluation of local needs and adjustments to recommendations as new information emerges. To understand and address structural changes needed to reduce racial and socioeconomic inequities exacerbated by the pandemic, authentic partnerships between community, academic, and public health practice partners are necessary. Conclusion: As we face continued COVID-19 vaccine rollout, booster vaccination, and future pandemic challenges, community knowledge and public health literature should be integrated to inform similar equity-driven strategic actions.
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Affiliation(s)
- Kameko J. Washburn
- Department of Health, Society, and Behavior, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
| | - Alana M.W. LeBrón
- Department of Health, Society, and Behavior, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
- Department of Chicano/Latino Studies, School of Social Sciences, University of California, Irvine, Irvine, California, USA
| | - Abigail S. Reyes
- Community Resilience Projects, University of California, Irvine, Irvine, California, USA
| | - Isabel Becerra
- Coalition of Orange County Community Health Centers, Santa Ana, California, USA
| | | | - Ellen Ahn
- Korean Community Services, Buena Park, California, USA
| | | | - Mary Anne Foo
- Orange County Asian and Pacific Islander Community Alliance, Garden Grove, California, USA
| | - Salvador Zárate
- Department of Anthropology, School of Social Sciences, University of California, Irvine, Irvine, California, USA
| | - Sora Park Tanjasiri
- Department of Epidemiology, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
| | - Bernadette Boden-Albala
- Department of Health, Society, and Behavior, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
- Department of Epidemiology, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
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31
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Omer SB, Benjamin RM, Brewer NT, Buttenheim AM, Callaghan T, Caplan A, Carpiano RM, Clinton C, DiResta R, Elharake JA, Flowers LC, Galvani AP, Lakshmanan R, Maldonado YA, McFadden SM, Mello MM, Opel DJ, Reiss DR, Salmon DA, Schwartz JL, Sharfstein JM, Hotez PJ. Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA. Lancet 2021; 398:2186-2192. [PMID: 34793741 PMCID: PMC8592561 DOI: 10.1016/s0140-6736(21)02507-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/31/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022]
Abstract
Since the first case of COVID-19 was identified in the USA in January, 2020, over 46 million people in the country have tested positive for SARS-CoV-2 infection. Several COVID-19 vaccines have received emergency use authorisations from the US Food and Drug Administration, with the Pfizer-BioNTech vaccine receiving full approval on Aug 23, 2021. When paired with masking, physical distancing, and ventilation, COVID-19 vaccines are the best intervention to sustainably control the pandemic. However, surveys have consistently found that a sizeable minority of US residents do not plan to get a COVID-19 vaccine. The most severe consequence of an inadequate uptake of COVID-19 vaccines has been sustained community transmission (including of the delta [B.1.617.2] variant, a surge of which began in July, 2021). Exacerbating the direct impact of the virus, a low uptake of COVID-19 vaccines will prolong the social and economic repercussions of the pandemic on families and communities, especially low-income and minority ethnic groups, into 2022, or even longer. The scale and challenges of the COVID-19 vaccination campaign are unprecedented. Therefore, through a series of recommendations, we present a coordinated, evidence-based education, communication, and behavioural intervention strategy that is likely to improve the success of COVID-19 vaccine programmes across the USA.
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Affiliation(s)
- Saad B Omer
- Yale Institute for Global Health, Yale University, New Haven, CT, USA; Infectious Diseases Section, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale University, New Haven, CT, USA; Yale School of Nursing, Yale University, Orange, CT, USA.
| | | | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alison M Buttenheim
- Department of Family and Community Health, University of Pennsylvania School of Nursing, and Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy Callaghan
- Department of Health Policy and Management, School of Public Health, A&M University, College Station, TX, USA
| | - Arthur Caplan
- Langone School of Medicine, New York University, New York, NY, USA
| | | | - Chelsea Clinton
- Clinton Foundation, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Renee DiResta
- Stanford Internet Observatory, Stanford University, Stanford, CA, USA
| | - Jad A Elharake
- Yale Institute for Global Health, Yale University, New Haven, CT, USA; Infectious Diseases Section, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Lisa C Flowers
- Department of Obstetrics & Gynecology, Emory University, Atlanta, GA, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, CT, USA
| | | | | | - SarahAnn M McFadden
- Yale Institute for Global Health, Yale University, New Haven, CT, USA; Infectious Diseases Section, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Michelle M Mello
- School of Medicine, Stanford University, Stanford, CA, USA; Stanford Law School, Stanford University, Stanford, CA, USA; Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; UC Hastings College of Law, University of California, San Francisco, CA, USA
| | - Dorit R Reiss
- UC Hastings College of Law, University of California, San Francisco, CA, USA
| | - Daniel A Salmon
- Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jason L Schwartz
- Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Joshua M Sharfstein
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Peter J Hotez
- Hagler Institute for Advanced Study at Texas A&M University, A&M University, College Station, TX, USA; Scowcroft Institute of International Affairs, Bush School of Government and Public Service Texas, A&M University, College Station, TX, USA; Texas Children's Center for Vaccine Development, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA
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32
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Choi Y, Fox AM. Does media slant polarize compliance with science-based public health recommendations? Effects of media consumption patterns on COVID-19 attitudes and behaviors in the United States. J Health Psychol 2021; 27:1331-1341. [PMID: 34886687 DOI: 10.1177/13591053211061413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Has political polarization undermined the media' informational role during the COVID-19 pandemic? Recent studies show that politicized reporting from conservative media discouraged compliance with COVID-19 guidelines in the U.S. However, greater attention to the 24-hour news cycle may make high-consumption viewers better factually informed regardless of the source. We examine how the extent of media consumption affects people's emotions, attitudes, and behaviors toward the pandemic. With an online survey of 1128 respondents, we found a strong convergence in anxiety and health-protective behaviors in more avid media viewers regardless of media outlet while finding a divergence in attitudes toward specific mitigation strategies.
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Affiliation(s)
- Yongjin Choi
- University at Albany, State University of New York, USA
| | - Ashley M Fox
- University at Albany, State University of New York, USA
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33
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Bari MS, Hossain MJ, Ahmmed F, Sarker MMR, Khandokar L, Chaithy AP, Aziz F, Mitra S, Emran TB, Islam MS, Islam MR, Mohamed IN. Knowledge, Perception, and Willingness towards Immunization among Bangladeshi Population during COVID-19 Vaccine Rolling Period. Vaccines (Basel) 2021; 9:1449. [PMID: 34960195 PMCID: PMC8706921 DOI: 10.3390/vaccines9121449] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Vaccine willingness among the mass populace, as well as their proper knowledge and perception regarding vaccines and the vaccination process, may contribute extensively towards attaining their anticipated vaccination rates. The current study endeavored to ascertain the Bangladeshi population's knowledge, perception, and willingness towards COVID-19 vaccination. Relevant information was collected from 1201 adults aged 18 years or older by employing an online-based survey from 1 to 30 July 2021. Descriptive statistics, the chi-square (χ2) test, and a binary logistic regression analysis were applied in order to compare the extent of knowledge and perception prevalent among different demographic groups and correlate such prevalence with respective vaccine willingness. The participants expressed mean (± standard deviation) knowledge and perception scores of 6.48 ± 1.13 out of 8 and 5.37 ± 1.22 out of 7, respectively. A multivariate analysis confirmed the significant association (p < 0.05) of gender, age, and family income with the knowledge score, whereas age and knowledge level significantly influenced perception. Current living area, family income, and age were considerable contributors to COVID-19 vaccine willingness. Overall vaccine willingness was found to be significantly curtailed by inadequate knowledge (AOR 0.514, CI 95% 0.401-0.658, p < 0.001) and perception (AOR 0.710, CI 95% 0.548-0.920, p = 0.010) among the participants. All of the concerned authorities' efforts are warranted in order to improve public understanding, perception, and inclination towards vaccination.
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Affiliation(s)
- Md. Sazzadul Bari
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka 1205, Bangladesh; (M.S.B.); (M.M.R.S.); (A.P.C.)
| | - Md. Jamal Hossain
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka 1205, Bangladesh; (M.S.B.); (M.M.R.S.); (A.P.C.)
| | - Foyez Ahmmed
- Department of Statistics, Comilla University, Kotbari, Cumilla 3506, Bangladesh;
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka 1205, Bangladesh; (M.S.B.); (M.M.R.S.); (A.P.C.)
| | - Labony Khandokar
- Department of Pharmacy, East West University, A/2 Jahurul Islam Avenue, Dhaka 1212, Bangladesh;
| | - Aperajita Paul Chaithy
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka 1205, Bangladesh; (M.S.B.); (M.M.R.S.); (A.P.C.)
| | - Farina Aziz
- Department of Pharmacy, University of Asia Pacific, 74/A Green Road, Farmgate, Dhaka 1215, Bangladesh; (F.A.); (M.R.I.)
| | - Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh;
| | - Md. Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh;
| | - Md. Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, 74/A Green Road, Farmgate, Dhaka 1215, Bangladesh; (F.A.); (M.R.I.)
| | - Isa Naina Mohamed
- Pharmacology Department, Medical Faculty, Universiti Kebangsaan Malaysia (The National University of Malaysia), Cheras, Kuala Lumpur 56000, Malaysia
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34
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Hwang SE, Kim WH, Heo J. Socio-demographic, psychological, and experiential predictors of COVID-19 vaccine hesitancy in South Korea, October-December 2020. Hum Vaccin Immunother 2021; 18:1-8. [PMID: 34614382 PMCID: PMC8920123 DOI: 10.1080/21645515.2021.1983389] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Vaccine hesitancy is the primary barrier to controlling the COVID-19 pandemic in South Korea. We used logistic multivariate regression modeling to investigate (1) the prevalence and reasons for COVID-19 vaccine hesitancy, (2) sub-groups that had higher rates of vaccine hesitancy, and (3) vaccine hesitancy predictors. We used a national survey of representatively sampled households (n = 13,021 adults) from October to December 2020. A self-report questionnaire asked about vaccination intention and reasons for hesitancy and gathered data on socio-demographic, demographic, psychological, and experiential factors. Our study indicated that 39.8% of the participants answered that they hesitated or refused to be vaccinated. The most common reason for vaccine hesitancy was a lack of confidence in the COVID-19 vaccine (77.9%). Less or no fear of COVID-19 (OR = 2.08, 95% CI = 1.92–2.26; OR = 1.79, 95% CI = 1.54–2.08), unstable job status (OR = 1.42, 95% CI = 1.18–1.70), decreased family income (OR = 1.40, 95% CI = 1.21–1.61), and worsening health status (OR = 1.38, 95% CI = 1.13–1.68) were predictors of vaccine hesitancy. Younger age, no religious affiliation, political conservatism, and lower family income were also significantly associated with vaccine hesitancy. Effective health communication and policies need to consider the target subgroup population and predictors of vaccine hesitancy to attain herd immunity at an early stage.
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Affiliation(s)
- Seo Eun Hwang
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.,Department of Medicine, Seoul National University Graduate School of Medicine, Seoul, Republic of Korea
| | - Woong-Han Kim
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongho Heo
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Quality of Life Group, National Assembly Futures Institute, Seoul, Republic of Korea
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Dudley MZ, Bernier R, Brewer J, Salmon DA. Walking the Tightrope: Reevaluating science communication in the era of COVID-19 vaccines. Vaccine 2021; 39:5453-5455. [PMID: 34446317 DOI: 10.1016/j.vaccine.2021.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Abstract
Scientists are trained to be skeptical and not overstate the existing evidence. This cautiousness is a valuable asset when working in scientific research, where the goal is the pursuit of knowledge and truth. It becomes a handicap when scientists are asked to communicate to the public about pressing topics such as COVID-19 vaccines. Often in such contexts, immediate recommendations are sought, and decisions must be made even when complete evidence is lacking. For scientists to be effective public communicators, they must adjust their mindset and embrace brevity, clarity, and other principles of effective communication. Focusing messages on what is known fosters public confidence in taking needed actions, whereas focusing on what is still unknown fosters inaction and seeds doubt. The implementation of principles of effective communication does not inherently conflict with maintaining scientific accuracy and acknowledging uncertainty, but it does require additional care, effort, and training.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Roger Bernier
- Senior Epidemiologist Editor, The Epidemiology Monitor, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
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36
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Carson SL, Casillas A, Castellon-Lopez Y, Mansfield LN, Morris D, Barron J, Ntekume E, Landovitz R, Vassar SD, Norris KC, Dubinett SM, Garrison NA, Brown AF. COVID-19 Vaccine Decision-making Factors in Racial and Ethnic Minority Communities in Los Angeles, California. JAMA Netw Open 2021; 4:e2127582. [PMID: 34591103 PMCID: PMC8485164 DOI: 10.1001/jamanetworkopen.2021.27582] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022] Open
Abstract
Importance The COVID-19 pandemic has had disproportionate effects on racial and ethnic minority communities, where preexisting clinical and social conditions amplify health and social disparities. Many of these communities report lower vaccine confidence and lower receipt of the COVID-19 vaccine. Understanding factors that influence the multifaceted decision-making process for vaccine uptake is critical for narrowing COVID-19-related disparities. Objective To examine factors that members of multiethnic communities at high risk for COVID-19 infection and morbidity report as contributing to vaccine decision-making. Design, Setting, and Participants This qualitative study used community-engaged methods to conduct virtual focus groups from November 16, 2020, to January 28, 2021, with Los Angeles County residents. Potential participants were recruited through email, video, and telephone outreach to community partner networks. Focus groups were stratified by self-identified race and ethnicity as well as age. Transcripts were analyzed using reflexive thematic analysis. Main Outcomes and Measures Themes were categorized by contextual, individual, and vaccine-specific influences using the World Health Organization's Vaccine Hesitancy Matrix categories. Results A total of 13 focus groups were conducted with 70 participants (50 [71.4%] female) who self-identified as American Indian (n = 17 [24.3%]), Black/African American (n = 17 [24.3%]), Filipino/Filipina (n = 11 [15.7%]), Latino/Latina (n = 15 [21.4%]), or Pacific Islander (n = 10 [14.3%]). A total of 39 participants (55.7%) were residents from high-poverty zip codes, and 34 (48.6%) were essential workers. The resulting themes included policy implications for equitable vaccine distribution: contextual influences (unclear and unreliable information, concern for inequitable access or differential treatment, references to mistrust from unethical research studies, accessibility and accommodation barriers, eligibility uncertainty, and fears of politicization or pharmaceutical industry influence); social and group influences (inadequate exposure to trusted messengers or information, altruistic motivations, medical mistrust, and desire for autonomy); and vaccination-specific influences (need for vaccine evidence by subpopulation, misconceptions on vaccine development, allocation ambiguity, vaccination safety preferences, the importance of perceiving vaccine equity, burden of vaccine scheduling, cost uncertainty, and desire for practitioner recommendation). Conclusions and Relevance In this qualitative study, participants reported a number of factors that affected their vaccine decision-making, including concern for inequitable vaccine access. Participants endorsed policy recommendations and strategies to promote vaccine confidence. These results suggest that support of informed deliberation and attainment of vaccine equity will require multifaceted, multilevel policy approaches that improve COVID-19 vaccine knowledge, enhance trust, and address the complex interplay of sociocultural and structural barriers to vaccination.
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Affiliation(s)
- Savanna L. Carson
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Yelba Castellon-Lopez
- Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles
| | - Lisa N. Mansfield
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - D’Ann Morris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Juan Barron
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Ejiro Ntekume
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Raphael Landovitz
- Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles
| | - Stefanie D. Vassar
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Olive View-UCLA Medical Center, Sylmar, California
| | - Keith C. Norris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Steven M. Dubinett
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Nanibaa’ A. Garrison
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Institute for Society & Genetics, College of Letters and Science, University of California, Los Angeles
- Institute for Precision Health, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Arleen F. Brown
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Olive View-UCLA Medical Center, Sylmar, California
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37
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Abstract
This is the thirty-eighth epidemiological report for coronavirus disease 2019 (COVID-19), reported in Australia as at 23:59 Australian Eastern Daylight Time [AEDT] 28 March 2021. It includes data on COVID-19 cases diagnosed in Australia and the international situation.
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Affiliation(s)
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- Australian Government Department of Health
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38
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Salmon DA, Dudley MZ, Brewer J, Kan L, Gerber JE, Budigan H, Proveaux TM, Bernier R, Rimal R, Schwartz B. COVID-19 vaccination attitudes, values and intentions among United States adults prior to emergency use authorization. Vaccine 2021; 39:2698-2711. [PMID: 33781601 PMCID: PMC7988387 DOI: 10.1016/j.vaccine.2021.03.034] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 01/29/2023]
Abstract
Introduction Safe and effective vaccines against Coronavirus Disease 2019 (COVID-19) provide the best opportunity to control the pandemic. Having safe and efficacious vaccines available is only half the equation; people must also take them. We describe a study to identify COVID-19 vaccine attitudes, values and intentions immediately preceding authorization of COVID-19 vaccines in the US. Methods A national panel survey was conducted to measure intent to receive COVID-19 vaccines as well as disease and vaccine attitudes, values and trust in local, state and federal public health authorities. Results Greater than 80% of respondents reported confidence they could adhere to COVID recommendations such as mask wearing, social distancing and hand washing. The majority of respondents (70%) reported believing that current drugs were somewhat or very good at treating COVID-19 infection. Vaccine intent fell into three groups: Intenders (50%), Wait and Learn (40%), and Unlikelys (10%). Intent to get vaccinated was substantially lower among African American (32%), and higher among men (56%), those over 60 years of age (61%), those with a Bachelor’s degree or higher (63%), and Democrats (63%). The Wait and Learn group, compared to the Intenders, were less likely to report being diagnosed with a high risk condition for COVID-19, receiving an influenza vaccine in the past 12 months, discussing COVID-19 vaccine with their healthcare provider, perceiving COVID-19 as severe, considering a COVID-19 vaccine important to stop the spread of infection, and wering a mask usually or almost always. Conclusion Only half of US adults intend to accept COVID-19 vaccines; most others (40%) are uncertain. Levels of immunity associated with community protection will not be achieved without reaching those who are currently uncertain. Characterizing COVID-19 vaccine attitudes and intentions and ascertaining values and trust in local, state, and federal public health authorities that impact vaccine decision-making are essential.
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Affiliation(s)
- Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States.
| | - Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States
| | - Janesse Brewer
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States
| | - Lilly Kan
- National Association of County and City Health Officials, United States
| | | | - Haley Budigan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States
| | - Tina M Proveaux
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States
| | | | - Rajiv Rimal
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, United States
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