Factors Influencing COVID-19 Vaccination Intentions Among College Students: A Cross-Sectional Study in India

Assessing vaccine hesitancy among healthcare providers in Brazil: the influence of vaccine status and professional experience

OBJECTIVE

Assess the occurrence of vaccine hesitancy among pediatricians and their patients and identify potential predictors to mitigate hesitancy among them.

METHODS

The study is a cross-sectional survey using an online questionnaire sent to pediatricians affiliated with the Brazilian Society of Pediatrics. The data was analyzed using statistical methods such as exploratory factor analysis, principal component analysis, correspondence analysis, and generalized linear mixed models.

RESULTS

A total of 982 respondents, with a majority being females (77.4%), participated in the research. Among them, the proportion of pediatricians with complete vaccine status was 41.14%, while 90.6% had undergone medical residency. Furthermore, 9.3% worked in public healthcare settings, 30.4% in private settings, and 60.3% in mixed healthcare settings. The analysis revealed a significant association between vaccine status and pediatricians' misconceptions about COVID-19 vaccines, with those having complete vaccine status showing lower misconceptions (mean difference of -0.15, p = 0.010). Moreover, pediatricians with medical residency experience exhibited fewer misconceptions about COVID-19 vaccines (mean difference of -0.33, p = 0.002). Additionally, correspondence analysis unveiled the presence of two distinct profiles among pediatricians, showcasing variations in vaccine education, professional experience, and vaccine confidence perceptions.

CONCLUSION

The study highlights the influence of vaccine status and medical residency experience on pediatricians' attitudes and misconceptions about vaccines, emphasizing the need for targeted educational interventions to promote vaccine confidence and combat hesitancy within the healthcare provider community.

How Technology, Health Information Seeking, and Socioeconomic Factors Are Associated With Coronavirus Disease 2019 Vaccination Readiness in Estonians Over 50 Years?

Despite the proven effectiveness of COVID-19 vaccines in preventing severe illness, many individuals, including older adults who are most susceptible to the virus, have opted against vaccination. Various factors could shape vaccination decisions, including seeking health information (HI). The internet is the primary source of HI today; however, older adults are often referred to as those missing out on digital benefits. The study explores the correlations between information and communication technology (ICT) use, online HI seeking, socioeconomic factors, and COVID-19 vaccination readiness among individuals aged 50 and above in Estonia. The survey data were gathered from 501 people aged 50 and older after the first lockdown in 2020. The outcomes revealed that vaccination readiness positively correlated with factors such as higher educational attainment, greater income, male gender, access to ICT, a readiness to employ digital technologies for health-related purposes, a greater demand for HI, and a higher frequency of seeking it online. There was some discrepancy in the preference of HI sources; for example, vaccination consenters preferred online versions of professional press publications and specific health portals. Based on the findings, it is advisable to encourage older adults to utilize the internet and new technology for health-related purposes. This practice expands the range of information sources available to them, ultimately enabling better decision-making regarding their health behaviors.

The Impact of the COVID-19 Pandemic on Elite Swimmers and Water Polo Players: Lessons for the Future

BACKGROUND

The COVID-19 pandemic has disrupted global daily life, including the world of elite athletes. This paper examines the multifaceted impact the COVID-19 pandemic had on elite swimmers and water polo athletes, specifically their mental health, their concerns over the virus, their intentions of getting vaccinated, and sleep disturbances that they may have faced.

METHODS

We conducted a cross-sectional study on elite swimmers and water polo players, using an anonymous questionnaire.

RESULTS

A total of 200 elite athletes participated. The majority of the participants reported a negative impact on their mental health, screened positive for insomnia (n = 107 (53.5%), with females (n = 101; 57.7%), swimmers (n = 100, 66.7%), and university students (n = 71, 71.7%) being more vulnerable (p < 0.001). Concerns about contracting the disease especially during important training or tournament periods and potential career disruption also affected their psychological well-being. While the majority (75%) had the intention of getting vaccinated, an alarming percentage was yet uncertain over its decision.

CONCLUSIONS

This study highlights the significant psychological distress faced by elite aquatic athletes during the pandemic. It emphasizes the difficulties faced by elite swimmers and water polo athletes and determines not only the importance of addressing the vaccination intentions of athletes, but also how critical it is to confront the challenges they face both for their personal health and for the restoration of world sports to their pre-pandemic state. More large-scale studies are required to inform policies targeted at minimizing disruption to the athletes' career, provision of information on preventive measures and vaccination, and improvement in psychological well-being in case of similar major public health issues in the future. Additionally, this study calls for further research to explore the unique challenges faced by aquatic athletes, such as those related to their training environments and fear of contagion, to better support them in future public health crises.

Perceptions and attitudes toward COVID-19 vaccination among health professional students in Australia: a qualitative study

Using two qualitative data sources: free-text responses to an open-ended question of an online survey and subsequent interviews and focus groups, we explored perceptions and attitudes toward COVID-19 vaccination among health professional students enrolled in Australian universities during the pandemic with data collected from October 2021 to April 2022. Students provided free-text responses to the open-ended question (n = 313) in the online survey and participated in interviews or focus groups (n = 17). Data analysis revealed three themes, including perceptions of COVID-19 seriousness and the risk of contracting the virus, information dissemination, and attitudes toward the vaccine mandate. The study identified evolving perceptions of COVID-19 seriousness among Australian health professional students and their sentiments toward the vaccine mandate. There is a need to ensure the quality of information dissemination related to the vaccine mandate. This may not only support students' uptake of mandatory vaccination but also provide a means for them to address vaccination with healthcare consumers and patients.

Predictors of the willingness to receive the third dose of COVID-19 vaccine based on the Health Belief Model: A cross-sectional study in South Khorasan province

Coronavirus disease 2019 (COVID-19) infections have re-emerged in several countries due to reduced levels of antibodies provided by vaccines or the rapid emergence of viral variants, such as Alpha, Beta, Gamma, and Delta. A considerable supplementary intervention is recommended, including an additional dose of vaccination. The present study aimed to assess the predictors of the willingness to receive the third dose of the COVID-19 vaccine based on the Health Belief Model (HBM) constructs among people referring to health centers in South Khorasan province. In this cross-sectional-analytical study, 283 people over 18 years old in South Khorasan province were randomly selected using the multi-stage cluster sampling method. The data were collected using a researcher-made questionnaire, including demographic information and health status, knowledge about COVID-19, and the third dose of the vaccine, as well as a questionnaire according to the HBM constructs, which was completed through self-report methods. Finally, the data were analyzed using the Chi-square test and multivariate logistic regression analysis. The mean age of the study participants was 36.57±11.56 years (range of 18-55). The results of multivariate logistic regression analysis demonstrated that gender (P=0.012), marital status (P=0.038), occupation (P=0.013), perceived severity (P=0.005), and cues to action (P=0.018) had a significant direct effect, while perceived barriers (P=0.010) had a significant inverse effect on the willingness to accept the third dose of the vaccine. Moreover, the predictor variables explained about 67.7% of the willingness to receive the third dose of the vaccine. The current study suggested that enhancing the perceived severity of COVID-19, along with healthcare providers' recommendations to receive the vaccine and reducing perceived barriers, can effectively encourage individuals to receive the third dose of the COVID-19 vaccine. These findings can be utilized to develop interventions aimed at promoting the uptake of the booster dose of the COVID-19 vaccine.

Assessment of the Knowledge, Attitudes, and Practices of Indian Medical Students Towards Coronavirus Disease 2019 (COVID-19) After Two Doses of Vaccination and Their Approach Towards the Third (Booster) Dose

Background and objectives Medical students not only directly impact coronavirus disease 2019 (COVID-19) transmission due to their behavior and perceptions but also play an important role in influencing the behavior and vaccine intentions of their families and the community at large. The study's objective was to assess the knowledge, attitudes, and practices of medical students who have completed two doses of the COVID-19 vaccine towards the disease and their approach towards the third (booster) dose. Methods A total of 705 individual responses were obtained from a cross-sectional web-based study deployed using Google Forms. After getting consent and basic information, data was obtained regarding knowledge of the disease, attitudes towards the disease, and practices regarding the same. The mean score was calculated for the above different categories and compared with their respective cut-offs using a one-sample t-test. Data was also collected regarding their approach towards the booster dose of the COVID-19 vaccine, and the proportion of each response for different categories of questions was calculated. Results Participants were found to have mean scores in the range of moderate knowledge in the first part (47.67±4.49) and the second part (6.96±1.10) of the questionnaire and moderate practices (30.6±4.27) regarding COVID-19 disease. However, they had a mean score in the range of low attitude (39.79±4.07). The majority of participants acknowledge the role of vaccines in preventing the severity and spread of the disease (71.95%) and its effect on workers and medical professionals (60.26%). Mixed opinions were obtained for concerns regarding its pre-market testing and adverse effects and the government's vaccination policy. Interpretation and conclusion Responses of the medical students obtained in this study were majorly positive and in accordance with pre-vaccination studies concerning knowledge and practices. However, the low mean score in attitude obtained can be possibly explained due to their lack of direct exposure to patient management during the pandemic. The majority of participants had a positive response towards the use of the vaccine and the effectiveness of the booster dose, but concerns regarding pre-market testing, adverse effects, and the government's vaccination policy suggested the role of awareness campaigns and government endeavors to curb the same.

Barriers and facilitators to COVID-19 vaccine uptake among Australian health professional students during the pandemic: a nationwide study

Using a cross-sectional online survey we investigated knowledge, attitudes, and risk perception about COVID-19 vaccination and identified factors influencing vaccine uptake among Australian health professional students from October 2021 to January 2022. We analysed data from 1114 health professional students from 17 Australian universities. Most participants were enrolled in nursing programs (n = 958, 86.8%), and 91.6% (n = 858) of the participants received COVID-19 vaccination. Approximately 27% believed COVID-19 was no more serious than seasonal influenza and that they had a low risk of acquiring COVID-19. Nearly 20% disagreed that COVID-19 vaccines in Australia were safe and perceived they were at higher-risk of acquiring COVID infection than the general population. Higher-risk perception viewing vaccination as their professional responsibility, and vaccine mandate strongly predicted vaccination behaviour. Participants consider COVID-19 information from health professionals, government websites, and World Health Organization as the most trusted information sources. The findings highlight that healthcare decision-makers and university administrators need to monitor students' hesitancy with vaccination to improve students' promotion of the vaccination to the general population.

Vaccine hesitancy and post-vaccination adherence to safety measures: A mixed-method study

Background

Despite being recognized as one of the most successful public health measures, vaccination is still considered to be unnecessary and unreliable in the context of the COVID-19 pandemic. The current study utilized a two-pronged approach in analyzing vaccine hesitancy and health behaviors after vaccination by employing a mixed-method design. Phase 1 was aimed at identifying predictors of COVID-19 vaccine hesitancy and acceptance among the Pakistani population using protection motivation theory (PMT), whereas Phase 2 was aimed at exploring the factors related to the vaccination of COVID-19.

Method

A convenient sample of 1,736 individuals from the vaccine-eligible population (12 years and above) was selected to collect data on vaccine hesitancy and acceptance (Phase 1). Phase 2 of the study explored post-vaccination health behaviors, especially adherence to safety measures for COVID-19, through 23 in-depth interviews with the vaccinated population.

Results

Multiple regression analyses showed that response cost is a major predictor of vaccine hesitancy (in Phase 1). In terms of the role of demographic variables, the results showed that being male (for severity: B = −0.481; threat appraisal: B = −0.737), old age (B = −0.044), not vaccinated, and not infected with COVID-19 (themselves and family members) are strongly associated with vaccination hesitancy. Results of thematic analysis in Phase 2 revealed that perceived individual experience and insensitivity toward the severity of the disease are strongly associated with a lack of adherence to safety measures of COVID-19. Faith and religious beliefs and reliance on traditional remedies are also key predictors of people's general non-compliance to health behaviors. One interesting aspect that was revealed in the analysis was the general financially and socially destabilized situation in the context of developing countries that contributed to general apathy in the pandemic situation.

Conclusion

The findings of the current study may help in devising a health model for the public from the developing world to deal with future pandemic situations.

Acceptance and attitude towards the traditional chinese medicine among asymptomatic COVID-19 patients in Shanghai Fangcang hospital

Objective

The Coronavirus Disease 2019 (COVID-19) has brought severe damage to global health and socioeconomics. In China, traditional Chinese medicine (TCM) is the most important complementary and alternative medicine (CAM) and it has shown a beneficial role in the prevention and treatment of COVID-19. However, it is unknown whether patients are willing to accept TCM treatment. The objective of our study is to investigate the acceptance, attitude, and independent predictors of TCM among asymptomatic COVID-19 patients admitted to Shanghai fangcang hospital during the outbreak of the COVID-19 pandemic in Shanghai in 2022.

Methods

A cross-sectional study was conducted on asymptomatic COVID-19 patients in the largest fangcang hospital in Shanghai, China, from April 22, 2022, to May 25, 2022. Based on the literature review of previous similar studies, a self-report questionnaire was developed to assess the patients’ attitude and acceptance of TCM, and a multivariate logistic regression analysis was conducted to determine the independent predictors of TCM acceptance.

Results

A total of 1,121 patients completed the survey, of whom 91.35% were willing to accept CAM treatment whereas 8.65% of participants showed no willingness. Multivariate logistic regression analysis revealed that the patients who have received two doses of COVID-19 vaccine (OR = 2.069, 95%CI: 1.029–4.162, P = 0.041 vs. not received), understood the culture of TCM (OR = 2.293, 95%CI: 1.029–4.162, P = 0.014 vs. not understood), thought the TCM treatment is safe (OR = 2.856, 95%CI: 1.334–6.112, P = 0.007 vs. not thought), thought the TCM treatment is effective (OR = 2.724, 95%CI: 1.249–5.940, P = 0.012 vs. not thought), and those who informed their attending physician if using TCM for treatment (OR = 3.455, 95%CI:1.867–6.392, P < 0.001 vs. not informed) were more likely to accept TCM treatment. However, patients who thought TCM might delay your treatment (OR = 0.256, 95%CI: 0.142–0.462, P < 0.001 not thought) was an independent predictor for unwillingness to accept TCM treatment.

Conclusion

This study preliminarily investigated the acceptance, attitude, and predictors of intention to receive TCM among asymptomatic COVID-19 patients. It is recommended to increase the publicity of TCM, clarify the impact of TCM and communicate with attending doctors that meet the healthcare needs of asymptomatic COVID-19 patients.

A statistical analysis of tweets on covid-19 vaccine hesitancy utilizing opinion mining: an Indian perspective

The world witnessed the emergence of a deadly virus in December 2019, later named COVID-19. The virus was found to be highly contagious, and so people across the world were highly prone to be affected by the virus. Being a virus-borne disease, developing a vaccine was one of the most promising remedies. Thus, research organizations across the globe started working on developing the vaccine. However, it was later found by many researchers that a large number of people were hesitant to receive the vaccine. This paper aims to study the acceptance and hesitancy levels of people in India and compares them with the acceptance and hesitancy levels of people from the UK, the USA, and the rest of the world by analyzing their tweets on Twitter. For this study, 2,98,452 tweets were fetched from January 2020 to March 2022 from Twitter, and 1,84,720 tweets from 1,22,960 unique users were selected based on their country of origin. Machine learning based Sentiment analysis is then used to evaluate and analyze the tweets. The paper also proposes an NLP-based algorithm to perform opinion mining on Twitter data. The study found the public sentiment of the Indian population to be 63% positive, 28% neutral, and 9% negative. While the worldwide sentiment distribution is 45% positive, 34% neutral, and 21% negative, the USA has 42% positive, 34% neutral, and 23% negative and the UK has 50% positive, 29% neutral, and 21% negative. Also, sentiment analysis for individual vaccines in Indian context resulted in "Covaxin" with the highest positive sentiment at 43% followed by "Covishield" at 36%. The outcome of this work yields an insight into the public perception of the COVID-19 vaccine and thus can be used to formulate policies for existing and future vaccine campaigns. This study becomes more relevant as it is the consolidated opinion of Indian people, which is versatile in nature.

COVID-19 Vaccine Acceptance Among Healthcare Students in Vietnam, Based on Health Belief Model

Introduction

Healthcare students have a high risk of acquiring COVID-19 while practicing in medical facilities, and their health-related decisions might considerably impact the people around them. In the circumstance of many people refusing vaccination, the delay in accepting the COVID-19 vaccine by this group could be a barrier to providing effective immunity to the entire population against the COVID-19 pandemic.

Objective

The study aimed to assess the prevalence of vaccination acceptance and the factors influencing COVID-19 vaccine acceptance among Vietnamese healthcare students.

Methods

A web-based cross-sectional study was conducted among 384 respondents. The chi-square, Fisher's exact, and Mann-Whitney tests were used to assess the association between independent and dependent variables. Binary logistic regression analysis was used to identify the potential determinants of COVID-19 vaccine acceptance. Variables with p values of less than .05 at the 95% confidence interval were considered significant variables.

Results

Out of 384 participants, 91.7% accepted COVID-19 vaccination. Nurse and midwife (odds ratio [OR] = 6.81, confidence interval [CI] = 2.02-22.94, p < .01), perceived normal health status (OR = 15.22, CI = 2.74-84.66, p < .001), perceived good health status (OR = 149.00, CI = 11.08-2003.42, p < .01), COVID-19 infection among relatives or friends (OR = 4.19, CI = 1.77-9.95, p < .01) were predictors for the COVID-19 vaccine acceptance. Participants were less likely to accept COVID-19 vaccination if they reported greater perceived barriers (OR = 0.80, CI = 0.69-0.93, p < .01).

Conclusion

The current study offers helpful information on the factors influencing vaccine acceptance based on the Health Belief Model. The findings could benefit policymakers in establishing effective campaigns to improve the acceptance rate of the COVID-19 vaccine among healthcare students and shorten the time required to achieve herd immunity.

Determinants of COVID-19 vaccine behaviour intentions among the youth in Kenya: a cross-sectional study

Introduction

COVID-19 has become a public health concern globally with increased numbers of cases of the disease and deaths reported daily. The key strategy for the prevention of COVID-19 disease is to enhance mass COVID-19 vaccination. However, mass vaccination faces challenges of hesitation to acceptance of the vaccine in the community. The youth may not be among the vulnerable population to severe COVID-19 disease but are highly susceptible to contracting the virus and spreading it. The aim of the study was to assess COVID-19 vaccine youth behavior intentions and their determinants in Kenya.

Methods

The study used a mixed method design, employing a cross-sectional survey and focused group discussions across 47 counties in Urban, Peri-Urban and Rural settings of Kenya. The interviewees were youths aged 18–35, registered in online platforms/peer groups that included Shujaaz, Brck Moja, Aiffluence, Y Act and Heroes for Change. Quantitative data was collected using Google forms. A total of 665 interviews were conducted. Quantitative data was analysed using STATA version 16. In this paper we report quantitative study findings.

Results

The findings of the study indicated that only 42% of the youth were ready to be vaccinated, with 52% adopting a wait and see approach to what happens to those who had received the vaccine and 6% totally unwilling to be vaccinated. The determinants of these behavior intentions included: the perceived adverse effects of the vaccine on health, inadequate information about the COVID-19 vaccine, conflicting information about COVID-19 vaccine from the social media, religious implications of the vaccine, impact of education level on understanding of the vaccine, perceived risk of contracting the COVID-19 disease, efficacy of the COVID-19 vaccine, COVID-19 affecting women than men and trust in the ministry of health to lead COVID-19 interventions. Significantly it was found that hesitancy is higher among females, protestants and those with post-secondary education. Lack of information and concerns around vaccine safety and effectiveness were main cause of COVID-19 vaccine hesitancy. Social media was the major source of information contributing to hesitancy. Other contributors to hesitancy included low trust in the MoH and belief that mass vaccination is not helpful.

Conclusion

Vaccine hesitancy remains high among the youth but the causes of it are modifiable and health systems need to have evidence based engagements with the youth to reduce vaccine hesitancy.

Knowledge and practices toward COVID-19 among healthcare students: A cross-sectional study at the University of Zambia

Background

The COVID-19 pandemic led to the disruption of physical classes for university students globally, as large gatherings fuelled the transmission of the virus. In the efforts to mitigate its transmission and return to normality, prevention measures, including vaccination, have been encouraged. Therefore, it is critical to understand the knowledge and practices of students regarding COVID-19. This study assessed the knowledge and practices toward COVID-19 among healthcare students at the University of Zambia.

Materials and methods

This questionnaire-based cross-sectional study was carried out from August 2021 to October 2021 among 478 healthcare students (pharmacy, physiotherapy, nursing, biomedical, medicine, and radiography). We used a previously validated questionnaire to measure knowledge and practice. The predictors of knowledge and practices were assessed using logistic regression with robust estimation of standard errors. Statistical analysis was conducted using Stata/BE version 17.0.

Results

Of the 478 respondents, 243 (50.8%) were females. A larger proportion, 175 (36.6%) were in Pharmacy training, and 156 (32.6%) were in their fifth year of study. The overall mean knowledge score of the participants was 87.9 (SD = 16.1), being higher at 89.6 (SD = 14.3) among medical students and the lowest at 86.7 (SD = 17.1) among Pharmacy students, although this was statistically non-significant (p = 0.488). The overall mean practice score was 60.0 (SD = 24.7), being significantly higher at 63.5 (23.4) among nursing, physiotherapy and environmental students compared to other students (p = 0.048). In multivariable analysis, the participant training program was non-significantly associated with knowledge and practice toward COVID-19. However, increased age (AOR = 1.09, 95% CI: 1.01-1.117) and residing in urban areas (AOR = 1.79, 95% CI: 1.07-3.01) than in rural areas were associated with higher odds of good practice toward COVID-19.

Conclusion

The healthcare students generally showed good knowledge levels and poor practices toward COVID-19. Further, there was no evidence of a difference in knowledge of COVID-19 among healthcare students. These findings suggest the need for implementation strategies to be centered on improving the practices of students toward COVID-19.

A, Chaudhary RK, Mateti UV, Kellarai A, Unnikrishnan MK, Dsouza JD, Parsa AD, Kabir R, Sah R. Perception of Availability, Accessibility, and Affordability of COVID-19 Vaccines and Hesitancy: A Cross-Sectional Study in India

Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Results: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.

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

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

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

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

Trends in willingness to receive COVID-19 vaccines among healthcare workers in India: Findings from repeated cross-sectional national surveys

Background

COVID-19 vaccination of the healthcare workers (HCWs) is a key priority in the fight against the SARS-CoV-2 pandemic. India launched its COVID-19 vaccination program in January 2021. We aimed to understand the trends in willingness to receive COVID-19 vaccines and its associated factors among HCWs in India.

Methods

Using a repeated cross-sectional survey design, we collected information from HCWs in three critical time points: before (n = 937, October 2020), during (n = 1346, January 2021); and after (n = 812, May 2021) the introduction of COVID-19 vaccines in India. The third survey coincided with the peak of the second wave of COVID-19 pandemic in India.

Findings

Of the study participants, 43.7, 60.2, and 73.2% were willing to receive COVID-19 vaccines during the first, second and third rounds of surveys, respectively. In multivariable logistic regression analysis, participants who trusted the health care system were more likely to report willingness to receive a COVID-19 vaccine; medical trust emerged as a significant factor in all the three rounds of surveys (First survey-aOR: 2.24, 95% CI: 1.67-2.99; Second survey-aOR: 3.38, 95% CI: 2.64-4.33; Third survey-aOR: 2.54, 95% CI: 1.65-3.91). Having confidence in domestic vaccines (Second survey-aOR: 2.21, 95% CI: 1.61-3.02; Third survey-aOR: 2.05, 95% CI: 1.24-3.37); and high perceived risk of contracting COVID-19 (Second survey-aOR: 1.48, 95% CI: 1.13-1.93; Third survey-aOR: 2.02, 95% CI: 1.31-3.13) were found to be associated with willingness to receive vaccines. Among socio-demographic characteristics, being married (aOR: 1.71, 95% CI: 1.08-2.71) and having high socio-economic status (aOR: 3.01, 95% CI: 1.65-5.51) emerged as significant factors associated with willingness to receive COVID-19 vaccines in the third round of the surveys.

Interpretation

Willingness to receive COVID-19 vaccine increased with time, as the severity of the pandemic increased. To increase COVID-19 acceptance and coverage among HCWs, it is important to instill confidence in domestic vaccines and assist in accurate assessment of risk toward contracting COVID-19 infection.

Predictors of COVID-19 Vaccine Acceptance among Healthcare Workers in Nigeria

Healthcare workers (HCWs) are regarded as role models regarding health-related issues, including vaccination. Therefore, it is essential to identify the predictors for COVID-19 vaccine acceptance among them. A cross-sectional study to assess the risk perception, attitudes and knowledge of HCWs toward COVID-19 vaccination was carried out. A total of 710 responses were received between September 2021 and March 2022, from HCWs in the Northern, Western and Eastern regions of Nigeria. Cross tabulations were performed to determine statistical relations between sociodemographic variables, knowledge, attitudes and risk perceptions concerning COVID-19 vaccine acceptance. Multinomial logistic regression analysis was performed to determine the predictive variables for COVID-19 vaccine acceptance. Statistical analyses were performed and P-values less than 0.05 were considered statistically significant at a CI of 95%. Results showed that 59.3% of the participants were amenable to COVID-19 vaccines. Multinomial regression analysis identified 14 variables at α < 0.05 as predictors for vaccine acceptance. Male HCWs were 2.8 times more likely to accept the vaccine than their female counterparts. HCWs that were knowledgeable of the different kinds of vaccines, were willing to recommend the vaccines to their patients, believed that the timing of COVID-19 vaccination was appropriate and had recent vaccination history within three years were 1.6, 24.9, 4.4 and 3.1 times more likely to take COVID-19 vaccine than those not sure. The study found a relatively high trust (51.3%) in the Nigerian Center for Disease Control (NCDC) for information regarding COVID-19 vaccines. Therefore, the NDCD should disseminate more robust insights regarding the safety profiles of various COVID-19 vaccines.

Predicting intentions to get the COVID-19 vaccine in India: An integration of theory of planned behaviour and health belief model

The aim of the study was to determine intention to receive Coronavirus disease-19 (COVID-19) vaccination in India. An integrated model of Theory of Planned behaviour (TPB) and Health Belief Model (HBM) was used. Online survey was conducted in Delhi NCR region to find out the intention to receive vaccination. Data was collected from 845 respondents during 15 February 2021-15 March 2021, just after COVID-19 vaccination became available in the India. Partial Least Square-Structural Equation Modelling was used to establish the relationships. The results of the analysis show that proposed framework is significant and explained 71% variance in intentions. Attitude, subjective norm, perceived behaviour control and self-efficacy from the TPB had direct (or significant independent) effects on intention and perceived benefits, perceived susceptibility from the HBM have indirect effect on the intentions through attitude. The present study can be used to maximise the uptake of vaccination in any future pandemic. This theoretically-driven model can be used to guide health policy makers and health care providers to increase the uptake of vaccination.

Sociodemographic Determinants of Willingness and Extent to Pay for COVID-19 Vaccine in India

Background

Responding to the fast transmission rates and increasing fatality rates, countries across the world expedited the development and deployment of the vaccine for coronavirus disease 2019 (COVID-19). Evaluation of individuals' willingness to pay (WTP) would provide pertinent information regarding future demand and financing preferences, which shall help to devise the effective payment strategy for COVID-19 vaccination.

Methods

A nationwide, cross-sectional, and self-administered online survey using a structured questionnaire was conducted to identify the sociodemographic determinants of willingness and extent to pay for COVID-19 vaccine in India. A non-probability convenience sampling followed by snowball sampling was employed to recruit participants (n = 3,341). The likelihood of sociodemographic determinants to predict willingness and extent to pay was modeled using the multivariate binary logistic regression analysis.

Results

Out of 3,341 participants, 68% (n = 2,271) were willingness to pay for COVID-19 vaccine. Results showed significantly higher odds for willingness to pay among participants who were single [adjusted odds ratio (aOR) = 1.394, p < 0.01] and having a family size of 4 members (aOR = 1.346, p < 0.01). The adjusted odds ratio sizably increased from 1.396 for participants whose monthly income was between INR 10,000 and 20,000/month to 2.240 for participants whose monthly income was above INR 50,000/month. Further, out of 2,271 of those participants who were willingness to pay for COVID-19 vaccine, majority (n = 1,246, 54.9%) of participants were willingness to pay below 50% of COVID-19 vaccine cost. This study found that those who are single (aOR = 0.688, p < 0.01), having an income between INR 20,000 and 50,000/month (aOR = 0.686, p < 0.05), and those who belonged to socially disadvantaged category (aOR = 0.450, p < 0.01) were estimated to have significantly lower odds of willingness to pay more than 50% of COVID-19 vaccine cost.

Conclusion

This study observed that majority of those participants who willingness to pay for COVID-19 vaccine were willingness to pay only up to 50% of COVID-19 vaccine and income was observed as a precursor predictor of the willingness and extent to pay for COVID-19 vaccine. The understanding on the willingness and extent to pay for COVID-19 vaccine and its sociodemographic determinants will be helpful for making the strategic decisions related to the financing of COVID vaccine in India.

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

Background

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

Methods

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

Findings

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

Interpretation

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

Funding

None.

COVID-19 Vaccine Acceptance Rate and Its Factors among Healthcare Students: A Systematic Review with Meta-Analysis

Healthcare students are clinicians-in-training likely to come into contact with COVID-19 as much as other frontline healthcare professionals. It is therefore necessary to prioritize vaccinations for this group. We conducted a global systematic assessment of COVID-19 vaccine acceptance rates and related factors among healthcare students using the PubMed, Scopus, and Web of Science databases and keyword searches in March of 2022. We found 1779 articles with relevant information and 31 articles that matched our inclusion criteria. We performed a random-effects meta-analysis and quality assessment using the eight-item Joanna Briggs Institute Critical Appraisal test for cross-sectional studies. A total of 30,272 individuals from 16 countries were studied. Most of the studies were carried out in the U.S. (n = 6), China (n = 5), Poland (n = 5), India (n = 2), Italy (n = 2), and Israel (n = 2). The prevalence of the COVID-19 vaccine acceptance rate was 68.8% (95% confidence interval [CI]: 60.8-76.3, I2 = 100%), and the prevalence of the vaccine hesitancy rate was 25.8% (95% CI: 18.5-33.8, I2 = 99%). In country-specific analyses, Romania showed the highest acceptance rate (88.0%, 95% CI: 44.5-100%), while Iraq showed the lowest acceptance rate (66.2%, 95% CI: 35.5-90.8%). In time-trend analyses, we found that acceptance rates among healthcare students decreased over time. Students concerned about potentially serious side effects of the vaccine were less willing to accept the vaccine. National and international interventions should be adopted to reduce COVID-19 vaccination hesitancy rates among these important frontline workers.

Factors Associated With the Vaccination Behavior Among COVID-19 Vaccine Hesitant College Students in Wuhan, China: A Survey Based on Social Psychological Dimension

Background

During the COVID-19 pandemic, vaccine hesitancy (VH) on COVID-19 vaccination still exists in different populations, which has a negative impact on epidemic prevention and control. The objectives were to explore college students' willingness to vaccinate, determine the factors influencing the vaccination behavior of students with COVID-19 vaccine hesitancy, and provide a basis for improving the compliance of college students with COVID-19 vaccination.

Methods

The universities in Wuhan are categorized into three levels according to their comprehensive strength and randomly sampled at each level, of which ten universities were selected. A self-designed anonymous electronic questionnaire was distributed online from May 12 to 31, 2021 to investigate the hesitancy, vaccination status, and influencing factors of COVID-19 vaccination among college students in Wuhan.

Results

Of the 1,617 participants (1,825 students received the electronic questionnaire) surveyed, 19.0% reported COVID-19 vaccine hesitancy. Among the vaccine-hesitant students, 40.1% were vaccinated against COVID-19. The binary logistic regression analysis shows that families' attitudes "Uncertain" (odds ratio (OR) = 0.258 [0.132-0.503]), vaccination risk psychology (OR = 0.242 [0.079-0.747]) and wait-and-see mentality (OR = 0.171 [0.068-0.468]) are negative factors for the vaccination behavior of hesitant students, while herd mentality (OR = 7.512 [2.718-20.767]) and uncertainty of free policy's impact on vaccine trust (OR = 3.412 [1.547-7.527]) are positive factors.

Conclusion

The vaccine hesitancy among college students in Wuhan was relatively high. Family support, herd mentality and free vaccination strategies can help improve vaccination among hesitant students, while vaccination risk psychology and "wait-and-see" psychology reduce the possibility of vaccination. The vaccination strategy of college students should be strengthened from the perspective of social psychological construction.

COVID-19 Pandemic and Vaccination from The Perspective of University Students: Knowledge, Attitudes and Practices

Aim: Our aim was to find out the knowledge, attitudes, and practices of university students regarding the COVID-19 pandemic, as well as to evaluate their vaccination status and the students' approaches to COVID-19 vaccination. Methods: Our cross-sectional study was carried out in the province of Tokat between 01 December 2021 and 31 December 2021. The sample of the research consists of Tokat Gaziosmanpasa University students. The students were reached by sending an online survey to their corporate e-mails. The survey form consists of socio-demographic data and parts regarding knowledge, attitudes, and practices towards COVID-19 and vaccines. Results: Our study included 1053 participants. The mean age of the participants was 22.1±5.2, and 56.2% were female. The rate of having COVID-19 among the participants was 27.8%. Of the students, 94.5% were vaccinated with the COVID-19 vaccines. The average correct response rate of the participants about the disease was 79.1±15.2%. Although the high rate of knowledge regarding the effectiveness of protective attitudes, it was seen that the rate of wearing a mask was 70.2% and just 49.9% of participants always avoid crowded areas. Conclusion: The approaches of young people, who can be the source of transmission, regarding COVID-19 disease and vaccines are extremely effective in controlling the pandemic. Keywords: COVID-19, vaccines, knowledge, attitude, students