Determinants of COVID-19 Vaccine Hesitancy During the Pandemic: A Cross-Sectional Survey in the Canton of Vaud, Switzerland

Association between underlying conditions, multimorbidity, and COVID-19 vaccination status of adults aged ≥80 years old in Beijing, China

BACKGROUND

Promoting coronavirus disease 2019 (COVID-19) vaccination is crucial among older adults, particularly those geriatric. This study aimed to analyze the association between chronic conditions, multimorbidity, and vaccination status in adults aged ≥80 years old to provide recommendations for vaccine-preventable diseases.

METHODS

A cross-sectional study was conducted in Beijing from April 5, 2023, to May 5, 2023, including participants aged ≥80 years old who did not receive the booster COVID-19 vaccination. Data on vaccination status, COVID-19 infection history, nine underlying conditions, and disease-control status were collected via cluster sampling through door-to-door interviews and telephone surveys using questionnaires. A multiple logistic regression model adjusted for age, sex, location, COVID-19 infection history, and education level were used to analyze the association between underlying conditions and vaccination status.

RESULTS

In total, 51,834 participants were included of whom 41,209 (76.6 %) were unvaccinated. Underlying diseases (92.3 %) and multimorbidities (65.7 %) were prevalent among the participants. Hypertension (74.6 %), cardiovascular disease (48.5 %), and diabetes (42.0 %) were the most prevalent conditions. Participants diagnosed with underlying conditions were significantly associated with being unvaccinated (Odds ratio [95 % confidential interval] OR [95 %CI]: 2.21 [2.05-2.37]). Furthermore, the proportion of unvaccinated individuals increased with both the number and severity of underlying conditions.

CONCLUSIONS

The number and severity of underlying conditions were associated with unvaccinated status. To promote vaccination for geriatrics, standardized vaccination guidelines for individuals with underlying conditions should be developed. Additionally, family doctors play an essential role in vaccination assessment and recommendations during disease diagnosis and treatment.

The Interplay of Politics and Conspiracy Theories in Shaping Vaccine Hesitancy in a Diverse Cultural Setting in Italy

Vaccine hesitancy presents a significant challenge to public health, particularly in culturally diverse regions, such as South Tyrol, Italy. This article examines the interplay between political influences, conspiracy theories, and vaccine hesitancy in South Tyrol, an autonomous province characterised by its linguistic diversity and historical scepticism toward central authority. This study aimed to identify the important drivers of vaccine hesitancy and propose targeted strategies to enhance vaccine acceptance. Peer-reviewed and grey literature was examined to explore the sociocultural factors, political dynamics, and conspiracy narratives influencing vaccine hesitancy in South Tyrol. The analysis incorporated publicly available materials, including propaganda from anti-vaccine organisations, and regional public health data to contextualise the findings. Vaccine hesitancy in South Tyrol was influenced by historical tensions with the central government, cultural alignment with Austrian healthcare practices, and politically motivated opposition to vaccination. Conspiracy theories disseminated by local organisations and political entities exploit concerns regarding governmental overreach and personal autonomy. These dynamics are compounded by the selective misrepresentation of scientific discourse, which further polarises public opinion. Addressing vaccine hesitancy in South Tyrol requires culturally sensitive communication, community engagement through trusted local figures, transparency in health policies, and the proactive monitoring of misinformation. These strategies can mitigate mistrust and promote vaccine acceptance in regions with similar sociopolitical complexities.

The COVID-19 vaccination campaign in Switzerland and its impact on disease spread

We analyse infectious disease case surveillance data to estimate COVID-19 spread and gain an understanding of the impact of introducing vaccines to counter the disease in Switzerland. The data used in this work is extensive and detailed and includes information on weekly number of cases and vaccination rates by age and region. Our approach takes into account waning immunity. The statistical analysis allows us to determine the effects of choosing alternative vaccination strategies. Our results indicate greater uptake of vaccine would have led to fewer cases with a particularly large effect on undervaccinated regions. An alternative distribution scheme not targeting specific age groups also leads to fewer cases overall but could lead to more cases among the elderly (a potentially vulnerable population) during the early stage of prophylaxis rollout.