1
|
Nyalundja AD, Bugeme PM, Ntaboba AB, Hatu’m VU, Ashuza GS, Tamuzi JL, Ndwandwe D, Iwu-Jaja C, Wiysonge CS, Katoto PDMC. COVID-19 Vaccine Hesitancy and Associated Oral Cholera Vaccine Hesitancy in a Cholera-Endemic Country: A Community-Based Cross-Sectional Study in the Democratic Republic of Congo. Vaccines (Basel) 2024; 12:444. [PMID: 38675826 PMCID: PMC11053998 DOI: 10.3390/vaccines12040444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
COVID-19 vaccine hesitancy and its enablers shape community uptake of non-covid vaccines such as the oral cholera vaccine (OCV) in the post-COVID-19 era. This study assessed the impact of COVID-19 vaccine hesitancy and its drivers on OCV hesitancy in a cholera-endemic region of the Democratic Republic of Congo. We conducted a community-based survey in Bukavu. The survey included demographics, intention to take OCV and COVID-19 vaccines, reasons for COVID-19 hesitancy, and thoughts and feelings about COVID-19 vaccines. Poisson regression analyses were performed. Of the 1708 respondents, 84.66% and 77.57% were hesitant to OCV alone and to both OCV and COVID-19, respectively. Hesitancy to COVID-19 vaccines rose OCV hesitancy by 12% (crude prevalence ratio, [cPR] = 1.12, 95%CI [1.03-1.21]). Independent predictors of OCV hesitancy were living in a semi-urban area (adjusted prevalence ratio [aPR] = 1.10, 95%CI [1.03-1.12]), religious refusal of vaccines (aPR = 1.06, 95%CI [1.02-1.12]), concerns about vaccine safety (aPR = 1.05, 95%CI [1.01-1.11]) and adverse effects (aPR = 1.06, 95%CI [1.01-1.12]), as well as poor vaccine literacy (aPR = 1.07, 95%CI [1.01-1.14]). Interestingly, the belief in COVID-19 vaccine effectiveness reduced OCV hesitancy by 24% (aPR = 0.76, 95%CI [0.62-0.93]). COVID-19 vaccine hesitancy and its drivers exhibited a significant domino effect on OCV uptake. Addressing vaccine hesitancy through community-based health literacy and trust-building interventions would likely improve the introduction of novel non-COVID-19 vaccines in the post-COVID-19 era.
Collapse
Affiliation(s)
- Arsene Daniel Nyalundja
- Center for Tropical Diseases and Global Health (CTDGH), Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.D.N.); (P.M.B.)
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Patrick Musole Bugeme
- Center for Tropical Diseases and Global Health (CTDGH), Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.D.N.); (P.M.B.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alain Balola Ntaboba
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Victoire Urbain Hatu’m
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Guillaume Shamamba Ashuza
- Faculty of Medicine, Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.B.N.); (V.U.H.); (G.S.A.)
| | - Jacques Lukenze Tamuzi
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa;
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
| | - Chinwe Iwu-Jaja
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
- Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville P.O. Box 06, Congo
| | - Patrick D. M. C. Katoto
- Center for Tropical Diseases and Global Health (CTDGH), Catholic University of Bukavu (UCB), Bukavu 285, Democratic Republic of the Congo; (A.D.N.); (P.M.B.)
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa;
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; (D.N.); (C.I.-J.); (C.S.W.)
- Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7505, South Africa
| |
Collapse
|
2
|
Javid N, Phipps H, Homer C, de Vries B, Kaufman J, Danchin M, Hyett J. Factors influencing uptake of the COVID-19 vaccination among pregnant women in Australia: A cross-sectional survey. Birth 2023; 50:877-889. [PMID: 37431957 DOI: 10.1111/birt.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Mounting evidence shows the risk of COVID-19 on perinatal outcomes, as well as the safety and efficacy of vaccination during pregnancy. However, little is known about vaccine uptake among pregnant women in Australia, including women who are culturally and linguistically diverse (CALD), and about sources of information pregnant women use when making decisions about vaccines. We aimed to determine the proportion of pregnant women who had been vaccinated and to identify factors associated with vaccine uptake or decline during pregnancy. METHOD A cross-sectional, anonymous, online survey was conducted from October 2021 to January 2022 in two metropolitan hospitals in New South Wales, Australia. RESULTS Of 914 pregnant women, 406 (44%) did not speak English at home. Overall, 101 (11%) received a vaccine prepregnancy and 699 (76%) during pregnancy. In the nonvaccinated cohort, 87 (76%) declined vaccination during pregnancy. The uptake was more than 87% among women during pregnancy who received information from government or health professional websites but 37% when received from personal blogs. The main reasons for vaccine uptake were (1) hearing that COVID-19 affects pregnant women, (2) being concerned about the COVID-19 outbreak, and (3) receiving vaccine recommendation from a general practitioner. In a multivariable logistic regression, three main factors associated with declining or feeling unsure about vaccination were (1) concerns about the safety of the COVID-19 vaccine, (2) lack of trust and being unsatisfied with the information received about COVID-19 vaccination during pregnancy, and (3) doubting the importance of COVID-19 vaccine. CONCLUSION Clinicians play a critical role in counseling women to alleviate vaccine fear, support vaccine acceptance, and direct women to use reliable information sources, such as government and professional healthcare organizations, for information about vaccines.
Collapse
Affiliation(s)
- Nasrin Javid
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Hala Phipps
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
| | | | - Bradley de Vries
- Department of Obstetrics and Gynaecology, RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Jessica Kaufman
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Margie Danchin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jonathan Hyett
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
| |
Collapse
|
3
|
Luevanich C, Kane R, Naklong A, Surachetkomson P. Perceptions and Intentions around Uptake of the COVID-19 Vaccination among Older People: A Mixed-Methods Study in Phuket Province, Thailand. Int J Environ Res Public Health 2023; 20:5919. [PMID: 37297522 PMCID: PMC10252300 DOI: 10.3390/ijerph20115919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND A 70% vaccination rate against COVID-19 in the general population was required for re-opening Phuket tourist industry. However, prior to this research, 39.61% of older people remained unvaccinated. This study aimed to examine perceptions and intentions around COVID-19 vaccination amongst older people and to explore the reasons and factors influencing their decisions to receive or refuse vaccination. METHODS This was a mixed-methods approach with a sequential explanatory design. We conducted an online survey and semi-structured qualitative interview with a subsample. Multinomial logistic regression was applied and thematic content analysis was conducted. RESULTS 92.4% of participants reported intention to receive the vaccine. Multinomial regression analysis revealed that perceived barriers (AdjOR = 0.032; 95% CI: 0.17-0.59), perceived benefit (AdjOR = 2.65; 95% CI: 1.49-4.71), good health (AdjOR = 3.51; 95% CI: 1.01-12.12) and health not good (AdjOR = 0.10; 95% CI: 0.02-0.49) were predictors of vaccine uptake. In the qualitative interviews, four key influences on up-take for the 28 vaccinated participants were: prevention and protection, convenience, fear of death from COVID-19, and trust in the vaccine. Four key influences on refusal of vaccination in the eight unvaccinated participants were: rarely leaving the house, fear of vaccine side-effects, fear of death after getting the vaccine, and not enough information for decision-making. CONCLUSION Intervention and campaigns addressing COVID-19 vaccination should employ strategies, including the widespread use of social and other popular media to increase older people's perceived benefit of vaccination on their current and future health status, while decreasing perceived barriers to receiving the vaccine.
Collapse
Affiliation(s)
- Chayanit Luevanich
- Public Health Program, Faculty of Science and Technology, Phuket Rajabhat University, Phuket 83000, Thailand
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Aimon Naklong
- Teaching Profession Department, Faculty of Education, Phuket Rajabhat University, Phuket 83000, Thailand
| | - Prapaipim Surachetkomson
- Science and Mathematics Program, Faculty of Science and Technology, Phuket Rajabhat University, Phuket 83000, Thailand
| |
Collapse
|
4
|
Ayre J, Muscat DM, Mac O, Batcup C, Cvejic E, Pickles K, Dolan H, Bonner C, Mouwad D, Zachariah D, Turalic U, Santalucia Y, Chen T, Vasic G, McCaffery K. COVID-19 Testing and Vaccine Willingness: Cross-Sectional Survey in a Culturally Diverse Community in Sydney, Australia. Health Equity 2022; 6:965-974. [PMID: 36636119 PMCID: PMC9811837 DOI: 10.1089/heq.2021.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/29/2022] Open
Abstract
Objective The current study examined patterns in COVID-19 testing and vaccination intentions across multiple language groups in Greater Western Sydney, Australia. Methods Participants completed a cross-sectional survey available from March 21 to July 9, 2021 in Sydney, Australia. Surveys were available in English or translated (11 languages). Participants could complete surveys independently or with support from bilingual staff. Logistic regression models using poststratification weighted frequencies identified factors associated with testing and vaccination intentions. Results Most of the 708 participants (88%, n=622) were not born in Australia; 31% reported that they did not speak English well or at all (n=220); 70% had no tertiary qualifications (n=497); and 41% had inadequate health literacy (n=290). Half (53.0%) reported willingness to get a COVID-19 vaccine if recommended to them (n=375); 18% were unwilling (n=127), and the remainder unsure (29%, n=205). These proportions varied significantly by language group (p<0.001). Participants were more likely to be unwilling/hesitant if they were female (p=0.02) or did not use Australian commercial information sources (p=0.01). Concerns about side effects (30.4%, n=102) and safety (23.9%, n=80), were key reported barriers to vaccination. Most participants reported high testing intention (77.2%, n=546), with differences observed across language groups (p<0.001). The most frequently reported barrier to testing was concerns about infection at the clinic (26.1%) followed by concerns that testing was painful (25.3%). Conclusion Different language groups have unique and specific needs to support uptake of COVID-19 testing and vaccination. Health services must work collaboratively with culturally and linguistically diverse communities to provide tailored support to encourage COVID-19 testing and vaccination.
Collapse
Affiliation(s)
- Julie Ayre
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia.,*Address correspondence to: Julie Ayre, PhD, Sydney Health Literacy Laboratory, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Room 128C, Edward Ford Building (A27), Sydney, NSW, Australia.
| | - Danielle M. Muscat
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Olivia Mac
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Carys Batcup
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Erin Cvejic
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Kristen Pickles
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Hankiz Dolan
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Carissa Bonner
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Dana Mouwad
- Western Sydney Local Health District, Sydney, Australia
| | | | - Una Turalic
- Nepean Blue Mountains Local Health District, Sydney, Australia
| | | | - Tingting Chen
- Western Sydney Local Health District, Sydney, Australia
| | - Gordana Vasic
- Western Sydney Local Health District, Sydney, Australia
| | - Kirsten McCaffery
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
5
|
Lupton D. Understandings and practices related to risk, immunity and vaccination during the Delta variant COVID-19 outbreak in Australia: An interview study. Vaccine X 2022; 11:100183. [PMID: 35722522 PMCID: PMC9192109 DOI: 10.1016/j.jvacx.2022.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study was to use indepth social research to better understand the relationships and intersections between understandings and practices of COVID-19 risk, immunity and vaccination in lay people’s accounts. Methods This article reports findings from a qualitative research project involving semi-structured telephone interviews with a diverse group of 40 adults from around Australia about their experiences of the COVID crisis, conducted in late 2021 during the Delta variant outbreak. The participants’ responses to questions about COVID risk, COVID vaccines and how they thought they could best protect their health were analysed using an inductive thematic approach. Results A notion of ‘communal risk’ was expressed together with ‘individual risk’. Relatedly, people’s understandings of what might be characterised as ‘communal immunity’ as well as individual immunity also dominated in their accounts. Both communal risk and communal immunity are influenced by a range of constantly changing and interrelated factors. Locale was a strong factor in shaping people’s experiences and stances related to COVID risk. The participants referred to aspects such as their community’s geographical location; the number of COVID cases and the level of COVID vaccination by others living in their state or territory; adoption of preventive measures; vaccine availability, scheduling and take-up; viral testing and tracing reporting; and the extent and timing of viral spread in the population. These factors were continually related back to highly specific conditions and practices in their community or state of residence. Conclusions Understandings and practices related to COVID risk, immunity and vaccination were based both on individual experiences and broader ideas about the role of community. Spatial contexts are influential but there is also a strong temporality to these understandings and practices. There is a fine balance to be maintained between individual-level protection from COVID risk and community-level actions.
Collapse
Affiliation(s)
- Deborah Lupton
- Vitalities Lab, Centre for Social Research in Health and Social Policy Research Centre, Goodsell Building, University of New South Wales (UNSW), Sydney, Australia
| |
Collapse
|
6
|
Yıldırım DF, Serçekuş P, Özkan S. Reasons for Individuals' COVID-19 vaccine hesitations and changing decisions over time: A longitudinal qualitative study. Vacunas 2022; 23:S1-S7. [PMID: 35813990 PMCID: PMC9250900 DOI: 10.1016/j.vacun.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
Objective COVID-19 is a serious public health problem. Therefore, it is important to vaccinate the community. This study was aimed at examining the reasons for individuals' COVID-19 vaccine hesitations, and decisions that have changed over time. Material and methods This was a prospective longitudinal qualitative study. Results Confidence, fear, conspiracy theories, belief, and social pressure play a role in vaccine hesitancy. The most important factor in the changing decisions of individuals who are hesitant about vaccination is pressure. Confidence and fear also lead to a change of decision. However, it was remarkable that most of the participants who were vaccinated due to pressure did not want to be revaccinated. Conclusions Governments, media, vaccine companies, health professionals, and scientists should act together to increase the vaccination rates of individuals.
Collapse
Affiliation(s)
- Dicle Filiz Yıldırım
- Research Assisstant, Faculty of Health Sciences, Pamukkale University, Kınıklı / Denizli/, Turkey
| | - Pınar Serçekuş
- Professor, Faculty of Health Sciences, Pamukkale University, Kınıklı / Denizli/, Turkey
| | - Sevgi Özkan
- Professor, Faculty of Health Sciences, Pamukkale University, Kınıklı / Denizli/, Turkey
| |
Collapse
|
7
|
Lu H, Xia M, Qin Z, Lu S, Guan R, Yang Y, Miao C, Chen T. The Built Environment Assessment of Residential Areas in Wuhan during the Coronavirus Disease (COVID-19) Outbreak. IJERPH 2022; 19:7814. [PMID: 35805475 PMCID: PMC9266129 DOI: 10.3390/ijerph19137814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 epidemic has emerged as one of the biggest challenges, and the world is focused on preventing and controlling COVID-19. Although there is still insufficient understanding of how environmental conditions may impact the COVID-19 pandemic, airborne transmission is regarded as an important environmental factor that influences the spread of COVID-19. The natural ventilation potential (NVP) is critical for airborne infection control in the micro-built environment, where infectious and susceptible people share air spaces. Taking Wuhan as the research area, we evaluated the NVP in residential areas to combat COVID-19 during the outbreak. We determined four fundamental residential area layouts (point layout, parallel layout, center-around layout, and mixed layout) based on the semantic similarity model for point of interest (POI) picking. Our analyses indicated that the center-around and point layout had a higher NVP, while the mixed and parallel layouts had a lower NVP in winter and spring. Further analysis showed that the proportion of the worst NVP has been rising, while the proportion of the poor NVP remains very high in Wuhan. This study suggested the need to efficiently improve the residential area layout in Wuhan for better urban ventilation to combat COVID-19 without losing other benefits.
Collapse
|
8
|
Abstract
This study aimed to assess vaccine willingness, and the reasons why respondents were not likely to receive COVID-19 vaccine prior to and during the COVID-19 vaccine rollout. This cross-sectional survey (n = 5,130) was conducted between January and April 2021 in South Australia, Australia. Weighted multiple logistic regression was performed to assess the association between sociodemographic/health factors and outcome measures. The percentage of respondents who stated they were very likely to get vaccinated fluctuated between 50% and 78% during the survey period. The willingness of receiving COVID-19 vaccination was significantly lower among women than men (aOR: 0.70) and higher among adults ≥50 years (aOR: 1.82 for 50–69 years and aOR: 3.01 for ≥70 years vs 16–29-year olds). Other factors significantly associated with higher willingness were ≥Year 12 education (aOR: 2.50 for Year 12/TAFE/certificate/diploma vs <Year 12 education; aOR: 1.44 for bachelor’s degree or higher vs <Year 12 education), highest socioeconomic level vs lowest socioeconomic level (aOR: 1.75), and unpaid work/retirement/other vs unemployment (aOR: 1.77). Other factors such as being Aboriginal, not being married, not having chronic illness, and/or culturally and linguistically diverse backgrounds were identified to be significantly related to low confidence in vaccine safety, perceived low risk of disease and/or perceived lack of information. Parents or caregivers were significantly less willing for their child to be vaccinated compared to people in general (OR: 0.62). Targeted campaigns to improve uptake need to include appropriate messaging about vaccine safety and disease burden in addition to strategies to improve access to less willing groups.
Collapse
Affiliation(s)
- Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Rebecca Nolan
- Epidemiology Branch, Prevention and Population Health Directorate, Wellbeing SA, Adelaide, Australia
| | - Benjamin Krumeich
- Epidemiology Branch, Prevention and Population Health Directorate, Wellbeing SA, Adelaide, Australia
| | - Katina D'Onise
- Prevention and Population Health Directorate, Wellbeing SA, Adelaide, Australia.,School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Helen Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
9
|
Pickles K, Copp T, Meyerowitz-Katz G, Dodd RH, Bonner C, Nickel B, Steffens MS, Seale H, Cvejic E, Taba M, Chau B, McCaffery KJ. COVID-19 Vaccine Misperceptions in a Community Sample of Adults Aged 18-49 Years in Australia. Int J Environ Res Public Health 2022; 19:6883. [PMID: 35682466 DOI: 10.3390/ijerph19116883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023]
Abstract
Central to a successful population vaccination program is high uptake of vaccines. However, COVID-19 vaccine uptake may be impeded by beliefs based on misinformation. We sought to understand the prevalence and nature of misbeliefs about COVID-19 vaccines, and identify associated factors, shortly after commencement of Australia’s national vaccine rollout. A cross-sectional survey was administered to unvaccinated young adults (n = 2050) in Australia aged 18–49 years (mean age 33 years), 13 July–21 August 2021. This sample was previously under-represented in COVID-19 research but shown to have less willingness to vaccinate. Two thirds of participants agreed with at least one misbelief item. Misperceptions about COVID-19 vaccines were found to be significantly associated with lower health literacy, less knowledge about vaccines, lower perceived personal risk of COVID-19, greater endorsement of conspiracy beliefs, and lower confidence and trust in government and scientific institutions. Misbeliefs were more common in participants with less educational attainment, in younger age groups, and in males, as per previous research. Understanding determinants and barriers to vaccination uptake, such as knowledge and beliefs based on misinformation, can help to shape effective public health communication and inform debunking efforts at this critical time and in the future.
Collapse
|
10
|
Xiao J, Cheung JK, Wu P, Ni MY, Cowling BJ, Liao Q. Temporal changes in factors associated with COVID-19 vaccine hesitancy and uptake among adults in Hong Kong: Serial cross-sectional surveys. The Lancet Regional Health - Western Pacific 2022; 23:100441. [PMID: 35359914 PMCID: PMC8961079 DOI: 10.1016/j.lanwpc.2022.100441] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
11
|
Su J, Jia Z, Wang X, Qin F, Chen R, Wu Y, Lu B, Lan C, Qin T, Liao Y, Shi M, Liao Y, Pan P, Ye L, Jiang J, Liang H. Acceptance of COVID-19 vaccination and influencing factors among people living with HIV in Guangxi, China: a cross-sectional survey. BMC Infect Dis 2022; 22:471. [PMID: 35578187 DOI: 10.1186/s12879-022-07452-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Vaccination has been proven to be an effective approach against the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine the acceptance rate and factors influencing acceptance of COVID-19 vaccination among people living with HIV (PLWH) in Guangxi, China. Methods A cross-sectional survey was carried out in five cities in Guangxi, China from May 7 to June 1, 2021. Questionnaires on the acceptance of COVID-19 vaccination and the related factors were conducted among PLWH recruited by simple random sampling. Univariate and multivariate logistic regression analyses were performed to identify factors associated with acceptance of COVID-19 vaccination. Results Of all valid respondents (n = 903), 72.9% (n = 658) were willing to receive COVID-19 vaccination. Fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was the main reason for being willing to receive vaccination (76.0%), while the main reasons for not willing were the concerns about vaccine safety (54.7%) and the vaccination’s effect on antiretroviral therapy (ART) (50.6%). The most important factors influencing acceptance were the perception that vaccination is unsafe for HIV-infected people (aOR = 0.082, 95% CI = 0.024–0.282) and the poor efficacy in preventing SARS-CoV-2 infection in HIV-infected people (aOR = 0.093, 95% CI = 0.030–0.287). Other factors associated with acceptance included Zhuang ethnicity (aOR = 1.653, 95% CI = 1.109–2.465), highest education level of middle school, high school or above (aOR = 1.747, 95% CI = 1.170–2.608; aOR = 2.492, 95% CI = 1.326–4.682), and the vaccination having little effect on ART efficacy (aOR = 2.889, 95% CI = 1.378–6.059). Conclusions Acceptance rate of the COVID-19 vaccination is relatively low among PLWH compared to the general population in China, although some patients refused vaccination due to concerns about vaccine safety and vaccination affecting ART efficacy. More research is needed to investigate the impact of the COVID-19 vaccines on ART efficacy and the effectiveness in preventing SARS-CoV-2 infection among PLWH. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07452-w.
Collapse
|
12
|
Tokiya M, Hara M, Matsumoto A, Ashenagar MS, Nakano T, Hirota Y. Association of Vaccine Confidence and Hesitancy in Three Phases of COVID-19 Vaccine Approval and Introduction in Japan. Vaccines (Basel) 2022; 10:vaccines10030423. [PMID: 35335055 PMCID: PMC8954745 DOI: 10.3390/vaccines10030423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 02/01/2023] Open
Abstract
Understanding vaccine hesitancy, considering the target region and phase, is an urgent issue to quell the coronavirus disease (COVID-19) pandemic. This study aimed to monitor COVID-19 vaccine hesitancy in the Japanese population during the three phases of vaccine approval and introduction, and evaluate the association of vaccine hesitancy with vaccine confidence and literacy. We conducted web-based cross-sectional surveys during the three phases of COVID-19 vaccine introduction: January 2021, before approval; June, start of vaccination of the elderly; and September, when about 70% of the target population was vaccinated with at least one dose. There were 7210 participants, aged 20−80 years. We evaluated the association of vaccine hesitancy with vaccine confidence and literacy in the three phases using multivariate logistic regression analysis. The proportion of hesitancy in January, June, and September was 17.5%, 65.3%, and 19.4%, respectively. In any phase, lower vaccine confidence and literacy showed a higher adjusted odds ratio (AOR) of vaccine hesitancy in most items (AOR > 1, p < 0.001). Vaccine hesitancy in June had a different trend in perception of COVID-19 compared to that in the January and September surveys. The findings suggested that hesitancy increases transiently during vaccination introduction phases, and changes as the vaccination program progressed or waves of epidemic. Careful risk communication to increase vaccine confidence and literacy is essential to reduce vaccine hesitancy, especially in the introduction phase.
Collapse
Affiliation(s)
- Mikiko Tokiya
- Department of Social and Environmental Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; (A.M.); (M.S.A.)
- Correspondence: ; Tel.: +81-952-34-2289
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan;
| | - Akiko Matsumoto
- Department of Social and Environmental Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; (A.M.); (M.S.A.)
| | - Mohammad Said Ashenagar
- Department of Social and Environmental Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; (A.M.); (M.S.A.)
| | - Takashi Nakano
- Department of Pediatrics, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan;
| | - Yoshio Hirota
- Clinical Epidemiology Research Center, Medical Co. LTA (SOUSEIKAI), Higashi-ku, Fukuoka 813-0017, Japan;
| |
Collapse
|
13
|
Holt M, MacGibbon J, Bavinton B, Broady T, Clackett S, Ellard J, Kolstee J, Molyneux A, Murphy D, Power C, de Wit J. COVID-19 Vaccination Uptake and Hesitancy in a National Sample of Australian Gay and Bisexual Men. AIDS Behav 2022; 26:2531-2538. [PMID: 35102499 PMCID: PMC8803280 DOI: 10.1007/s10461-022-03603-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 11/25/2022]
Abstract
Minority groups may face additional barriers to vaccination. In April-June 2021, we assessed the level of COVID-19 vaccination and willingness to be vaccinated in a national, online survey of 1280 gay and bisexual men in Australia. Over a quarter of the sample (28.0%) had been partially or fully vaccinated, and 80.0% of the unvaccinated were willing to be vaccinated. Vaccination was independently associated with older age, being university educated, and HIV status (with HIV-positive participants being more likely and untested participants less likely to be vaccinated). Willingness to be vaccinated was independently associated with living in a capital city and being university educated. Those who had lost income or their job due to COVID-19 were less willing to be vaccinated. Our results suggest encouraging COVID-19 vaccination among those with lower levels of health literacy and supporting those who have experienced financial stress because of the pandemic.
Collapse
Affiliation(s)
- Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia.
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | | | - Timothy Broady
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | | | - Jeanne Ellard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | | | | | - Dean Murphy
- The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Cherie Power
- New South Wales Ministry of Health, Sydney, Australia
| | - John de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
14
|
Kaufman J, Bagot KL, Hoq M, Leask J, Seale H, Biezen R, Sanci L, Manski-Nankervis JA, Bell JS, Munro J, Jos C, Ong DS, Oliver J, Tuckerman J, Danchin M. Factors Influencing Australian Healthcare Workers' COVID-19 Vaccine Intentions across Settings: A Cross-Sectional Survey. Vaccines (Basel) 2021; 10:3. [PMID: 35062664 PMCID: PMC8781521 DOI: 10.3390/vaccines10010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/21/2022] Open
Abstract
Healthcare workers' COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey to healthcare workers in hospitals, primary care and aged or disability care settings (12 February-26 March 2021). The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework informed survey design and framing of results. Binary regression results adjusted for demographics provide risk differences between those intending and not intending to accept a COVID-19 vaccine. In total, 3074 healthcare workers completed the survey. Primary care healthcare workers reported the highest intention to accept a COVID-19 vaccine (84%, 755/898), followed by hospital-based (77%, 1396/1811) and aged care workers (67%, 243/365). A higher proportion of aged care workers were concerned about passing COVID-19 to their patients compared to those working in primary care or hospitals. Only 25% felt they had sufficient information across five vaccine topics, but those with sufficient information had higher vaccine intentions. Approximately half thought vaccines should be mandated. Despite current high vaccine rates, our results remain relevant for booster programs and future vaccination rollouts.
Collapse
Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - Kathleen L. Bagot
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney 2052, Australia;
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney 2052, Australia;
| | - Ruby Biezen
- Department of General Practice, University of Melbourne, Carlton 3010, Australia; (R.B.); (L.S.); (J.-A.M.-N.)
| | - Lena Sanci
- Department of General Practice, University of Melbourne, Carlton 3010, Australia; (R.B.); (L.S.); (J.-A.M.-N.)
| | - Jo-Anne Manski-Nankervis
- Department of General Practice, University of Melbourne, Carlton 3010, Australia; (R.B.); (L.S.); (J.-A.M.-N.)
| | - J. Simon Bell
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne 3052, Australia;
| | - Jane Munro
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
- The Royal Children’s Hospital, Melbourne 3052, Australia
| | - Carol Jos
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
| | - Darren Suryawijaya Ong
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
| | - Jane Oliver
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne 3000, Australia
| | - Jane Tuckerman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (K.L.B.); (M.H.); (J.M.); (C.J.); (D.S.O.); (J.O.); (J.T.); (M.D.)
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia
- The Royal Children’s Hospital, Melbourne 3052, Australia
| |
Collapse
|
15
|
Wang B, Nolan R, Marshall H. COVID-19 Immunisation, Willingness to Be Vaccinated and Vaccination Strategies to Improve Vaccine Uptake in Australia. Vaccines (Basel) 2021; 9:vaccines9121467. [PMID: 34960213 PMCID: PMC8704895 DOI: 10.3390/vaccines9121467] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/28/2021] [Accepted: 12/07/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 vaccine rollout is crucial to lifting community and economic restrictions. This cross-sectional study aimed to assess: (a) COVID-19 vaccine uptake and associated factors; (b) COVID-19 vaccine intentions and associated factors; (c) community support for COVID-19 vaccination strategies and associated factors. The survey was conducted between May and July 2021 in Australia. Of 3003 participants, 30% reported they were already vaccinated and 39% indicated they would get vaccinated. Low socioeconomic and education levels, non-English speaking backgrounds and being parents were associated with decreased vaccine willingness and/or vaccination rates. High levels of support for vaccination strategies were demonstrated with mandatory vaccination being less preferable. Respondents from non-English speaking backgrounds were more likely to support a mandatory vaccination policy. Respondents with the highest socioeconomic level were more likely to support vaccination requirements for international travel, visiting nursing homes and working in healthcare settings. Respondents who were aged ≥70 years were more likely to support all proposed vaccination strategies. Targeted campaigns should be implemented for parents and those who live in socioeconomic disadvantaged areas and have lower educational attainment. Concise and clear vaccine information should be provided in lay and multiple languages to improve vaccine confidence. Vaccine enforcement policies should be considered and implemented with caution.
Collapse
Affiliation(s)
- Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia;
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, SA 5006, Australia
| | - Rebecca Nolan
- Epidemiology Branch, Prevention and Population Health Directorate, Wellbeing SA, Adelaide, SA 5006, Australia;
| | - Helen Marshall
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia;
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, SA 5006, Australia
- Correspondence: ; Tel.: +61-8-8161-8115
| |
Collapse
|
16
|
Pickles K, Copp T, Dodd RH, Cvejic E, Seale H, Steffens MS, Meyerowitz-Katz G, Bonner C, McCaffery K. COVID-19 vaccine intentions in Australia. The Lancet Infectious Diseases 2021; 21:1627-1628. [PMID: 34838219 PMCID: PMC8612724 DOI: 10.1016/s1473-3099(21)00686-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Kristen Pickles
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia.
| | - Tessa Copp
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Rachael H Dodd
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Erin Cvejic
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | - Gideon Meyerowitz-Katz
- Population Wellbeing and Environment Research Lab, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia; Western Sydney Diabetes, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Carissa Bonner
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Kirsten McCaffery
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
17
|
Evans S, Klas A, Mikocka-Walus A, German B, Rogers G, Ling M, Fernando J, Kothe E, Westrupp E. "Poison" or "protection"? A mixed methods exploration of Australian parents' COVID-19 vaccination intentions. J Psychosom Res 2021; 150:110626. [PMID: 34583017 PMCID: PMC8503786 DOI: 10.1016/j.jpsychores.2021.110626] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The success of COVID-19 vaccination programs relies on community attitudes, yet little is known about parents' views. We aimed to explore the reasons behind Australian parents' vaccine intentions for themselves and for their children. METHOD This mixed methods study relates to Wave 13 (January 2021) of a longitudinal study of Australian parents' experiences during COVID-19 and contained 1094 participants (83% mothers). We used multinomial logistic regression to understand demographic predictors of vaccine intention, and a descriptive template thematic analysis to analyse open-ended questions about parents' reasons for vaccine intentions for themselves and their children. RESULTS 64% of Australian parents intend on vaccination, 26% are unsure and 9% intend to decline; 48% intend to vaccinate their children, 38% are unsure, and 14% intend to decline. Relative to those intending to vaccinate, parents unsure (OR = -0.63, 95% CI: 0.46, -0.84, p = .002) or not intending (OR = -0.41, 95% CI: 0.24, 0.67 p < .001) to vaccinate were more likely to have lower trust in doctors. Similar predictors emerged for parents who did not intend to vaccinate their children (OR = 0.47, 95% CI: 0.31, 0.70, p < .001). Qualitative data indicated that many parents had not made a firm decision, including a lack of alignment between intentions and reasons. For example, parents who said 'yes' to vaccination, often then expressed hesitance and a focus on risks in their written response. Reasons for hesitancy for themselves included concerns about testing, side effects, and long-term outcomes. Similar themes were present for children, but parents expressed a strong desire to protect their children, and an eagerness for health information. CONCLUSION Based on prior research and the themes identified here, a multipronged campaign that includes education/promotion, good access to vaccines and role models, is likely to support parents to make informed decisions regarding COVID-19 vaccination.
Collapse
Affiliation(s)
- S. Evans
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia,Corresponding author at: School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - A. Klas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia,Deakin University, Misinformation Lab, School of Psychology, Victoria, Australia
| | - A. Mikocka-Walus
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
| | - B. German
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
| | - G.D. Rogers
- School of Medicine, Deakin University, Victoria, Australia
| | - M. Ling
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia,Deakin University, Misinformation Lab, School of Psychology, Victoria, Australia
| | - J.W. Fernando
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
| | - E. Kothe
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia,Deakin University, Misinformation Lab, School of Psychology, Victoria, Australia
| | - E.M. Westrupp
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia,Department of Paediatrics, University of Melbourne, Victoria, Australia,Judith Lumley Centre, La Trobe University, Victoria, Australia
| |
Collapse
|