Concerns and motivations about COVID-19 vaccination

Use of UK faith Centre as a COVID-19 community vaccination clinic: exploring a potential model for community-based health care delivery

INTRODUCTION

Effective and safe vaccines against COVID-19 are essential to achieve global control of the coronavirus (SARS-CoV-2). Using faith centres may offer a promising route for promoting higher vaccine uptake from certain minority ethnic groups known to be more likely to be vaccine hesitant.

METHODS

This cross-sectional study explored attendees' perceptions, experiences of being offered, and receiving COVID-19 vaccination in a local mosque in Woking, Surrey, UK. About 199 attendees completed a brief questionnaire on experiences, views, motivations about attending the mosque and vaccination on site.

RESULTS

The most common ethnic groups reported were White British (39.2%) and Pakistani (22.6%); 36.2% identified as Christian, 23.6% as Muslim, 5.5% as Hindu, and 17.1% had no religion. Genders was relatively equal with 90 men (45.2%) and 98 women (49.2%), and 35-44-year-olds represented the most common age group (28.1%). Views and experiences around receiving vaccinations at the mosque were predominantly positive. Primary reasons for getting vaccinated at the mosque included convenience, accessibility, positive aspects of the venue's intercultural relations, and intentions to protect oneself against COVID-19, regardless of venue type. Negative views and experiences in regards to receiving the vaccination at the mosque were less common (7% expressed no intention of recommending the centre to others), and disliked aspects mostly referred to the travel distance and long waiting times.

CONCLUSIONS

Offering COVID-19 vaccination in faith centres appears acceptable for different faith groups, ensuring convenient access for communities from all religions and ethnic backgrounds.

Marital conflict of a nurse family following COVID-19 vaccinations: A case studying

Vaccination is one of the best strategies to control a pandemic. Although there is much research evidence of its effectiveness, a small percentage of people would not incubate the vaccine. After starting vaccination of healthcare workers as the first group in Iran, there were many debates and concerns regarding the effectiveness of the COVID-19 vaccine and its long-term side effects among them. In this investigation, the impact of these disagreements on the relationship of a nurse couple has been presented. The wife believed that people should incubate the COVID-19 vaccine as soon as possible and the man was anti-vaxxer and he believed that COVID-19 vaccines are not safe and it should be refused. After that, the wife got the COVID-19 vaccine, and their difference in views led to marital conflicts and disturbance in the function of the family. This case study was approved by the Research Council and Ethics Committee of Semnan University of Medical Science. Vaccine refusing could have complicated effects on a community and family. There should be a plan to assess families' function and apply it in the case of disturbance in families' function. Moreover, several strategies should be implemented to persuade anti-vaxxers.

The Underlying Structure of Preventive Behaviors and Related Factors During the COVID-19 Pandemic: A Comprehensive Network Analysis

BACKGROUND

Various strategies against COVID-19 have been adopted in different countries, with vaccination and mask-wearing being widely used as self-preventive interventions. However, the underlying structure of these behaviors and related factors remain unclear.

PURPOSE

In this study, we aimed to explore the network structure of preventive behaviors during the COVID-19 pandemic and their underlying factors, incorporating age and sex in the network.

METHODS

We used a multi-center sample of 20,863 adults who were vaccinated against COVID-19 in China between April 1, 2021, and June 1, 2021. Networks were estimated using unregularized partial correlation models. We also estimated the accuracy and stability of the network.

RESULTS

The preventive behaviors related to network factors revealed that self-initiated vaccination was more connected with cognition factors, and mask-wearing was more connected with personal profiles. The two clusters were linked through information-seeking and political beliefs. Moreover, self-initiated vaccination was negatively connected with vaccine hesitancy and concerns about COVID-19 vaccines and positively connected with trust in the vaccines, pandemic-related altruism, political beliefs, and being married. Mask-wearing was negatively connected with being a professional/white collar worker and higher education level and positively connected with regular physical examination, self-rated health, migration, being married, and better family relationships. Incorporation of age and sex into the network revealed relevant associations between age and mask-wearing and age and self-initiated vaccination. The network was highly accurately estimated. The subset bootstrap showed that the order of node strength centrality, betweenness, and closeness were all stable. The correlation stability coefficient (CS-coefficient) also showed the stability of this estimate, with 0.75 for node strength, 0.75 for betweenness, and 0.67 for closeness.

CONCLUSIONS

The internal structures of vaccination and mask-wearing behaviors were quite different, the latter of which were mainly affected by socioeconomic status and health-related behaviors and the former by knowledge about vaccines and political beliefs. Information-seeking and family relationships were the bridge factors connecting these two self-preventive behavior clusters, suggesting the direction of future efforts.

The current state of pertussis vaccination in pregnancy around the world, with recommendations for improved care: Consensus statements from the Global Pertussis Initiative

Bordetella pertussis, which causes a respiratory disease known as pertussis ("whooping cough") remains an important global challenge, with the incidence in pertussis cases increasing in recent years. Newborns and infants are at increased risk for severe morbidity and mortality from this bacterium. Vaccination in pregnancy has become an important strategy to both passively transfer immunity as well as prevent infection in pregnant persons, who are a major source of newborn infection, thus attempting to decrease the impact of this serious disease. It is considered safe for the pregnant person, the developing fetus, and the infant, and during the first 3 months of life it has been shown to be highly effective in preventing pertussis. There are a variety of strategies, recommendations, and adherence rates associated with pertussis vaccination in pregnancy around the world. We summarize the 2021 Global Pertussis Initiative Annual Meeting that reviewed the current global status of pertussis vaccination in pregnancy and remaining medical and scientific questions, with a focus on vaccination challenges and strategies for obstetric and gynecologic healthcare providers.

Healthcare professionals' acceptance of COVID-19 vaccination for their children: A cross-sectional study at a tertiary care hospital in Western India

Background and Aims

Establishing a transparent and forthright dialog between healthcare professionals (HCPs) and the public is paramount in promoting the effective acceptance of COVID-19 vaccination for children. Hence, this study aimed to assess the COVID-19 vaccine acceptance, knowledge, and perception among HCPs for their children.

Methods

A cross-sectional study was conducted among HCPs at a tertiary care teaching hospital in Western India. A structured questionnaire was designed and validated to collect data. Descriptive statistics were used for data analysis.

Results

The study found that more than 80% of HCPs had good knowledge about COVID-19 vaccines, and 92.74% of them were willing to accept the vaccine for their children. Doctors were more likely to vaccinate their children, and 73% of HCPs had a favorable attitude toward immunizing their children if a new COVID-19 vaccine was available. Academic/peer-reviewed publications were considered the most reliable source of information for COVID-19 vaccination, followed by government sources.

Conclusion

This study found that parental vaccine hesitancy was significantly lower among the HCP group. The majority of HCPs were in favor of vaccinating their children against COVID-19, indicating that they can serve as an effective channel for promoting parental acceptance of COVID-19 vaccines in the community.

Cultural Tightness-Looseness: How Was It Related to Vaccination Behavior among University Students in Japan, the United States, and India?

As a next step to better understand the role of cultural tightness-looseness (CTL), this study aimed to examine whether CTL is associated with COVID-19 vaccination behavior among university students, taking into consideration sociocultural perceptions of vaccination across countries. A global online survey was conducted. University students from Japan, the US, and India participated. The average CTL score, three sociocultural perceptions related to COVID-19 vaccination, side effects, infection experience of themselves and family members, and other demographic variables were used to identify the model and to explain the second vaccination status using stepwise logistic regression methods with Akaike Information Criterion (AIC) scores which was for both the total, with the country as a variable, and for each country. Analyses of data from 1289 respondents who received the first vaccine revealed the essential role of CTL in individuals getting the second vaccine, while also revealing differences between countries. Regardless of the limitations, this study adds knowledge about CTL's roles in the COVID-19 vaccination behavior among young generations and provides insights into public health communication practices for issues like COVID-19.

Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures

BACKGROUND

The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients.

AIM

To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic.

METHODS

We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy.

FINDINGS

Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators.

CONCLUSION

Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.

COVID-19 Vaccine Acceptance Among Pregnant, Lactating, and Nonpregnant Women of Reproductive Age in Turkey: A Cross-Sectional Analytical Study

OBJECTIVE

This study aims to identify the rates of coronavirus disease 2019 (COVID-19) vaccine acceptance, the reasons for receiving and not receiving the vaccine, and the associated factors among pregnant, lactating, and nonpregnant women of reproductive age.

METHODS

This cross-sectional and analytical study was conducted online in Turkey, at the end of the fourth wave of the COVID-19 pandemic, between February and May 2022. A total of 658 women (230; 35% pregnant) (187; 28.4% lactating) (241; 36.6% nonpregnant) women of reproductive age participated in the study.

RESULTS

Vaccine acceptance rates were found to be 91.7% in nonpregnant women of reproductive age, 77% in lactating women, and 59% in pregnant women (P < 0.05). The highest rate of vaccine hesitancy was observed in pregnant women (31.3%), and vaccine rejection rate was the highest in lactating women (10.2%). Pregnancy (odds ratio [OR] = 3.98; confidence interval [CI] = 1.13-14.10), and the breastfeeding period (OR = 3.84; CI = 1.15-12.78), increased vaccine hesitancy approximately four times.

CONCLUSIONS

Lack of knowledge about and confidence in the COVID-19 vaccine is still one of the barriers to vaccine acceptance today. Health-care providers (HCPs) should provide effective counseling to pregnant, lactating, and nonpregnant reproductive-aged women based on current information and guidelines.

How Should Doctors Frame the Risk of a Vaccine's Adverse Side Effects? It Depends on How Trustworthy They Are

BACKGROUND

How health workers frame their communication about vaccines' probability of adverse side effects could play an important role in people's intentions to be vaccinated (e.g., positive frame: side effects are unlikely v. negative frame: there is a chance of side effects). Based on the pragmatic account of framing as implicit advice, we expected that participants would report greater vaccination intentions when a trustworthy physician framed the risks positively (v. negatively), but we expected this effect would be reduced or reversed when the physician was untrustworthy.

DESIGN

In 4 online experiments (n = 191, snowball sampling and n = 453, 451, and 464 UK residents via Prolific; Mage≈ 34 y, 70% women, 84% White British), we manipulated the trustworthiness of a physician and how they framed the risk of adverse side effects in a scenario (i.e., a chance v. unlikely adverse side effects). Participants reported their vaccination intention, their level of distrust in health care systems, and COVID-19 conspiracy beliefs.

RESULTS

Physicians who were trustworthy (v. untrustworthy) consistently led to an increase in vaccination intention, but the way they described adverse side effects mattered too. A positive framing of the risks given by a trustworthy physician consistently led to increased vaccination intention relative to a negative framing, but framing had no effect or the opposite effect when given by an untrustworthy physician. The exception to this trend occurred in unvaccinated individuals in experiment 3, following serious concerns about one of the COVID vaccines. In that study, unvaccinated participants responded more favorably to the negative framing of the trustworthy physician.

CONCLUSIONS

Trusted sources should use positive framing to foster vaccination acceptance. However, in a situation of heightened fears, a negative framing-attracting more attention to the risks-might be more effective.

HIGHLIGHTS

How health workers frame their communication about a vaccine's probability of adverse side effects plays an important role in people's intentions to be vaccinated.In 4 experiments, we manipulated the trustworthiness of a physician and how the physician framed the risk of adverse side effects of a COVID vaccine.Positive framing given by a trustworthy physician promoted vaccination intention but had null effect or did backfire when given by an untrustworthy physician.The effect occurred over and above participants' attitude toward the health care system, risk perceptions, and beliefs in COVID misinformation.

Strategies and Trends in COVID-19 Vaccination Delivery: What We Learn and What We May Use for the Future

Vaccination has been the most effective way to control the outbreak of the COVID-19 pandemic. The numbers and types of vaccines have reached considerable proportions, even if the question of vaccine procedures and frequency still needs to be resolved. We have come to learn the necessity of defining vaccination distribution strategies with regard to COVID-19 that could be used for any future pandemics of similar gravity. In fact, vaccine monitoring implies the existence of a strategy that should be measurable in terms of input and output, based on a mathematical model, including death rates, the spread of infections, symptoms, hospitalization, and so on. This paper addresses the issue of vaccine diffusion and strategies for monitoring the pandemic. It provides a description of the importance and take up of vaccines and the links between procedures and the containment of COVID-19 variants, as well as the long-term effects. Finally, the paper focuses on the global scenario in a world undergoing profound social and political change, with particular attention on current and future health provision. This contribution would represent an example of vaccination experiences, which can be useful in other pandemic or epidemiological contexts.

Factors associated with COVID-19 vaccination hesitancy in South Korea: A cross-sectional study

Vaccination against COVID-19 has been promoted as a way to protect oneself and others from infection. To ensure the comprehensive acceptance of COVID-19 vaccines, the factors that affect COVID-19 vaccination hesitancy should be examined. This study aimed to identify the factors that affect COVID-19 vaccination hesitancy among Korean adults, focusing on COVID-19 knowledge and attitudes toward vaccination. This was a cross-sectional study conducted with 2286 Korean adults aged 20-64 years. Demographic characteristics, knowledge regarding COVID-19, and attitudes toward vaccination were assessed. A generalized linear model with Poisson regression was used to identify factors associated with COVID-19 vaccination hesitancy. Approximately 67% of the COVID-19 knowledge-related questions were correctly answered. A neutral attitude toward vaccination and relatively low vaccination hesitancy were found. COVID-19 vaccination hesitancy was affected by individuals' attitudes toward vaccination, as well as their gender and age, but not by their knowledge. Interventions or policies considering gender and age could be helpful in reducing COVID-19 vaccination hesitancy. Strategies to disseminate more accurate and novel information related to the COVID-19 vaccines should be implemented.

Predictors and motives for mask-wearing behavior and vaccination intention

Containing a pandemic requires that individuals adhere to measures such as wearing face-masks and getting vaccinated. Therefore, identifying predictors and motives for both behaviors is of importance. Here, we study the decisions made by a cross-national sample in randomized hypothetical scenarios during the COVID-19 pandemic. Our results show that mask-wearing was predicted by empathic tendencies, germ aversion, and higher age, whilst belief in misinformation and presentation of an interaction partner as a family member lowered the safety standards. The main motives associated with taking the mask off included: rationalization, facilitating interaction, and comfort. Vaccination intention was positively predicted by empathy, and negatively predicted by belief in misinformation and higher costs of the vaccine. We found no effect of immunization status of the surrounding social group. The most common motive for vaccination was protection of oneself and others, whereas undecided and anti-vaccine groups reported doubts about the effectiveness and fear of side effects. Together, we identify social and psychological predictors and motives of mask-wearing behavior and vaccination intention. The results highlight the importance of social context for mask-wearing, easy access to vaccines, empathy, and trust in publicly distributed information.

Real-World Safety of COVID-19 mRNA Vaccines: A Systematic Review and Meta-Analysis

With the mass vaccination program for COVID-19 mRNA vaccines, there has been sufficient real-world study (RWS) on the topic to summarize their safety in the total population and in immunocompromised (IC) patients who were excluded from phase 3 clinical trials. We conducted a systematic review and meta-analysis to evaluate the safety of COVID-19 mRNA vaccines, with a total of 5,132,799 subjects from 122 articles. In the case of the total population vaccinated with first, second, and third doses, the pooled incidence of any adverse events (AEs) was 62.20%, 70.39%, and 58.60%; that of any local AEs was 52.03%, 47.99%, and 65.00%; that of any systemic AEs was 29.07%, 47.86%, and 32.71%. Among the immunocompromised patients, the pooled odds ratio of any AEs, any local AEs, and systemic AEs were slightly lower than or similar to those of the healthy controls at 0.60 (95% CI: 0.33-1.11), 0.19 (95% CI: 0.10-0.37), and 0.36 (95% CI: 0.25-0.54), with pooled incidences of 51.95%, 38.82%, and 31.00%, respectively. The spectrum of AEs associated with the vaccines was broad, but most AEs were transient, self-limiting, and mild to moderate. Moreover, younger adults, women, and people with prior SARS-CoV-2 infection were more likely to experience AEs.

Exploring epidemic voluntary vaccinating behavior based on information-driven decisions and benefit-cost analysis

A complex dynamic interplay exists between epidemic transmission and vaccination, which is significantly influenced by human behavioral responses. We construct a research framework combining both the function modeling of the cumulative global COVID-19 information and limited individuals' information processing capacity employing the Gompertz model for growing processes. Meanwhile, we built a function representing the decision to get vaccinated following benefit-cost analysis considered the choices made by people in each scenario have an influence from altruism, free-riding and immunity escaping capacity. Through the mean-field calculation analysis and using a fourth-order Runge-Kutta method with constant step size, we obtain plots from numerical simulations. We found that only when the total number of infectious individuals proves sufficient to reach and exceed a certain level will the individuals face a better trade-off in determining whether to get vaccinated against the diseases based on that information. Besides, authoritative media have a higher decisive influence and efforts should be focused on extending the duration of vaccine protection, which is beneficial to inhibit the outbreaks of epidemics. Our work elucidates that reducing the negative payoff brought about by the free-riding behavior for individuals or improving the positive payoff from the altruistic motivation helps to control the disease in cultures that value social benefits, vaccination willingness is generally stronger. We also note that at a high risk of infection, the decision of vaccination is highly correlated with global epidemic information concerning COVID-19 infection, while at times of lower risk, it depends on the game theoretic vaccine strategy. The findings demonstrate that improving health literacy, ensuring open and transparent information on vaccine safety and efficacy as a public health priority can be an effective strategy for mitigating inequalities in health education, as well as alleviating the phenomenon that immunity escaping abilities is more likely to panic by populations with high levels of education. In addition, prosocial nudges are great ways to bridge these immunity gaps that can contribute to implementing government public health control measures, creating a positive feedback loop.

COVID-19 vaccine hesitancy, vaccination, and mental health: A national study among U.S. parents

The COVID-19 pandemic led to increased mental health concerns among parents. Emerging studies have shown links between COVID-19 vaccine hesitancy and psychological distress, including among parents. The primary aim of this study was to extend these emerging findings by examining the role of COVID-19 vaccine hesitancy in mental health functioning in a national sample of U.S. parents, accounting for the effects of COVID-19 vaccination status and underlying medical conditions increasing COVID-19 risk. A nationally representative sample of U.S. parents (N = 796) completed a cross-sectional survey between February-April 2021, including measures of depressive, anxiety, and COVID-19 acute stress symptoms; COVID-19 vaccination status; underlying medical conditions increasing COVID-19 risk; and COVID-19 vaccine hesitancy. The sample consisted of 51.8% fathers, Mage=38.87 years, 60.3% Non-Hispanic white, 18.1% Hispanic/Latinx, 13.2% Non-Hispanic Black/African American, 5.7% Asian, and 2.8% Other Race. Hierarchical regression models adjusted for demographic covariates revealed that greater COVID-19 vaccination hesitancy and presence of an underlying medical condition were consistently associated with higher levels of depressive, anxiety, and COVID-19 acute stress symptoms among parents. Having had at least one COVID-19 vaccination dose was associated with greater levels of COVID-19 acute stress, but was not associated with depressive or anxiety symptoms. Results add new evidence from the U.S. in support of the link between COVID-19 vaccine hesitancy and psychological distress, point to the potential utility of behavioral health care workers in helping reduce vaccine hesitancy, and provide tentative data suggesting that COVID-19 vaccination for parents alone may not have provided mental health relief.

Audience segmentation analysis of public intentions to get a COVID-19 vaccine in Australia

While previous studies provide broad categories of the public who intend to get a COVID-19 vaccine, few systematically segment and help understand and engage with distinct publics to improve COVID-19 vaccine uptake. Using data from a national sample of the Australian public (N = 1054) and using measures primarily based on the Theory of Planned Behaviour, a latent class analysis of 16 items was undertaken to identify COVID-19 audience segments for potential future message targeting. We found five different segments of COVID-19 vaccine intentions: vaccine enthusiasts (28%), supporters (26%), socials (20%), hesitant (15%) and sceptics (10%). These five audience segments also differ on demographic variables and their level of trust in mainstream media, scientists and health experts, social media and family and friends. Understanding the COVID-19 vaccine attitudinal and information-seeking characteristics of these sub-publics will help inform appropriate messaging campaigns.

Drivers of COVID-19 Vaccine Intent Among Survivors of Adolescent and Young Adult Cancer: a Mixed Method Study

BACKGROUND

Survivors of adolescent and young adult (AYA) cancer are susceptible to severe COVID-19 outcomes due to their cancer history. Drivers of COVID-19 vaccine hesitancy and willingness are largely unexplored among AYA cancer survivors.

METHODS

We surveyed survivors of AYA cancer from October 2020-February 2021 who received services through an AYA cancer care program. Survey measures included vaccine hesitancy on a five-point Likert scale and an open-ended question on vaccine intent. Open-ended responses were content analyzed through two cycles of structured coding. Quantitative vaccine intent and qualitative drivers of intent were integrated during data analysis.

RESULTS

Of participants who responded to the open-ended vaccine intent question (N = 300), 39.0% reported COVID-19 vaccine hesitancy. Qualitative content analysis resulted in N = 517 codes and seven content categories. The most common content category associated with hesitancy included COVID-19 vaccine development, approval, and efficacy (34.5%; p value ≤ 0.001), as well as content areas including presence of misinformation about COVID-19 in the response (4.8%; p value = 0.04), the desire for more information about COVID-19/COVID-19 vaccine (6.0%; p value ≤ 0.001), and reference to political influence on participants' intent to get the vaccine (2.5%; p value = 0.005). The most common category associated with vaccine willingness was personal perceptions of COVID-19 vaccination including protecting oneself and others (36.6% of codes; p value ≤ 0.001), followed by pro-vaccine beliefs (8.3%; p value ≤ 0.001) and trust in science (3.9%; p value ≤ 0.001).

CONCLUSIONS

Common drivers of COVID-19 vaccine hesitancy among survivors of AYA cancer include concern about vaccine side effects and approval process, and misinformation. Cancer survivors COVID-19 vaccine uptake could be improved by focusing communication on drivers of willingness, motivational interviewing, and physician recommendations.

Exploring the Perceptions of Nurses on Receiving the SARS CoV-2 Vaccine in Palestine: A Qualitative Study

BACKGROUND

Uncertainty about vaccination among nurses are major barriers to managing the ongoing COVID-19 pandemic worldwide.

PURPOSE

To explore nurseś perceptions about receiving the SARS CoV-2 vaccine to inform the upcoming Palestinian Ministry of Health (MOH) vaccination efforts.

METHODS

Four focus groups were conducted with nurses between January 18 and 30, 2021, before MOH launched vaccinations in Palestine. Participants working in government and private facilities were invited to participate and completed an online or paper form to provide demographics, review the study purpose, and give consent. Meetings were facilitated in Arabic either online via the Zoom platform or face-to-face using the same interview guide. Transcripts were translated into English and coded using a template analysis approach.

RESULTS

Forty-six nurses, with a median age of 29.5y (range, 22-57) from across Palestine participated. Three major themes emerged: uncertainty, trust, and the knowledge needed to move forward. Uncertainty related to the evolving nature of COVID-19, the rapidity of vaccine development, the types and timing of available vaccines. The need for trusted experts to share scientific information about the vaccines to counteract the misinformation in social media. Moreover, reliable vaccine information may help vaccine-hesitant nurses move to vaccine-acceptors and to convince others, including their patients.

CONCLUSION

The negative perception of nurses towards vaccines is problematic in Palestine and uncertainty about which vaccine(s) will be available adds to the lack of education and mass-media misinformation. Other countries with vaccination efforts that are not wholly planned or implemented and may be struggling with similar concerns.

Comparison of Immunogenicity and Reactogenicity of Five Primary Series of COVID-19 Vaccine Regimens against Circulating SARS-CoV-2 Variants of Concern among Healthy Thai Populations

To compare immunogenicity and reactogenicity of five COVID-19 vaccine regimens against wild-type SARS-CoV-2 and variants of concern (VoCs) among Thai populations, a prospective cohort study was conducted among healthy participants aged ≥18 years who had never been infected with COVID-19 and were scheduled to get one of the five primary series of COVID-19 vaccine regimens, including CoronaVac/CoronaVac, AZD1222/AZD1222, CoronaVac/AZD1222, AZD1222/BNT162b2, and BNT162b2/BNT162b2. Anti-receptor binding domain (anti-RBD-WT) IgG and neutralizing antibody (NAb-WT) against wild-type SARS-CoV-2 were measured at pre-prime, post-prime, and post-boost visits. NAb against VoCs (NAb-Alpha, NAb-Beta, NAb-Delta, and NAb-Omicron) were assessed at the post-boost visit. Adverse events (AEs) following vaccination were recorded. A total of 901 participants (CoronaVac/CoronaVac: 332, AZD1222/AZD1222: 221, CoronaVac/AZD1222: 110, AZD1222/BNT162b2: 128, and BNT162b2/BNT162b2: 110) were enrolled. Anti-RBD-WT IgG and NAb-WT levels increased substantially after each vaccine dose. At the post-boost visit, BNT162b2/BNT162b2 induced the highest GMC of anti-RBD-WT IgG level (1698 BAU/mL), whereas AZD1222/BNT162b2 induced the highest median NAb-WT level (99% inhibition). NAb levels against VoCs, particularly the Omicron strain, were markedly attenuated for all vaccine regimens (p < 0.001). Overall, no serious AEs following vaccination were observed. All five primary series of COVID-19 vaccine regimens were well-tolerated and elicited robust antibody responses against wild-type SARS-CoV-2 but had attenuated responses against VoCs, particularly the Omicron strain, among healthy Thai populations.

Vaccinated Yet Booster-Hesitant: Perspectives from Boosted, Non-Boosted, and Unvaccinated Individuals

Though available for all age groups in the US, only about half of those vaccinated have obtained a COVID-19 booster. Similar to the unvaccinated, those vaccinated-but-not-boosted may reduce the effectiveness of widespread viral protection. Booster hesitancy differs from general vaccine hesitancy yet remains less researched. We examined booster perceptions across vaccination status using qualitative methodologies. Four focus groups and 11 individual interviews (total n = 32) revealed nuanced changes and differences compared to the first-dose decision. Booster hesitancy stemmed from questions and surprises. Most vaccinated participants accepted the booster, though to varying degrees: enthusiastically with feelings of appreciation and added confidence, passively as an intuitive next step, indifferently following recommendation—“primed” by the yearly flu shot, and reluctantly with worries. The vaccinated-but-not-boosted group expressed confusion about the need for a new shot and discontentment as to why it was not communicated from the start, which coincided with their uncertainty about ending the pandemic. Inadvertently, booster recommendations further polarized non-vaccinated participants, augmenting their skepticism of the original dosages’ efficacy or necessity and intensifying their distrust of the government. The findings illuminate the need for adjusting vaccination promotions to better tailor communications (e.g., distinguishing its benefits from the first vaccine and emphasizing the continued risk of COVID-19 spread). Future researchers should further explore the vaccine-accepting-yet-booster-hesitant groups’ motivations and risk perceptions to reduce booster rejection.

Exploring the impact of motivations on individual online and offline preventive actions against COVID-19

Having accurate and sufficient information about the outbreak and actively adopting preventive actions are important to reduce the adverse effects of COVID-19 and control the spread of the epidemic. To this end, grounded in the situational theory of problem solving (STOPS) and self-concern and other-orientation theory, this study aims to examine motivations of individuals to adopt online and offline preventive actions during the COVID-19 pandemic. We explored the effects of three motivations, i.e., situational motivation, concern-for-self and concern-for-others motivation, and their antecedents on individual online and offline preventive actions. We used PLS-SEM to analyze the results of 628 questionnaires and found that: first, individual online preventive actions have a positive predictive effect on offline actions; secondly, individual online preventive actions are positively affected by situational motivation and concern-for-others motivation, and individual offline preventive actions are positively affected by concern-for-self and concern-for-others motivation; finally, three situational perceptual factors including problem, involvement and constraint recognition have significant effects on the three motivations. The findings of this study enriched the research results on individual behaviors in the context of COVID-19, and provided a basis for making decisions on the guidance and management of the individuals' COVID-19 preventive actions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04283-z.

A Retrospective Evaluation of Self-Reported Adverse Events Following Immunization with Different COVID-19 Vaccines in Türkiye

BACKGROUND

The Sinovac and BioNTech vaccines were the first to be introduced in Türkiye to fight the ongoing global COVID-19 pandemic. As these vaccines had shown some side-effects in its clinical trial, we aimed to conduct a survey study to assess the short-term adverse events following immunization (AEFIs) in Türkiye.

METHOD

A cross-sectional study was conducted using social and electronic media platforms by delivering a pre-formed and validated online questionnaire among people who had received at least one dose of the COVID-19 vaccine. This survey study focused on mass populations from different regions in Türkiye. A total of 603 responses were collected. Among these, 602 were selected based on complete answers and used for the assessment. The collected data were then analyzed to evaluate the various parameters related to the AEFIs of the respondents.

RESULTS

Among the total 602 participants, 20.8% were male, and 78.7% were female, actively answering all of the constructive questions. Most of the respondents were between 18-30 years of age. We found that a total of 23.3% of the total respondents had been infected with the SARS-CoV-2 virus. Our survey revealed that out of 602 volunteers, the rate of experiencing physical discomfort was higher in participants who had received the Pfizer-BioNTech vaccine at all three doses than in those who had received the Sinovac vaccine. When all vaccine types were examined, the most common side effect was pain at the injection site, reported by 75.19% participants. When the side effects were compared according to vaccine types, there was a significant difference only in terms of fever. Fever rates in those who had received the Pfizer-BioNTech vaccine (20.96%) were found to be significantly higher than those who had received the Sinovac vaccine (8%).

CONCLUSIONS

The studied vaccines showed minor side effects and there was no significant difference between the vaccines in terms of other side effects. Moreover, further research is needed to determine the efficacy of the existing vaccines in preventing SARS-CoV-2 infections or after-infection hospitalization.

Knowledge, attitude, and practices of front line health workers after receiving a COVID-19 vaccine: a cross-sectional study in Pakistan

Background

Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine.

Methods

A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant.

Results

Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination.

Conclusion

The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population.

COVID-19 and pregnancy: clinical outcomes; mechanisms, and vaccine efficacy

As the COVID-19 pandemic continues into its third year, emerging data indicates increased risks associated with SARS-CoV-2 infection during pregnancy, including pre-eclampsia, intrauterine growth restriction, preterm birth, stillbirth, and risk of developmental defects in neonates. Here, we review clinical reports to date that address different COVID-19 pregnancy complications. We also document placental pathologies induced by SARS-CoV-2 infection, entry mechanisms in placental cells, and immune responses at the maternal-fetal interface. Since new variants of SARS-CoV-2 are emerging with characteristics of higher transmissibility and more effective immune escape strategies, we also briefly highlight the genomic and proteomic features of SARS-CoV-2 investigated to date. Vector and mRNA-based COVID-19 vaccines continue to be rolled out globally. However, because pregnant individuals were not included in the vaccine clinical trials, some pregnant individuals have safety concerns and are hesitant to take these vaccines. We describe the recent studies that have addressed the effectiveness and safety of the current vaccines during pregnancy. This review also sheds light on important areas that need to be carefully or more fully considered with respect to understanding SARS-CoV-2 disease mechanisms of concern during pregnancy.

COVID-19 Testing and Vaccine Willingness: Cross-Sectional Survey in a Culturally Diverse Community in Sydney, Australia

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.

An exploration on COVID-19 vaccination motivation patterns from the perspective of the Chaxu culture in metropolis of China: A multi-center study

Objectives

Chaxugeju is a very special Chinese culture following a self-centered and outward expanding social network, which might be a significant culture factor for vaccination behavior. This study aimed to identify the motivation pattern in China, and paid special focus on socio-economic status (SES), region, and migration.

Methods

We used a latent class analysis, with a sample of 12,432 participants collected in China from April to June, to identify the COVID-19 vaccination motivation patterns. Multinomial logistic regression models were utilized to separately explore associations between SES, migration, region, and COVID-19 vaccination motivation patterns.

Results

Three COVID-19 vaccination motivation patterns were identified: Self-protection (41.9%), Trust and Self-protection (38.5%), and Trust and Differential Protection (19.6%). Participants with higher income were more likely to be Trust and Self-protection, and when income is more than 50,000 CNY per month, they are more likely to be self-protection. Professional/white collar were more likely to be Self-protection. Participants from Shenzhen were more likely to be Trust and Differential protection. The moderating effects of gender were found for income and region. Gender does not moderate the associations of occupation or migration and COVID-19 vaccination motivation patterns.

Conclusion

Three motivational patterns were identified in which the Trust & Differential Pattern followed the traditional self-family-community Chaxu circle. However, the Chaxu motivation pattern was not the dominant one which might be weakened by SES. Migration and Shenzhen preserved the traditional social network, keeping in the trust and differential pattern. All of these factors in various cultural contexts should be considered when promoting vaccines.

Perceived COVID-19 vaccine attributes associated with early adoption among adults in rural Indiana

2019 Novel coronavirus (COVID-19) vaccination rates in the United States have plateaued in specific populations, including rural areas. To improve COVID-19 vaccination rates and to encourage early vaccine uptake in future pandemics, this study aimed to examine vaccine attributes associated with early adoption. Data are from an anonymous online survey of adults using targeted Facebook pages of rural southern Indiana towns in January and February 2021 (n = 286). The diffusion of innovation theory states that the rate of adoption of a product in a specific population is explained by five perceived attributes: relative advantage, compatibility, observability, complexity and trialability. Binary logistic regression analyses were used to examine the association of Diffusion of Innovation theory attributes of the COVID-19 vaccine on early adoption. Results indicated that trialability [odds ratio (OR) = 3.307; 95% confidence interval (CI) = 1.964-5.571; P < 0.001], relative advantage (OR = 2.890; 95% CI = 1.789-4.667; P < 0.001) and compatibility (OR = 2.606; 95% CI = 1.476-4.601; P < 0.001) showed significant independent associations with early adoption. Furthermore, age and political ideology were significant moderators of complexity and relative advantage, respectfully. Health education strategies for early vaccine uptake should focus on building trust in vaccine safety, increasing short-term benefits of vaccination and promoting relatability to personal values.

The BioExperience Research and Entrepreneurship Challenge: An iGEM-inspired applied research program for BIOSTEM talent and skills development

Post-secondary education is falling behind in delivering the talent and skills development needed to support the growth of biology-based economies and the demands of professional and research-based graduate degree programs. Here, we describe an applied research program, the BioExperience Research and Entrepreneurship Challenge, launched in May 2020 to mitigate the impact of the COVID-19 pandemic on undergraduate experiential learning programs at the University of Ottawa, Ontario, Canada. The program provided undergraduates with meaningful talent and skills development opportunities by implementing a student-centred, project-based learning approach inspired by the International Genetically Engineered Machine (iGEM) competition. We present evidence from participant exit surveys suggesting that the program delivers a high-quality learning environment and improves learning outcomes compared to traditional work-integrated learning. Notably, 84% of respondents reported an excellent or exceptional learning experience and significant or profound improvements in skills, such as leadership (72% of respondents), problem-solving (42% of respondents) and research preparedness (52%) that are difficult to develop in conventional academic programs. Remarkably, 60% of respondents report that the job-readiness training provided by the program is better or much better than traditional work-integrated learning. Our study demonstrates that a cost-effective and scalable alternative to the iGEM competition can improve talent and skills development in BIOSTEM fields.

Stroke and TIA Survivors' Perceptions of the COVID-19 Vaccine and Influences on Its Uptake: Cross Sectional Survey

BACKGROUND

People who have experienced a stroke or transient ischaemic attack (TIA) have greater risks of complications from COVID-19. Therefore, vaccine uptake in this vulnerable population is important. To prevent vaccine hesitancy and maximise compliance, we need to better understand individuals' views on the vaccine.

OBJECTIVES

We aimed to explore perspectives of the COVID-19 vaccine and influences on its uptake from people who have experienced a stroke or TIA.

METHOD

A cross-sectional, electronic survey comprising multiple choice and free text questions. Convenience sampling was used to recruit people who have experienced a stroke/TIA in the UK/Ireland.

RESULTS

The survey was completed by 377 stroke/TIA survivors. 87% (328/377) had either received the first vaccine dose or were booked to have it. The vaccine was declined by 2% (7/377) and 3% (11/377) had been offered the vaccine but not yet taken it up. 8% (30/377) had not been offered the vaccine despite being eligible. Some people expressed concerns around the safety of the vaccine (particularly risk of blood clots and stroke) and some were hesitant to have the second vaccine. Societal and personal benefits were motivations for vaccine uptake. There was uncertainty and lack of information about risk of COVID-19 related complications specifically for people who have experienced a stroke or TIA.

CONCLUSION

Despite high uptake of the first vaccine, some people with stroke and TIA have legitimate concerns and information needs that should be addressed. Our findings can be used to identify targets for behaviour change to improve vaccine uptake specific to stroke/TIA patients.

What message appeal and messenger are most persuasive for COVID-19 vaccine uptake: Results from a 5-country survey in India, Indonesia, Kenya, Nigeria, and Ukraine

Effective strategies to encourage COVID-19 vaccination should consider how health communication can be tailored to specific contexts. Our study aimed to evaluate the influence of three specific messaging appeals from two kinds of messengers on COVID-19 vaccine acceptance in diverse countries. We surveyed 953 online participants in five countries (India, Indonesia, Kenya, Nigeria, and Ukraine). We assessed participants’ perceptions of three messaging appeals of vaccination—COVID-19 disease health outcomes, social norms related to COVID-19 vaccination, and economic impact of COVID-19—from two messengers, healthcare providers (HCP), and peers. We examined participants’ ad preference and vaccine hesitancy using multivariable multinomial logistic regression. Participants expressed a high level of approval for all the ads. The healthcare outcome–healthcare provider ad was most preferred among participants from India, Indonesia, Nigeria, and Ukraine. Participants in Kenya reported a preference for the health outcome–peer ad. The majority of participants in each country expressed high levels of vaccine hesitancy. However, in a final logistic regression model participant characteristics were not significantly related to vaccine hesitancy. These findings suggest that appeals related to health outcomes, economic benefit, and social norms are all acceptable to diverse general populations, while specific audience segments (i.e., mothers, younger adults, etc.) may have preferences for specific appeals over others. Tailored approaches, or approaches that are developed with the target audience’s concerns and preferences in mind, will be more effective than broad-based or mass appeals.

Impact of ventilation and avoidance measures on SARS-CoV-2 risk of infection in public indoor environments

BACKGROUND

The literature includes many studies which individually assess the efficacy of protective measures against the spread of the SARS-CoV-2 virus. This study considers the high infection risk in public buildings and models the quality of the indoor environment, related safety measures, and their efficacy in preventing the spread of the SARS-CoV-2 virus.

METHODS

Simulations are created that consider protective factors such as hand hygiene, face covering and engagement with Covid-19 vaccination programs in reducing the risk of infection in a university foyer. Furthermore, a computational fluid dynamics model is developed to simulate and analyse the university foyer under three ventilation regimes. The probability of transmission was measured across different scenarios.

FINDINGS

Estimates suggest that the Delta variant requires the air change rate to be increased >1000 times compared to the original strain, which is practically not feasible. Consequently, appropriate hygiene practices, such as wearing masks, are essential to reducing secondary infections. A comparison of different protective factors in simulations found the overall burden of infections resulting from indoor contact depends on (i) face mask adherence, (ii) quality of the ventilation system, and (iii) other hygiene practices.

INTERPRETATION

Relying on ventilation, whether natural, mechanical, or mixed, is not sufficient alone to mitigate the risk of aerosol infections. This is due to the internal configuration of the indoor space in terms of (i) size and number of windows, their location and opening frequency, as well as the position of the air extraction and supply inlets, which often induce hotspots with stagnating air, (ii) the excessive required air change rate. Hence, strict reliance on proper hygiene practices, namely adherence to face coverings and hand sanitising, are essential. Consequently, face mask adherence should be emphasized and promoted by policymakers for public health applications. Similar research may need to be conducted using a similar approach on the Omicron (B.1.1.529) variant.

Association of food habit with the COVID-19 severity and hospitalization: A cross-sectional study among the recovered individuals in Bangladesh

Background: It was assumed that dietary habits might influence the status of COVID-19 patients. Aim: We aimed at the identification of association of dietary habits with the COVID-19 severity and hospitalization. Methods: It was a retrospective cross-sectional study (n = 1025). We used bivariate and multivariate analyses to correlate the association between self-reported dietary patterns and COVID-19 severity and hospitalization. Results: Dietary habits (black tea, milked tea, pickles, black caraway seeds, honey, fish, fruits, vegetables, garlic, onion and turmeric) were identified with lower risk of COVID-19 severity and hospitalization. Interestingly, the consumption frequency (one-, two- or three-times/day) of rice - the staple food in Bangladesh - was not associated with COVID-19 severity and hospitalization for comorbid patients. In contrast, a moderate rice-eating habit (two times/day) was strongly associated with the lower risk of severity and hospitalization for non-comorbid patients. However, for both comorbid and non-comorbid patients, consumption of black tea, milked tea, pickles and honey were associated with a lower likelihood of severity and hospitalization. Overall, a high consumption (three-times/day) of fish, fruits and vegetables, a moderate consumption of garlic, onion and turmeric spices and a daily intake of black/milked tea, and honey were associated with reduced risk of COVID-19 severity and hospitalization. Conclusions: To reduce the severity of COVID-19, a habitual practice of intaking black tea, milked tea, black caraway seeds and honey along with dietary habit (rice, fish and vegetables) and with a moderate consumption of ginger, garlic, onion, mixed aromatic spices (cinnamon + cardamom + cloves) and turmeric might be suggested.

Considering epitopes conservity in targeting SARS-CoV-2 mutations in variants: a novel immunoinformatics approach to vaccine design

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has gained mutations at an alarming rate in the past years. Developing mutations can increase the virus's pathogenicity and virulence; reduce the efficacy of vaccines, antibodies neutralization, and even challenge adaptive immunity. So, it is essential to identify conserved epitopes (with fewer mutations) in different variants with appropriate antigenicity to target the variants by an appropriate vaccine design. Yet as, 3369 SARS-CoV-2 genomes were collected from global initiative on sharing avian flu data. Then, mutations in the immunodominant regions (IDRs), immune epitope database (IEDB) epitopes, and also predicted epitopes were calculated. In the following, epitopes conservity score against the total number of events (mutations) and the number of mutated sites in each epitope was weighted by Shannon entropy and then calculated by the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). Based on the TOPSIS conservity score and antigenicity score, the epitopes were plotted. The result demonstrates that almost all epitopes and IDRs with various lengths have gained different numbers of mutations in dissimilar sites. Herein, our two-step calculation for conservity recommends only 8 IDRs, 14 IEDB epitopes, and 10 predicted epitopes among all epitopes. The selected ones have higher conservity and higher immunogenicity. This method is an open-source multi-criteria decision-making platform, which provides a scientific approach to selecting epitopes with appropriate conservity and immunogenicity; against ever-changing viruses.

Communicating about COVID-19 vaccine development and safety

Purpose

Beliefs that the risks from a COVID-19 vaccine outweigh the risks from getting COVID-19 and concerns that the vaccine development process was rushed and lacking rigor have been identified as important drivers of hesitancy and refusal to get a COVID-19 vaccine. We tested whether messages designed to address these beliefs and concerns might promote intentions to get a COVID-19 vaccine.

Method

We conducted an online survey fielded between March 8–23, 2021 with US Veteran (n = 688) and non-Veteran (n = 387) respondents. In a between-subjects experiment, respondents were randomly assigned to a control group (with no message) or to read one of two intervention messages: 1. a fact-box styled message comparing the risks of getting COVID-19 compared to the vaccine, and 2. a timeline styled message describing the development process of the COVID-19 mRNA vaccines.

Results

Most respondents (60%) wanted a COVID-19 vaccine. However, 17% expressed hesitancy and 23% did not want to get a COVID-19 vaccine. The fact-box styled message and the timeline message did not significantly improve vaccination intentions, F(2,358) = 0.86, p = .425, ηP2 = .005, or reduce the time respondents wanted to wait before getting vaccinated, F(2,306) = 0.79, p = .453, ηP2 = .005, compared to no messages.

Discussion

In this experimental study, we did not find that providing messages about vaccine risks and the development process had an impact on respondents’ vaccine intentions. Further research is needed to identify how to effectively address concerns about the risks associated with COVID-19 vaccines and the development process and to understand additional factors that influence vaccine intentions.

COVID-19 vaccine uptake among physicians during the second wave of COVID-19 pandemic: Attitude, intentions, and determinants: A cross-sectional study

Background

Developed within a short period of time, the COVID-19 vaccine is not yet widely accepted among the public despite its availability, including by physicians, who are considered a vulnerable group.

Methodology

A descriptive cross-sectional study selected 436 governmental physicians from different specializations, representing four random administrative regions in Egypt. The data were collected through a self-administrated online questionnaire and analyzed using suitable tests.

Results

Out of the studied 436 physicians, 229 (52.2%) [aged 20-30, 284 (65.1%)] were women, 270 (61.9%) were residents, 219 (50.2%) were married, 398 (91.3%) were non-smokers, and 263 (60.3%) were non-frontline caregivers. The majority of the physicians, 227 (52.1%) of them, hesitated to take the vaccine, 236 (54.1%) had not decided on the preferred type of vaccine, and 101 (23.2%) were neutrally confident in the Egyptian healthcare system; 302 (96.3%) had no history of drug or food hypersensitivity. There was no statistically significant (p < 0.05) relationship between the physicians' attitude toward COVID-19 vaccine uptake and the studied demographic variables. There was a statistically significant connection between all of the doctors' intentions to get the COVID-19 vaccine and all of the four attitude domains that were looked at.

Conclusion

The study concluded that a low level of willingness among Egyptian physicians to take the COVID-19 vaccine is a prevalent problem. COVID-19 vaccination hesitancy and non-acceptance were linked to negative attitudes about natural immunity, mistrust of vaccine benefits, and concerns about commercial profiteering.

Drivers of Routine and Outbreak Vaccination Uptake in the Western Democratic Republic of Congo: An Exploratory Study in Ten Health Zones

We performed a cross-sectional survey on vaccination-related knowledge, attitudes, and practices (KAP) among randomly selected parents of <5 years-old children, elderly populations (aged ≥ 55 years), and health care workers (HCWs) in 10 health zones from 4 provinces of the Democratic Republic of Congo (DRC). Questionnaires targeted both routine (BCG, measles, polio) and outbreak-related (cholera, Ebola, COVID-19) vaccinations. In total, 2751 participants were included, 1165 parents, 1040 elderly, and 546 HCWs. In general, KAP expressed were supportive of vaccination uptake, although concerns regarding side effects and feelings of being insufficiently informed were more prevalent among parents and the elderly. Vaccine acceptance was lower for outbreak vaccinations (57%) than for routine vaccinations (90%). HCWs expressed the highest vaccine acceptance. Problems with the vaccine supply chain were reported by 20% of respondents. Despite a high level of positive KAP towards vaccination, parents and the elderly expressed a need to be better informed and had concerns regarding vaccine side-effects. A high acceptance for routine vaccinations was reported by participants, but somewhat less for outbreak vaccinations. In conclusion, HCWs in the communities could play a key role in the increased uptake of routine vaccinations and in optimizing uptake during outbreaks, provided that the supply chain is functioning well.

The effect of health literacy on COVID-19 vaccine hesitancy among community population in China: The moderating role of stress

Background

The public’s hesitant attitude is a major subjective barrier in promoting vaccination against COVID-19 to build herd immunity. The current study aimed to address how individual factors such as health literacy and perceived stress affect people’s vaccine hesitancy of COVID-19 vaccine, and to provide insights for tailoring vaccine-promotion strategies.

Methods

With structured questionnaires, an online survey was conducted to address the relationship between the health literacy, perceived stress, and COVID-19 vaccine hesitancy among community population in mainland, China. Moderated analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of perceived stress.

Results

560 responses were collected in total. 39.8% of the participants reported vaccine hesitancy, and this rate was higher among younger people and female. Moreover, people with higher level of health literacy showed reduced vaccine hesitancy, while this effect was only significant among those with low or moderate level of stress. For people with high level of stress, no significant effect of health literacy was found.

Conclusions

The findings suggest that increasing people’s health literacy could lead to reduced vaccine hesitancy in community sample. However, this effect disappeared when the stress level was high, suggesting other promotion services may need to be developed to increase the acceptance of COVID-19 vaccine. In conclusion, vaccine promotion strategies should be tailored for different populations, with taking account of individual’s health literacy and perceived stress.

COVID-19 Vaccine Misperceptions in a Community Sample of Adults Aged 18-49 Years in Australia

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.

Understanding the societal factors of vaccine acceptance and hesitancy: evidence from Hong Kong

OBJECTIVES

Vaccination is considered to be an important public health strategy for controlling the COVID-19 pandemic. Besides subjective evaluations of the vaccine and the health threat, societal factors have been seen as crucial to vaccination decisions. Based on a socioecological perspective, this study examines the role of societal factors in COVID-19 vaccine hesitancy in Hong Kong.

STUDY DESIGN AND METHOD

An online survey was fielded between 25 and 28 June 2021, collecting 2753 complete responses. Multinomial logistic regression was conducted to examine how subjective evaluations of the vaccine (summarised by the 5C model - Confidence, Collective responsibility, Constraints, Complacency and Calculation), threat perception, interpersonal influences and institutional trust contribute to explaining three types of decision - acceptant (vaccinated, scheduled or indicated 'Yes'), hesitant (unvaccinated and indicated 'Maybe' on intention) and resistant (unvaccinated and indicated 'No').

RESULTS

A total of 43.2%, 21.7% and 35.1% of respondents were acceptant, hesitant and resistant. Although the 5C model remained useful in explaining vaccination decisions, respondents were heavily influenced by the decisions of their family, although they were less influenced by friends. Second, respondents tended to accept the vaccine when they had a weaker perception that the act is supportive of the government and were less resistant if they had stronger institutional trust.

CONCLUSION

Under the low-incidence and low-trust environment such as Hong Kong, vaccination decisions are heavily influenced by family's decision and the perception of vaccination as socially and politically desirable. Our findings highlight the importance of a nuanced conception of interpersonal and political influence towards vaccine acceptance/hesitancy.

Assessment of Dietary and Lifestyle Responses After COVID-19 Vaccine Availability in Selected Arab Countries

Background

The COVID-19 pandemic has been consistently associated with unhealthy lifestyle behaviors and dietary practices. This study aimed to assess the dietary and lifestyle behaviors of adults after COVID-19 vaccine availability and their attitude toward the vaccine in selected Arab countries.

Methods

A cross-sectional survey-based study was conducted between October 2021 and December 2021 using Google Forms (n = 2259). A multi-component questionnaire was used to collect socio-demographic characteristics, attitudes toward the COVID-19 vaccine, and behavioral, dietary, and lifestyle responses after easing the restriction. Participants were given a score based on the sum of positive dietary and lifestyle changes. The generalized linear models were used to identify the association between positive dietary and lifestyle changes score and sociodemographic characteristics.

Results

Weight gain during the pandemic was reported by 39.5% of the participants, 36.1% reported ever getting infected with the COVID-19 virus, and 85% received at least one dose of the vaccine. The key adverse reactions of the COVID-19 vaccine were fatigue, headache, and joint pain, and the main reason for vaccination was protection against infection. Most participants were concerned about the vaccine side effects (45.8%) and inadequate testing (50.7%). After easing of restriction, 54.3% of the participants reduced the frequency of disinfecting objects, and 58.3% joined social events. Most dietary and lifestyle behaviors remained unchanged after vaccine availability but there was an increase in the time spent behind the screen for work (50.1%) and entertainment (42.9%). The results of the multivariate regression analyses revealed that older participants (p = 0.001), those with higher education (p = 0.010), and those working from home (p = 0.040) were more likely to have higher positive dietary and lifestyle changes scores.

Conclusion

Although most participants were concerned about vaccine safety, low vaccine hesitancy rates were observed among the study sample. The availability of the COVID-19 vaccines resulted in loosening some of the safety social measures among Arab adults but the negative impact of the pandemic on dietary and lifestyle behaviors remained unaltered.

Perceived public health threat a key factor for willingness to get the COVID-19 vaccine in Australia

BACKGROUND

Vaccination rollout against COVID-19 is underway across multiple countries worldwide. Although the vaccine is free, rollout might still be compromised by hesitancy or concerns about COVID-19 vaccines.

METHODS

We conducted two online surveys of Australian adults in April (during national lockdown; convenience cross-sectional sample) and November (very few cases of COVID-19; nationally representative sample) 2020, prior to vaccine rollout. We asked about intentions to have a potential COVID-19 vaccine (If a COVID-19 vaccine becomes available, I will get it) and free-text responses (November only).

RESULTS

After adjustment for differences in sample demographics, the estimated proportion agreeing to a COVID-19 vaccine if it became available in April (n = 1146) was 76.3%. In November (n = 1941) this was estimated at 71.5% of the sample; additional analyses identified that the variation was driven by differences in perceived public health threat between April and November. Across both surveys, female gender, being younger, having inadequate health literacy and lower education were associated with reluctance to be vaccinated against COVID-19. Lower perceived susceptibility to COVID-19, belief that data on the efficacy of vaccines is 'largely made up', having lower confidence in government, and lower perception of COVID-19 as a public health threat, were also associated with reluctance to be vaccinated against COVID-19. The top three reasons for agreeing to vaccinate (November only) were to protect myself and others, moral responsibility, and having no reason not to get it. For those who were indifferent or disagreeing to vaccinate, safety concerns were the top reason, followed by indecision and lack of trust in the vaccine respectively.

CONCLUSIONS

These findings highlight some factors related to willingness to accept a COVID-19 vaccine prior to one being available in Australia. Now that the vaccine is being offered, this study identifies key issues that can inform public health messaging to address vaccine hesitancy.

The Importance of Vaccination in the Context of the COVID-19 Pandemic: A Brief Update Regarding the Use of Vaccines

The COVID-19 pandemic has led the world to undertake the largest vaccination campaign in human history. In record time, unprecedented scientific and governmental efforts have resulted in the acquisition of immunizers utilizing different technologies (nucleotide acids, viral vectors, inactivated and protein-based vaccines). Currently, 33 vaccines have already been approved by regulatory agencies in different countries, and more than 10 billion doses have been administered worldwide. Despite the undeniable impact of vaccination on the control of the pandemic, the recurrent emergence of new variants of interest has raised new challenges. The recent viral mutations precede new outbreaks that rapidly spread at global proportions. In addition, reducing protective efficacy rates have been observed among the main authorized vaccines. Besides these issues, several other crucial issues for the appropriate combatting of the pandemic remain uncertain or under investigation. Particularly noteworthy issues include the use of vaccine-boosting strategies to increase protection; concerns related to the long-term safety of vaccines, child immunization reliability and uncommon adverse events; the persistence of the virus in society; and the transition from a pandemic to an endemic state. In this review, we describe the updated scenario regarding SARS-CoV-2 variants and COVID-19 vaccines. In addition, we outline current discussions covering COVID-19 vaccine safety and efficacy, and the future pandemic perspectives.

Communications to Promote Interest and Confidence in COVID-19 Vaccines

PURPOSE

Communicating about COVID-19 vaccine side effects and efficacy is crucial for promoting transparency and informed decision-making, but there is limited evidence on how to do so effectively.

DESIGN

A within-subjects experiment.

SETTING

Online survey from January 21 to February 6, 2021.

SUBJECTS

596 US Veterans and 447 non-Veterans.

INTERVENTION

5 messages about COVID-19 vaccine side effects and 4 messages about COVID-19 vaccine efficacy.

MEASURES

COVID-19 vaccine interest (1 = "I definitely do NOT want the vaccine" to 7 = "I definitely WANT the vaccine" with the midpoint 4 = "Unsure"). Confidence about COVID-19 vaccine efficacy (1= "Not at all confident," 2 = "Slightly confident," 3 = "Somewhat confident," 4 = "Moderately confident," 5 = "Extremely confident").

RESULTS

Compared to providing information about side effects alone (M = 5.62 [1.87]), messages with additional information on the benefits of vaccination (M = 5.77 [1.82], P < .001, d_z = .25), reframing the likelihood of side effects (M = 5.74 [1.84], P < .001, d_z = .23), and emphasizing that post-vaccine symptoms indicate the vaccine is working (M = 5.72 [1.84], P < .001, d_z = .17) increased vaccine interest. Compared to a vaccine efficacy message containing verbal uncertainty and an efficacy range (M = 3.97 [1.25]), messages conveying verbal certainty with an efficacy range (M = 4.00 [1.24], P = .042, d_z=.08), verbal uncertainty focused on the upper efficacy limit (M = 4.03 [1.26], P < .001, d_z = .13), and communicating the point estimate with certainty (M = 4.02 [1.25], P < .001, d_z = .11) increased confidence. Overall, Veteran respondents were more interested (M_Veterans = 5.87 [1.72] vs M_NonVeterans = 5.45 [2.00], P < .001, d = .22) and confident (M_Veterans = 4.13 [1.19] vs M_NonVeterans = 3.84 [1.32], P < .001, d = .23) about COVID-19 vaccines than non-Veterans.

CONCLUSIONS

These strategies can be implemented in large-scale communications (e.g., webpages, social media, and leaflets/posters) and can help guide healthcare professionals when discussing vaccinations in clinics to promote interest and confidence in COVID-19 vaccines.

The Effect of Message Framing on COVID-19 Vaccination Intentions among the Younger Age Population Groups: Results from an Experimental Study in the Italian Context

The coronavirus pandemic has been recognized as a major threat to public health. Widespread acceptance of COVID-19 vaccines is crucial for achieving adequate immunization coverage to end the global pandemic. However, to date, there are still hesitant people, especially among the younger population groups. For this reason, it is essential to identify the psychological variables that may affect vaccination intention among these “at risk groups” and to select possible successful communication frames in order to increase vaccination rates. An online cross-sectional survey was carried out on 208 Italian citizens younger than 50 years old, to explore message framing effects on their intention to receive the vaccination and to understand the psychological factors influencing it. Results showed that depending on the goal (stimulate vaccination intention, vaccination trust, or vaccine attitude), not all the communication stimuli are equally effective on this target population. Furthermore, the study showed that sociodemographic variables do not help to explain the vaccination intention of the younger population groups, while the psychological variables have been found to have a stronger impact on such attitude. Trust and attitudes towards vaccines, concern about the pandemic and concern about infecting others have been found to be the most effective predictive variables of people vaccination intention. The study results underline the importance of understanding the psychological roots behind vaccine hesitancy to shape sensitization actions and vaccination campaigns targeting this population group.

COVID-19 vaccination perceptions and attitudes among Egyptian medical students

Background:

This study aimed to assess perceptions and attitudes toward COVID-19 vaccines among medical students.

Methods:

A consecutive convenient sample of 2100 university students representing the student’s union network were included using an electronic self-administered questionnaire. About 12 items were used to assess attitudes and acceptance of COVID-19 vaccines.

Results:

A total of 2100 volunteers responded to the survey. All ages ranged from 18 to 25 years, 69% were females, and 57.3% were from urban residences. According to their willingness to receive the COVID-19 vaccine, 49.7% accepted, 38.5% hesitated, and 11.8% refused vaccination. Out of 60 scales measuring their attitudes, a median total score of 46.0 (42.0–49.0) differed significantly in relation to genders, residence, and vaccine decision-making groups. Logistic regression analysis showed that participants who consented that COVID-19 mass vaccination could prevent the spread of infection in the community and stop the pandemic have 1.9 higher odds of accepting vaccination ( p = 0.003). Additionally, the participants who believed that the vaccine had no severe infection or side effects were 3.1 and 2.8 higher folds for vaccine acceptance, respectively ( p = 0.001). Moreover, participants who thought it was not too early for clinical trials were 4.3 times more likely to take the vaccine ( p = 0.001). Individuals who agreed that information about vaccine side effects better to discuss openly with the authorities were 2.8 times more likely to accept vaccination than other hesitating/ refusing groups, p-value < 0.001.

Conclusions:

Understanding students’ perspectives of the COVID-19 vaccine and supporting their health engagement and awareness may help plan an adequate response.

Covid 19 vaccination: Accessibility or literacy? Israel as a case study

Israel is ranked as the leading country in terms of prevalence of vaccination against SARS-COV-2 virus (persons vaccinated divided by total population). Based on updated data as of January 19, 2021, the objective of the current study is to assess the relationship between the prevalence of vaccination and population density. A-priori, given the better infrastructure of health services (more physicians and nurses per 1000 persons), one would anticipate a higher level of vaccination in denser cities. Surprisingly, the outcomes demonstrate an opposite relationship: a lower level in the per capita level of vaccination with higher population densities from 0.2144 for 2 persons per sq. Km. to a minimum of 0.007191 for 16,642 persons per sq. Km. Given the relatively good accessibility to vaccination centers and high spread of clinics and health centers in Israel, research findings thus stress the major importance of promoting the benefits of vaccination (vaccination literacy) to diversified populations.

Physicians' attitudes and acceptance regarding COVID-19 vaccines: a cross-sectional study in mid Delta region of Egypt

Safe and effective vaccines became an important preventive tool against novel corona virus disease infection. Physicians were prioritized for early vaccination since they are at higher risk for contagion of the infection and they might affect the general populations' uptake of the vaccine. This study aimed to examine the acceptability of COVID-19 vaccines and the underpinnings of reluctance to uptake the vaccine among working physicians in Egypt. A cross-sectional study was conducted for 3 months, recruiting 1268 physicians using a snowballing random sampling technique. A self-administered electronic questionnaire was deployed to collect related data. Of participants, 24% expressed their acceptance towards COVID-19 vaccines, 39% would wait for further review, while 36.7% did not agree to get vaccinated. Findings revealed that 22% of them were vaccinated and the significant determinants of unacceptability included age, gender, higher educational attainments, prior infection, lack of direct patients' contact, and working in rural health facilities (p < 0.05). The most common reasons beyond their reluctance were fear of the vaccines' adverse effects and the short duration of its clinical trials (60% and 49.5%). Physicians had a low intention to receive COVID-19 vaccines particularly between females, senior staff, and those who had a low self-perceived risk for the infection. Integrated approaches should be designed to address concerns and factors associated with vaccine unacceptability to reduce vaccination reluctance between physicians, hence the general population.

COVID-19 Vaccination Coverage, Behaviors, and Intentions among Adults with Previous Diagnosis, United States

To determine the extent of gaps in coronavirus disease (COVID-19) vaccine coverage among those in the United States with and without previous COVID-19 diagnoses, we used July 21–August 2, 2021, data from a large, nationally representative survey (Household Pulse Survey). We analyzed vaccine receipt (≥1 dose and full vaccination) and intention to be vaccinated for 63,266 persons. Vaccination receipt was lower among those who had a prior diagnosis of COVID-19 compared to those without: >1 dose: 73% and 85%, respectively, p<0.001; full vaccination: 69% and 82%, respectively, p<0.001). Reluctance to be vaccinated was higher among those with a previous COVID-19 diagnosis (14%) than among those without (9%). These findings suggest the need to focus educational and confidence-building interventions on adults when they receive a COVID-19 diagnosis, during clinic visits, or at the time of discharge if hospitalized and to better educate the public about the value of being vaccinated, regardless of previous COVID-19 status.

Knowledge, attitude and practice survey towards COVID-19 vaccination: A mediation analysis

BACKGROUND AND AIM

The COVID-19 pandemic has significantly impacted human lives across the world. In a country like India, with the second highest population in the world, impact of COVID-19 has been diverse and multidimensional. Under such circumstances, vaccination against COVID-19 infection is claimed to be one of the major solutions to contain the pandemic. Understanding of Knowledge, Attitude and Practice (KAP) measures are essential prerequisites to design suitable intervention programs. This paper examines the different KAP factors in Indians towards their decision of vaccine uptake.

METHOD

An online questionnaire was administered to Indian respondents. (Pilot study: n = 100, Main study: n = 221) to assess their existing knowledge on COVID-19 infections and vaccination, attitude and intentions towards COVID-19 vaccines and their decision towards COVID-19 vaccine uptake.

RESULT

The findings highlighted that existing knowledge on COVID-19 infections and vaccination directly impacted their attitude and intention towards vaccination. The attitude and intention towards COVID-19 vaccines directly impacted their practice of undergoing COVID-19 vaccination. Further, there was a statistically significant and considerably large indirect effect of existing knowledge on COVID-19 infections and vaccination on the practice of undergoing COVID-19 vaccination through attitude and intention towards the vaccine. There was no direct effect of Knowledge (existing knowledge on COVID-19 infections and vaccination) on Practice (decision to undergo COVID-19 vaccination). Therefore, Attitude and intention towards COVID-19 vaccine is the primary mediator between Knowledge (existing knowledge on COVID-19 infections and vaccination) and Practice (decision to undergo COVID-19 vaccination).

CONCLUSION

Participants decision towards COVID-19 vaccination decisions are strongly related to their attitude and intentions that confirms the strong role of attitude towards success of COVID-19 vaccination programme. Therefore, 'person-centric' attitude based positive intervention strategies that links their prior knowledge on COVID-19 infections and vaccination must be designed for greater vaccine acceptance amongst Indians.