Factors associated with the willingness and acceptance of SARS-CoV-2 vaccine from adult subjects in China

Caregiver's perceptions of COVID-19 vaccination, and intention to vaccinate their children against the disease: a questionnaire based qualitative study

Coronavirus disease 2019 (COVID-19) vaccine side effects have an important role in the hesitancy of the general population toward vaccine administration. Another reason for vaccine hesitancy might be that healthcare professionals may not address their concerns regarding vaccines appropriately. Regardless, hesitancy in the form of delay, refusal, or acceptance with doubts about its usefulness can limit the downward trajectory of the COVID-19 pandemic. Therefore, the authors conducted a national cross-sectional study (n=306) to assess causes and concerns for vaccine hesitancy in caregivers in Pakistan toward getting their children vaccinated. The questions identified caregivers by socioeconomic demographics, perceived COVID-19 pandemic severity, and concerns toward the COVID-19 vaccine. The majority of the participants were 45-59 years of age (42.8%) with a mean age of 36.11 years (SD: 7.81). A total of 80% of these participants were willing to vaccinate their child with any COVID-19 vaccine. Present comorbidities had a frequency of 28.4% (n=87/306) and only 26.9% (n=66/245) participants were willing to vaccinate their child. Participants with high social standing were 15.4% (n=47/306) with the majority of them being willing to vaccinate their children (45/47). Socioeconomic status (OR:2.911 [0.999-8.483]), and the child's vaccinations being up to date (OR:1.904 [1.078-3.365]) were found to be independent factors for caregivers to be willing to vaccinate their child. Around 62% (n=191/306) were not willing to vaccinate due to the concern for side effects, 67.6% (n=207/306) were not willing because they did not have ample information available, and 51% (n=156/306) were not willing as they were concerned about vaccine effectiveness. Further studies on vaccine safety in the pediatric population are required to improve caregivers' perceptions.

A social ecological approach to identify the barriers and facilitators to COVID-19 vaccination acceptance: A scoping review

BACKGROUND

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that has caused substantial impact on population health, healthcare, and social and economic systems around the world. Several vaccines have been developed to control the pandemic with varying effectiveness and safety profiles. One of the biggest obstacles to implementing successful vaccination programmes is vaccine hesitancy stemming from concerns about effectiveness and safety. This review aims to identify the factors influencing COVID-19 vaccine hesitancy and acceptance and to organize the factors using the social ecological framework.

METHODS

We adopted the five-stage methodological framework developed by Arksey and O'Malley to guide this scoping review. Selection criteria was based on the PICo (Population, Phenomenon of interest and Context) framework. Factors associated with acceptance and hesitancy were grouped into the following: intrapersonal, interpersonal, institutional, community, and public policy factors using the social ecological framework.

RESULTS

Fifty-one studies fulfilled this review's inclusion criteria. Most studies were conducted in Europe and North America, followed by Asia and the Middle East. COVID-19 vaccine acceptance and hesitancy rates varied across countries. Some common demographic factors associated with hesitancy were younger age, being female, having lower than college education, and having a lower income level. Most of the barriers and facilitators to acceptance of the COVID-19 vaccines were intrapersonal factors, such as personal characteristics and preferences, concerns with COVID-19 vaccines, history/perception of general vaccination, and knowledge of COVID-19 and health. The remaining interpersonal, institution, community, and public policy factors were grouped into factors identified as barriers and facilitators.

CONCLUSION

Our review identified barriers and facilitators of vaccine acceptance and hesitancy and organised them using the social ecological framework. While some barriers and facilitators such as vaccine safety are universal, differentiated barriers might exist for different target groups, which need to be understood if they are to be addressed to maximize vaccine acceptance.

Willingness to Receive a COVID-19 Vaccine and Associated Factors among Older Adults: A Cross-Sectional Survey in Shanghai, China

Background: Older individuals have a high risk of morbidity and mortality due to COVID-19, and one of the most effective ways to prevent COVID-19 is vaccination. Little is known about older people’s willingness to receive a COVID-19 vaccine. Therefore, the objective of this study was to assess the acceptance of and factors influencing the intention to receive a COVID-19 vaccination among older adults in Shanghai, China. Methods: A cross-sectional study was conducted among older adults (≥60 years old) in Shanghai. Face-to-face interviews with a questionnaire were conducted in community health service centers, recording several parameters: demographic information, health-related factors; perceived likelihood, severity, and burden of COVID-19; perceived safety, effectiveness, necessity, and benefit of the COVID-19 vaccine, as well as their trust in the vaccine delivery system and doctors; willingness to receive a COVID-19 vaccination. Bivariate analysis between several survey items and the willingness to receive a COVID-19 vaccination was conducted using a chi-square test. Logistic regression was used to assess to what degree each variable affected the willingness to receive a COVID-19 vaccination. Results: Of the 1067 participants, 90.91% (970/1067) confirmed that they were willing to receive a COVID-19 vaccination. The participants were more likely to be willing to be vaccinated if they were immigrants (OR = 1.988, 95%CI = 1.062−3.717), had an education level of junior high school (OR = 2.724, 95%CI = 1.000−7.423) or high school or above (OR = 3.993, 95%CI = 1.576−10.119), and had a monthly income of CNY 3000−5000 (OR = 32.770, 95%CI = 1.144−6.711) or CNY >5000 (OR = 2.309, 95%CI = 1.003−5.319). The participants were also more likely to be willing to be vaccinated if they had received a pneumonia vaccination previously (OR = 2.138, 95%CI = 1.016−4.500), perceived the safety of the COVID-19 vaccine (OR = 1.508, 95%CI = 1.073−2.119), perceived the necessity of the COVID-19 vaccine (OR = 2.604, 95%CI = 1.946−3.484), or trusted the suggestions of doctors (OR = 1.706, 95%CI = 1.115−2.618). The participants were less likely to be willing to be vaccinated if they were aged ≥76 years (OR = 0.498, 95%CI = 0.264−0.939), reported a physical health condition of bad or below (OR = 0.229, 95% CI = 0.095−0.549), or were worried about the adverse effects of a COVID-19 vaccination (OR = 0.503, 95%CI = 0.364−0.695). Conclusions: Under the free vaccination policy for COVID-19, older adults have a high intention to be vaccinated to prevent COVID-19 in Shanghai, China. Widely publicizing the safety and necessity of COVID-19 vaccination is necessary.

Why Vaccinate Against COVID-19? A Population-Based Survey in Switzerland

Objectives: This study examined factors associated with COVID-19 vaccination intention at the very beginning of the vaccination campaign in a representative sample of the population in southern Switzerland.

Methods: In March 2021, we measured vaccination intention, beliefs, attitudes, and trust in a sample of the Corona Immunitas Ticino study.

Results: Of the 2681 participants, 1933 completed the questionnaire (response rate = 72%; 55% female; meanage = 41, SD = 24, rangeage = 5–91). Overall, 68% reported an intention to get vaccinated. Vaccination intention was higher in social/healthcare workers, and increased with age, trust in public health institutions, and confidence in the vaccine efficacy. Prior infection of a family member, predilection for waiting for more evidence on the safety and efficacy of the vaccine, and for alternative protective means were negatively associated with intention.

Conclusion: In view of needs of COVID-19 vaccine boosters and of suboptimal vaccination coverage, our results have relevant public health implications and suggest that communication about vaccine safety and efficacy, and aims of vaccination programs, should be bi-directional, proportionate, and tailored to the concerns, expectations, and beliefs of different population subgroups.

Attitude for vaccination prophylaxis among pregnant women: a cross-sectional study

Pregnant women and newborns are considered a subgroup of population at increased risk for several infectious diseases, some of which are vaccine-preventable. Anti-diphtheria-tetanus-pertussis vaccine (dTpa) and influenza vaccine are recommended for pregnant women. We carried out a study to evaluate the knowledge of new mothers toward the main vaccine-preventable diseases and to assess their compliance with recommended vaccinations. Using the Hospital Discharge Forms (SDO), the list of women who gave birth in 2018 was generated. Women were interviewed by a questionnaire administered by telephone. The study sample consisted of 145 subjects, with an average age of 35.0 ± 5.9 years (range = 18.0–47.0). 5/145 (3.4%; 95% CI = 1.1–7.9%) subjects were advised during pregnancy to have the flu shot; only 1/145 (0.7%; 95% CI = 0.5–71.6%) reported the flu vaccine during the last pregnancy. 94/145 (64.8%; 95% CI = 57.2–73.2%) respondents declared that they had carried out the TORCH panel exams before pregnancy; of these 18/94 (19.2%; 95% C = 11.8–28.6%) were susceptible for rubella. Of these subjects, for 7/18 (38.9%; 95% CI = 17.3–64.3%) rubella vaccination was offered and 5/7 (71.4%; 95% CI = 29.0–96.3%) decided to carry out the vaccination. Only 1/145 (0.7%; 95% CI = 0.0–3.8%) of the interviewed woman underwent anti-dTap vaccination. Greater efforts must be made by public health institutions to raise awareness and improve vaccination compliance in this population.

Sickness presenteeism associated with influenza-like illness in veterinarians working in New South Wales: Results of a state-wide survey

BACKGROUND

Sickness presenteeism in the veterinary profession potentially jeopardises the wellbeing of veterinary team members and endangers quality of patient care. In veterinary team members with influenza-like illness (ILI), sickness presenteeism poses a risk to the health and wellbeing of colleagues and clients, particularly in the context of the COVID-19 pandemic. This study aimed to evaluate factors associated with sickness presenteeism in NSW registered veterinarians suffering from ILI, both before and since the beginning of the COVID-19 pandemic.

METHODS

Veterinarians registered in NSW were invited to complete an anonymous online mixed-methods survey between 31 March 2021 and 31 June 2021, regarding sickness presenteeism and absenteeism associated with ILI. The questionnaire was distributed through online and print newsletters of the Australian Veterinary Association NSW Branch and the NSW Veterinary Practitioners Board.

RESULTS

From a total of 122 participants, 81 veterinarians (66.4%) reported that they would attend work despite displaying symptoms of ILI. Most veterinarians would stay at home with a fever alone (n = 108, 88.5%), however, many would still attend work with a sore throat (n = 121, 99.2%) or a dry cough (n = 91, 74.6%). Sickness presenteeism was significantly associated with lack of staff to cover workers. Although sickness presenteeism remained common, participants reported that they were less likely to attend work with symptoms of ILI since the beginning of the COVID-19 pandemic.

DISCUSSION

The data are discussed in relation to sickness presenteeism in healthcare workers. These findings underscore an urgent need for relief staff to decrease sickness presenteeism.

Impact of the COVID-19 Lockdown on Quality of Life in Pregnant Women

Background

The COVID-19 pandemic has been associated with significant impacts on mental health and well-being of populations worldwide. However, little is known about its significant impact on psychological aspects of vulnerable population groups such as pregnant women. Therefore, the aim of the study was to determine the psychological impact of the COVID-19 pandemic among pregnant women in mainland China.

Methods

A cross-sectional survey was performed between July and August 2020 using a modified validated 40-item questionnaire which consisted of sociodemographics, attitude, lifestyle changes and the Impact of Event Scale (IES) toward COVID-19 using snowball and convenience samplings.

Results

A total of 1,078 participants were included in the study. The mean age of participants was 29.4 ± 4.0 years. Overall, the mean IES of participants was 30.6 ± 12.8 (i.e., moderate-to-severe stressful impact) amidst the COVID-19 pandemic, with 63.9% of participants had an IES score ≥26. Despite increased family and social support, more than half of participants also reported increased feeling of being horrified, apprehensive and helpless.

Conclusions

The COVID-19 pandemic has several psychological impacts on pregnant women. Therefore, based on these valuable data of pregnant women collected, we recommend that a thoughtful planning and time preparation by the government would definitely help to reduce the negative impacts caused by the COVID-19 pandemic and restore the quality of life among pregnant women. Further research is needed to identify vulnerable groups including pregnant women to better adapt and inform mental health interventions and policies by health authorities.

Systematic Review and Meta-Analysis of COVID-19 Vaccination Acceptance

INTRODUCTION

Vaccination is an essential intervention to curb the coronavirus disease 2019 (COVID-19) pandemic. This review aimed to estimate the pooled proportion of COVID-19 vaccine acceptance worldwide.

METHODS

A systematic search of the MEDLINE (PubMed) database using "COVID-19," "vaccine" and "acceptance" to obtain original research articles published between 2020 and July 2021. Only studies with full text and that were published in English were included. The Joanna Briggs Institute meta-analysis was used to assess the data quality. The meta-analysis was performed using generic inverse variance with a random-effects model using the Review Manager software.

RESULTS

A total of 172 studies across 50 countries worldwide were included. Subgroup analyses were performed with regard to vaccine acceptance, regions, population, gender, vaccine effectiveness, and survey time. The pooled proportion of COVID-19 vaccine acceptance was 61% (95% CI: 59, 64). It was higher in Southeast Asia, among healthcare workers, in males, for vaccines with 95% effectiveness, and during the first survey.

CONCLUSION

COVID-19 vaccine acceptance needs to be increased to achieve herd immunity to protect the population from the disease. It is crucial to enhance public awareness of COVID-19 vaccination and improve access to vaccines.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2021, identifier CRD42021268645.

The Uptake and Vaccination Willingness of COVID-19 Vaccine among Chinese Residents: Web-Based Online Cross-Sectional Study

Objective: To investigate the uptake and vaccination willingness of the COVID-19 vaccine among Chinese residents and analyze the difference and factors that impact vaccination. Methods: The snowball sampling method was used to distribute online questionnaires. Relevant sociodemographic data along with the circumstances of COVID-19 vaccination were collected from the respondents. The χ² test, independent samples t test and binary logistic regression analysis were used to analyze the data. Results: Among 786 respondents, 84.22% had been vaccinated. Over 80% of the vaccinated population have completed all the injections because of supporting the national vaccination policies of China, while the unvaccinated population (23.91%) is mainly due to personal health status. Meanwhile, statistical analysis revealed that the main predictors of not being vaccinated were younger age (3 to 18 years old), personal health status, and lower vaccinated proportion of family members and close friends (p < 0.05). Conclusions: There was a high level of uptake of the COVID-19 vaccine in China, and people who have not been vaccinated generally had a low willingness to vaccinate in the future. Based on our results, it suggested the next work to expand the coverage of the COVID-19 vaccination should be concentrated on targeted publicity and education for people who have not been vaccinated.

Acceptance of SARS-CoV-2 vaccines by liver transplant recipients and candidates

Guidelines recommend vaccination against SARS-CoV-2 in transplant recipients, candidates, and their household contacts. However, little is known about the acceptance of COVID-19 vaccines in these groups.In March 2021, we surveyed 826 liver transplant recipients, candidates, and their household contacts to determine acceptance rates and factors influencing the acceptance of the COVID-19 vaccine; 341 patients (40%) and 237 household contacts (28%) returned the questionnaire. Ninety percent of patients returning the survey reported they were willing to receive the vaccine within the next 6 months or had already started vaccination. Only 2% of patients and 4% of household contacts reported refusing the vaccine, and 8% of patients and 9% of household contacts wanted to postpone vaccination because of concerns about side effects. Having received the influenza vaccine in the last 2 seasons was the strongest indicator of acceptance to receive the SARS-CoV-2 vaccine within 6 months (odds ratio 5.11; 95% confidence interval 2.43-10.74; p < 0.001). Thirty-two percent of responding patients reported fear of side effects as a reason for having refused vaccination before.Although the acceptance of the SARS-CoV-2 vaccine was particularly high among German liver transplant recipients, candidates, and household contacts in this survey, transplant physicians are encouraged to discuss safety concerns with patients who have refused the seasonal influenza vaccine in the past.