1
|
Wehling H, Weston D, Hall C, Mills F, Amlôt R, Dennis A, Forbes L, Armes J, Mohamed M, Buckley S, Dar OA, Mohamed A, Wurie F, Shafi S, Zumla SA, Ala A. Use of UK faith Centre as a COVID-19 community vaccination clinic: exploring a potential model for community-based health care delivery. Postgrad Med J 2024:qgae028. [PMID: 38702294 DOI: 10.1093/postmj/qgae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/29/2023] [Indexed: 05/06/2024]
Abstract
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.
Collapse
Affiliation(s)
- Helena Wehling
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Dale Weston
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Charlotte Hall
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Freya Mills
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Richard Amlôt
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Amelia Dennis
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Lindsay Forbes
- Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, United Kingdom
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford GU2 7YH, United Kingdom
| | - Munira Mohamed
- Sheerwater Health Centre, Woking, Surrey GU21 5QJ, United Kingdom
| | - Seema Buckley
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7YH, United Kingdom
| | - Osman A Dar
- Chatham House, Royal Institute of International Affairs, London SW1Y 4LE, United Kingdom
- Global Operations, UK Health Security Agency, London E14 4PH United Kingdom
| | - Amran Mohamed
- Department of Access and Medicine, Royal Surrey NHS FT, Guildford GU2 7XX, United Kingdom
| | - Fatima Wurie
- National Inclusion Health Division, Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, United Kingdom
- Department of Health and Social Care, London SW1H 0EU, United Kingdom
- Public Health Advice Guidance and Expertise Function, UK Health Security Agency, London E14 4PH, United Kingdom
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, London HA4 7AE, United Kingdom
| | - Sir Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, WC1E 6BT, United Kingdom
| | - Aftab Ala
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7YH, United Kingdom
- Department of Access and Medicine, Royal Surrey NHS FT, Guildford GU2 7XX, United Kingdom
- Instititute of Liver Studies, King's College Hospital NHS Foundation, London SE5 9RS, United Kingdom
| |
Collapse
|
2
|
Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following receipt of influenza and COVID-19 vaccination among healthcare workers. medRxiv 2024:2024.01.17.24301440. [PMID: 38318206 PMCID: PMC10843156 DOI: 10.1101/2024.01.17.24301440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Introduction Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. We sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. Methods This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination (DPV) for bivalent COVID-19 and Influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. Results Females were more likely to report local AEs after influenza (OR=2.28, p=0.001) or COVID-19 (OR=2.57, p=0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after influenza (OR=1.18, p=0.552) or COVID-19 (OR=0.96, p=0.907) vaccination. Exogenous hormones from birth control use did not impact the rates of reported AEs following COVID-19 vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. Conclusions Our findings highlight the need for sex- and gender-inclusive policies to inform more effective occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers and to more fully characterize the post-vaccination behavioral differences between men and women. KEY MESSAGE What is already known on this topic: ⇒ Among diversely aged adults 18-64 years, females report more AEs to vaccines, including the influenza and COVID-19 vaccines, than males.⇒ Vaccine AEs play a role in shaping vaccine hesitancy and uptake.⇒ Vaccine uptake related to influenza and COVID-19 are higher among men than women.⇒ Research that addresses both the sex and gender disparities of vaccine outcomes and behaviors is lacking.What this study adds: ⇒ This prospective active reporting study uses both quantitative and qualitative survey data to examine sex and gender differences in AEs following influenza or COVID-19 vaccination among a cohort of reproductive-aged healthcare workers.How this study might affect research, practice, or policy: ⇒ Sex and gender differences in AEs and perceptions relating to vaccination should drive the development of more equitable and effective vaccine strategies and policies in occupational health settings.
Collapse
|
3
|
Liepins T, Davie G, Miller R, Whitehead J, De Graaf B, Clay L, Crengle S, Nixon G. Rural-urban variation in COVID-19 vaccination uptake in Aotearoa New Zealand: Examining the national roll-out. Epidemiol Infect 2024; 152:e7. [PMID: 38174436 PMCID: PMC10789992 DOI: 10.1017/s0950268823001978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/02/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
This study aimed to understand rural-urban differences in the uptake of COVID-19 vaccinations during the peak period of the national vaccination roll-out in Aotearoa New Zealand (NZ). Using a linked national dataset of health service users aged 12+ years and COVID-19 immunization records, age-standardized rates of vaccination uptake were calculated at fortnightly intervals, between June and December 2021, by rurality, ethnicity, and region. Rate ratios were calculated for each rurality category with the most urban areas (U1) used as the reference. Overall, rural vaccination rates lagged behind urban rates, despite early rapid rural uptake. By December 2021, a rural-urban gradient developed, with age-standardized coverage for R3 areas (most rural) at 77%, R2 81%, R1 83%, U2 85%, and U1 (most urban) 89%. Age-based assessments illustrate the rural-urban vaccination uptake gap was widest for those aged 12-44 years, with older people (65+) having broadly consistent levels of uptake regardless of rurality. Variations from national trends are observable by ethnicity. Early in the roll-out, Indigenous Māori residing in R3 areas had a higher uptake than Māori in U1, and Pacific peoples in R1 had a higher uptake than those in U1. The extent of differences in rural-urban vaccine uptake also varied by region.
Collapse
Affiliation(s)
- Talis Liepins
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Gabrielle Davie
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Rory Miller
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Jesse Whitehead
- Te Ngira Institute for Population Research, University of Waikato, Hamilton, New Zealand
| | - Brandon De Graaf
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Lynne Clay
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | - Garry Nixon
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| |
Collapse
|
4
|
Brown J, Xia C, Tazelaar H, Crow J, Telionis A, Anson-Dwamena R, Landen M. COVID-19 Case, Death, and Vaccination Rate Disparities by Race and Ethnicity in Virginia. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01856-3. [PMID: 38012433 DOI: 10.1007/s40615-023-01856-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/18/2023] [Accepted: 10/29/2023] [Indexed: 11/29/2023]
Abstract
This paper tracks trends in COVID-19 case, death, and vaccination rate disparities by race and ethnicity in Virginia during the COVID-19 pandemic. COVID-19 case, death, and vaccination rates were obtained from electronic state health department records from March 2020 to February 2022. Rate ratios were then utilized to quantify racial and ethnic disparities for several time periods during the pandemic. The Hispanic population had the highest COVID-19 case and age-adjusted death rates, and the lowest vaccination rates at the beginning of the pandemic in Virginia. These disparities resolved later in the pandemic. COVID-19 case and death rates among the Black population were also higher than those of the White population and these disparities remained throughout the pandemic. Racial and ethnic disparities changed over time in Virginia as vaccination coverage and public health policies evolved. Year 2 of the analysis saw lower case and death rates, and higher vaccination rates for non-White populations in Virginia. Public health strategies need to be addressed during the pandemic and developed before the next pandemic to ensure that large racial and ethnic disparities are not again present at the outset.
Collapse
Affiliation(s)
- Juwairiyah Brown
- Office of Health Equity, Virginia Department of Health, Richmond, VA, USA.
| | - Chenyang Xia
- Office of Health Equity, Virginia Department of Health, Richmond, VA, USA
| | - Helen Tazelaar
- Office of Information Management, Virginia Department of Health, Richmond, VA, USA
| | - Justin Crow
- Office of Emergency Preparedness, Virginia Department of Health, Richmond, VA, USA
| | - Alex Telionis
- Office of Emergency Preparedness, Virginia Department of Health, Richmond, VA, USA
| | | | - Michael Landen
- Office of Epidemiology, Virginia Department of Health, Richmond, VA, USA
| |
Collapse
|
5
|
Aggarwal M, Katz A, Kokorelias KM, Wong ST, Aghajafari F, Ivers NM, Martin-Misener R, Aubrey-Bassler K, Breton M, Upshur REG, Kwong JC. What are effective vaccine distribution approaches for equity-deserving and high-risk populations during COVID-19? Exploring best practices and recommendations in Canada: protocol for a mixed-methods multiple case codesign study. BMJ Open 2023; 13:e072238. [PMID: 37940159 PMCID: PMC10632871 DOI: 10.1136/bmjopen-2023-072238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION The WHO has stated that vaccine hesitancy is a serious threat to overcoming COVID-19. Vaccine hesitancy among underserved and at-risk communities is an ongoing challenge in Canada. Public confidence in vaccine safety and effectiveness and the principles of equity need to be considered in vaccine distribution. In Canada, governments of each province or territory manage their own healthcare system, providing an opportunity to compare and contrast distribution strategies. The overarching objective of this study is to identify effective vaccine distribution approaches and advance knowledge on how to design and implement various strategies to meet the different needs of underserved communities. METHODS AND ANALYSIS Multiple case studies in seven Canadian provinces will be conducted using a mixed-methods design. The study will be informed by Experience-Based CoDesign techniques and theoretically guided by the Socio-Ecological Model and the Vaccine Hesitancy Matrix frameworks. Phase 1 will involve a policy document review to systematically explore the vaccine distribution strategy over time in each jurisdiction. This will inform the second phase, which will involve (2a) semistructured, in-depth interviews with policymakers, public health officials, researchers, providers, groups representing patients, researchers and stakeholders and (2b) an analysis of population-based administrative health data of vaccine administration. Integration of qualitative and quantitative data will inform the identification of effective vaccine distribution approaches for various populations. Informed by this evidence, phase 3 of the study will involve conducting focus groups with multiple stakeholders to codesign recommendations for the design and implementation of effective vaccine delivery strategies for equity-deserving and at-risk populations. ETHICS AND DISSEMINATION This study is approved by the University of Toronto's Health Sciences Research Ethics Board (#42643), University of British Columbia Behavioural Research Ethics Board (#H22-01750-A002), Research Ethics Board of the Nova Scotia Health Authority (#48272), Newfoundland and Labrador Health Research Ethics Board (#2022.126), Conjoint Health Research Ethics Board, University of Calgary (REB22-0207), and University of Manitoba Health Research Board (H2022-239). The outcome of this study will be to produce a series of recommendations for implementing future vaccine distribution approaches from the perspective of various stakeholders, including equity-deserving and at-risk populations.
Collapse
Affiliation(s)
- Monica Aggarwal
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alan Katz
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Family Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristina Marie Kokorelias
- Rehabiliation Sciences Institute, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabiliation Sciences Institute, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Sabrina T Wong
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Noah M Ivers
- Department of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Kris Aubrey-Bassler
- Primary Healthcare Research Unit, Memorial University, St. John's, Newfoundland, Canada
| | - Mylaine Breton
- Department of Community Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada
| | - Ross E G Upshur
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Eger WH, Suttiratana SC, Herbst RL, Behringer H, Ibrahim E, Jones BA. Disparities in COVID-19 vaccine hesitancy among a diverse community-based sample in Connecticut, United States. Prev Med Rep 2023; 34:102263. [PMID: 37252068 PMCID: PMC10207837 DOI: 10.1016/j.pmedr.2023.102263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 05/09/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023] Open
Abstract
Though vaccination is among our strongest tools to prevent COVID-19 infections, its delivery has proven challenging. At a time when COVID-19 cases were rapidly increasing in the Northeast, we examined the role of sociodemographic factors, social determinants of health (SDOH), and health-related beliefs, including conspiracy theories, in influencing COVID-19 vaccine hesitancy among a diverse sample of Connecticut (United States) residents. Between August and December 2020, utilizing community partners and advertisements via social media, we surveyed communities known to be most impacted by COVID-19. We used descriptive analysis and multivariable logistic regression to examine vaccine hesitancy. Among 252 participants, most were female (69.8%) and under the age of 55 (62.7%). Approximately one-third reported household incomes less than $30,000 per year and 23.5% were non-Hispanic Black and 17.5% were Hispanic/Latinx. While 38.9% of participants were vaccine hesitant, non-Hispanic Black and Hispanic/Latinx participants were more vaccine hesitant (adjusted odds ratio [AOR] = 3.62; 95% CI 1.77, 7.40) compared to non-Hispanic Whites/Others. Additional factors associated with vaccine hesitancy after adjustment for socioeconomic status and barriers related to SDOH included low perceived risk of COVID-19 and not receiving COVID-19 information from medical institutions and community health workers (p < 0.05). Race/ethnicity, perceived risk, sources of health information, and conspiracy beliefs played a significant role in vaccine hesitancy among this diverse sample. Interventions to promote vaccination should include trusted messengers and sources of information, while long term efforts should focus on addressing the social conditions that deter confidence in scientific data, vaccine efficacy, and the healthcare system.
Collapse
Affiliation(s)
- William H Eger
- San Diego State University, San Diego, CA, United States
- University of California San Diego, San Diego, CA, United States
- Yale School of Public Health, New Haven, CT, United States
| | - Sakinah C Suttiratana
- Yale School of Public Health, New Haven, CT, United States
- Yale School of Medicine, New Haven, CT, United States
| | - Roy L Herbst
- Yale School of Medicine, New Haven, CT, United States
| | | | - Eiman Ibrahim
- Yale School of Public Health, New Haven, CT, United States
- Yale School of Medicine, New Haven, CT, United States
| | - Beth A Jones
- Yale School of Public Health, New Haven, CT, United States
| |
Collapse
|
7
|
Tolley AJ, Scott VC, Mitsdarffer ML, Scaccia JP. The Moderating Effect of Vaccine Hesitancy on the Relationship between the COVID-19 Vaccine Coverage Index and Vaccine Coverage. Vaccines (Basel) 2023; 11:1231. [PMID: 37515046 PMCID: PMC10386611 DOI: 10.3390/vaccines11071231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
To examine COVID-19 vaccination barriers in the US, this study drew on publicly available county-level data (n = 3130) to investigate the impact of vaccine hesitancy on the relationship between county-level social/structural barriers and vaccine coverage. A hierarchical regression was performed to establish the relationship between the COVID-19 Vaccine Coverage Index (CVAC) and vaccine coverage, assess the moderating effect of vaccine hesitancy on this relationship, and explore the influence of ethno-racial composition on vaccine coverage. A significant, negative relationship (r2 = 0.11, f2 = 0.12) between CVAC and vaccine coverage by county was established (step 1). When vaccine hesitancy was introduced as a moderator (step 2), the model significantly explained additional variance in vaccine coverage (r2 = 0.21, f2 = 0.27). Simple slopes analysis indicated a significant interaction effect, whereby the CVAC-vaccine coverage relationship was stronger in low hesitancy counties as compared with high hesitancy counties. Counties with low social/structural barriers (CVAC) but high hesitancy were projected to have 14% lower vaccine coverage. When county-level ethno-racial composition was introduced (step 3), higher proportions of white residents in a county predicted decreased vaccination rates (p < 0.05). Findings indicate that CVAC should be paired with vaccine hesitancy measures to better predict vaccine uptake. Moreover, counties with higher proportions of white residents led to decreases in vaccine uptake, suggesting that future intervention strategies should also target whites to reach herd immunity. We conclude that public health leaders and practitioners should address both social/structural and psychological barriers to vaccination to maximize vaccine coverage, with a particular focus on vaccine hesitancy in communities with minimal social/structural barriers.
Collapse
Affiliation(s)
- Annalise Julia Tolley
- Department of Psychology, Health Psychology, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA
| | - Victoria C Scott
- Department of Psychology, Health Psychology, Faculty of Psychological Science and Public Health Science, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA
| | - Mary Louise Mitsdarffer
- Biden School of Public Policy & Administration, Research Faculty in the Center for Community Research and Service, University of Delaware, Newark, DE 19716, USA
| | - Jonathan P Scaccia
- Dawn Chorus Group, 342 N. Queen Street, Candy Factory Warehouse D, Lancaster, PA 17603, USA
| |
Collapse
|
8
|
Hashim A, Taha Y. The Role of Sudanese Doctors in the United Kingdom in Mitigating COVID-19 Vaccine Hesitancy Among Their Diaspora Communities. Glob Health Sci Pract 2023; 11:e2200447. [PMID: 37348947 DOI: 10.9745/ghsp-d-22-00447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/04/2023] [Indexed: 06/24/2023]
Abstract
People from ethnic minority groups are at risk of adverse sequelae of COVID-19, but their vaccine acceptance and enrollment rates remain suboptimal. Diaspora communities are unique in that they continue to engage in epistemic networks related to vaccination with dwellers in their country of origin. We describe the COVID-19 vaccine awareness campaign we conducted from January 2021 to November 2021 for Sudanese diaspora groups in the United Kingdom and the various techniques and methods used by health care professionals from the same ethnocultural background to address vaccine reluctance among this cohort. We explore the impact of our joint efforts with local authorities in Sudan to overcome the initial barriers to the national vaccination program in Sudan. The influence of the intercommunication between the diaspora and their relatives at home regarding COVID-19 vaccine misinformation is also discussed. Finally, we highlight these observations as key areas for future research to improve the global impact of vaccine deployment in pandemic situations.
Collapse
Affiliation(s)
- Ahmed Hashim
- Royal Free London NHS Foundation Trust, London, United Kingdom.
| | - Yusri Taha
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
9
|
Montiel Ishino FA, Villalobos K, Williams F. COVID-19 Vaccination Among US-Born and Non-US-Born Residents of the United States From a Nationally Distributed Survey: Cross-sectional Study. JMIR Form Res 2023; 7:e43672. [PMID: 37097810 PMCID: PMC10284035 DOI: 10.2196/43672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Extended literature has demonstrated that COVID-19 vaccination is crucial for the health of all individuals, regardless of age. Research on vaccination status in the United States (US) among US-born and non-US-born residents is limited. OBJECTIVE The objective of our study was to examine COVID-19 vaccination during the pandemic among US-born and non-US-born people, while accounting for sociodemographic and socioeconomic factors gathered through a nationally distributed survey. METHODS A descriptive analysis was conducted on a comprehensive 116-item survey distributed between May 2021 and January 2022 across the US by self-reported COVID-19 vaccination and US/non-US birth status. For participants that responded that they were not vaccinated, we asked if they were "not at all likely," "slightly to moderately likely," or "very to extremely likely" to be vaccinated. Race and ethnicity were categorized as White, Black or African American, Asian, American Indian or Alaskan Native, Hawaiian or Pacific Islander, African, Middle Eastern, and multiracial or multiethnic. Additional sociodemographic and socioeconomic variables included gender, sexual orientation, age group, annual household income, educational attainment, and employment status. RESULTS The majority of the sample, regardless of whether they were US-born or non-US-born, reported being vaccinated (3639/5404, 67.34%). The US-born participants with the highest proportion of COVID-19 vaccination self-identified as White (1431/2753, 51.98%), while the highest proportion of vaccination among non-US-born participants was found among participants who self-identified as Hispanic/Latino (310/886, 34.99%). Comparing US-born and non-US-born participants showed that among those who were not vaccinated, the highest self-reported sociodemographic characteristics by proportion were similar between the groups, and included identifying as a woman, being straight or heterosexual, being aged 18 to 35 years, having an annual household income <$25,000, and being unemployed or taking part in nontraditional work. Among the 32.66% (1765/5404) of participants that reported not being vaccinated, 45.16% (797/1765) stated that they were not at all likely to seek vaccination. Examining US/non-US birth status and the likelihood to be vaccinated for COVID-19 among nonvaccinated participants revealed that the highest proportions of both US-born and non-US-born participants reported being not at all likely to seek vaccination. Non-US-born participants, however, were almost proportionally distributed in their likelihood to seek vaccination; they reported to be "very to extremely likely" to vaccinate (112/356, 31.46%); compared to 19.45% (274/1409) of US-born individuals reporting the same. CONCLUSIONS Our study highlights the need to further explore factors that can increase the likelihood of seeking vaccination among underrepresented and hard-to-reach populations, with a particular focus on tailoring interventions for US-born individuals. For instance, non-US-born individuals were most likely to vaccinate when reporting COVID-19 nonvaccination than US-born individuals. These findings will aid in identifying points of intervention for vaccine hesitancy and promoting vaccine adoption during current and future pandemics.
Collapse
Affiliation(s)
| | - Kevin Villalobos
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, United States
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, United States
| |
Collapse
|
10
|
Sujarwoto S, Maharani A. Is knowledge about COVID-19 associated with willingness to receive vaccine, vaccine uptake, and vaccine booster uptake in rural Malang, Indonesia? Front Public Health 2023; 11:1203550. [PMID: 37351094 PMCID: PMC10282756 DOI: 10.3389/fpubh.2023.1203550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023] Open
Abstract
Background Lack of knowledge regarding the coronavirus disease (COVID-19) and COVID-19 vaccines is a key barrier to COVID-19 vaccine uptake in low- and middle-income countries (LMICs). Aims To examine factors associated with knowledge about COVID-19 and the association between knowledge of COVID-19, willingness to receive a COVID-19 vaccine, and vaccine uptake in Malang, East Java, Indonesia. Method A cross-sectional study among individuals aged 15-99 years was conducted in Malang, Java Timur, Indonesia between November 2022 and January 2023. Of 10,050 potential respondents, 10,007 were able to complete the survey. The main independent variable was knowledge about COVID-19, which was assessed using a six-item questionnaire. The dependent variables were COVID-19 vaccine uptake and COVID-19 booster vaccine uptake. The mediating variable was respondent's willingness to receive a COVID-19 vaccine. Linear regression was used to examine factors associated with knowledge about COVID-19. Logistic regression was employed to examine the association of knowledge about COVID-19 with vaccine uptake. Generalized structural equation modeling (GSEM) was performed to examine whether willingness to receive a vaccine mediated the association between knowledge about COVID-19 and vaccination uptake. Findings The percentage of respondents who reported having received at least one dose of a COVID-19 vaccine was 94.8%, while the percentage of those who reported having received at least three doses was 88.5%. These numbers are higher than the national average for COVID-19 vaccine and booster vaccine uptake. Most respondents answered about four of six knowledge items correctly (M = 4.60, SD = 1.1). Among respondents who had not received a vaccine, 83.1% expressed willingness to receive a vaccine when it became available to them. Older, more educated, employed respondents, and those with higher economic status, demonstrated more accurate knowledge about COVID-19 than younger, less educated, unemployed respondents and those with lower economic status. Respondents who demonstrated more accurate knowledge about COVID-19 were more likely to have received a vaccine (OR = 1.528, 95% CI = 1.428-1.634) and a booster vaccine (OR = 1.260, 95% CI = 1.196-1.328). Willingness to receive a vaccine mediated the association between knowledge about COVID-19 and vaccine uptake (coef. = 0.426, 95% CI = 0.379-0.473). Implications Interventions and public health programs aiming to improve knowledge about COVID-19 can be implemented to improve individual willingness to receive COVID-19 vaccination and to improve COVID-19 vaccine uptake among the general population.
Collapse
Affiliation(s)
- Sujarwoto Sujarwoto
- Department of Public Administration, Faculty of Administrative Science, Brawijaya University, Malang, Indonesia
| | - Asri Maharani
- Department of Nursing, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| |
Collapse
|
11
|
Lillebråten A, Todd M, Dimka J, Bakkeli NZ, Mamelund SE. Socioeconomic status and disparities in COVID-19 vaccine uptake in Eastern Oslo, Norway. Public Health Pract (Oxf) 2023; 5:100391. [PMID: 37293528 PMCID: PMC10225062 DOI: 10.1016/j.puhip.2023.100391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/04/2023] [Accepted: 04/20/2023] [Indexed: 06/10/2023] Open
Abstract
Objective The objective of this study was to assess whether socioeconomic status still remain a barrier to COVID-19 vaccination in eastern Oslo, Norway. Study design A cross-section study. Methods We conducted a web-based survey among the residents of six eastern parishes in Oslo, Norway. Text (SMS) messages were sent to 59978 potential participants. 5447 surveys were completed for a response rate of 9.1%. After removing participants who had not been offered the COVID-19 vaccine, we ended up with a valid sample of 4000. Results We find a significant association between education and the likelihood of taking the COVID-19 vaccine in bivariate logistic regression. Further, we find a significant higher likelihood of taking the vaccine in the above-low-income group compared to the low-income group. However, when we add control variables to the regression, the significant results concerning both income and education are eliminated. In further analysis, we found that age worked as a moderator between socioeconomic status and vaccine uptake: In the youngest age group (18-29), we found a significant higher likelihood of taking the vaccine in the above-low-income group compared to the low-income group, and in the higher education group compared to the primary education group. Conclusion Socioeconomic status remains a barrier to COVID-19 vaccination in the eastern parishes of Oslo, Norway. Indicating that Norwegians of lower socioeconomic status still disproportionately face barriers such as transportation, language, flexible work hours, and paid sick time. However, our analysis shows that this association is only found in the age group 18-29.
Collapse
Affiliation(s)
| | - Megan Todd
- Department of Public Health, City of Philadelphia, United States
| | - Jessica Dimka
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Nan Zou Bakkeli
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| |
Collapse
|
12
|
Wang H, Dewidar O, Whittle SL, Ghogomu E, Hazlewood G, Leder K, Mbuagbaw L, Pardo Pardo J, Robinson PC, Buchbinder R, Welch V. Equity Considerations in COVID-19 Vaccination Studies of Individuals With Autoimmune Inflammatory Rheumatic Diseases. Arthritis Care Res (Hoboken) 2023; 75:967-974. [PMID: 36194078 PMCID: PMC9874440 DOI: 10.1002/acr.25034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/23/2022] [Accepted: 09/29/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE We sought to examine the extent to which populations experiencing inequities were considered in studies of COVID-19 vaccination in individuals with autoimmune inflammatory rheumatic diseases (AIRDs). METHODS We included all studies (n = 19) from an ongoing Cochrane living systematic review on COVID-19 vaccination in patients with AIRDs. We used the PROGRESS-Plus framework (place of residence, race/ethnicity, occupation, gender/sex, religion, education, socioeconomic status, and social capital, plus: age, multimorbidity, and health literacy) to identify factors that stratify health outcomes. We assessed equity considerations in relation to differences in COVID-19 baseline risk, eligibility criteria, and description of participant characteristics and attrition, controlling for confounding factors, subgroup analyses, and applicability of findings. RESULTS All 19 studies were cohort studies that followed individuals with AIRDs after vaccination. Three studies (16%) described differences in baseline risk for COVID-19 across age. Two studies (11%) defined eligibility criteria based on occupation and age. All 19 studies described participant age and sex. Twelve studies (67%) controlled for age and/or sex as confounders. Eight studies (47%) conducted subgroup analyses across at least 1 PROGRESS-Plus factor, most commonly age. Ten studies (53%) interpreted applicability in relation to at least 1 PROGRESS-Plus factor, most commonly age (47%), then ethnicity (16%), sex (16%), and multimorbidity (11%). CONCLUSION Sex and age were the most frequently considered PROGRESS-Plus factors in studies of COVID-19 vaccination in individuals with AIRDs. The generalizability of evidence to populations experiencing inequities is uncertain. Future COVID-19 vaccine studies should report participant characteristics in more detail to inform guideline recommendations.
Collapse
Affiliation(s)
- Harry Wang
- University of Ottawa and Bruyère Research InstituteOttawaOntarioCanada
| | | | - Samuel L. Whittle
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia, and Monash UniversityMelbourneVictoriaAustralia
| | | | | | | | | | | | - Philip C. Robinson
- University of Queensland School of Medicine and Royal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | | | | |
Collapse
|
13
|
Abstract
The poultry and meatpacking industry is one of the largest in Arkansas and was associated with several COVID-19 outbreaks at the start of the pandemic. Marshallese and Hispanic workers account for much of the poultry and meatpacking workforce and were disproportionately affected. The Arkansas Department of Health held worksite vaccination clinics and administered 1794 doses. Of those doses, 1219 (67.9%) and 391 (21.8%) were administered to Hispanic and Marshallese workers, respectively. Vaccination efforts must target populations that have been disproportionately affected by the pandemic. (Am J Public Health. 2023;113(5):500-503. https://doi.org/10.2105/AJPH.2023.307226).
Collapse
Affiliation(s)
- Austin Porter
- Austin Porter is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, and the Arkansas Department of Health, Little Rock. Pansy James and Cassie Cochran are with the Arkansas Department of Health
| | - Pansy James
- Austin Porter is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, and the Arkansas Department of Health, Little Rock. Pansy James and Cassie Cochran are with the Arkansas Department of Health
| | - Cassie Cochran
- Austin Porter is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, and the Arkansas Department of Health, Little Rock. Pansy James and Cassie Cochran are with the Arkansas Department of Health
| |
Collapse
|
14
|
Tsui J, Martinez B, Shin MB, Allee-Munoz A, Rodriguez I, Navarro J, Thomas-Barrios KR, Kast WM, Baezconde-Garbanati L. Understanding medical mistrust and HPV vaccine hesitancy among multiethnic parents in Los Angeles. J Behav Med 2023; 46:100-115. [PMID: 35107656 PMCID: PMC8808279 DOI: 10.1007/s10865-022-00283-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/03/2022] [Indexed: 01/26/2023]
Abstract
Determinants of parental HPV vaccine hesitancy, including medical mistrust and exposure to negative vaccine information, are understudied in racial/ethnic minority communities where vaccine uptake is low. We conducted a cross-sectional survey (March 2021) among parents of adolescents, ages 9-17 years, from an academic enrichment program serving low-income, first-generation, underrepresented minority families in Los Angeles to understand determinants of parental HPV vaccine hesitancy. Parents completed self-administered surveys, including a 9-item HPV vaccine hesitancy scale, in either English, Spanish, or Chinese. Logistic regression was used to identify individual and interpersonal factors associated with parental hesitancy and adolescent HPV vaccination. One-fifth of parents (n = 357) reported high HPV vaccine hesitancy and > 50% reported concerns about safety or side effects. High medical mistrust was associated with high parental HPV vaccine hesitancy (adjusted-OR 1.69, 95% CI: 1.13, 2.37). Community-tailored and multilevel strategies to increase vaccine confidence are needed to improve HPV and other adolescent vaccinations.
Collapse
Affiliation(s)
- Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Bibiana Martinez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michelle B Shin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alec Allee-Munoz
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ivonne Rodriguez
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - Jazmin Navarro
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - Kim R Thomas-Barrios
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
15
|
Willis DE, Selig JP, Andersen JA, Hall S, Hallgren E, Williams M, Bryant-Moore K, McElfish PA. Hesitant but vaccinated: assessing COVID-19 vaccine hesitancy among the recently vaccinated. J Behav Med 2023; 46:15-24. [PMID: 35032254 PMCID: PMC8760868 DOI: 10.1007/s10865-021-00270-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/04/2021] [Indexed: 11/06/2022]
Abstract
We administered a survey during the fifteen-minute wait time after the COVID-19 vaccine was given (N = 1475) to examine attitudes towards COVID-19 vaccines among adults who were vaccinated in Arkansas between April 22nd and July 6th, 2021. We found 60% of those who had just been vaccinated reported some level of hesitancy, including 10% who reported being "very hesitant." Hesitancy was not evenly distributed across sociodemographic groups (age, sex, race/ethnicity, and education) and was associated with whether a non-English language is spoken in the home, health care coverage, and flu vaccination over the past five years in bivariate analysis. Generalized ordered logistic regression results reveal associations between the log-ordered odds of COVID-19 vaccine hesitancy and age, sex, race/ethnicity, health care coverage, health literacy, and flu vaccination over the past five years. Surprisingly, a prior COVID-19 diagnosis was not significantly associated with COVID-19 vaccine hesitancy. These results can inform health care and communication strategies. Further attention to "hesitant adopters" can provide insights into the process of overcoming vaccine hesitancy that are critical to vaccine uptake.
Collapse
Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Spencer Hall
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Mark Williams
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Keneshia Bryant-Moore
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
| |
Collapse
|
16
|
Hegde SJ, Mahmassani H, Smilowitz K. A two-regime analysis of the COVID-19 vaccine distribution process. JHLSCM 2023. [DOI: 10.1108/jhlscm-10-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Purpose
The purpose of this paper is to develop a framework to evaluate and assess the performance of the COVID-19 vaccine distribution process that is sensitive to the unique supply-side and demand-side constraints exhibited in the US vaccine rollout.
Design/methodology/approach
A queuing framework that operates under two distinct regimes is formulated to analyze service rates that represent system capacity to vaccinate (under the first regime) and hesitancy-induced throughput (under the second regime). These supply- and hesitancy-constrained regimes form the focus of the present paper, as the former reflects the inherent ability of the nation in its various jurisdictions to mobilize, whereas the latter reflects a critical area for public policy to protect the population’s overall health and safety.
Findings
The two-regime framework analysis provides insights into the capacity to vaccinate and hesitancy-constrained demand, which is found to vary across the country primarily by politics and region. The framework also allows analysis of the end-to-end supply chain, where it is found that the ability to vaccinate was likely constrained by last-mile administration issues, rather than the capacity of the manufacturing and transportation steps of the supply chain.
Originality/value
This study presents a new framework to consider end-to-end supply chains as dynamic systems that exhibit different regimes because of unique supply- and demand-side characteristics and estimate rollout capacity and underlying determinants at the national, state and county levels.
Collapse
|
17
|
Elkin JA, McDowell M, Yau B, Machiri SV, Pal S, Briand S, Muneene D, Nguyen T, Purnat TD. The Good Talk! A Serious Game to Boost People's Competence to Have Open Conversations About COVID-19: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40753. [PMID: 36884269 PMCID: PMC9997707 DOI: 10.2196/40753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is one of the many factors impeding efforts to control the COVID-19 pandemic. Exacerbated by the COVID-19 infodemic, misinformation has undermined public trust in vaccination, led to greater polarization, and resulted in a high social cost where close social relationships have experienced conflict or disagreements about the public health response. OBJECTIVE The purpose of this paper is to describe the theory behind the development of a digital behavioral science intervention-The Good Talk!-designed to target vaccine-hesitant individuals through their close contacts (eg, family, friends, and colleagues) and to describe the methodology of a research study to evaluate its efficacy. METHODS The Good Talk! uses an educational serious game approach to boost the skills and competences of vaccine advocates to have open conversations about COVID-19 with their close contacts who are vaccine hesitant. The game teaches vaccine advocates evidence-based open conversation skills to help them speak with individuals who have opposing points of view or who may ascribe to nonscientifically supported beliefs while retaining trust, identifying common ground, and fostering acceptance and respect of divergent views. The game is currently under development and will be available on the web, free to access for participants worldwide, and accompanied by a promotional campaign to recruit participants through social media channels. This protocol describes the methodology for a randomized controlled trial that will compare participants who play The Good Talk! game with a control group that plays the widely known noneducational game Tetris. The study will evaluate a participant's open conversation skills, self-efficacy, and behavioral intentions to have an open conversation with a vaccine-hesitant individual both before and after game play. RESULTS Recruitment will commence in early 2023 and will cease once 450 participants complete the study (225 per group). The primary outcome is improvement in open conversation skills. Secondary outcomes are self-efficacy and behavioral intentions to have an open conversation with a vaccine-hesitant individual. Exploratory analyses will examine the effect of the game on implementation intentions as well as potential covariates or subgroup differences based on sociodemographic information or previous experiences with COVID-19 vaccination conversations. CONCLUSIONS The outcome of the project is to promote more open conversations regarding COVID-19 vaccination. We hope that our approach will encourage more governments and public health experts to engage in their mission to reach their citizens directly with digital health solutions and to consider such interventions as an important tool in infodemic management. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40753.
Collapse
Affiliation(s)
- Javier A Elkin
- Digital Health and Innovation Department, World Health Organization, Geneva, Switzerland
| | - Michelle McDowell
- Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Development, Berlin, Germany
| | - Brian Yau
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Shanthi Pal
- Department of Regulation and Prequalification, World Health Organization, Geneva, Switzerland
| | - Sylvie Briand
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Derrick Muneene
- Digital Health and Innovation Department, World Health Organization, Geneva, Switzerland
| | - Tim Nguyen
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Tina D Purnat
- Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
18
|
Zhang V, Zhu P, Wagner AL. Spillover of Vaccine Hesitancy into Adult COVID-19 and Influenza: The Role of Race, Religion, and Political Affiliation in the United States. Int J Environ Res Public Health 2023; 20:3376. [PMID: 36834071 PMCID: PMC9966756 DOI: 10.3390/ijerph20043376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Due to its potential to lead to vaccine delays and refusals, vaccine hesitancy has attracted increased attention throughout the COVID-19 pandemic. It is crucial to investigate whether demographic patterns differ between adult general vaccine hesitancy and COVID-19 and flu vaccine non-receipt. METHODS A cross-sectional survey was conducted online in August 2022. In response to questions about vaccine hesitancy, participants indicated whether they would receive the vaccine given various safety and efficacy profiles. Through logistic regression models, we examined variations between general vaccine hesitancy and COVID-19 non-vaccination. RESULTS Among the 700 participants, 49% of the respondents were classified as having general vaccine hesitancy, 17% had not received the COVID-19 vaccine, and 36% had not had flu vaccinations. In the multivariable analysis, general vaccine hesitancy and the non-receipt of COVID-19 vaccines were significantly higher in Non-Hispanic Black participants, those with no religious affiliation, and Republicans and Independents. CONCLUSIONS Patterns of vaccine hesitancy and the non-receipt of the COVID-19 vaccination did not vary, indicating a substantial overlap and potential spillover in vaccine hesitancy over the course of the pandemic. Because changing people's opinions regarding vaccinations is generally a challenge, different interventions specific to demographic subgroups may be necessary.
Collapse
Affiliation(s)
| | | | - Abram L. Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| |
Collapse
|
19
|
Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Zogaki E, Kaitelidou D. Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece. Vaccines (Basel) 2023; 11:269. [PMID: 36851147 PMCID: PMC9967309 DOI: 10.3390/vaccines11020269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.
Collapse
Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleftheria Zogaki
- Faculty of Midwifery, University of West Attica, West Attica, 12243 Aigaleo, Greece
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| |
Collapse
|
20
|
Peña JM, Schwartz MR, Hernandez-Vallant A, Sanchez GR. Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups. J Behav Med 2023; 46:129-139. [PMID: 36652085 PMCID: PMC9846662 DOI: 10.1007/s10865-023-00393-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
Latino, Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian or Other Pacific Islander people have the highest hospitalizations and death rates from COVID-19. Social inequalities have exacerbated COVID-19 related health disparities. This study examines social and structural determinants of COVID-19 vaccine uptake. Results from logistic regressions suggest Latino and Black people were less likely to be vaccinated. People that did not have health insurance, a primary care doctor and were unemployed were more than 30% less likely to be vaccinated for COVID-19. Greater perceived health inequalities in one's neighborhood and perceived racial/ethnic discrimination were associated with a decreased odds in being vaccinated. People that suffered the loss of a household member from COVID-19 were three times more likely to have been vaccinated. Establishing policies that will increase access to health insurance and create jobs with living wages may have lasting impacts. Furthermore, collaboration with local and national community organizations can enhance the development of sustainable solutions.
Collapse
Affiliation(s)
- Juan M. Peña
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106 NM USA ,Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA
| | - Matthew R. Schwartz
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Department of Internal Medicine, The University of New Mexico, Albuquerque, NM USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106 NM USA ,Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Center of Alcohol, The University of New Mexico, Substance Use, and Addictions, Albuquerque, NM USA
| | - Gabriel R. Sanchez
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Department of Political Science, The University of New Mexico, Albuquerque, NM USA
| |
Collapse
|
21
|
Natale R, Agosto Y, Bulotsky Shearer RJ, St George SM, Jent J. Designing a virtual mental health consultation program to support and strengthen childcare centers impacted by COVID-19: A randomized controlled trial protocol. Contemp Clin Trials 2023; 124:107022. [PMID: 36442806 PMCID: PMC9694403 DOI: 10.1016/j.cct.2022.107022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had negative psychosocial impacts on young children; teachers in childcare centers continue to be overwhelmed by how to address the downstream psychological effects children are experiencing. This randomized controlled trial will study the role of a community-based, childcare center-support system in improving resilience and mitigating the long-term impacts of COVID-19 on children's development. METHODS This study will be modeled on a successful Early Childhood Mental Health Consultation (ECMHC) intervention which utilizes mental health consultants to deliver a Jump Start+: COVID 19 Support (JS + CS) virtual toolkit to childcare centers in Miami-Dade County via a Kubi robot. The toolkit comprises four strength-based strategies likely to be effective in improving resiliency following disasters: Safety Planning, Effective Communication, Adult Self-Care, and Trauma-Informed Behavior Support. Our first aim will utilize a cluster randomized trial to examine the effectiveness of JS + CS on improving the psychosocial functioning of young children, as compared to an obesity prevention intervention control group. Children will be followed at 6, 12, 18, and 24 months. The second aim will examine the mechanisms that contribute to effective uptake by teachers of the JS + CS support strategies on child outcomes. The third aim will explore implementation barriers/facilitators as well as potential societal contextual factors (e.g., vaccine uptake) to help centers serving disproportionately affected minority communities recover from and prepare for future crises. CONCLUSION This design will inform the refinement and scaling of JS + CS and generalize impacts to other childcare center interventions in the context of disasters.
Collapse
Affiliation(s)
- Ruby Natale
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave, Miami, Florida 33136, USA.
| | - Yaray Agosto
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave, Miami, Florida 33136, USA.
| | - Rebecca J Bulotsky Shearer
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, Florida 33146, USA.
| | - Sara M St George
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14(th) St, Miami, Florida 33136, USA.
| | - Jason Jent
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave, Miami, Florida 33136, USA.
| |
Collapse
|
22
|
Alhossan A, Alsaran AK, Almahmudi AH, Aljohani ZS, Albishi MR, Almutairi AK. Adverse Events of COVID-19 Vaccination among the Saudi Population: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10. [PMID: 36560499 DOI: 10.3390/vaccines10122089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
This systematic review and meta-analysis aimed to synthesize the evidence on the adverse events (AEs) of coronavirus disease 2019 (COVID-19) vaccinations in Saudi Arabia. A computerized search in MEDLINE via PubMed and OVID, Scopus, CENTRAL, and Web of Science was conducted using relevant keywords. The NIH tools were used for the quality assessment. A total of 14 studies (16 reports) were included. The pooled analysis showed that the incidence of AEs post-COVID-19 vaccination was 40.4% (95% CI:6.4% to 87%). Compared to the AstraZeneca vaccine, the Pfizer-BioNTech vaccine was associated with a lower risk ratio (RR) of wheezing (RR = 0.04), fever (RR = 0.32), chills (RR = 0.41), headache (RR = 0.47), dizziness (RR = 0.49), and joint pain (RR = 0.51). The Pfizer-BioNTech vaccine was associated with significantly higher RR of general allergic reactions (RR = 1.62), dyspnea (RR = 1.68), upper respiratory tract symptoms (RR = 1.71), and lymphadenopathy (RR = 8.32). The current evidence suggests that the incidence of AEs following COVID-19 vaccines is 40%; however, most of these AEs were mild and for a short time. The overall number of participants with AEs was higher in the Pfizer group compared to the AstraZeneca group; however, the AstraZeneca vaccine was associated with a higher RR of several AEs.
Collapse
|
23
|
Levinson Z, Cantor J, Williams MV, Whaley C. The association of strained ICU capacity with hospital patient racial and ethnic composition and federal relief during the COVID-19 pandemic. Health Serv Res 2022; 57 Suppl 2:279-290. [PMID: 35808952 PMCID: PMC9349922 DOI: 10.1111/1475-6773.14028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To identify the association between strained intensive care unit (ICU) capacity during the COVID-19 pandemic and hospital racial and ethnic patient composition, federal pandemic relief, and other hospital characteristics. DATA SOURCES We used government data on hospital capacity during the pandemic and Provider Relief Fund (PRF) allocations, Medicare claims and enrollment data, hospital cost reports, and Social Vulnerability Index data. STUDY DESIGN We conducted cross-sectional bivariate analyses relating strained capacity and PRF award per hospital bed with hospital patient composition and other characteristics, with and without adjustment for hospital referral region (HRR). DATA COLLECTION We linked PRF data to CMS Certification Numbers based on hospital name and location. We used measures of racial and ethnic composition generated from Medicare claims and enrollment data. Our sample period includes the weeks of September 18, 2020 through November 5, 2021, and we restricted our analysis to short-term, general hospitals with at least one intensive care unit (ICU) bed. We defined "ICU strain share" as the proportion of ICU days occurring while a given hospital had an ICU occupancy rate ≥ 90%. PRINCIPAL FINDINGS After adjusting for HRR, hospitals in the top tercile of Black patient shares had higher ICU strain shares than did hospitals in the bottom tercile (30% vs. 22%, p < 0.05) and received greater PRF amounts per bed ($118,864 vs. $92,407, p < 0.05). Having high versus low ICU occupancy relative to pre-pandemic capacity was associated with a modest increase in PRF amounts per bed after adjusting for HRR ($107,319 vs. $96,627, p < 0.05), but there were no statistically significant differences when comparing hospitals with high versus low ICU occupancy relative to contemporaneous capacity. CONCLUSIONS Hospitals with large Black patient shares experienced greater strain during the pandemic. Although these hospitals received more federal relief, funding was not targeted overall toward hospitals with high ICU occupancy rates.
Collapse
|
24
|
Latkin C, Dayton L, Miller J, Yi G, Balaban A, Boodram B, Uzzi M, Falade-Nwulia O. A longitudinal study of vaccine hesitancy attitudes and social influence as predictors of COVID-19 vaccine uptake in the US. Hum Vaccin Immunother 2022; 18:2043102. [PMID: 35417302 PMCID: PMC9196649 DOI: 10.1080/21645515.2022.2043102] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background In many countries with high levels of COVID-19 vaccine access, uptake remains a major issue. We examined prospective predictors of COVID-19 vaccine uptake in a United States longitudinal study. Methods An online longitudinal study on COVID-19 and well-being assessed vaccine hesitancy attitudes, social norms, and uptake among 444 respondents who had completed both survey waves in March and June 2021. Results The mean sample age was 41, with 55% female, 71% white, 13% Black, and 6% Latinx. In March 2021, 14% had received at least one COVID-19 vaccine dose. By June 2021, 64% reported receiving at least one dose. In prospectively assessing predictors of vaccine uptake, we found strong correlations among five different vaccine hesitancy questions. In multivariable logistic regression models, family and friends discouraging vaccination (adjusted odds ratios [aOR] = .26, 95% CI = .07, .98), not knowing whom to believe about vaccine safety (aOR = .51, 95% CI = .27, .95), and concerns that shortcuts were taken with vaccine development (aOR = .43, 95% CI = .23, .81) were all independent predictors of lower vaccine uptake. Political conservatism, gender, education, and income were also independent predictors of reduced uptake. Vaccine hesitancy items were also modeled as a scale, and the scale was found to be strongly predictive of vaccine uptake. Conclusions The findings highlight the importance of social norm interventions and suggest general and specific vaccine hesitancy attitudes, especially trust, should be considered in developing vaccine uptake programs.
Collapse
Affiliation(s)
- Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lauren Dayton
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacob Miller
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Grace Yi
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ariel Balaban
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Basmattee Boodram
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | - Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
25
|
Eiden AL, Barratt J, Nyaku MK. Drivers of and barriers to routine adult vaccination: A systematic literature review. Hum Vaccin Immunother 2022; 18:2127290. [PMID: 36197070 DOI: 10.1080/21645515.2022.2127290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We performed a systematic literature review in PubMed and Embase (2016-2021) to investigate the drivers of and barriers to routine vaccination in adults aged 50 and older globally. A thematic assessment identified three categories across 61 publications: sociodemographic, health-related, and attitudinal. The most common sociodemographic determinants (factors identified in studies; n = 47) associated with vaccination uptake were economic status, age, education, and household composition, which had mixed effects on vaccine uptake. For health-related determinants (n = 27), individuals with comorbidities and health care consumption were the most common factors, both increased vaccine uptake. The most common attitudinal factors (n = 42) were self-efficacy, provider or other's recommendations, and vaccine-preventable disease awareness; across studies, all attitude factors had a positive effect, unlike the sociodemographic and health status categories. Findings suggest that patient and provider awareness and education campaigns are effective ways to increase uptake of routine vaccinations in older adults.
Collapse
Affiliation(s)
- Amanda L Eiden
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
| | - Jane Barratt
- International Federation on Ageing, Toronto, Ontario, Canada
| | - Mawuli K Nyaku
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
| |
Collapse
|
26
|
Marie Reinhart A, Tian Y, Lilly AE. The role of trust in COVID-19 vaccine hesitancy and acceptance among Black and White Americans. Vaccine 2022; 40:7247-7254. [PMID: 36333223 PMCID: PMC9618447 DOI: 10.1016/j.vaccine.2022.10.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Mass vaccination has been identified as the easiest way to combat the deadly spread of the coronavirus (COVID-19) disease, yet many Americans are still hesitant to be vaccinated. To understand motivations behind why someone is vaccine hesitant, we conceptualized a theoretical model in which demographic variables are positively associated with four types of trust (i.e., trust in institutions, physicians, non-discrimination, and social media). These trust variables, in turn, are positively associated with the outcome variable of vaccine acceptance. A multi-group structural equation modeling analysis of survey data from 1008 U.S. adults suggested that trust in institutions and physicians were important for both White and Black Americans in whether they were vaccine accepting or hesitant, while trust in non-discrimination was important for Black Americans and trust in social media was important for White Americans. Implications of the findings and how they can inform future vaccine campaigns are discussed.
Collapse
Affiliation(s)
| | - Yan Tian
- University of Missouri, Saint Louis, USA.
| | | |
Collapse
|
27
|
Kour P, Gele A, Aambø A, Qureshi SA, Sheikh NS, Vedaa Ø, Indseth T. Lowering COVID-19 vaccine hesitancy among immigrants in Norway: Opinions and suggestions by immigrants. Front Public Health 2022; 10:994125. [PMID: 36466508 PMCID: PMC9709441 DOI: 10.3389/fpubh.2022.994125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
Even though COVID-19 vaccine has been proved effective, vaccine uptake and coverage has been and still is a great concern across different immigrant groups. Vaccine hesitancy remains a barrier to accept the vaccine among immigrants across the globe-including Norway-despite higher rates of hospitalizations and deaths. This study aimed to explore the opinions and suggestions of immigrants on how to lower the COVID-19 vaccine hesitancy among immigrants in Norway. Qualitative interviews were conducted with 88 persons with different immigrant background. Data was analyzed using framework analysis, utilizing "3Cs model of vaccine hesitancy" as a theoretical framework. The analysis yielded five main themes related to factors that may lower the vaccine hesitancy among immigrants in Norway: (1) Effective cultural communication, (2) Vaccine advocacy through community engagement, (3) Motivating factors, (4) Collaborative efforts via government and healthcare, and (5) Incentives for vaccination. This study enhanced our understanding of factors that according to immigrants themselves may lower the vaccine hesitancy. The insights obtained in this study can contribute to a better understanding of the current status of vaccine uptake among immigrants and can further give directions on how to improve vaccine uptake in these groups in Norway.
Collapse
Affiliation(s)
- Prabhjot Kour
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway,*Correspondence: Prabhjot Kour
| | - Abdi Gele
- Unit for Migration and Health, Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Arild Aambø
- Unit for Migration and Health, Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Samera A. Qureshi
- Unit for Migration and Health, Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Naima Said Sheikh
- Unit for Migration and Health, Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Thor Indseth
- Unit for Migration and Health, Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
28
|
Zhou S, Villalobos JP, Munoz A, Bull S. Ethnic Minorities' Perceptions of COVID-19 Vaccines and Challenges in the Pandemic: A Qualitative Study to Inform COVID-19 Prevention Interventions. Health Commun 2022; 37:1476-1487. [PMID: 35775369 PMCID: PMC9481672 DOI: 10.1080/10410236.2022.2093557] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To inform health communication campaigns for COVID-19 prevention and vaccine promotion among racial and ethnic minorities facing disparities, we conducted formative research by interviewing Hispanic/Latino American (Latino), Black/African American (AA), and American Indian/Alaska Native (AI/AN) participants to explore their challenges during the pandemic, the barriers and facilitators to receiving COVID-19 vaccines, acceptability of using chatbots to deliver COVID-19 and vaccine information, and preferred features and suggestions for culturally tailored prevention messages. Positive perceptions of the COVID-19 vaccine were mainly derived from beliefs that the vaccine can protect oneself and families from getting infected and help stop the pandemic. Negative perceptions of the COVID-19 vaccine were driven by concerns about vaccine safety due to the rapid development process and side effects. Latino participants would like to know more information about the vaccine and evidence of its effectiveness. AA participants identified seeing others, especially government officials, get the vaccine first as a facilitator and low trust in the government and healthcare system as barriers to getting the COVID-19 vaccine. AI/AN participants emphasized the importance of equitable access to the vaccine. Participants preferred messages with the following features: informative and evidence-based messages about COVID-19 and vaccination, encouraging and motivational messages that focused on the hope to end the pandemic and return to normal, prosocial messages, and clear instructions for COVID-19 prevention strategies. Participants also suggested that messages should include different cultural practices, be translated into their native languages, and emphasize care for family members.
Collapse
Affiliation(s)
- Shuo Zhou
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, 80045, USA
- mHealth Impact Lab, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Communication Studies and the System Health Lab, Hong Kong Baptist University, Hong Kong
| | - Jennifer Paola Villalobos
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, 80045, USA
- mHealth Impact Lab, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Alondra Munoz
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, 80045, USA
- Public Health Institute at Denver Health, Denver, CO, 80204, USA
| | - Sheana Bull
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, 80045, USA
- mHealth Impact Lab, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| |
Collapse
|
29
|
Nichol BAB, Hurlbert AC, Read JCA. Predicting attitudes towards screening for neurodegenerative diseases using OCT and artificial intelligence: Findings from a literature review. J Public Health Res 2022; 11:22799036221127627. [PMID: 36310821 PMCID: PMC9597051 DOI: 10.1177/22799036221127627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Recent developments in artificial intelligence (AI) and machine learning raise the possibility of screening and early diagnosis for neurodegenerative diseases, using 3D scans of the retina. The eventual value of such screening will depend not only on scientific metrics such as specificity and sensitivity but, critically, also on public attitudes and uptake. Differential screening rates for various screening programmes in England indicate that multiple factors influence uptake. In this narrative literature review, some of these potential factors are explored in relation to predicting uptake of an early screening tool for neurodegenerative diseases using AI. These include: awareness of the disease, perceived risk, social influence, the use of AI, previous screening experience, socioeconomic status, health literacy, uncontrollable mortality risk, and demographic factors. The review finds the strongest and most consistent predictors to be ethnicity, social influence, the use of AI, and previous screening experience. Furthermore, it is likely that factors also interact to predict the uptake of such a tool. However, further experimental work is needed both to validate these predictions and explore interactions between the significant predictors.
Collapse
Affiliation(s)
- Beth AB Nichol
- Department of Social Work, Education,
and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK,Beth AB Nichol, Department of Social Work,
Education, and Community Wellbeing, Northumbria University, Coach Lane,
Newcastle upon Tyne NE7 7XA, UK.
| | - Anya C Hurlbert
- Biosciences Institute, Newcastle
University, Newcastle upon Tyne, UK
| | - Jenny CA Read
- Biosciences Institute, Newcastle
University, Newcastle upon Tyne, UK
| |
Collapse
|
30
|
Kenworthy T, Harmon SL, Delouche A, Abugattas N, Zwiebel H, Martinez J, Sauvigné KC, Nelson CM, Horigian VE, Gwynn L, Pulgaron ER. Community voices on factors influencing COVID-19 concerns and health decisions among racial and ethnic minorities in the school setting. Front Public Health 2022; 10:1002209. [PMID: 36339209 PMCID: PMC9627500 DOI: 10.3389/fpubh.2022.1002209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Racial and ethnic minority communities have been disproportionately affected by COVID-19, but the uptake of COVID-19 mitigation strategies like vaccination and testing have been slower in these populations. With the continued spread of COVID-19 while in-person learning is a priority, school-aged youth and their caregivers must make health-related decisions daily to ensure health at school. It is critical to understand factors associated with COVID-related health decisions such as vaccination, testing, and other health behaviors (e.g., wearing masks, hand washing). Community-engaged campaigns are necessary to overcome barriers to these health behaviors and promote health equity. The aim of this study was to examine COVID-19-related concerns and influences on health decisions in middle and high schools serving primarily racial and ethnic minority, low-income families. Seven focus groups were conducted with school staff, parents, and students (aged 16 years and older). Qualitative data were analyzed using a general inductive approach. Factors related to COVID-19 concerns and health decisions centered on (1) vaccine hesitancy, (2) testing hesitancy, (3) developmental stage (i.e., ability to engage in health behaviors based on developmental factors like age), (4) cultural and family traditions and beliefs, (5) compatibility of policies and places with recommended health behaviors, (6) reliability of information, and (7) perceived risk. We explore sub-themes in further detail. It is important to understand the community's level of concern and identify factors that influence COVID-19 medical decision making to better address disparities in COVID-19 testing and vaccination uptake.
Collapse
|
31
|
Sopjani I, Arbag E, Tokat MA, Ozozturk S. The COVID-19 Vaccine Opinions of Women Planning a Pregnancy: International Web Blogs Scanning. Med Arch 2022; 76:354-362. [PMID: 36545459 PMCID: PMC9760235 DOI: 10.5455/medarh.2022.76.354-362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background The unprecedented COVID-19 has infected millions of people and killed hundreds of thousands of people. A strategy to contain the spread of the disease was the development of the COVID-19 vaccine. Objective In our study, it was determined the opinions of women who are planning to become pregnant about the COVID-19 vaccine. Methods Blogs were used as the data source in the research, which was designed as a descriptive qualitative study. For this purpose, the expressions of 34 women identified between February and March 2021 were evaluated with directed qualitative content analysis. Results Psychological changes, cognitive changes, and coping methods were determined as the themes of our results. This study demonstrates the value of using qualitative methods to determine the thoughts of women planning to become pregnant regarding the COVID-19 vaccine. Conclusion For women planning pregnancy, continued research into vaccine safety and efficacy is vital, and results should be carefully investigated and handed in the right channels.
Collapse
Affiliation(s)
| | - Esra Arbag
- Dokuz Eylul University, Institute of Health Sciences, Izmir, Turkey
| | - Merlinda Alus Tokat
- Dokuz Eylul University Faculty of Nursing Obstetric and Gynecologic Nursing Department, Izmir, Turkey
| | | |
Collapse
|
32
|
Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Katsoulas T, Mariolis-Sapsakos T, Kaitelidou D. COVID-19 Vaccine Uptake among Healthcare Workers: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1637. [PMID: 36298502 PMCID: PMC9610263 DOI: 10.3390/vaccines10101637] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
The vaccine-induced immunity of healthcare workers (HCWs) is crucial to controlling the COVID-19 pandemic. Therefore, we conducted a systematic review and meta-analysis to assess the COVID-19 vaccine uptake among HCWs worldwide and to identify predictors of vaccination. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL, and medRxiv up to 25 August 2022. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We found 25 studies including 491,624 vaccinated HCWs, while the full sample included 555,561 HCWs. The overall proportion of vaccinated HCWs was 77.3%. Vaccine uptake for studies that were conducted in North America (85.6%) was higher than the proportion for studies that were conducted in Asia (79.5%), Europe (72.8%), and Africa (65.6%). The overall prevalence of COVID-19 vaccine uptake was 83.6% and 77.4% for physicians and nurses, respectively. Older age, white race, physicians' profession, seasonal influenza vaccine, direct COVID-19 patient care, and confidence in COVID-19 vaccine safety and effectiveness were positive predictors of vaccine uptake, while history of SARS-CoV-2 infection was a negative predictor. Deep understanding of the factors that influence HCWs' decisions to receive a COVID-19 vaccine is critical to implementing tailored communication strategies for HCWs who are at risk for not getting vaccinated.
Collapse
Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| |
Collapse
|
33
|
Adeagbo M, Olukotun M, Musa S, Alaazi D, Allen U, Renzaho AMN, Sekyi-Otu A, Salami B. Improving COVID-19 Vaccine Uptake among Black Populations: A Systematic Review of Strategies. Int J Environ Res Public Health 2022; 19:11971. [PMID: 36231270 PMCID: PMC9565689 DOI: 10.3390/ijerph191911971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 09/19/2022] [Indexed: 05/28/2023]
Abstract
Given the growing body of evidence on COVID-19 vaccine hesitancy among Black populations, the aim of this systematic review was to identify the interventions and strategies used to improve COVID-19 vaccine confidence and uptake among Black populations globally. To identify relevant studies, we conducted a systematic review of the literature based on a systematic search of 10 electronic databases: MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Cochrane Library, Web of Science, Sociological Abstracts, Dissertations and Theses Global, and SocINDEX. We screened a total of 1728 records and included 14 peer-reviewed interventional studies that were conducted to address COVID-19 vaccine hesitancy among Black populations. A critical appraisal of the included studies was performed using the Newcastle-Ottawa Quality Assessment Scale. The intervention strategies for increasing COVID-19 vaccine uptake were synthesized into three major categories: communication and information-based interventions, mandate-based interventions, and incentive-based interventions. Interventions that incorporated communication, community engagement, and culturally inclusive resources significantly improved vaccine uptake among Black populations, while incentive- and mandate-based interventions had less impact. Overall, this systematic review revealed that consideration of the sociocultural, historical, and political contexts of Black populations is important, but tailored interventions that integrate culture-affirming strategies are more likely to decrease COVID-19 vaccine hesitancy and increase uptake among Black populations.
Collapse
Affiliation(s)
- Morolake Adeagbo
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Mary Olukotun
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Salwa Musa
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Dominic Alaazi
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Upton Allen
- Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Andre M. N. Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3004, Australia
| | - Ato Sekyi-Otu
- Department of Surgery, University of Toronto, Toronto, ON M5S 2J7, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| |
Collapse
|
34
|
Mahmud S, Mohsin M, Hossain S, Islam MM, Muyeed A. The acceptance of COVID-19 vaccine at early stage of development and approval: A global systematic review and meta-analysis. Heliyon 2022; 8:e10728. [PMID: 36168558 PMCID: PMC9499991 DOI: 10.1016/j.heliyon.2022.e10728] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/27/2021] [Accepted: 09/15/2022] [Indexed: 12/03/2022] Open
Abstract
Background Vaccination seems to be the most effective way to prevent and control the spread of COVID-19, a disease that has adversely impacted the lives of over 7 billion people across the globe. Vaccine hesitancy represents an important threat to combat infectious diseases worldwide. This study aims to inspect the COVID-19 vaccine acceptance rate worldwide and the regional variation of the acceptance rates among the general population and healthcare workers across different territories of the world. In addition, it compares the vaccine acceptance rates between the pre- and post-vaccine approval periods. Method A comprehensive systematic review was conducted using PRISMA statements. After quality evaluation, the data from eligible studies were analyzed using the random effect model. Q-test and I2 statistics were used to search for heterogeneity. The publication bias was assessed by using Egger’s test and funnel plot. Results The combined COVID-19 vaccine acceptance rate among the general population and healthcare workers (n = 1,581,562) was estimated at 62.79% (95% CI: 58.98–66.60). The acceptance rate substantially decreased from 66.29% (95% CI: 61.24–71.35) to 56.69% (95% CI: 48.68–64.71) among the general population from the pre-to post-vaccine approval periods but remained almost constant at 58.25% (95% CI: 46.52–69.97) among healthcare workers. The acceptance rates also varied in different regions of the world. The highest acceptance rate was found in the South-East Asia region at 70.18% (95% CI: 58.12–82.25) and the lowest was found in African Region at 39.51% (95% CI: 23.42–55.59). Conclusion Low COVID-19 vaccine acceptance rate might be a massive barrier to controlling the pandemic. More research is needed to address the responsible factors influencing the low global rate of COVID-19 vaccine acceptance. Integrated global efforts are required to remove the barriers.
Collapse
Affiliation(s)
- Sultan Mahmud
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Mohsin
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Sorif Hossain
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Mynul Islam
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Abdul Muyeed
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh-2224, Bangladesh
| |
Collapse
|
35
|
Abstract
BACKGROUND Vaccines are effective in preventing severe COVID-19, a disease for which few treatments are available and which can lead to disability or death. Widespread vaccination against COVID-19 may help protect those not yet able to get vaccinated. In addition, new and vaccine-resistant mutations of SARS-CoV-2 may be less likely to develop if the spread of COVID-19 is limited. Different vaccines are now widely available in many settings. However, vaccine hesitancy is a serious threat to the goal of nationwide vaccination in many countries and poses a substantial threat to population health. This scoping review maps interventions aimed at increasing COVID-19 vaccine uptake and decreasing COVID-19 vaccine hesitancy. OBJECTIVES To scope the existing research landscape on interventions to enhance the willingness of different populations to be vaccinated against COVID-19, increase COVID-19 vaccine uptake, or decrease COVID-19 vaccine hesitancy, and to map the evidence according to addressed populations and intervention categories. SEARCH METHODS We searched Cochrane COVID-19 Study Register, Web of Science (Science Citation Index Expanded and Emerging Sources Citation Index), WHO COVID-19 Global literature on coronavirus disease, PsycINFO, and CINAHL to 11 October 2021. SELECTION CRITERIA We included studies that assess the impact of interventions implemented to enhance the willingness of different populations to be vaccinated against COVID-19, increase vaccine uptake, or decrease COVID-19 vaccine hesitancy. We included randomised controlled trials (RCTs), non-randomised studies of intervention (NRSIs), observational studies and case studies with more than 100 participants. Furthermore, we included systematic reviews and meta-analyses. We did not limit the scope of the review to a specific population or to specific outcomes assessed. We excluded interventions addressing hesitancy towards vaccines for diseases other than COVID-19. DATA COLLECTION AND ANALYSIS Data were analysed according to a protocol uploaded to the Open Science Framework. We used an interactive scoping map to visualise the results of our scoping review. We mapped the identified interventions according to pre-specified intervention categories, that were adapted to better fit the evidence. The intervention categories were: communication interventions, policy interventions, educational interventions, incentives (both financial and non-financial), interventions to improve access, and multidimensional interventions. The study outcomes were also included in the mapping. Furthermore, we mapped the country in which the study was conducted, the addressed population, and whether the design was randomised-controlled or not. MAIN RESULTS We included 96 studies in the scoping review, 35 of which are ongoing and 61 studies with published results. We did not identify any relevant systematic reviews. For an overview, please see the interactive scoping map (https://tinyurl.com/2p9jmx24) STUDIES WITH PUBLISHED RESULTS Of the 61 studies with published results, 46 studies were RCTs and 15 NRSIs. The interventions investigated in the studies were heterogeneous with most studies testing communication strategies to enhance COVID-19 vaccine uptake. Most studies assessed the willingness to get vaccinated as an outcome. The majority of studies were conducted in English-speaking high-income countries. Moreover, most studies investigated digital interventions in an online setting. Populations that were addressed were diverse. For example, studies targeted healthcare workers, ethnic minorities in the USA, students, soldiers, at-risk patients, or the general population. ONGOING STUDIES Of the 35 ongoing studies, 29 studies are RCTs and six NRSIs. Educational and communication interventions were the most used types of interventions. The majority of ongoing studies plan to assess vaccine uptake as an outcome. Again, the majority of studies are being conducted in English-speaking high-income countries. In contrast to the studies with published results, most ongoing studies will not be conducted online. Addressed populations range from minority populations in the USA to healthcare workers or students. Eleven ongoing studies have estimated completion dates in 2022. AUTHORS' CONCLUSIONS: We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake. A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research. AUTHORS CONCLUSIONS We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake. A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research.
Collapse
Affiliation(s)
- Marike Andreas
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Bohndorf
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, Cologne, Germany
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
36
|
Frisco ML, Van Hook J, Thomas KJA. Racial/ethnic and nativity disparities in U.S. Covid-19 vaccination hesitancy during vaccine rollout and factors that explain them. Soc Sci Med 2022; 307:115183. [PMID: 35843179 PMCID: PMC9242888 DOI: 10.1016/j.socscimed.2022.115183] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 01/26/2023]
Abstract
While research has begun to investigate disparities in Covid-19 vaccine hesitancy between White, Black and Hispanic adults, no nationally representative studies to date have accounted for Hispanic immigrants as a unique group or fully investigated the reasons behind racial/ethnic and nativity disparities. We make these contributions by substantively drawing from what is known about the ways that immigrant fear and structural racism create conditions that produce countervailing forces that are likely to contribute to racial/ethnic and nativity disparities in vaccine hesitancy. We use OLS regression and decomposition techniques to analyze data from 1936 18-65 year-old United States (U.S.) adults who participated in the COVID-19 and its Implications for American Communities (CIAC) study during February and March 2021, a period of time that coincides with early stages of the U.S. vaccine roll-out effort that pre-dated universal adult eligibility for Covid-19 vaccination. Results indicate that U.S.-born Black adults are more vaccine hesitant than U.S.-born White adults. This disparity is largely due to differences in anti-vaccine beliefs. U.S.-born Hispanic adults are less vaccine hesitant than U.S.-born White adults in adjusted OLS regression models and personal experiences with Covid-19 drive this difference. There were not significant differences between foreign-born Hispanic and U.S.-born White adults in vaccine hesitancy. These findings suggest that foreign-born Hispanic adults did not drive early disparities in vaccine hesitancy and that alleviating concerns about anti-vaccine beliefs and utilizing personal stories have important roles in preventing future racial/ethnic disparities in Covid-19 vaccine hesitancy as new Covid-19 vaccines and booster shots are rolled out. Study findings may also have implications for reducing racial/ethnic disparities in the uptake of other new vaccines.
Collapse
Affiliation(s)
- Michelle L Frisco
- Penn State University Department of Sociology & Criminology and Population Research Institute, 211 Oswald Tower, University Park, PA, 16802, United States.
| | - Jennifer Van Hook
- Penn State University Department of Sociology & Criminology and Population Research Institute, 211 Oswald Tower, University Park, PA, 16802, United States
| | - Kevin J A Thomas
- University of Texas-Austin Department of African and African Diaspora Studies and Population Research Center, 116 Inner Campus Dr. Stop G6000, Austin, TX, 181712, United States
| |
Collapse
|
37
|
Lundberg DJ, Cho A, Raquib R, Nsoesie EO, Wrigley-Field E, Stokes AC. Geographic and Temporal Patterns in Covid-19 Mortality by Race and Ethnicity in the United States from March 2020 to February 2022. medRxiv 2022:2022.07.20.22277872. [PMID: 35898347 PMCID: PMC9327633 DOI: 10.1101/2022.07.20.22277872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Prior research has established that American Indian, Alaska Native, Black, Hispanic, and Pacific Islander populations in the United States have experienced substantially higher mortality rates from Covid-19 compared to non-Hispanic white residents during the first year of the pandemic. What remains less clear is how mortality rates have changed for each of these racial/ethnic groups during 2021, given the increasing prevalence of vaccination. In particular, it is unknown how these changes in mortality have varied geographically. In this study, we used provisional data from the National Center for Health Statistics (NCHS) to produce age-standardized estimates of Covid-19 mortality by race/ethnicity in the United States from March 2020 to February 2022 in each metro-nonmetro category, Census region, and Census division. We calculated changes in mortality rates between the first and second years of the pandemic and examined mortality changes by month. We found that when Covid-19 first affected a geographic area, non-Hispanic Black and Hispanic populations experienced extremely high levels of Covid-19 mortality and racial/ethnic inequity that were not repeated at any other time during the pandemic. Between the first and second year of the pandemic, racial/ethnic inequities in Covid-19 mortality decreased-but were not eliminated-for Hispanic, non-Hispanic Black, and non-Hispanic AIAN residents. These inequities decreased due to reductions in mortality for these populations alongside increases in non-Hispanic white mortality. Though racial/ethnic inequities in Covid-19 mortality decreased, substantial inequities still existed in most geographic areas during the pandemic's second year: Non-Hispanic Black, non-Hispanic AIAN, and Hispanic residents reported higher Covid-19 death rates in rural areas than in urban areas, indicating that these communities are facing serious public health challenges. At the same time, the non-Hispanic white mortality rate worsened in rural areas during the second year of the pandemic, suggesting there may be unique factors driving mortality in this population. Finally, vaccination rates were associated with reductions in Covid-19 mortality for Hispanic, non-Hispanic Black, and non-Hispanic white residents, and increased vaccination may have contributed to the decreases in racial/ethnic inequities in Covid-19 mortality observed during the second year of the pandemic. Despite reductions in mortality, Covid-19 mortality remained elevated in nonmetro areas and increased for some racial/ethnic groups, highlighting the need for increased vaccination delivery and equitable public health measures especially in rural communities. Taken together, these findings highlight the continued need to prioritize health equity in the pandemic response and to modify the structures and policies through which systemic racism operates and has generated racial health inequities.
Collapse
Affiliation(s)
| | - Ahyoung Cho
- Center for Antiracist Research, Boston University
- Department of Political Science, Boston University
| | - Rafeya Raquib
- Department of Global Health, Boston University School of Public Health
| | - Elaine O. Nsoesie
- Department of Global Health, Boston University School of Public Health
- Center for Antiracist Research, Boston University
| | | | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health
| |
Collapse
|
38
|
Abstract
Understanding what lies behind actual COVID-19 vaccine hesitancy is fundamental to help policy makers increase vaccination rates and reach herd immunity. We use June 2021 data from the COME-HERE survey to explore the predictors of actual vaccine hesitancy in France, Germany, Italy, Luxembourg, Spain and Sweden. We estimate a linear-probability model with a rich set of covariates and address issues of common-method variance. 13% of our sample say they do not plan to be vaccinated. Post-Secondary education, home-ownership, having an underlying health condition, and one standard-deviation higher age or income are all associated with lower vaccine hesitancy of 2-4.5% points. Conservative-leaning political attitudes and a one standard-deviation lower degree of confidence in the government increase this probability by 3 and 6% points respectively. Vaccine hesitancy in Spain and Sweden is significantly lower than in the other countries.
Collapse
Affiliation(s)
- Liyousew G Borga
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, 4366, Esch-sur-Alzette, Luxembourg
| | - Andrew E Clark
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, 4366, Esch-sur-Alzette, Luxembourg
- Paris School of Economics - CNRS, 75014, Paris, France
| | - Conchita D'Ambrosio
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, 4366, Esch-sur-Alzette, Luxembourg
| | - Anthony Lepinteur
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, 4366, Esch-sur-Alzette, Luxembourg.
| |
Collapse
|
39
|
Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Katsoulas T, Mariolis-Sapsakos T, Kaitelidou D. First COVID-19 Booster Dose in the General Population: A Systematic Review and Meta-Analysis of Willingness and Its Predictors. Vaccines (Basel) 2022; 10:1097. [PMID: 35891260 DOI: 10.3390/vaccines10071097] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
The emergence of breakthrough infections and new highly contagious variants of SARS-CoV-2 threaten the immunization in individuals who had completed the primary COVID-19 vaccination. This systematic review and meta-analysis investigated, for the first time, acceptance of the first COVID-19 booster dose and its associated factors among fully vaccinated individuals. We followed the PRISMA guidelines. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL and medrxiv from inception to 21 May 2022. We found 14 studies including 104,047 fully vaccinated individuals. The prevalence of individuals who intend to accept a booster was 79.0%, while the prevalence of unsure individuals was 12.6%, and the prevalence of individuals that intend to refuse a booster was 14.3%. The main predictors of willingness were older age, flu vaccination in the previous season, and confidence in COVID-19 vaccination. The most important reasons for decline were adverse reactions and discomfort experienced after previous COVID-19 vaccine doses and concerns for serious adverse reactions to COVID-19 booster doses. Considering the burden of COVID-19, a high acceptance rate of booster doses could be critical in controlling the pandemic. Our findings are innovative and could help policymakers to design and implement specific COVID-19 vaccination programs in order to decrease booster vaccine hesitancy.
Collapse
|
40
|
Odejinmi F, Mallick R, Neophytou C, Mondeh K, Hall M, Scrivener C, Tibble K, Turay-Olusile M, Deo N, Oforiwaa D, Osayimwen R. COVID-19 vaccine hesitancy: a midwifery survey into attitudes towards the COVID-19 vaccine. BMC Public Health 2022; 22:1219. [PMID: 35717164 PMCID: PMC9206526 DOI: 10.1186/s12889-022-13540-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background Ethnically minoritised people have been disproportionately affected by the COVID-19 pandemic. Emerging evidence suggests a lower uptake of the vaccine in ethnically minoritised people, particularly Black females of reproductive age. Unvaccinated pregnant women are high risk for morbidity and mortality from COVID-19. Midwives are the principal healthcare professionals responsible for counselling the pregnant population on decisions relating to vaccine uptake. The aim of this study was to explore midwifery uptake of and attitudes towards the COVID-19 vaccine in two ethnically diverse areas. Methods A 45-point questionnaire was circulated over a six-week period to midwives employed in two teaching hospitals in England; London (Barts Health NHS Trust) and Sussex (Brighton and Sussex University Hospitals NHS Trust (BSUH)). A total of 378 out of 868 midwives responded. Results were analysed to determine vaccine uptake as well as factors influencing vaccine hesitancy and decision-making between the two trusts and ethnic groups. Thematic analysis was also undertaken. Results Midwives of Black ethnicities were over 4-times less likely to have received a COVID-19 vaccine compared to midwives of White ethnicities (52% vs 85%, adjusted OR = 0.22, p = < 0.001). Overall, there were no significant differences between trusts in receipt of the COVID-19 vaccine (p = 0.13). Midwives at Barts Health were significantly more likely to have tested positive for COVID-19 compared to midwives at BSUH (adjusted OR = 2.55, p = 0.007). There was no statistical difference between ethnicities in testing positive for COVID-19 (p = 0.86). The most common concerns amongst all participants were regarding the long-term effect of the vaccine (35%), that it was developed too fast (24%), having an allergic reaction (22%) and concerns about fertility (15%). Amongst unvaccinated midwives, those of Black ethnicity had a higher occurrence of concern that the vaccine contained meat / porcine products (adjusted OR = 5.93, p = 0.04) and that the vaccine would have an adverse effect on ethnic minorities (adjusted OR = 4.42, p = 0.03). Conclusion This study highlights the significantly higher level of vaccine hesitancy amongst Black midwives and offer insights into midwives’ concerns. This can facilitate future targeted public health interventions. It is essential that vaccine hesitancy amongst midwifery staff is addressed to improve vaccine uptake in the pregnant population.
Collapse
Affiliation(s)
- Funlayo Odejinmi
- Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK
| | - Rebecca Mallick
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Lewes Road, Haywards Heath, RH16 4EX, UK
| | - Christina Neophytou
- Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK
| | - Kade Mondeh
- Newham University Hospital, Barts Health NHS Trust, Glen Rd, London, E13 8S, UK
| | - Megan Hall
- Newham University Hospital, Barts Health NHS Trust, Glen Rd, London, E13 8S, UK
| | - Claire Scrivener
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Lewes Road, Haywards Heath, RH16 4EX, UK.
| | - Katie Tibble
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Lewes Road, Haywards Heath, RH16 4EX, UK
| | - Mary Turay-Olusile
- Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK
| | - Nandita Deo
- Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK
| | - Doreen Oforiwaa
- Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK
| | - Rita Osayimwen
- Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK
| |
Collapse
|
41
|
Juarez R, Phankitnirundorn K, Okihiro M, Maunakea AK. Opposing Role of Trust as a Modifier of COVID-19 Vaccine Uptake in an Indigenous Population. Vaccines (Basel) 2022; 10:968. [PMID: 35746577 DOI: 10.3390/vaccines10060968] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 01/26/2023] Open
Abstract
Native Hawaiians and other Pacific Islanders (NHPIs) were disproportionately impacted by COVID-19 and remain significantly under-vaccinated against SARS-CoV-2. To understand vaccine hesitancy, we surveyed 1124 adults residing in a region with one of the lowest vaccination rates in Hawaii during our COVID-19 testing program. Probit regression analysis revealed that race/ethnicity was not directly associated with the probability of vaccine uptake. Instead, a higher degree of trust in official sources of COVID-19 information increased the probability of vaccination by 20.68%, whereas a higher trust in unofficial sources decreased the probability of vaccination by 12.49% per unit of trust. These results revealed a dual and opposing role of trust on vaccine uptake. Interestingly, NHPIs were the only racial/ethnic group to exhibit a significant positive association between trust in and consumption of unofficial sources of COVID-19 information, which explained the vaccine hesitancy observed in this indigenous population. These results offer novel insight relevant to COVID-19 mitigation efforts in minority populations.
Collapse
|
42
|
Hassen HD, Welde M, Menebo MM. Understanding determinants of COVID-19 vaccine hesitancy; an emphasis on the role of religious affiliation and individual's reliance on traditional remedy. BMC Public Health 2022; 22:1142. [PMID: 35672720 PMCID: PMC9172606 DOI: 10.1186/s12889-022-13485-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background The damage COVID-19 has caused interms of mortalities, economic breakdown and social disruption is immense. The COVID-19 vaccine has been one of the efficient prevention strategies so far in preventing the pandemic. However, the publics’ hesitancy towards vaccines has enormously affected this task. With emerging research findings indicating that a substantial proportion of adults are hesitant about a vaccine for COVID-19, important work that identifies and describes vaccine hesitant individuals is required to begin to understand and address this problem. Objective This study assessed public attitude towards COVID-19 Vaccine and identified important factors that lead to its hesitancy. Methods A web and paper-based cross-sectional survey study was conducted from July 31 to August 12, 2021. The study participants are staffs and students at Jimma University. A total of 358 participants were selected using stratified simple random sampling and requested to fill a survey questionnaire. Binomial logistic regression analysis was done to identify factors associated with COVID-19 vaccine hesitancy. Results Half of the participants were found to be hesitant to COVID-19 vaccine. The odds of becoming vaccine hesitant among middle income was two times more than those with lower income (AOR 2.17, 95% CI 1.05–4.5). Furthermore, respondent’s extent of exposure was associated with vaccine hesitancy with the odds of becoming vaccine hesitant among those whose source of COVID-19 information is from four media sources (Social Media, Mass Media, Health care worker and Friends/family/Neighbor) being 74% lower (AOR .26, 95% CI .09–.69) than those with one media source. Concern towards vaccine side effect, vaccine effectiveness and having the belief to treat COVID-19 with traditional remedies were found to increase the odds of becoming vaccine hesitant by 31%, 42% and 37% respectively. Moreover, the association between side-effect concern and vaccine hesitancy was moderated by participant’s religious affiliation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13485-2.
Collapse
Affiliation(s)
- Hanna Defar Hassen
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Mengistu Welde
- Department of Biomedical Sciences, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mesay Moges Menebo
- Department of Business and IT, School of Business, University of South-Eastern Norway, Campus Bø, Notodden, Norway
| |
Collapse
|
43
|
Mann S, Christini K, Chai Y, Chang CP, Hashibe M, Kepka D. "Vaccine hesitancy and COVID-19 immunization among rural young adults". Prev Med Rep 2022; 28:101845. [PMID: 35669235 PMCID: PMC9159780 DOI: 10.1016/j.pmedr.2022.101845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 11/18/2022] Open
Abstract
Rural young adults may be more averse to receiving a COVID-19 immunization than urban young adults. We aimed to assess differences in COVID-19 vaccine hesitancy for rural, compared with urban, young adults and characterize modifiable factors. This cross-sectional online survey collected demographic data, vaccination attitudes, and COVID-19 impacts from 2937 young adults, ages 18-26 years, across the western U.S. from October 2020 to April 2021. Rurality was determined by participants' zip code and classified using the rural and urban continuum codes (RUCC). Multivariable logistic regression described adjusted (age, gender, race and ethnicity, being a current student, and month of survey) odds of self-reported intent to receive the COVID-19 vaccination by rurality. Mediation analysis was used to decompose total effects into average direct effects and average causal mediation (indirect) effects. Rural participants had 40% lower odds than urban participants of intending to receive the COVID-19 vaccine after adjustments (adjusted odds ratio, 0.62 [95% CI, 0.50-0.76]). The direct effect remained (P<0.001), but was mediated by both education (8.3%, P<0.001) and month in which the survey was taken (23.5%, P<0.001). We observed a divergence after December 2020 in vaccination intent between rural and urban young adults that widened over time. Hesitancy to receive the COVID-19 vaccine was greater among rural, compared with urban young adults, and grew disproportionally after December 2020. Mediation by whether one was a current student or not suggests differences in sources of information for vaccination decision-making, and highlights areas for addressing vaccine hesitancy.
Collapse
Affiliation(s)
- Sara Mann
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kaila Christini
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Corresponding author at: 2000 Circle of Hope, Rm 4144, Salt Lake City, UT 84112, USA.
| | - Yan Chai
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Chun-Pin Chang
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Mia Hashibe
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Deanna Kepka
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- University of Utah College of Nursing, Salt Lake City, UT, USA
| |
Collapse
|
44
|
Breckenridge LA, Burns D, Nye C. The use of motivational interviewing to overcome COVID-19 vaccine hesitancy in primary care settings. Public Health Nurs 2022; 39:618-623. [PMID: 34716618 PMCID: PMC8661599 DOI: 10.1111/phn.13003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022]
Abstract
Vaccine hesitancy is not a new phenomenon. However, the COVID-19 pandemic has highlighted the impact of political, racial, and health disparities on vaccine hesitancy at a global level. With the creation of the COVID-19 vaccine, a resurgence of vaccine hesitancy has emerged and many are reluctant to receive the vaccination. The reluctance varies from concerns about government interference in vaccine development, to the speed of vaccine development, to long-term health outcomes and potential side effects. Health care professionals need to consider evidence-based approaches that are effective in assisting patients with health care decision-making regarding vaccine uptake. Motivational Interviewing (MI) is an effective technique to positively impact behavior change. Definitions and examples of MI techniques are provided to illustrate how MI can be used to support patient autonomy and provide a safe and trusting environment, with the goal of increasing COVID-19 vaccination uptake.
Collapse
Affiliation(s)
| | - Dana Burns
- Clinical Assistant Professor, Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Carla Nye
- Clinical Assistant Professor, Virginia Commonwealth UniversityRichmondVirginiaUSA
| |
Collapse
|
45
|
Sargent RH, Laurie S, Moncada L, Weakland LF, Lavery JV, Salmon DA, Orenstein WA, Breiman RF. Masks, money, and mandates: A national survey on efforts to increase COVID-19 vaccination intentions in the United States. PLoS One 2022; 17:e0267154. [PMID: 35446922 PMCID: PMC9022841 DOI: 10.1371/journal.pone.0267154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
Various efforts to increase COVID-19 vaccination rates have been employed in the United States. We sought to rapidly investigate public reactions to these efforts to increase vaccination, including self-reported responses to widespread reduced masking behavior, monetary incentive programs to get vaccinated, and work vaccination requirements. Using a unique method for data collection (Random Domain Intercept Technology), we captured a large (N = 14,152), broad-based sample of the United States Web-using population (data collected from June 30 -July 26, 2021). About 3/4 of respondents reported being vaccinated. The likelihood of vaccination and vaccination intention differed across various demographic indicators (e.g., gender, age, income, political leaning). We observed mixed reactions to efforts aimed at increasing vaccination rates among unvaccinated respondents. While some reported that specific efforts would increase their likelihood of getting vaccinated (between 16% and 32%), others reported that efforts would decrease their likelihood of getting vaccinated (between 17% and 42%). Reactions differed by general vaccination intention, as well as other demographic indicators (e.g., race, education). Our results highlight the need to fully understand reactions to policy changes, programs, and mandates before they are communicated to the public and employed. Moreover, the results emphasize the importance of understanding how reactions differ across groups, as this information can assist in targeting intervention efforts and minimizing potentially differential negative impact.
Collapse
Affiliation(s)
| | | | | | - Leo F. Weakland
- Center for Global Health Innovation, Atlanta, Georgia, United States of America
| | - James V. Lavery
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Center for Ethics, Emory University, Atlanta, Georgia, United States of America
| | - Daniel A. Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Walter A. Orenstein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Robert F. Breiman
- Center for Global Health Innovation, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
| |
Collapse
|
46
|
Blacksin BA. Case report: Vaccine Brigade Chicago, Illinois: From founding February to July, 2021. Public Health Nurs 2022; 39:1034-1040. [PMID: 35352391 PMCID: PMC9115447 DOI: 10.1111/phn.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 11/28/2022]
Abstract
The COVID 19 epidemic disrupted every aspect of American life and imposed severe trauma as a result of lockdown, fears of disease or death, separation from and death of loved ones, and daily media coverage of the unfolding pandemic. The following case report describes the experiences of the Vaccine Brigade, a group of Public Health Nurses (PHNs) and other professionals, mostly retired, who organized themselves to provide assistance with vaccine administration in the city of Chicago and Cook County, Illinois. The report describes the founding of their organization in February, 2021 and their work to support vaccine administration in communities of color and other underserved communities. This case report presents a successful model of volunteerism, built on foundational principals of collective decision making, democracy and social justice. Its members developed existing social networks and skills they had learned during their careers as PHNs and activists to create a functional organization that could assist with the task of getting shots into arms.
Collapse
Affiliation(s)
- Beth A. Blacksin
- Adjunct FacultySchool of NursingUniversity of Missouri‐Kansas CityKansasMissouri
| |
Collapse
|
47
|
Alam MD, Paul SK, Momi M, Ni L, Xu Y. Factors Associated With Psychological Outcomes Among Vaccinated and Unvaccinated Health Care Workers Against COVID-19 Infection in Bangladesh. Front Med (Lausanne) 2022; 9:852922. [PMID: 35402432 PMCID: PMC8988188 DOI: 10.3389/fmed.2022.852922] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 01/09/2023] Open
Abstract
Background Vaccination of healthcare workers (HCWs) is recommended during the COVID-19 pandemic to reduce the risk of infection for themselves and their patients, as well as to encourage their patients to get immunized. The present study aimed to investigate the psychological outcomes and associated factors among vaccinated and unvaccinated HCWs against COVID-19 infection in Bangladesh. Methods From March to August 2021, an online nationwide survey was conducted with a total of 2,038 Bangladeshi HCWs. The frequency of symptoms of general health problems, depression, anxiety, stress, post-traumatic stress disorder, insomnia, and loneliness was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and UCLA-LS scales, respectively. Results Compared with unvaccinated HCWs (n = 1,058), vaccinated HCWs (n = 980) had a statistically significant lower prevalence of general health problems (16.7 vs. 59.1%), depression (15.6 vs. 31.9%), post-traumatic stress disorder (22.3 vs. 30.8%), insomnia (23.8 vs. 64.9%), and loneliness symptoms (13.9 vs. 21.8%). Among vaccinated HCWs, females were significantly associated with a higher risk of symptoms of general health problems (AOR, 2.71; 95% CI, 0.97-7.60), anxiety (AOR, 2.17; 95% CI, 1.14-4.13), and loneliness (AOR, 2.52; 95% CI, 1.11-5.73). Except for anxiety and post-traumatic stress disorder symptoms, participants living in urban areas had a significantly lower risk of all psychological outcomes (e.g., depression: AOR, 0.43; 95% CI, 0.27-0.67; stress: AOR, 0.64; 95% CI, 0.47-0.88). Respondents who were married were significantly less likely to experience symptoms of general health problems (AOR, 0.10; 95% CI, 0.02-0.39), depression (AOR, 0.31; 95% CI, 0.22-0.82), insomnia (AOR, 0.46; 95% CI, 0.20-1.03), and loneliness (AOR, 0.31; 95% CI, 0.10-0.92). Participants who worked as doctors were significantly less chance of experiencing symptoms of general health problems (AOR, 0.18; 95% CI, 0.08-0.37), depression (AOR, 0.51; 95% CI, 0.30-0.87), and anxiety (AOR, 0.54; 95% CI, 0.37-0.78). On the other hand, unvaccinated HCWs who were 18-29 years old and had <5 years of work experience were significantly associated with a higher risk of all psychological outcomes except anxiety and insomnia symptoms (e.g., depression among 18-29 years old: AOR, 1.83; 95% CI, 0.27-2.60; stress among those with <5 years of work experience: AOR, 2.37; 95% CI, 0.93-6.07). Participants who worked as nurses were significantly more likely to suffer from depression (AOR, 1.44; 95% CI, 0.84-2.46), anxiety (AOR, 1.42; 95% CI, 0.24-1.73), and stress (AOR, 1.55; 95% CI, 0.31-0.89) symptoms. Except for anxiety and stress symptoms, respondents who worked as frontline workers and provided direct care to infected patients were the significantly higher chance of experiencing all psychological outcomes (e.g., depression among who worked as frontline workers: AOR, 2.41; 95% CI, 0.23-3.73; insomnia among those who provide direct care to infected patients: AOR, 2.60; 95% CI, 0.34-3.06). Participants who were infected with COVID-19 had a significantly less chance of experiencing symptoms of general health problems (AOR, 0.89; 95% CI, 0.65-1.22), depression (AOR, 0.66; 95% CI, 0.48-0.92), and anxiety (AOR, 0.63; 95% CI, 0.46-0.87). Conclusions To control the infection and improve psychological outcomes, this study suggests emphasizing the vaccinated to unvaccinated HCWs as soon as possible. They also required special attention, health-related education, and psychological support.
Collapse
Affiliation(s)
- Md. Dhedharul Alam
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, China
| | - Sujan Kumer Paul
- Department of Periodontology and Oral Pathology, Holy Family Red Crescent Medical College and Hospital, Dhaka, Bangladesh
| | - Mahmuda Momi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Li Ni
- Department of Psychiatry, Fuyang Third Peoples Hospital, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, China
| |
Collapse
|
48
|
Song S, Zang S, Gong L, Xu C, Lin L, Francis MR, Hou Z. Willingness and uptake of the COVID-19 testing and vaccination in urban China during the low-risk period: a cross-sectional study. BMC Public Health 2022; 22:556. [PMID: 35313843 PMCID: PMC8935604 DOI: 10.1186/s12889-022-12969-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Evidence on the willingness and uptake of the COVID-19 testing is scarce, and the willingness and uptake of vaccination may change as the pandemic evolves. This study aims to examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China. METHODS A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents' willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate factors associated with the willingness and uptake of the two measures. RESULTS In early 2021, about half (52.45%) of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) of the respondents were willing to receive testing. About two-thirds (63.28%) of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants, having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated. CONCLUSIONS By early 2021, Chinese adults expressed almost universal willingness of COVID-19 testing and over half of adults have been tested, while the willingness and uptake of COVID-19 vaccination were relatively low at the low-risk period of the COVID-19 pandemic. Maintaining willingness of COVID-19 vaccination is critical and necessary, especially when the pandemic evolved into a low-risk period.
Collapse
Affiliation(s)
- Suhang Song
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Shujie Zang
- School of Public Health, Fudan University, Shanghai, China
| | - Liubing Gong
- Chizhou Center for Disease Prevention and Control, Chizhou, Anhui province, China
| | - Cuilin Xu
- Yuhuatai Center for Disease Prevention and Control, Nanjing, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong SAR, China
| | - Mark R Francis
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai, China. .,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| |
Collapse
|
49
|
Kader F, Kruchten S, Campo M, Collica-Cox K, Davidson C, Wald A, Hewlett D. Dialogic health education to reduce COVID-19 disparities and increase health literacy in community and correctional settings: Protocol (Preprint). JMIR Res Protoc 2022; 11:e37713. [PMID: 36194870 PMCID: PMC9591706 DOI: 10.2196/37713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 vaccines significantly reduce rates of hospitalization and death for those infected with the SARS-CoV-2 virus. Those facing social oppression, including people of color, experience heightened risk for COVID-19 and comorbidities, but are often mistrustful of governmental agencies and initiatives, contributing to low vaccine uptake and a reluctance to access vital health care services. Dialogue-based health literacy interventions may mitigate mistrust and increase access to health services and information, subsequently increasing rates of vaccination and other behaviors that reduce COVID-19 risk. Objective To improve health literacy and reduce COVID-19 disparities, the Westchester County Department of Health, in partnership with two universities, community- and faith-based organizations, and the Westchester County Department of Correction, co-developed a health education program for community members, correctional officers, and incarcerated jail residents in Westchester, New York. Specific objectives are to increase preventative health behaviors, positive attitudes toward use of public health protocols, full vaccination or intentions to vaccinate, health care information understanding, health provider care access, clear communication with health care providers, and personal health care decision-making. Methods Grounded in dialogic learning, the program entails training community-based “trusted messengers” and correctional officers to lead health information sessions in community and correctional settings. During the grant period, the program intends for 80 community-based trusted messengers to receive training from the Department of Health and will be expected to reach a goal of 100 members (N=8000) of their communities. Correctional staff with experience delivering educational programs will be trained to facilitate sessions among 400 correctional facility residents and 600 correctional staff. Results Pre-post surveys will assess changes in health behaviors, attitudes, and perceptions. The program has been administered in the correctional facility since February 2022, with information sessions expected to cease for correctional staff and residents in June 2022 and November 2022, respectively. An initial cohort of community-based trusted messengers began training in February 2022, and information sessions have been scheduled in various virtual and community settings since March 2022. As of April 2022, the two-pronged health education program has reached 439 correctional officers, 98 jail residents, and 201 community members countywide. Program evaluation findings will be released in future publications after study implementation is complete. Conclusions Few studies have evaluated the combined effects of training-of-trainers (ToT) and dialogical learning models on behavior and health literacy. As the first known COVID-19–specific dialogue-based health education program that applies a ToT model in the community-based, correctional, and virtual settings simultaneously, this study fills a gap in current knowledge about health literacy and health behavior in marginalized populations. Thus, this evidence-based framework can remedy COVID-19 disparities while also addressing risks for a host of health-related issues at the community level, potentially serving as a best-practice model for future health programs. International Registered Report Identifier (IRRID) PRR1-10.2196/37713
Collapse
Affiliation(s)
- Farah Kader
- Westchester County Department of Health, White Plains, NY, United States
| | - Stephanie Kruchten
- Westchester County Department of Health, White Plains, NY, United States
| | - Marc Campo
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, United States
| | - Kimberly Collica-Cox
- Dyson College of Arts and Sciences, Pace University, New York, NY, United States
| | - Charis Davidson
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, United States
| | - Adrienne Wald
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, United States
| | - Dial Hewlett
- Westchester County Department of Health, White Plains, NY, United States
| |
Collapse
|
50
|
Raza SA, Zhang X, Oluyomi A, Adepoju OE, King B, Amos CI, Badr H. Predictors of COVID-19 perceived susceptibility: insights from population-based self-reported survey during lockdown in the United States. J Infect Public Health 2022; 15:508-514. [PMID: 35429789 PMCID: PMC8941860 DOI: 10.1016/j.jiph.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/01/2021] [Accepted: 03/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background The COVID-19 pandemic during lockdown has highlighted the importance of identifying individuals most at risk of infection with SARS-CoV-2, underscoring the need to assess factors contributing to susceptibility to disease. With the rapidly evolving nature of the pandemic and its new variants, there is an inadequate understanding on whether there are certain factors such as a specific symptom or collection of symptoms that combined with life-style behaviors may be useful to predict susceptibility. The study aims to explore such factors from pre-vaccination data to guide public health response to potential new waves. Methods An anonymous electronic survey was distributed through social media during the lockdown period in the United States from April to June 2020. Respondents were questioned regarding COVID testing, presenting symptoms, demographic information, comorbidities, and confirmation of COVID‐19 test results. Stepwise logistic regression was used to identify predictors for COVID‐19 perceived susceptibility. Selected classifiers were assessed for prediction performance using area under receiver operating characteristic (AUROC) curve analysis. Results A total of 130 participants deemed as susceptible because they self-reported their perception of having COVID-19 (but without the evidence of positive test) were compared with 130 individuals with documented negative test results. Participants had a mean age of 45 years, and 165 (63%) were female. Final multivariable model showed significant associations with perceived susceptibility for the following variables: fever (OR:33.5; 95%CI: 3.9,85.9), body ache (OR:3.0; 95%CI:1.1,6.4), contact history (OR:2.7; 95%CI:1.1,6.4), age> 50 (OR:2.7; 95%CI:1.1, 6.6) and smoking (OR:3.3; 95%CI: 1.2,9.1) after adjusting for other symptoms and presence of comorbid conditions. The AUROC ranged from poor to fair (0.65–0.76) for cluster of symptoms but improved to a good model (AUROC = 0.803) after inclusion of sociodemographic and lifestyle behaviors e.g., age and smoking tobacco. Conclusions Fever and body aches suggest association with perceived COVID‐19 susceptibility in the presence of demographic and lifestyle behaviors. Using other constitutional and respiratory symptoms with fever and body aches, the parsimonious classifier correctly predicts 80.3% of COVID‐19 perceived susceptibility. A larger cohort of respondents will be needed to study and refine classifier performance in future lockdowns and with expected surge of new variants of COVID-19 pandemic.
Collapse
|