Willingness of Greek general population to get a COVID-19 vaccine

COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review

OBJECTIVE

To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries.

DESIGN

A realist review.

DATA SOURCES

Embase, PubMed, Dimensions ai and Google Scholar.

SETTING

High-income countries.

DEFINITIONS

We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021.

RESULTS

We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited.

CONCLUSION

Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.

Understanding Sociodemographic Factors and Reasons Associated with COVID-19 Vaccination Hesitance among Adults in Tanzania: A Mixed-Method Approach

Although studies on COVID-19 vaccine hesitancy are being undertaken widely worldwide, there is limited evidence in Tanzania. This study aims to assess the sociodemographic factors associated with COVID-19 vaccine hesitancy and the reasons given by unvaccinated study participants. We conducted a mixed-method cross-sectional study with two components-health facilities and communities-between March and September 2022. A structured questionnaire and in-depth interviews were used to collect quantitative and qualitative data, respectively. A total of 1,508 individuals agreed to participate in the survey and explained why they had not vaccinated against COVID-19. Of these participants, 62% indicated they would accept the vaccine, whereas 38% expressed skepticism. In a multivariate regression analysis, adult study participants 40 years and older were significantly more likely to report not intending to be vaccinated (adjusted odds ratio [AOR], 1.28; 95% CI, 1.01-1.61; P = 0.04) than youth and middle-aged study participants between 18 and 40 years. Furthermore, female study participants had a greater likelihood of not intending to be vaccinated (AOR, 1.51; 95% CI, 1.19-1.90; P = 0.001) than male study participants. The study identified fear of safety and short-term side effects, and lack of trust of the COVID-19 vaccine; belief in spiritual or religious views; and belief in local remedies and other precautions or preventive measures as the major contributors to COVID-19 vaccine hesitancy in Tanzania. Further empirical studies are needed to confirm these findings and to understand more fully the reasons for vaccine hesitancy in different demographic groups.

Conspiracy Theories, Trust in Science, and Knowledge during the Third Wave of the COVID-19 Pandemic in Cyprus

Conspiracy theories flourish during periods of crisis. One way to counteract the believability of conspiracy theories is trust in science and knowledge about the "perceived threat", such as the SARS-CoV-2 virus. A total of 363 adults from Cyprus were recruited via convenience and snowball sampling methods. The data were collected via an internet-based questionnaire that examined participants' belief in 17 conspiracy theory statements, trust in science and scientists, knowledge about the symptoms and the spread of the SARS-CoV-2 virus, phobic anxiety, hostility, somatization, and personality traits based on the Big Five. The results suggest (a) the overall belief in conspiracy theories in Cyprus is low, even though a notable percentage holds a neutral stance towards these theories; (b) trust in science and knowledge about the symptoms and the spread of the SARS-CoV-2 virus is negatively related to conspiracy theories, indicating the importance of trusting science and having knowledge as a means to counteract conspiracy theories; (c) young adults, those residing in rural areas, and those with a low education level are more likely to believe in conspiracy theories; (d) there are no significant associations between conspiracy theories and the psychological dimensions of phobic anxiety, hostility, and somatization; (e) there is difficulty in identifying specific traits related to conspiracy ideation. Public health officials could benefit from the findings when communicating information during periods of crisis.

Neighbourhood sociodemographic factors and COVID-19 vaccine uptake in the Netherlands: an ecological analysis

BACKGROUND

While overall COVID-19 vaccine uptake is high in the Netherlands, it lags behind in certain subpopulations.

AIM

We aimed to explore the characteristics of groups with lower COVID-19 vaccine uptake at neighbourhood level to inform the strategy to improve uptake and guide research into barriers for vaccination.

METHODS

We performed an ecological study using national vaccination register and socio-demographic data at neighbourhood level. Using univariate and multivariable generalized additive models we examined the (potentially non-linear) effect of each determinant on uptake. We focused on those aged 50 years and older, since they are at highest risk of severe disease.

RESULTS

In those over 50 years of age, a higher proportion of individuals with a non-Western migration background and higher voting proportions for right-wing Christian and conservative political parties were at neighbourhood level univariately associated with lower COVID-19 vaccine uptake. In contrast, higher socioeconomic status and higher voting proportions for right-wing liberal, progressive liberal and Christian middle political parties were associated with higher uptake. Multivariable results differed from univariate results in that a higher voting proportion for progressive left-wing political parties was also associated with higher uptake. In addition, with regard to migration background only a Turkish background remained significant.

CONCLUSION

We identified determinants associated with COVID-19 vaccine uptake at neighbourhood level and observed heterogeneity in uptake between different subpopulations. Since the goal of vaccination is not only to reduce suffering and death by improving the average uptake, but also to reduce health inequity, it is important to focus on subpopulations with lower uptake.

Boosting COVID-19 vaccine inoculation and booster shots: a systematic review and meta-analysis of factors that influence Coronavirus vaccine uptake in practice

Introduction

Vaccines alone do not control pandemics, but vaccinations. The hope of COVID-19 pandemic control is hinged on vaccinations and other public health measures. This systematic review/meta-analysis (SR/MA) investigated the factors that inform coronavirus vaccine uptake globally in an attempt to improve COVID-19 immunization.

Method

The PRISMA 2020 methodology was used for this review. A total of 2902 articles were identified from electronic databases and other sources. After screening, 33 articles were included in the review and quantitative meta-analysis. Comprehensive meta-analysis software version 3 was used for the meta-analysis.

Results

We observed that vaccine effectiveness, side effects and the proportion of acquaintances vaccinated significantly influenced respondents' COVID-19 immunization decision. Also, associations of vaccine effectiveness, smaller risks to serious side effects, free and voluntary vaccinations and fewer vaccine doses, and longer duration to wanning were observed. We also observed variations in vaccine hesitancy trends in studies carried out in Asia, Europe, America, and Africa.

Conclusion

Wanning and acquaintance's vaccination status as factors to vaccination are insights the present paper is bringing to the limelight. Health promotion and COVID-19 vaccination planning are crucial for enhancing vaccine uptake.

Vaccine sentiment analysis using BERT + NBSVM and geo-spatial approaches

Since the spread of the coronavirus flu in 2019 (hereafter referred to as COVID-19), millions of people worldwide have been affected by the pandemic, which has significantly impacted our habits in various ways. In order to eradicate the disease, a great help came from unprecedentedly fast vaccines development along with strict preventive measures adoption like lockdown. Thus, world wide provisioning of vaccines was crucial in order to achieve the maximum immunization of population. However, the fast development of vaccines, driven by the urge of limiting the pandemic caused skeptical reactions by a vast amount of population. More specifically, the people's hesitancy in getting vaccinated was an additional obstacle in fighting COVID-19. To ameliorate this scenario, it is important to understand people's sentiments about vaccines in order to take proper actions to better inform the population. As a matter of fact, people continuously update their feelings and sentiments on social media, thus a proper analysis of those opinions is an important challenge for providing proper information to avoid misinformation. More in detail, sentiment analysis (Wankhade et al. in Artif Intell Rev 55(7):5731-5780, 2022. 10.1007/s10462-022-10144-1) is a powerful technique in natural language processing that enables the identification and classification of people feelings (mainly) in text data. It involves the use of machine learning algorithms and other computational techniques to analyze large volumes of text and determine whether they express positive, negative or neutral sentiment. Sentiment analysis is widely used in industries such as marketing, customer service, and healthcare, among others, to gain actionable insights from customer feedback, social media posts, and other forms of unstructured textual data. In this paper, Sentiment Analysis will be used to elaborate on people reaction to COVID-19 vaccines in order to provide useful insights to improve the correct understanding of their correct usage and possible advantages. In this paper, a framework that leverages artificial intelligence (AI) methods is proposed for classifying tweets based on their polarity values. We analyzed Twitter data related to COVID-19 vaccines after the most appropriate pre-processing on them. More specifically, we identified the word-cloud of negative, positive, and neutral words using an artificial intelligence tool to determine the sentiment of tweets. After this pre-processing step, we performed classification using the BERT + NBSVM model to classify people's sentiments about vaccines. The reason for choosing to combine bidirectional encoder representations from transformers (BERT) and Naive Bayes and support vector machine (NBSVM ) can be understood by considering the limitation of BERT-based approaches, which only leverage encoder layers, resulting in lower performance on short texts like the ones used in our analysis. Such a limitation can be ameliorated by using Naive Bayes and Support Vector Machine approaches that are able to achieve higher performance in short text sentiment analysis. Thus, we took advantage of both BERT features and NBSVM features to define a flexible framework for our sentiment analysis goal related to vaccine sentiment identification. Moreover, we enrich our results with spatial analysis of the data by using geo-coding, visualization, and spatial correlation analysis to suggest the most suitable vaccination centers to users based on the sentiment analysis outcomes. In principle, we do not need to implement a distributed architecture to run our experiments as the available public data are not massive. However, we discuss a high-performance architecture that will be used if the collected data scales up dramatically. We compared our approach with the state-of-art methods by comparing most widely used metrics like Accuracy, Precision, Recall and F-measure. The proposed BERT + NBSVM outperformed alternative models by achieving 73% accuracy, 71% precision, 88% recall and 73% F-measure for classification of positive sentiments while 73% accuracy, 71% precision, 74% recall and 73% F-measure for classification of negative sentiments respectively. These promising results will be properly discussed in next sections. The use of artificial intelligence methods and social media analysis can lead to a better understanding of people's reactions and opinions about any trending topic. However, in the case of health-related topics like COVID-19 vaccines, proper sentiment identification could be crucial for implementing public health policies. More in detail, the availability of useful findings on user opinions about vaccines can help policymakers design proper strategies and implement ad-hoc vaccination protocols according to people's feelings, in order to provide better public service. To this end, we leveraged geospatial information to support effective recommendations for vaccination centers.

COVID-19 Vaccination Refusal—Which Factors are Related in the Czech Republic, One of the Most Affected Countries in the World?

Objective: This study examined the willingness to get vaccinated and the factors influencing this attitude in extreme settings—in the Czech Republic (at the time of the survey, the third-worst affected country in the world).

Methods: We used national data from the general adult Czech population (N = 1,401) and measured attitudes towards vaccination, sociodemographic characteristics, government trust, knowledge about COVID-19 vaccines, personal characteristics, depression and anxiety.

Results: Respondents who were more likely to refuse the vaccine were: female, younger, living without a partner, self-employed or unemployed, living in a town, believers outside the church, and did not trust the government, obtained information about the vaccine from social media, were extroverts and depressed. Conversely, respondents who were less likely to refuse the vaccine were: pensioners, people with higher education, respondents with better real knowledge about the COVID-19 vaccines, those who obtained information about the vaccine from an expert and those who had higher scores in neuroticism.

Conclusion: This study thus offers a deeper understanding of the factors that might influence vaccine intention and subsequently the course of the COVID-19 pandemic.

Implications for COVID-19 vaccine uptake: A systematic review

BACKGROUND

Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake.

METHODS

We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA).

RESULTS

Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy.

CONCLUSION

Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.

Barriers and Facilitators Affecting the Uptake of COVID-19 Vaccines: A Qualitative Perspective of Frontline Nurses in Namibia

Aim

Vaccinations remain one of the most effective measures to prevent and control the spread of COVID-19, while also reducing hospitalizations and deaths, yet many are unwilling to be vaccinated. This study explores the barriers and facilitators affecting the uptake of COVID-19 vaccines among frontline nurses.

Design

A qualitative, explorative, descriptive, and contextual research strategy was employed.

Methods

A sample of 15 nurses were selected via purposeful sampling to the point of data saturation. The participants were nurses at the COVID-19 vaccinations Centre in Rundu, Namibia. Data were collected using semistructured interviews and analyzed thematically.

Results

Three themes and 11 subthemes were identified, namely: (a) barriers, (b) facilitators, and (c) measures to increase the COVID-19 vaccine uptake. Barriers included living in deep rural areas, unavailability of vaccines, and misinformation, whereas scared of death, availability of COVID-19 vaccines, and family influence and peer pressure emerged as facilitators to the uptake of COVID-19 vaccines. Adoption of vaccination passport as a requirement to work premises and as an international travel requirement were the measures proposed to increase the COVID-19 vaccine uptake.

Conclusion

The study found several facilitators and barriers to COVID-19 vaccine uptake among frontline nurses. The identified barriers cover the individual, health system, and social factors hindering the COVID-19 vaccine uptake among frontline nurses. Whereas fear of COVID-19 deaths, family influence, and availability of vaccines were found to promote COVID-19 uptake. This study recommends targeted interventions to improve the uptake of COVID-19 vaccines.

Vaccination Coverage and Associated Factors of COVID-19 Uptake in Adult Primary Health Care Users in Greece

In our study, attitudes and perceptions of adult primary health care users regarding COVID-19 vaccination were evaluated. A single-center, cross-sectional study was conducted during a 1-year period (March 2021-March 2022) in a rural area in Crete, Greece. A sample of 626 self-reported questionnaires was collected at the end of the study period. Overall, 78% of respondents stated that they had received the COVID-19 vaccine. The reasons behind vaccine uptake were mainly personal beliefs and the desire to avoid professional constraints. The presence of diabetes type 2, fear of infection, and high perceived efficacy of vaccine previous flu vaccination, living with vulnerable persons, and the influence of scientific information were all significant predictors of COVID-19 vaccine uptake. On the contrary, unwillingness and/or uncertainty to be vaccinated was associated with fear of vaccine side effects, information insufficiency, media/internet information, older age, the presence of inflammatory arthritis, previous COVID-19 infection, the belief that infection confers much greater immunity than the vaccine, and attitudes against vaccinations in general were predictors against COVID-19 vaccination. In conclusion, taking into account all of the above predictors and particularly those regarding safety and vaccine effectiveness may guide future strategies appropriately tailored to specific characteristics and needs of different geographic populations.

Practices and educational needs of Hellenic Police Officers in providing first aid/cardiopulmonary resuscitation: A cross-sectional survey

BACKGROUND

It is well known that police officers (POs) are expected to be the first responders in emergency cases requiring First Aid (FA) such as cardiac arrest.

OBJECTIVE

Description of practices and educational needs of Hellenic POs in providing FA/Cardiopulmonary Resuscitation (CPR) in case of medical emergencies and description of the equipment of professional FA kit.

METHODS

An anonymous cross-sectional survey was conducted from January 1, 2016, to December 31, 2017, using a self-administered questionnaire designed to serve the purposes of this particular survey. The instrument consisted of 53 questions (multiple choice and open-ended questions) administered in a convenience sample of 700 POs of the Attica prefecture.

RESULTS

A sample of 520 POs (constables and lieutenants) completed the questionnaire (response rate = 74.28%). Among the participants, 248 (47.7 %) declared that they had provided FA/CPR in the past, while among those declaring that they had never provided FA/PCR (n = 248), 153 (61.7%) said that they had experienced FA/CPR needs, but did not know what they had to do. Moreover, only 18.1% (94/520) of the POs answered that they have FA equipment in their professional equipment, which mainly includes bandages (54/94, 57.4%), while 29.7% of POs provided answers about their educational needs (313 in total) declared that they would like to be educated in bleeding control.

CONCLUSION

There is a need to educate and train Greek POs in first aid and CPR in an organized and mandatory way in order to meet emergency needs.

The perception and attitude of Turkish ophthalmologists related with COVID-19 pandemic

Türk göz hekimlerinin COVID-19 pandemisi ile ilgili algı ve tutumları. Öz Amaç: Üçüncü basamak bir referans göz hastalıkları hastanesinde görev yapan Türk göz hekimleri arasında, COVID-19 ile ilgili algı ve tutum düzeylerini araştırmak. Gereç ve Yöntem: Mart 2021'de, sosyodemografik form ve 52 çoktan seçmeli soru içeren ankete dayalı kesitsel bir çalışma yapılmıştır. Sorular, üç kavramın algısını ayrı ayrı değerlendirmeye yönelikti: Hastalık, COVID-19'un nedenleri ve COVID-19'un kontrolü. Yanısıra, COVID-19'dan kaçınma tutumlarını ve COVID-19 aşısına yönelik tutumları değerlendirmeyi hedefleyen sorulara da yer verildi. Bulgular: Toplam 43 (15 erkek ve 28 kadın) göz hekimi çevrimiçi anketi tamamladı. Göz hekimleri arasında tehlikelilik ve bulaşıcılık algısı güçlüydü. COVID-19'un nedenlerine ilişkin algı alt boyutlarındaki puanlar orta-ılımlı düzeydeydi. Aşağıdakiler arasında istatistiksel olarak anlamlı farklar ortaya çıktı: Asistan hekimler ve öğretim üyeleri arasında Makro Kontrol’de (p=0.02), Kontrol Edilebilirlik’te (p=0.38) ve COVID-19 Kontrolü Algısı’nda (p=0.022); erkekler ve kadınlar (p=0,009) ile asistan hekimler ve öğretim üyeleri (p=0,023) arasında COVID-19'dan Davranışsal Kaçınma Tutumları’nda; asistan hekimler ve öğretim üyeleri arasında COVID-19 Aşısına Yönelik Tutumlar’da (p=0.034). Sonuç: COVID-19, göz hekimlerince tehlikeli ve bulaşıcı olarak algılandı. COVID-19'un Kontrolü Algısı, öğretim üyelerinde, asistan hekimlere göre daha güçlüydü. Kadın ve öğretim üyesi katılımcılarda, COVID-19'dan Davranışsal Kaçınma tutumları daha yüksekti. Öğretim üyeleri, COVID-19 aşısına karşı asistan doktorlardan daha az olumsuz tutum sergiledi. Bu değerlendirmeler, hem COVID-19 pandemisinde hem de gelecekteki salgınlarda, hastalıkla mücadelede, yolumuza ışık tutabilir. Anahtar Kelimeler: Algı, COVID-19, oftalmologlar, pandemi, tutum.

Willingness to receive the COVID-19 vaccine among HIV positive men who have sex with men in China: a cross-sectional study

BACKGROUND

People living with HIV(PLWH) are deemed more vulnerable to the SARS-CoV-2 infection than the uninfected population. Vaccination is an effective measure for COVID-19 control, yet, little knowledge exists about the willingness of men who have sex with men (MSM) living with HIV in China to be vaccinated.

METHODS

This cross-sectional study evaluated the willingness of MSM living with HIV to receive COVID-19 vaccination in six cities of Guangdong, China, from July to September 2020. Factors associated with willingness to receive COVID-19 vaccination using multivariable logistic regression.

RESULTS

In total, we recruited 944 HIV-positive MSM with a mean age of 29.2 ± 7.7 years. Of all participants, 92.4% of them were willing to receive the COVID-19 vaccine. Participants who were separated, divorced, or widowed (adjusted OR: 5.29, 95%CI: 1.02-27.48), had an annual income higher than 9,000 USD (adjusted OR: 1.70, 95%CI: 1.01-2.86), had ever taken an HIV self-test (adjusted OR: 1.78, 95%CI: 1.07-2.95), had ever disclosed sexual orientation to a doctor/nurse (adjusted OR: 3.16, 95%CI: 1.33-7.50), had ever disclosed sexual orientation to others besides their male partners (adjusted OR: 2.18, 95%CI: 1.29-3.69) were more willing to receive the vaccine. Sex with a female partner in the past six months decreased the likelihood of willingness to receive the vaccine (adjusted OR: 0.40, 95%CI: 0.17-0.95). Economic burden, worry that my health condition could not bear the risk of receiving COVID-19 vaccines, and concern that the vaccination would affect the immune status and antiretroviral therapy were the main reasons for unwillingness to receive vaccination.

CONCLUSION

Our study showed that HIV-positive MSM had a high willingness to receive the COVID-19 vaccination. Targeted interventions such as health education should be conducted among MSM with HIV infection to enhance COVID-19 vaccine uptake.

Sentimental and spatial analysis of COVID-19 vaccines tweets

The world has to face health concerns due to huge spread of COVID. For this reason, the development of vaccine is the need of hour. The higher vaccine distribution, the higher the immunity against coronavirus. Therefore, there is a need to analyse the people's sentiment for the vaccine campaign. Today, social media is the rich source of data where people share their opinions and experiences by their posts, comments or tweets. In this study, we have used the twitter data of vaccines of COVID and analysed them using methods of artificial intelligence and geo-spatial methods. We found the polarity of the tweets using the TextBlob() function and categorized them. Then, we designed the word clouds and classified the sentiments using the BERT model. We then performed the geo-coding and visualized the feature points over the world map. We found the correlation between the feature points geographically and then applied hotspot analysis and kernel density estimation to highlight the regions of positive, negative or neutral sentiments. We used precision, recall and F score to evaluate our model and compare our results with the state-of-the-art methods. The results showed that our model achieved 55% & 54% precision, 69% & 85% recall and 58% & 64% F score for positive class and negative class respectively. Thus, these sentimental and spatial analysis helps in world-wide pandemics by identify the people's attitudes towards the vaccines.

Knowledge and willingness to receive a COVID-19 vaccine: a survey from Anhui Province, China

OBJECTIVES

Vaccinations can prevent COVID-19 and control its spread quickly and efficiently. This study aimed to investigate knowledge and willingness of geriatric care facility staff to receive a COVID-19 vaccine, and to provide a basis for the government to promote the COVID-19 vaccine and guide people to get vaccinated.

STUDY DESIGN

A cross-sectional study.

METHODS

Data on characteristics of the participants, knowledge about the COVID-19 vaccine, and willingness to get vaccinated for COVID-19 were collected through an online survey from May 19 to June 18, 2021. Statistical analyses were conducted with ANOVA, chi-square, logistic regression.

RESULTS

The survey illustrated that the highest score of COVID-19 vaccine knowledge was 50, the lowest 20, and the average 44.22. It also demonstrated that 91.3% of the participants had a good knowledge of COVID-19 vaccine, and that 97.3% participants were willing to receive the COVID-19 vaccine. The results showed that geriatric care facility staff had varied level of the COVID-19 vaccine knowledge depending upon their age, educational background, and other factors, and correspondingly, their willingness to receive COVID-19 vaccine was affected by their knowledge level of COVID-19 vaccine.

CONCLUSIONS

In general, the participants, the staff of geriatric care facilities in Anhui Province, had good mastery of the COVID-19 vaccine, and they were willing to get vaccinated. However, there still existed a few participants with poor knowledge, who were unwilling to get vaccinated against COVID-19. Government can guide people to accept vaccination by enhancing publicity about the effects and adverse reactions of COVID-19 vaccines.

Behavioral and Cultural Insights, a Nationwide Study Based on Repetitive Surveys of WHO Behavioral Insights Tool in Greece Regarding COVID-19 Pandemic and Vaccine Acceptance

Monitoring behavioral and cultural insights during the pandemic is a useful tool to identify factors related to COVID-19 vaccine acceptance and confront the pandemic’s vast impact. Data were collected using a questionnaire designed according to the “survey tool and guidance” provided by the World Health Organization (WHO). Surveys were conducted by a market research company for five consecutive months, with a sample of 1000 individuals recruited per survey. Vaccination acceptance increased from 55.2% to 67.2%, while the percentage of undecisive individuals decreased from 16.3% to 10.6%. The proportion of vaccine resistant participants remained relatively steady (25−30%). Knowledge about the pandemic and compliance with preventive measures was high (>90%). Factors associated with vaccination included: Increased age, male gender, influenza vaccination, following authorities’ recommendations, being informed by HCWs or formal information sources, care for others, concern about the country’s economic recession and health system overload. Pandemic fatigue was reflected across the surveys, indicated by a decrease in the intention to self-isolate and remain at home when ill. Despite the decrease of undecisive individuals, a firm core of vaccine resistant individuals may be responsible for the relatively lower vaccine coverage compared to northern EU countries. Study results could be useful for developing approaches tailored to a reluctant population.

Cueing quality: Unpacking country-of-origin effects on intentions to vaccinate against COVID-19 in Taiwan

While existing studies have reported and recognized country-of-origin effects on the intentions to vaccinate against COVID-19 among individual citizens in some countries, the causal mechanism behind such effects to inform public health policymakers remain unexplored. Adding up a quality cue explanation for such effects to the existing literature, the authors argue that individual consumers are less willing to get a vaccine designed and manufactured by a country with a significantly lower quality perception than other countries. A survey experiment that recruited a nationally representative sample of Taiwanese adults (n = 1951) between December 13, 2020 and January 11, 2021 was designed and conducted to test the argument. We find that all else equal, Taiwanese respondents were on average less likely to express stronger willingness to take a vaccine from China than from the US, Germany, and Taiwan. Furthermore, even when the intrinsic quality of the vaccine was held constant by the experimental design, respondents still had a significantly lower quality perception of the vaccine from China, both in terms of perceived protection and severe side effects. Further evidence from casual mediation analyses shows that about 33% and 11% of the total average causal effects of the "China" country-of-origin label on vaccine uptake intention were respectively mediated through the perceived efficacy of protection and perceived risk of experiencing severe side effects. We conclude that quality cue constitutes one of many casual mechanisms behind widely reported country-of-origin effects on intention to vaccinate against COVID-19.

COVID-19 vaccine acceptance rate and its predictors in Ethiopia: A systematic review and meta-analysis

Coronavirus disease (COVID-19) is a global pandemic caused by the SARS-CoV-2 virus. COVID-19 vaccine is the best strategy for prevention. However, it remained the main challenge. Therefore, this systematic review and meta-analysis aimed to determine the overall pooled estimate of COVID-19 vaccine acceptance and its predictors in Ethiopia. Consequently, we have searched articles from PubMed, EMBASE, Web of Science, Google Scholar, reference lists of included studies, and Ethiopian universities' research repository. The weighted inverse variance random effects model was employed. The quality of studies and the overall variation between studies were checked through Joanna Briggs Institute (JBI) quality appraisal criteria and heterogeneity test (I²), respectively. The funnel plot and Egger's regression test were also conducted. Following that, a total of 14 studies with 6,773 participants were considered in the study and the overall pooled proportion of COVID-19 vaccine acceptance was 51.2% (95% CI: 43.9, 58.5). Having good knowledge (Odds ratio: 2.7; 95% CI: 1.1, 7.1; P.

VALUE

0.00), chronic disease (Odds ratio: 2; 95% CI: 1.3, 3.1), older age (Odds ratio: 1.8; 95% CI: 1.1, 3.0; P.

VALUE

0.02), and secondary education and above (Odds ratio: 3.3; 95% CI: 1.7, 6.7; P.

VALUE

0.00) were significantly associated with the acceptance of COVID-19 vaccine. In conclusion, Having good knowledge, chronic disease, older age, and secondary education and above were significantly associated with COVID-19 vaccine acceptance. Therefore, special attention and a strengthened awareness, education, and training about COVID-19 vaccine benefits had to be given to uneducated segments of the population.

Knowledge, attitude, acceptance, and practice of COVID-19 vaccination and associated factors complemented with constructs of health belief model among the general public in South Gondar, Ethiopia: A community-based study

Introduction

Understanding the epidemiological dynamics of disease control, as well as the effectiveness, compliance, and success of the vaccination program requires an understanding of the local population's knowledge, attitude, and practice regarding the Corona Virus Disease of 2019 (COVID-19) vaccine. Thus, the objective of this study was to assess knowledge, attitude, and practice toward COVID-19 vaccination and associated factors among the general public.

Methods

A cross-sectional study was conducted in the South Gondar Zone, among residents above the age of 18 years. The study used objective measures and the constructs of the Health Belief Model. Binary logistic regression was used and the result of the final model was presented in terms of adjusted odds ratio (AOR) and 95% confidence intervals (CI), and statistical significance was taken and considered at a P-value < 0.05.

Results

The study was conducted on 1,111 study participants. The mean age is 30.83 ± 7.106. About 575 (51.8%) of the respondents have good knowledge about the COVID-19 vaccination and 43.4% have a positive attitude toward COVID-19 vaccination. About 361 (32.5%) of the respondents were willing to take the vaccine if it is available and 113 (10.2%) of them were vaccinated. Participants with a positive attitude and good knowledge, those with a secondary level of education AOR = 5.70, 95% CI (2.60-12.60), those with a monthly income of >2,000 birr AOR = 6.30, 95% CI (2.50-15.60), those having a television (TV), and those who use Facebook AOR = 17.70, 95% CI (10.10-30.90) had a higher level of acceptance of COVID-19 vaccination. The Health Belief Model's constructs of perceived susceptibility AOR = 1.53, 95% CI (1.26-1.85), perceived benefit AOR = 1.49, 95% CI (1.28-1.75), and cues to action AOR = 0.54, 95% CI (0.45-0.65) were all linked to COVID-19 vaccine acceptability.

Conclusion

The level of acceptance of COVID-19 vaccination is much lower. Having a positive attitude score and good knowledge score, level of education, monthly income, presence of TV, the use of Facebook, and knowing the means of transmission of COVID-19 increase the level of acceptance of COVID-19 vaccination.

Change in willingness to COVID-19 vaccination in China: Two online surveys during the pandemic

OBJECTIVE

As the variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge, periodic vaccine booster immunization may become a normal policy. This study investigated the changes and factors associated with vaccination intentions in various epidemic situations, which can provide suggestions for the construction and modification of routine vaccination program strategies.

METHODS

Two cross-sectional online surveys were conducted in January and June of 2021. The willingness and confidence of the coronavirus disease 2019 (COVID-19) vaccination were measured following propensity score matching (PSM) treatment. The difference in the willingness for COVID-19 Vaccination in the two surveys was analyzed by single or multi-factor analyses.

RESULTS

The willingness to accept the SARS-CoV-2 vaccine was higher in the second survey than that in the first survey (90.5% vs. 66.6%, p < 0.001). Concerns about the vaccine's safety declined (71.0% vs. 47.6%, p < 0.001), but concerns about the efficacy increased (22.4% vs. 30.9%, p < 0.001). Confidence in the SARS-CoV-2 vaccine had an important impact on the increased uptake willingness (odds ratio = 3.19, 95% confidence interval: 2.23-4.58, p < 0.001).

CONCLUSIONS

There has been a significant increase in attitudes towards the SARS-CoV-2 vaccine which was associated with higher vaccine confidence. Vaccine effectiveness received more concerns from respondents rather than safety after nearly 6 months' utilization of the SARS-CoV-2 vaccine. It indicates that aggressive communication and timely disclosure of vaccine data can build vaccine confidence.

Evaluation of the Perceptions, Attitudes and Practices among Greek Non-Professional Athletes Visiting a Public Hospital during March 2022, towards COVID-19 Vaccination and Its Consequences on Sports Training and Sports Activity

Sports have been majorly impacted by the COVID-19 pandemic. After the lockdown period, vaccination and protocols were implemented to return to normality. We aimed to assess the attitudes and practices related to COVID-19 vaccination among athletes, and to record adverse effects of vaccination, if any. A questionnaire was distributed to 1012 male and female athletes, 15+ years old, within the region of Athens. Vaccination coverage with at least one dose was 93.5%, whereas 53.9% were fully vaccinated. More than half of the participants were infected with SARS-CoV-2 at the time of the study. More than 90% of the participants, considered the vaccines as safe, effective and important for public health. Concern about potential side-effects was raised especially by women athletes (59.1% of women compared to 42.2% of men, p < 0.001). The main reasons for avoiding vaccination were fear of vaccine safety, concern about the short time period for vaccine development and testing and doubt of risk of being exposed to SARS-CoV-2 infection. The main reported side-effects were pain at the injection site, fatigue, fever and headache. Approximately two thirds of the participants reported that vaccination did not affect their training, and none reported missing participation in scheduled athletic events. Participants reported high compliance to preventive measures by themselves and fellow athletes, but low satisfaction regarding the implementation of public protocols and the flow of information provided by the authorities. Athletes of older age and those less concerned about potential side-effects were more likely to get fully vaccinated. Nevertheless, the vast majority of the athletes in our study were vaccinated for COVID-19 despite any hesitation regarding effectiveness, safety, or potential side-effects from the vaccines.

Social Vulnerability and COVID-19 Vaccine in Spain

Different analyses show that the design of vaccination policies should especially protect the most vulnerable social groups, since the level of acceptance is determined by the population's knowledge, attitude and concerns about the safety and efficacy of vaccines. The objective of this work will be to detect the most socially vulnerable groups with respect to COVID-19 and to analyze the factors that influence predisposition to vaccination. This is a cross-sectional study using data from the Centro de Investigaciones Sociológicas (CIS) on the Effects and Consequences of Coronavirus (Study 3346 of December 2021). Sociodemographic variables (sex, age, employment status, studies and subjective class identification) were extracted, as well as the answers to the questions indicating the attitude towards vaccination, corresponding to questions 7,8,10 and 11 of the study. The most vulnerable group was lower class women (self-perceived), under 45 years of age with lower educational level, unemployed or performing unpaid work in the home. Most of them are not predisposed to vaccinate only because of the obligation to do so, mainly due to lack of belief in the power and efficacy of vaccines, as well as fear of health risks/collateral side effects. The lower vaccine uptake in this vulnerable population group may be due to a lack of awareness and lower trust in the authorities, as well as the benefits of the vaccine, which could be related to a lack of policy targeting the most socially vulnerable populations.

The Willingness of Parents to Vaccinate Their Children Aged from Five to under Twelve Years with COVID-19 Vaccines between February and March 2022 in Vietnam

The current study used data surveyed with 5357 parents/guardians (parents would be used to represent both 'parents' and 'guardians' hereafter) between February and March 2022 in Vietnam to examine their willingness to vaccinate their children with current COVID-19 vaccines. It applied the multinomial logistic regression model to examine the association between the willingness of parents and selected influential factors. In addition, the reasons that made parent hesitant or unwilling to vaccinate their children were investigated. Moreover, it identified parents' preferences for vaccine origins. Approximately, 75.4% of the parents were willing, 21.3% were hesitant and 3.3% were unwilling to vaccinate their children. The most common reasons that made the parents hesitant or unwilling to vaccinate their children were their concerns about the vaccine safety, efficacy and immunity. The most and the second most preferred vaccines were those developed/originated in the US and EU, respectively. Parents who were more likely to vaccinate their children included those whose children were insured, who regularly vaccinated their children, who belonged to the vaccine priority groups, who possessed sufficient knowledge about the ways to prevent the virus or about the herd immunity, and who perceived that their children might be infected with the virus and whose children were afraid of needles. Parents who were less likely to vaccinate their children included those who were the family main income source, who had savings, and who had tertiary education or higher.

Determinants of Actual COVID-19 Vaccine Uptake in a Cohort of Essential Workers: An Area-Based Longitudinal Study in the Province of Prato, Italy

Identifying determinants of COVID-19 vaccine uptake is essential for developing effective strategies for promoting vaccination. This longitudinal study aimed to explore predictors of actual COVID-19 vaccine uptake in workers involved in essential services during the first lockdown period in the Prato Province (Italy). All essential workers were invited and surveyed before COVID-19 vaccine approval (96.5% participation rate). Participants were followed up to evaluate their actual COVID-19 vaccination uptake using the vaccination register. Multinomial models were performed to assess predictors of delayed vaccination or non-vaccination. A total of 691 participants were included, of whom 21.7% had delayed the vaccination and 4.4% were unvaccinated. Participants with a sufficient level of health literacy were 50.2% in the vaccinated-on-time group and 32.3% in the unvaccinated group. The multinomial model predictors of delayed vaccination were work type (OR = 0.51), age between 50 and 59 years (OR = 1.82), and influenza vaccination uptake in the last season (OR = 2.51). Predictors of being unvaccinated were work type (OR = 0.33) and attitudes related to attributing less importance to COVID-19 preventive measures (OR = 0.47). Findings showed distinct predictors for COVID-19 vaccination delay and for being unvaccinated. Being unvaccinated seems to be associated with a general skepticism toward prevention measures.

Determinants of SARS-CoV-2 vaccine willingness among people incarcerated in 3 Canadian federal prisons: a cross-sectional study

BACKGROUND

Maximizing uptake of SARS-CoV-2 vaccines among people in prison is essential in mitigating future outbreaks. We aimed to determine factors associated with willingness to receive SARS-CoV-2 vaccination before vaccine availability.

METHODS

We chose 3 Canadian federal prisons based on their low uptake of influenza vaccines in 2019-2020. Participants completed a self-administered questionnaire on knowledge, attitude and beliefs toward vaccines. The primary outcome was participant willingness to receive a SARS-CoV-2 vaccine, measured using a 5-point Likert scale to the question, "If a safe and effective COVID-19 vaccine becomes available in prison, how likely are you to get vaccinated?" We calculated the association of independent variables (age, ethnicity, chronic health conditions, 2019-2020 influenza vaccine uptake and prison security level), identified a priori, with vaccine willingness using logistic regression and crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS

We recruited 240 participants from Mar. 31 to Apr. 19, 2021 (median age 46 years; 19.2% female, 25.8% Indigenous). Of these, 178 (74.2%) were very willing to receive a SARS-CoV-2 vaccine. Participants who received the 2019-2020 influenza vaccine (adjusted OR 5.20, 95% CI 2.43-12.00) had higher odds of vaccine willingness than those who did not; those who self-identified as Indigenous (adjusted OR 0.27, 95% CI 0.11-0.60) and in medium- or maximum-security prisons (adjusted OR 0.36, 95% CI 0.12-0.92) had lower odds of vaccine willingness than those who identified as white or those in minimum-security prisons, respectively.

INTERPRETATION

Most participants were very willing to receive vaccination against SARS-CoV-2 before vaccine roll-out. Vaccine promotion campaigns should target groups with low vaccine willingness (i.e., those who have declined influenza vaccine, identify as Indigenous or reside in high-security prisons).

The Willingness to get Vaccinated Against SARS-CoV-2 Virus among Southeast Asian Countries: Does the Vaccine Brand Matter?

The current study uses data surveyed with 2,500 respondents during August and September 2021 in Vietnam, Indonesia, the Philippines and Malaysia to examine the willingness to get vaccinated against SARS-CoV-2 virus with six COVID-19 vaccines. The willingness to get vaccinated varies according to the vaccine brands and selected influential factors. Particularly, the percentage of respondents who are willing to get vaccinated with Pfizer, Moderna and AstraZeneca dominates that of those who are willing to get vaccinated with Sinopharm, Janssen and Sputnik V vaccines. Results generated from the binary logistic regressions show that the impact of the selected influential factors on the willingness to get vaccinated varies in terms of magnitude and direction, and depending on the vaccine brands. The results indicate that additional scientific evidence on the efficacy and safety of the vaccines is essential for the respondents to decide whether to vaccinate or not. Such evidence can be made available in multiple formats and provided through appropriate channels and vaccination communication campaigns.

Mapping the Prevalence of COVID-19 Vaccine Acceptance at the Global and Regional Level: A Systematic Review and Meta-Analysis

Despite the availability of effective and safe vaccines, the acceptance of COVID-19 vaccination is suboptimal. In this meta-analysis we quantified the prevalence estimates of COVID-19 vaccine acceptance with a specific focus on worldwide geographical differences. We searched PubMed, Scopus, Web of Science and PsycInfo up to April 2021 (PROSPERO ID: CRD42021235328). Generalized random-effects linear models with a logit link were used to calculate the pooled estimated rate of vaccine acceptance at both the global and regional level. A meta-regression analysis was performed to assess the association between COVID-19 vaccine acceptance and various characteristics of the studies. Overall, 71 articles yielding 128 prevalence estimates were included. The pooled prevalence of COVID-19 vaccination acceptance rate was 66% (95% CI: 61-71%). This varied by geographic area, ranging from 36% (95% CI: 18-60%) in Africa to 83% (95% CI: 82-84%) in Oceania, and there was high variability between countries (15.4% Cameroon-100% Bhutan). Meta-regression analysis showed that studies that investigated COVID-19 vaccination intentions using multiple choice/scoring gave a vaccine acceptance prevalence lower than studies with only two possible answers (yes/no) (ß: -1.02 95% CI: -1.41 to -0.63). Despite some variation in the estimates, the results showed that one in three people may refuse/delay COVID-19 vaccination.

COVID-19 vaccination coverage and associated factors in seasonal fruit workers in Lleida

Objectives

Seasonal fruit workers are a high-risk group for SARS-COV-2 infection. We aimed to estimate vaccination coverage and factors associated with vaccination in seasonal fruit workers.

Methods

We carried out an anonymous survey of seasonal fruit workers in the 2021 campaign in Baix Segria region and Lleida city (Spain) on vaccination, knowledge and attitudes about the COVID-19 vaccine. Univariate and bivariate descriptive analyses were performed comparing vaccinated versus non-vaccinated. Multivariate analysis was performed using to assess factors associated to vaccination uptake.

Results

We included 286 seasonal workers. The prevalence of confirmed COVID-19 background was 39.5% and overall vaccination coverage was 78.7%. Factors associated with vaccination were age (aOR = 0.96; 95% CI: 0.94-0.99), good knowledge of disease (aOR = 1.87; 95% CI : 1.01-3.47) and having a high-perceived vaccine effectiveness (aOR = 2.94; 95% CI : 1.50-5.73). High vaccination coverage in workers was associated to knowledge (OR = 3.69; 95% CI: 1.61-8.48), safe transport (OR = 2.84; 95% CI: 1.40-5.76) and appropriate housing (OR = 2.62; 95% CI: 1.25-5.46) as important non-pharmacological measures to reduced transmission.

Conclusion

The study confirms the high prevalence of COVID-19 history and moderate vaccination coverage in seasonal fruit workers. Health education programs to improve knowledge about COVID-19 and its vaccination can help improve vaccination uptake.

Trust is the common denominator for COVID-19 vaccine acceptance: a literature review

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Vaccine hesitancy is a central barrier to ending the COVID-19 pandemic.

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Trust in the quality and safety of vaccines and the institutions dispensing the vaccines is critical for the willingness to be vaccinated.

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Trust in vaccines and institutions are subject to individual and societal perceptions built over time, and vary by social, cultural and historical context.

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Preconceived perceptions of COVID-19 vaccines played a more important role in decision-making than science-based information.

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Targeted and tailored approaches are essential to build trust in COVID-19 vaccines.

Vaccine hesitancy and refusal to be vaccinated are major reasons why mass vaccination strategies do not reach the intended coverage, even if adequate vaccine supply has been achieved. The main objective of this study is to explore the role and contribution of trust in public willingness to accept COVID-19 vaccinations. The study utilised a qualitative synthesis of literature around hesitancy, willingness to accept vaccination, and the role of trust. Data were extracted from the literature and first categorised using a deductive approach, and later analysed in QSR NVivo using a mix of deductive and inductive approaches. The impact of trust was mostly borne out in the willingness to accept a vaccine, but details on what trust is, how and why it affects willingness or lack of it, was not frequently reported. Three types of trust were identified: 1) Trust in the quality and safety of vaccines; 2) Institutional trust; and 3) Interpersonal trust in the professionals who communicate about and administer the vaccine. Trust in the vaccines’ quality and safety, and institutional affiliation significantly contributed towards willingness to be vaccinated. The bulk of the literature focused on how interpersonal trust and personal attributes of potential vaccinees affected the willingness to accept the vaccine. This complex relationship included a fragility of beliefs and perceptions at an individual level, with a bidirectional relationship to societal perceptions. Perceptions of vaccines had a predominant role in decision-making, in contrast to more science-based decision-making. Although globally, the perceptions and beliefs contributing to trust had commonalities and relevance, trust was often found to be dependent on factors embedded in local social, cultural, institutional, and individual attributes and experiences. Understanding different types of trust offers potential approaches to motivate undecided people to receive vaccine; and vaccine refusers to revisit their decisions.

The acceptance of COVID-19 vaccine at early stage of development and approval: A global systematic review and meta-analysis

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.

Human sentiments monitoring during COVID-19 using AI-based modeling

The whole world is facing health challenges due to wide spread of COVID-19 pandemic. To control the spread of COVID-19, the development of its vaccine is the need of hour. Considering the importance of the vaccines, many industries have put their efforts in vaccine development. The higher immunity against the COVID can be achieved by high intake of the vaccines. Therefore, it is important to analysis the people's behaviour and sentiments towards vaccines. Today is the era of social media, where people mostly share their emotions, experience, or opinions about any trending topic in the form of tweets, comments or posts. In this study, we have used the freely available COVID-19 vaccines dataset and analysed the people reactions on the vaccine campaign using artificial intelligence methods. We used TextBlob() function of python and found out the polarity of the tweets. We applied the BERT model and classify the tweets into negative and positive classes based on their polarity values. The classification results show that BERT has achieved maximum values of precision, recall and F score for both positive and negative sentiment classification.

Assessment of COVID-19 vaccination refusal among healthcare workers in Ethiopia

Background

Even though the emergence of the coronavirus disease 2019 (COVID-19) vaccine and the increasing vaccination rates are promising, there are reports of refusal to get vaccinated in a different segment of the population, including health care workers.

Objective

This study determines the acceptance/refusal of the COVID-19 vaccination and its predictors among health care workers in Ethiopia.

Methods

A cross-sectional survey was conducted among a group of health care workers at different health facilities in Ethiopia. Data were collected from 1 to 30 July 2020. Data were collected from 403 participants through an online Google submission form. Data were entered into Epi-info 7 and exported to SPSS version 20 for analysis.

Results

Approximately 38.5% of the health care workers in the study had refused COVID-19 vaccination. Younger age groups vs. 40 and above years (age 20-24 year [AOR: 0.03, 95% CI (0.00, 0.48)], age 25-29 year [AOR: 0.02, 95% CI (0.00, 0.49)], and age 30-34 year [AOR: 0.04 (0.00, 0.49)] and medical doctors vs. Nurses [AOR: 0.06, 95% CI, (0.01, 0.42)] were reported as risk factors; also, academic working staff vs. hospital staff [AOR: 4.42, 95% CI (1.85, 10.54)] was reported as a protective factor toward refusal of COVID-19 vaccination.

Conclusion

Two-fifths of health care workers in Ethiopia were indicated to refuse COVID-19 vaccination, implying a significant barrier to achieving WHO's a target of 70% double vaccination rate by mid-2022.

Are Fear of COVID-19 and Vaccine Hesitancy Associated with COVID-19 Vaccine Uptake? A Population-Based Online Survey in Nigeria

This study examined the association between COVID-19 and fear of contracting COVID-19 and reasons for vaccination refusal. A population-based online survey was conducted via social media in Nigeria using the Fear of COVID-19 scale and items related to vaccination refusal/hesitancy items. Individuals aged 13 years and older were invited to participate. Data were analysed using binary logistic regression to calculate odds ratios (ORs) and associated 95% confidence intervals (CIs) at a p-value of less than 0.05. The study enrolled 577 individuals with a mean age of 31.86 years, 70% of whom were male and 27.7% of whom had received at least one dose of the vaccine against COVID-19. None of the variables on the Fear of COVID-19 scale significantly predicted vaccine uptake in multivariate analysis. However, individuals who were fearful of COVID-19 were more likely to be vaccinated in bivariate analysis (OR: 1.7, 95% CI: 1.06–2.63). The most significant factors among the vaccination refusal items associated with COVID-19 vaccination were doubts about vaccination (adjusted OR: 2.56, 95% CI: 1.57–4.17) and misconceptions about vaccine safety/efficacy (adjusted OR: 2.15, 95% CI: 1.24–3.71). These results suggest that uptake of the vaccine against COVID-19 in Nigeria can be predicted by factors associated with vaccination refusal, but not by fear of COVID-19. To contain the pandemic COVID-19 in Nigeria, efforts should be made to educate people about the efficacy of the vaccine and to increase their confidence in vaccination.

Effect of Recombinant Vesicular Stomatitis Virus–Zaire Ebola Virus Vaccination on Ebola Virus Disease Illness and Death, Democratic Republic of the Congo

We conducted a retrospective cohort study to assess the effect vaccination with the live-attenuated recombinant vesicular stomatitis virus–Zaire Ebola virus vaccine had on deaths among patients who had laboratory-confirmed Ebola virus disease (EVD). We included EVD-positive patients coming to an Ebola Treatment Center in eastern Democratic Republic of the Congo during 2018–2020. Overall, 25% of patients vaccinated before symptom onset died compared with 63% of unvaccinated patients. Vaccinated patients reported fewer EVD-associated symptoms, had reduced time to clearance of viral load, and had reduced length of stay at the Ebola Treatment Center. After controlling for confounders, vaccination was strongly associated with decreased deaths. Reduction in deaths was not affected by timing of vaccination before or after EVD exposure. These findings support use of preexposure and postexposure recombinant vesicular stomatitis virus–Zaire Ebola virus vaccine as an intervention associated with improved death rates, illness, and recovery time among patients with EVD.

Mandatory COVID-19 Vaccination for Healthcare Professionals and Its Association With General Vaccination Knowledge: A Nationwide Cross-Sectional Survey in Cyprus

COVID-19 compulsory vaccination for healthcare professionals (HCPs) is a sensitive and controversial topic, with different support rates worldwide. Previous studies in Cyprus identified a low COVID-19 vaccination acceptance among HCPs, however, no studies have investigated their perceptions toward mandatory COVID-19 vaccination. This is the first study to investigate the attitudes of HCPs toward mandatory COVID-19 vaccination and its association with general vaccination knowledge. A cross-sectional study was conducted, using an online self-administered, anonymous questionnaire to collect data on sociodemographic and health-related characteristics, trust and satisfaction with the healthcare system, utilization of preventive healthcare services, COVID-19 vaccination information, vaccination knowledge, and attitudes among HCPs toward mandatory COVID-19 vaccination. A total of 504 HCPs participated in the survey, with 34% being in favor of mandatory COVID-19 vaccination. A sufficient vaccination knowledge score was identified among the HCPs, with higher scores being associated with mandatory vaccination support (p < 0.001). As age increases by one year, the odds of supporting mandatory vaccination increase by 1.03 units (95% CI: 1.01-1.06). In addition, as the general vaccination knowledge score increases by one unit, the odds of supporting mandatory COVID-19 vaccination increase by 1.55 units (95% CI: 1.33-1.81). Our findings show that about two-thirds of the HCPs in Cyprus were opposed to a mandatory COVID-19 vaccination policy. Older age and general vaccination knowledge were found to be the strongest predictors of mandatory vaccination support. To avoid unforeseen outcomes, mandatory vaccination policies should be implemented with caution and consultation.

A Gap between Relaxation of Government Quarantine Policy and Perceptions of COVID-19 among the General Public in Sports: Focusing on Vaccination Status

Although an increasing number of people are getting vaccinated for COVID-19 and quarantine policies are easing owing to fatigue from high-intensity social distancing, people’s fear remains. This study attempted to determine the appropriateness of quarantine policies that are gradually easing by comparing and analyzing sports participation and respiratory infection perception recognized by sports participants according to vaccination status. Data were collected from 302 ordinary Korean citizens aged 20 or older for three months from November 2021 in the Republic of Korea. From the survey respondents, data on the main factors of this study included (a) demographic information, (b) vaccination, (c) loyalty in sports, (d) behavioral intention to participate in sports, (e) infection anxiety from others, and (f) risk perception of COVID-19. As a result, the survey respondents, subdivided into an unvaccinated group (Group 1) and a vaccinated group (Group 2), derived statistically significant results on sports participation and respiratory infection perception. Specifically, survey participants who had completed all secondary vaccinations showed a relatively higher (a) loyalty in sport (M = 3.789), (b) behavioral intention for participation in sport (M = 4.056), and (c) infection anxiety from others (M = 3.548), but showed a relatively lower (a) risk perception of COVID-19 (sensitivity) (M = 3.494). The results of this study could be utilized as valuable data to minimize the gap between the relaxation of government quarantine policy and perceptions of COVID-19 among the general public in sports, which have not yet been clarified.

Trends in COVID-19 Vaccination Intent, Determinants and Reasons for Vaccine Hesitancy: Results from Repeated Cross-Sectional Surveys in the Adult General Population of Greece during November 2020-June 2021

Vaccine hesitancy is a major barrier to achieving large-scale COVID-19 vaccination. We report trends in vaccination intention and associated determinants from surveys in the adult general population in Greece. Four cross-sectional phone surveys were conducted in November 2020 and February, April and May 2021 on nationally representative samples of adults in Greece. Multinomial logistic regression was used on the combined data of the surveys to evaluate independent predictors of vaccination unwillingness/uncertainty. Vaccination intention increased from 67.6% in November 2020 to 84.8% in May 2021. Individuals aged 65 years or older were more willing to be vaccinated (May 2021: 92.9% vs. 79.5% in 18−39 years, p < 0.001) but between age-groups differences decreased over time. Vaccination intention increased substantially in both men and women, though earlier among men, and was higher in individuals with prograduate education (May 2021: 91.3% vs. 84.0% up to junior high). From multivariable analysis, unwillingness and/or uncertainty to be vaccinated was associated with younger age, female gender (in particular in the April 2021 survey), lower educational level and living with a child ≤12 years old. Among those with vaccine hesitancy, concerns about vaccine effectiveness declined over time (21.6% in November 2020 vs. 9.6% in May 2021, p = 0.014) and were reported more often by men; safety concerns remained stable over time (66.3% in November 2020 vs. 62.1% in May 2021, p = 0.658) and were reported more often by women. In conclusion, vaccination intention increased substantially over time. Tailored communication is needed to address vaccine hesitancy and concerns regarding vaccine safety.

Attitudes and Determinants of Mandatory Vaccination against COVID-19 among the General Population of Cyprus: A Nationwide Cross-Sectional Study

Vaccinations for the prevention of coronavirus disease (COVID-19) are important to control the ongoing pandemic. A much-discussed strategy to increase vaccination coverage is mandatory vaccination; however, its legitimacy and effectiveness as a measure are doubtful. This study aims to investigate the attitudes of the general population of Cyprus towards COVID-19 mandatory vaccination and to identify the factors influencing individuals’ attitudes towards such policy. An online cross-sectional study was conducted, using a self-administered, anonymous questionnaire to collect information on sociodemographic and health-related characteristics, trust, and satisfaction about the healthcare system and utilization of preventive healthcare services, COVID-19 vaccination information, general vaccination knowledge, and attitudes towards mandatory vaccination. A total of 2140 participants completed the survey, with 27.8% being in favor of mandatory vaccination. We found that as the age increases by one year, the odds of supporting mandatory vaccination increase by 1.04 units (OR 1.04, 95% CI: 1.02–1.05). In addition, those who reported increased trust in national healthcare authorities’ guidelines and recommendations (OR 3.74, 95% CI: 3.11–4.49) and those satisfied with the healthcare system (OR 1.38, 95% CI: 1.16–1.65) and follow doctor’s instructions (OR 1.29, 95% CI: 1.03–1.61), were significantly more likely to support mandatory vaccination while those who had underage children living in the household were significantly less likely to support mandatory vaccination (OR 0.69, 95% CI: 0.50–0.94). Public health authorities need to develop well-organized vaccination campaigns in which accurate evidence-based information would be disseminated with respect to individuals’ autonomy.

Acceptance of COVID‐19 vaccines in patients with chronic diseases: A cross‐sectional study

Aims and objectives

This study aimed to clarify the attitudes, knowledge and vaccination willingness of patients with chronic diseases toward COVID‐19 vaccines and the influencing factors.

Background

Vaccination against COVID‐19 is an important way to protect patients with chronic diseases, but the vaccination acceptance varies across diseases and populations. A better understanding of this condition will lead to tailored intervention strategies and high vaccination rates.

Design

Cross‐sectional study.

Methods

Data were collected between March 2021 and May 2021 in China. A self‐compiled questionnaire was used in the survey. Two independent‐samples t‐tests/one‐way analysis of variance or U test/H test was used to measure the differences between groups. Multivariate regression analysis was used to identify the influencing factors. The study adhered to the EQUATOR checklist, STROBE.

Results

A total of 998 patients participated in the study. Score rates of attitudes, knowledge and vaccination willingness were 69.9%, 68.4% and 70.6% respectively. Age, vaccination status of family members, education levels, vaccine side effects and economic level were positive factors that could influence patients’ vaccination acceptances, while time of illness, type of disease and political affiliations were negative predictors. The top reasons for willingness toward vaccination were supporting national strategies, belief on the vaccines and fearing of contracting COVID‐19, while physical reasons, side effects and having a wait‐and‐see attitude were unwillingness factors.

Conclusions

Patients’ attitudes, knowledge and vaccination willingness were medium. Nurses should pay attention to patients who are from lower socioeconomic backgrounds, under 30 or over 70 years old, have no political affiliations, have damage to vital organs, have a long course of illness, family members have not received COVID‐19 vaccines and had no side effects after receiving other vaccines.

Relevance to clinical practice

Clinical nurses are recommended to take measures from patients’ duration of illness, damaged organs, demographic characteristics and families to improve patients’ vaccination acceptances.

Public Preferences for a COVID-19 Vaccination Program in Quebec: A Discrete Choice Experiment

OBJECTIVES

We aimed to elicit preferences of the French-speaking Quebec population regarding a COVID-19 vaccination program and to characterize individuals with respect to their vaccination behaviors.

METHODS

A discrete choice experiment was conducted in Autumn 2020 via a web-based survey. Its design included seven attributes: vaccine origin, vaccine effectiveness, side effects, protection duration, priority population, waiting time to get vaccinated, and recommender of the vaccine. Utilities were estimated using a mixed-logit model and a latent class logit model.

RESULTS

Our sample included 1599 individuals. From this total, 119 always chose the opt-out option (7.4%). According to the mixed-logit model, the relative weights of attributes were as follows: effectiveness (28.48%), side effects (23.68%), protection duration (17.41%), vaccine origin (12.75%), recommender (11.96%), waiting time to get vaccinated (3.62%), and priority population (2.11%). Five classes were derived from the latent class logit model. Class 1 (9.13%) wanted to get vaccinated as fast as possible and was composed of uncertain and more vulnerable individuals. Class 5 (25.14%) was similar to the full sample, mostly favoring vaccination. Classes 2 (7.69%) and 4 (15.82%) included "vaccine hesitant and demanding" individuals but were different in their sociodemographic profiles. Finally, "anti-vaccine" and other "vaccine hesitant" individuals were in class 3 (42.21%).

CONCLUSIONS

This study showed the vaccine characteristics that are likely to improve vaccine uptake, which may more easily lead to herd immunity. Different profiles of respondents also showed various levels of acceptance toward a COVID-19 vaccination program, which may help to better understand vaccine hesitancy behaviors.

COVID-19 vaccine hesitancy among health professionals in a tertiary care center at the University of Gondar Specialized Hospital, Ethiopia: A cross-sectional study

Background

COVID-19 is a highly communicable disease that can be transmitted from animal-to-human and human-to-human contacts. It is still now a major global threat for which vaccination remains the ultimate solution to protect it, especially healthcare professionals are the first frontiers to fight against the COVID-19 virus which makes them at higher risk of this disease. Therefore, to reduce the spread of COVID-19, we need to improve the acceptance of COVID-19 vaccines is crucial. The aim of this study was to assess the vaccine hesitancy of the COVID-19 vaccine among health professionals who worked at the University of Gondar Specialized Hospital.

Methods

A cross-sectional survey was conducted between 1 May and 10 June 2021. And the data were analyzed using Statistical Package for Social Sciences version 26. A chi-square test was conducted and to assess the associations between socio-demographic characteristics, perceived risk of COVID-19, attitude, and acceptance of COVID-19 vaccine, a p-value of less than 0.05 was considered to declare statistical significance.

Results

We surveyed 319 health professionals with a response rate of 67.87%. Of these, 74.9% (239) were male, and 81.2% (259) of health professionals were perceived exposed to COVID-19 without testing. 87.7% of respondents would like to vaccinate their parents. 66.2% (208) of them have accepted the COVID-19 vaccine. 54.85% (175) of health professionals had a good attitude and 45.8% (146) of health professionals were received the first-round COVID-19 vaccine.

Conclusion

This study showed that more than 60% of health professionals had good acceptance of COVID-19 vaccination during the pandemic period. Regarding vaccine safety profile may reduce the vaccination in the future. To increase vaccine uptake in response to the COVID-19 pandemic, COVID-19 vaccination programs should be redesigned to remove barriers to vaccine acceptance. Knowledge and attitude toward the COVID-19 vaccine should be promoted.

Immune Response of Adult Sickle Cell Disease Patients after COVID-19 Vaccination: The Experience of a Greek Center

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are essential weapons to control the spread of the coronavirus disease-19 (COVID-19) pandemic and protect immunocompromised patients. With a greater susceptibility to infection, sickle cell disease (SCD) patients are considered as “high risk” patients during the current COVID-19 pandemic. In our study, we try to determine the immune response of adult SCD patients monitored at our center after the first and second dose of the qualified mRNA vaccines available and correlate them to several disease-specific markers, as well as complement activation. The results demonstrate that the levels of neutralizing antibodies (nAbs) against SARS-CoV-2 were adequate for most patients studied after the second dose and there seemed to be a certain association with complement activation. Further studies are critical to determine the durability of this immune response and the potential benefit of a third dose.

COVID-19 Vaccine Acceptance among ASEAN Countries: Does the Pandemic Severity Really Matter?

The current study uses data surveyed between August and September 2021 in four ASEAN (Association of South East Asian Nations) countries to identify drivers of COVID-19 vaccine acceptance with different levels of the pandemic severity. It also examines the impact of the drivers on vaccine acceptance. The results show that the number of respondents who accept vaccines significantly dominates that of those who do not. In addition, the number of respondents who get the vaccine if the pandemic becomes more severe dominates that of those if it becomes less severe. Results generated from the logistic regressions show that the impact of the drivers on the COVID-19 vaccine acceptance with different levels of the pandemic severity varies in terms of magnitude and direction. Practical recommendations are made based on the findings.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2021, identifier CRD42021268645.

Global intention of the general public to undergo COVID-19 vaccination: time trends and risk factors for vaccine refusal, a Systematic Review and Meta-analysis

Background:  Knowledge of facilitators and barriers regarding the uptake of COVID-19 vaccination at a global population level is critical for combating the pandemic, saving lives, and protecting the economy.  The aim of this work was to determine the proportion of people likely to accept or refuse to undergo COVID-19 vaccination.  This study also investigated (a) time trends regarding the intention to undergo COVID-19 vaccination and (b) socio-demographic risk factors influencing vaccine refusal. Methods: Databases (01 March 2020-01 March 2021) searched included PubMed, MEDLINE, and Scopus. The sample size was n ≥1000 and selected studies were those that determined vaccine ‘acceptance’, ‘refusal’ and ‘hesitancy’. A random-effects model was employed to obtain the overall odds ratio (OR) and 95% confidence interval (CI) for socio-demographic predictors for vaccine refusal. Results:  A total of 832 citations were screened and 35 studies from 21 countries (n=130,179) were analyzed.  The pooled proportion of individuals reporting an intention to vaccinate was 0.70 (95% CI: 0.65 to 0.74; I2 = 99.68%). The proportion of people intending to vaccinate decreased (regression coefficient = -0.13; p<0.001) during the study period and odds of refusal to vaccinate increased by 1.37-fold (95% CI: 1.33-1.41) during the second half. Risk factors identified for vaccine refusal included being female, rural residence, lower income, and lower level of formal education.  Conclusions: A moderate proportion of people showed an intention to receive vaccination, although this declined during the study period. A global and national multi-pronged strategic and targeted approach is urgently needed to enhance vaccination uptake amongst females, those with a relatively lower educational and socioeconomic status, and those in rural areas.

Association between COVID-19 vaccine hesitancy and generalized trust, depression, generalized anxiety, and fear of COVID-19

Background

Although numerous studies have been published on the predictors of COVID-19 vaccine hesitancy, some possible predictors remain underexplored. In this study, we explored the associations of unwillingness and indecisiveness regarding COVID-19 vaccination with generalized trust, mental health conditions such as depression and generalized anxiety, and fear of COVID-19.

Methods

Data of wave 1 (from October 27 till November 6, 2020) and wave 3 (from April 23 till May 6, 2021) of a longitudinal online study conducted in Japan were used for the analyses. Unvaccinated participants were asked at wave 3 about their willingness to be vaccinated, with possible responses of willing, unwilling, or undecided. These three responses were used as the outcome variable, and multinomial logistic regression analyses were conducted with willingness to be vaccinated as the reference group. Explanatory variables included generalized trust, depression, generalized anxiety, and fear of COVID-19 both at wave 1 and 3, and sociodemographic and health-related variables.

Results

Of the 11,846 valid respondents, 209 (1.8%) answered that they had already been vaccinated against COVID-19, 7089 (59.8%) responded that they were willing to be vaccinated, 3498 (29.5%) responded that they were undecided, and 1053 (8.9%) responded that they were unwilling to be vaccinated. After adjusting for covariates, we found that: (1) participants with lower levels of generalized trust at wave 1 and 3 were more likely to be undecided or unwilling at wave 3; (2) respondents with moderately severe or severe depression at wave 1 and 3 were more likely to be undecided at wave 3; (3) participants with moderate or severe levels of generalized anxiety at wave 3 but not at wave 1 were more likely to be unwilling at wave 3; and (4) respondents with high levels of fear of COVID-19 at wave 1 and 3 were less likely to be undecided and unwilling at wave 3.

Conclusions

Generalized trust, mental health conditions such as depression and generalized anxiety, and low level of fear of COVID-19 are associated with unwillingness or indecision regarding being vaccinated against COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12479-w.

COVID-19 vaccine hesitancy in the UK: a longitudinal household cross-sectional study

BACKGROUND

The approved COVID-19 vaccines have shown great promise in reducing disease transmission and severity of outcomes. However, the success of the COVID-19 vaccine rollout is dependent on public acceptance and willingness to be vaccinated. In this study, we aim to examine how the attitude towards public sector officials and the government impact vaccine willingness. The secondary aim is to understand the impact of ethnicity on vaccine-willingness after we explicitly account for trust in public institutions.

METHODS

This cross-sectional study used data from a UK population based longitudinal household survey (Understanding Society COVID-19 study, Understanding Society: the UK Household Longitudinal Study) between April 2020-January 2021. Data from 22,421 participants in Waves 6 and 7 of the study were included after excluding missing data. Demographic details in addition to previous survey responses relating to public sector/governmental trust were included as covariates in the main analysis. A logit model was produced to describe the association between public sector/governmental mistrust and the willingness for vaccination with interaction terms included to account for ethnicity/socio-economic status.

RESULTS

In support of existing literature, we identified those from BAME groups were more likely to be unwilling to take the COVID-19 vaccine. We found that positive opinions towards public sector officials (OR 2.680: 95% CI 1.888 - 3.805) and the UK government (OR 3.400; 95% CI 2.454-4.712) led to substantive increase in vaccine willingness. Most notably we identified this effect to vary across ethnicity and socio-economic status with those from South Asian background (OR 4.513; 95% CI 1.012-20.123) and possessing a negative attitude towards public officials and the government being the most unwilling to be vaccinated.

CONCLUSIONS

These findings suggests that trust in public sector officials play a key factor in the low vaccination rates particularly seen in at-risk groups. Given the additional morbidity/mortality risk posed by COVID-19 to those from lower socio-economic or ethnic minority backgrounds, there needs to be urgent public health action to review how to tailor health promotion advice given to these groups and examine methods to improve trust in public sector officials and the government.

Assessment of COVID-19 vaccines acceptance in the Lebanese population: a national cross-sectional study

Background

Vaccines have become the best weapon for epidemic prevention and control in the absence of standard approved effective therapies. However, skepticism about the vaccine efficacy and safety is constantly reported. To our knowledge, there has been no study assessing COVID-19 vaccine acceptance in Lebanon. The primary objective of this survey is to assess the COVID-19 vaccines’ acceptance and its related determinants in the Lebanese population.

Methods

A cross-sectional study was conducted in Lebanon from February 16 through February 25, 2021. Data was collected using an online questionnaire via social media platforms using the snowball technique. The questionnaire consisted of 47 questions related to sociodemographic and medical history, COVID-19 experience, knowledge, practice, and beliefs towards COVID-19 vaccines, including vaccines acceptance. Binary logistic regression was performed to identify factors associated with vaccine acceptance.

Results

A total of 1209 questionnaires were completed; around 63.4% have reported their acceptance for receiving the COVID-19 vaccine, while only 57% of participants registered themselves on the national platform. The multivariable analysis showed that a higher knowledge scale, living in an urban residential area, having hypertension, not having a food allergy, reporting a higher fear to experience COVID-19 infection, and receiving or wanting to receive influenza vaccine, were positive predictors of COVID-19 vaccines acceptance.

Conclusions

Our findings support the need to improve knowledge about COVID-19 infection and vaccination through education and awareness programs. Specifically residents of rural areas should be targeted to optimize COVID-19 vaccine acceptance among the Lebanese population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40545-021-00403-x.

A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review

The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination.