Vaccine Acceptance and Uptake: Insights from Behavioural and Social Sciences

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 283514

Special Issue Editor


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Guest Editor
Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
Interests: COVID-19 vaccination acceptance; COVID-19 vaccination hesitancy; lockdown; knowledges; behaviours; COVID-19; legionella; legionellosis; migrants; migrant's health; legionnaires' disease; chikungunya; dengue
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Special Issue Information

Dear Colleagues,

It is well known that it is not enough to simply have safe and effective vaccines in order to achieve high vaccination coverage. Indeed, vaccine hesitancy is a global problem, and behavioural sciences are key to understanding, informing, and guiding research on the acceptance and uptake of vaccines.

This Special Issue will gather research focusing on insights from behavioural and social sciences applied to the context of vaccines. Theoretical contributions, reviews and meta-analyses, and original reports are all welcomed.

Example of issues of interest include (but are not limited to): interventions to promote vaccines (e.g., nudges, inoculation or pre-bunking, presumptive communication, prosocial appeals, motivational interviewing); risk perception, confidence and trust in relation to vaccine safety, vaccine acceptance and vaccine uptake; restoring confidence after vaccine pause; decision-making processing; gaps between intentions and actual behaviours; decision making in specific contexts where evidence is lacking (e.g., pregnant women); factors involved in the decision to participate in vaccine clinical trials.

Prof. Dr. Christian Napoli
Guest Editor

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Keywords

  • COVID-19 vaccine hesitancy
  • COVID-19 vaccine acceptance
  • behavioural sciences
  • social sciences
  • decision making
  • vaccine confidence
  • risk perception
  • risk communication
  • public health

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Published Papers (81 papers)

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15 pages, 237 KiB  
Article
Drivers of COVID-19 Vaccination among Eligible Adults in Abuja, Nigeria: A Mixed-Methods Study Using the WHO Behavioral and Social Drivers of Vaccination Framework
by Chizoba B. Wonodi, Ikechukwu A. Okpe, Pius U. Angioha, Affiong S. Ebong, Janet B. Adegbola, Abdulrasheed A. Abdulraheem, Nwamaka Ezeanya, Adewumi A. Adetola, Oluwatosin I. Arogundade, Goodness I. Hadley and Joseph A. Olisa
Vaccines 2024, 12(10), 1128; https://doi.org/10.3390/vaccines12101128 - 1 Oct 2024
Viewed by 908
Abstract
Despite the availability of COVID-19 vaccines, Nigeria still faces significant COVID-19 vaccine hesitancy, with only 60.7% of the eligible population fully vaccinated as of 20 March 2023. Our study, part of a community-based effort to improve knowledge and uptake of the COVID-19 vaccine [...] Read more.
Despite the availability of COVID-19 vaccines, Nigeria still faces significant COVID-19 vaccine hesitancy, with only 60.7% of the eligible population fully vaccinated as of 20 March 2023. Our study, part of a community-based effort to improve knowledge and uptake of the COVID-19 vaccine in the Gwagwalada Area Council of Abuja, the Federal Capital Territory (FCT) of Nigeria, utilized the WHO’s Behavioral and Social Drivers (BeSDs)-of-vaccination framework to examine the drivers of COVID-19 vaccination among eligible adults. This was a mixed-method study with focus group discussions (FGDs) and in-depth interviews (IDIs) involving 40 purposively sampled participants. We triangulate qualitative findings with data from a household survey of 1512 eligible adults identified using a two-stage systematic cluster sampling approach. All data were collected from the 1–18 November 2022. The household survey showed 46% COVID-19 vaccine uptake, with Pearson chi-square and Fisher’s exact test showing significant associations between vaccine uptake and gender, religion, and education. Multivariate logistic regression showed that confidence in vaccine safety, knowing vaccination sites and family/friends’ endorsement of COVID-19 vaccination were the strongest items associated with vaccine uptake in the thinking-and-feeling, practical-issue, and social-process domains, respectively. Multiple items measuring these domains aligned with BeSD priority question, demonstrating the robustness of the pared-down framework. Qualitative data corroborated these findings. To address vaccine hesitancy and increase uptake, community-driven approaches to improve trust in vaccine safety and benefits and promote positive vaccination norms are needed. In addition, service delivery strategies to make vaccination services easily accessible and identifiable should be developed and tailored to community needs. Full article
16 pages, 1335 KiB  
Article
Use of the PRECEDE-PROCEED Model in Piloting Vaccine Promotion and Infection Self-Protection: Intervention Development and Effectiveness Examination
by Yao Jie Xie, Longben Tian, Yunyang Deng, Lin Yang, Kin Cheung, Yan Li, Harry Haoxiang Wang, Chun Hao, Gilman Kit Hang Siu, Qingpeng Zhang, Alex Molassiotis and Angela Yee Man Leung
Vaccines 2024, 12(9), 979; https://doi.org/10.3390/vaccines12090979 - 28 Aug 2024
Viewed by 1777
Abstract
Objectives: This study aimed to tailor and pilot a health education program using the PRECEDE-PROCEED model to promote vaccination and enhance self-protective behaviors against COVID-19 in Hong Kong populations. Study design: Quasi-experimental study. Methods: Phases 1–4 of the PRECEDE-PROCEED model were used to [...] Read more.
Objectives: This study aimed to tailor and pilot a health education program using the PRECEDE-PROCEED model to promote vaccination and enhance self-protective behaviors against COVID-19 in Hong Kong populations. Study design: Quasi-experimental study. Methods: Phases 1–4 of the PRECEDE-PROCEED model were used to identify the needs for COVID-19 prevention. Strategies to address predisposing, reinforcing, and enabling factors in the PRECEDE-PROCEED model were developed, and an intervention package was generated thereafter. A pre–post experimental study was conducted among 50 participants to preliminarily assess the effects of the intervention based on Phases 5 and 8 of the PRECEDE-PROCEED model. Results: The 3-month intervention package contained 16 health education videos, 36 health tips, individual consultations, regular reminders of vaccination, incentive of anti-epidemic packages, and vaccine booking services. By the third month, 33 participants took a new dose of COVID-19 vaccine, and 5 participants withdrew. The vaccination rate for new dose achieved 73.3% (95% CI: 58.06–85.40%). Compared with the Hong Kong population in the same period, our study demonstrated higher increase in vaccination rate (9.97 vs. 1.36 doses per 1000 person-days). The percentage of early testing in personal and family level increased to 86.7% and 84.4%, respectively (both p < 0.05). For correct mask wearing and hand washing, the scores increased from a baseline score of 9.1 ± 1.6 and 4.9 ± 1.3 to 9.5 ± 1.0 and 5.3 ± 1.2, respectively (both p < 0.05). Conclusions: The application of the PRECEDE-PROCEED model effectively facilitated the stepwise development, implementation, and evaluation of a health education program for improving vaccination rates and fostering self-protective behaviors against infections. Full article
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14 pages, 420 KiB  
Article
Vaccination Rates and Influencing Factors in Patients with Axial Spondyloarthritis and Immunosuppressive Treatment—A Survey-Based Cross-Sectional Study
by Tuğba Ocak, Selin İldemir Ekizoğlu, Burcu Yağız, Belkıs Nihan Coşkun, Ediz Dalkılıç and Yavuz Pehlivan
Vaccines 2024, 12(7), 756; https://doi.org/10.3390/vaccines12070756 - 9 Jul 2024
Viewed by 809
Abstract
Patients with axial spondyloarthritis (axSpA) who receive immunosuppressive therapy are at risk of infection due to impaired immune function and immunosuppressive medication. Vaccination plays a crucial role in preventing infections in this population. However, vaccination rates and factors influencing vaccination uptake in axSpA [...] Read more.
Patients with axial spondyloarthritis (axSpA) who receive immunosuppressive therapy are at risk of infection due to impaired immune function and immunosuppressive medication. Vaccination plays a crucial role in preventing infections in this population. However, vaccination rates and factors influencing vaccination uptake in axSpA patients still need to be adequately studied. This study was designed to determine the vaccination rates of vaccines covered by health insurance in this particular group in Turkey and attitudes towards vaccines and infections. This survey included 199 patients with axSpA who visited our outpatient clinic in June, July, and August 2023 and received biologic and targeted synthetic disease-modifying antirheumatic drugs. The mean age of the participants was 43.7 ± 0.7 years, and the majority were male (66.3%). The majority of the patients were vaccinated against COVID-19 (85.4%), followed by hepatitis B (41.2%), influenza (20.1%), and pneumococcal pneumonia (10.5%). While awareness of COVID-19 vaccination was widespread (100%), knowledge of other vaccines was lower (hepatitis B 80.9%, influenza 70.3%, pneumococcal 60.3%, respectively). Educational interventions targeting patients and healthcare professionals are needed to improve vaccination rates in this population. Our findings emphasize the need for strategies to increase vaccination rates in axSpA patients receiving immunosuppressive therapy. Removing barriers to vaccination and raising awareness of the importance of vaccination are critical to optimizing vaccination practices in this vulnerable population. Full article
14 pages, 1311 KiB  
Article
A Theory and Evidence-Based Artificial Intelligence-Driven Motivational Digital Assistant to Decrease Vaccine Hesitancy: Intervention Development and Validation
by Yan Li, Kit-Ching Lee, Daniel Bressington, Qiuyan Liao, Mengting He, Ka-Kit Law, Angela Y. M. Leung, Alex Molassiotis and Mengqi Li
Vaccines 2024, 12(7), 708; https://doi.org/10.3390/vaccines12070708 - 25 Jun 2024
Cited by 1 | Viewed by 1645
Abstract
Vaccine hesitancy is one of the top ten threats to global health. Artificial intelligence-driven chatbots and motivational interviewing skills show promise in addressing vaccine hesitancy. This study aimed to develop and validate an artificial intelligence-driven motivational digital assistant in decreasing COVID-19 vaccine hesitancy [...] Read more.
Vaccine hesitancy is one of the top ten threats to global health. Artificial intelligence-driven chatbots and motivational interviewing skills show promise in addressing vaccine hesitancy. This study aimed to develop and validate an artificial intelligence-driven motivational digital assistant in decreasing COVID-19 vaccine hesitancy among Hong Kong adults. The intervention development and validation were guided by the Medical Research Council’s framework with four major steps: logic model development based on theory and qualitative interviews (n = 15), digital assistant development, expert evaluation (n = 5), and a pilot test (n = 12). The Vaccine Hesitancy Matrix model and qualitative findings guided the development of the intervention logic model and content with five web-based modules. An artificial intelligence-driven chatbot tailored to each module was embedded in the website to motivate vaccination intention using motivational interviewing skills. The content validity index from expert evaluation was 0.85. The pilot test showed significant improvements in vaccine-related health literacy (p = 0.021) and vaccine confidence (p = 0.027). This digital assistant is effective in improving COVID-19 vaccine literacy and confidence through valid educational content and motivational conversations. The intervention is ready for testing in a randomized controlled trial and has high potential to be a useful toolkit for addressing ambivalence and facilitating informed decision making regarding vaccination. Full article
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19 pages, 3284 KiB  
Article
Understanding COVID-19 Vaccine Acceptance among Healthcare Workers in Indonesia: Lessons from Multi-Site Survey
by Madan Khatiwada, Ryan Rachmad Nugraha, Carine Dochez, Harapan Harapan, Kuswandewi Mutyara, Laili Rahayuwati, Maimun Syukri, Eustachius Hagni Wardoyo, Dewi Suryani, Bertha J. Que and Cissy Kartasasmita
Vaccines 2024, 12(6), 654; https://doi.org/10.3390/vaccines12060654 - 12 Jun 2024
Viewed by 1507
Abstract
The COVID-19 pandemic presented an unprecedented challenge to public health as well as an extraordinary burden on health systems worldwide. COVID-19 vaccines were attributed as a key tool to control the pandemic, with healthcare workers (HCWs) as a priority group to receive the [...] Read more.
The COVID-19 pandemic presented an unprecedented challenge to public health as well as an extraordinary burden on health systems worldwide. COVID-19 vaccines were attributed as a key tool to control the pandemic, with healthcare workers (HCWs) as a priority group to receive the vaccine. Healthcare workers are considered one of the most trusted sources of information on vaccines and vaccination. This study was conducted to evaluate the acceptability of the COVID-19 vaccine among HCWs in four different provinces of Indonesia. An anonymous cross-sectional study was conducted online among HCWs between December 2020 and February 2021. Out of 2732 participants, 80.39% stated that they would accept the COVID-19 vaccine, while 19.61% were hesitant to receive the vaccine. Concerns about the safety profile of COVID-19 vaccines and potential side-effects after vaccination were the main reasons among the participants to refuse the vaccine. Male gender, single status, higher education level, and higher risk perception increased the acceptability of the COVID-19 vaccine. Other motivators of COVID-19 vaccine acceptance include a high level of trust in the government and increased confidence in vaccine safety and efficacy studies. Dissemination of information in a timely manner as well as training programs for HCWs are crucial to increasing confidence in the COVID-19 vaccination program. Full article
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12 pages, 904 KiB  
Article
MivacunaLA (MyshotLA): A Community-Partnered Mobile Phone Intervention to Improve COVID-19 Vaccination Behaviors among Low-Income, Spanish-Speaking, and Immigrant Latino Parents or Caregivers
by Yelba M. Castellon-Lopez, Alexandra M. Klomhaus, Cruz Garcia, Denise Marquez, Hilda Avila, Hannah Gravette, Ray Lopez-Chang, Brenda Ortega, Keith C. Norris, Arleen F. Brown and Luisa Blanco
Vaccines 2024, 12(5), 511; https://doi.org/10.3390/vaccines12050511 - 8 May 2024
Cited by 1 | Viewed by 1597
Abstract
We developed and tested MivacunaLA/MyshotLA, a community-informed mobile phone intervention, to increase COVID-19 vaccination among Latino parents/caretakers of minors in under-resourced areas of Los Angeles by addressing misinformation and building trust. We recruited Latino parents/caregivers with at least one unvaccinated child in East [...] Read more.
We developed and tested MivacunaLA/MyshotLA, a community-informed mobile phone intervention, to increase COVID-19 vaccination among Latino parents/caretakers of minors in under-resourced areas of Los Angeles by addressing misinformation and building trust. We recruited Latino parents/caregivers with at least one unvaccinated child in East and South Los Angeles in the summer of 2021 and evaluated MivacunaLA as a randomized controlled trial with a wait-list control group. A difference-in-difference analysis showed Latino parents/caregivers that participated in MivacunaLA (n = 246), in comparison to the control group, were 15 percentage points more likely (p = 0.04) to report vaccination of minors aged 12–17 years, and 12 percentage points more likely (p = 0.03) to report a positive intention to vaccinate minors aged 2–11 years (when COVID-19 vaccines became available). Mobile phone-delivered digital interventions using videos and culturally tailored educational material to promote COVID-19 vaccine confidence can be an effective way to combat misinformation and deliver timely information to marginalized communities. Community-based participatory research approaches are crucial to advance health equity among minority communities, especially immigrant Spanish-speaking underserved communities. Full article
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13 pages, 248 KiB  
Article
Factors Associated with COVID-19 Vaccination Hesitancy and Most Frequently Vaccinated Status in a Japanese Population-Based Sample
by Aya Shirama, Andrew Stickley and Tomiki Sumiyoshi
Vaccines 2024, 12(5), 501; https://doi.org/10.3390/vaccines12050501 - 7 May 2024
Viewed by 1441
Abstract
While many countries across the world have had difficulty in providing continuous coronavirus disease (COVID-19) vaccine boosters, in Japan, the number of COVID-19 vaccinations has increased rapidly in the past two years to the point where the vaccination booster numbers are now at [...] Read more.
While many countries across the world have had difficulty in providing continuous coronavirus disease (COVID-19) vaccine boosters, in Japan, the number of COVID-19 vaccinations has increased rapidly in the past two years to the point where the vaccination booster numbers are now at the highest level in the world (by March 2023). Against this backdrop, this study aimed to determine the characteristics of individuals who either refused to be vaccinated or who were vaccinated multiple (five) times during this period. We analyzed data from a sample of 3710 Japanese adults that were collected in a nationwide, cross-sectional Internet survey that was undertaken in March 2023. Several demographics (e.g., age, education level, marital status, job status), medical conditions, daily smoking, and mental health/psychological factors (i.e., perceived stress, anxiety symptoms, loneliness) were associated with not having been vaccinated. Although the most frequently vaccinated status was also associated with some demographics (e.g., age, employment status), medical conditions, and daily smoking, other predictors such as having a COVID-19 infection history were unique to this outcome. Moreover, age-stratified analyses showed that depression (OR: 2.05, 95%CI: 1.08–3.89) and anxiety (OR: 3.87, 95%CI: 1.80–8.31) symptoms were associated with higher odds of being unvaccinated while loneliness was associated with lower odds for the most frequently vaccinated status (OR: 0.72, 95%CI: 0.54–0.96) among older adults (aged ≥ 60 years). The findings of this study indicate that many of the same factors are associated with vaccine hesitancy and being vaccinated multiple times among adults in Japan but that among older individuals, worse mental/psychological health problems may be important for vaccine hesitancy/infrequent vaccine uptake in an age range where the majority of individuals (57.7%) had been vaccinated five times. Full article
18 pages, 1483 KiB  
Article
Evolving Altruistic Attitudes towards Vaccination Post COVID-19 Pandemic: A Comparative Analysis across Age Groups
by Verena Barbieri, Christian J. Wiedermann, Stefano Lombardo, Giuliano Piccoliori, Timon Gärtner and Adolf Engl
Vaccines 2024, 12(5), 454; https://doi.org/10.3390/vaccines12050454 - 24 Apr 2024
Cited by 1 | Viewed by 1261
Abstract
Altruism plays an essential role in promoting vaccine uptake, an issue that came to the fore during the COVID-19 pandemic through discussions of herd immunity and altruistic motivations. In response, the primary objective of this cross-sectional survey was to explore how altruistic attitudes [...] Read more.
Altruism plays an essential role in promoting vaccine uptake, an issue that came to the fore during the COVID-19 pandemic through discussions of herd immunity and altruistic motivations. In response, the primary objective of this cross-sectional survey was to explore how altruistic attitudes have evolved in the post-pandemic era and to assess their effectiveness in motivating vaccination behavior in different age groups. The study aimed to elucidate changes in altruistic motivations for vaccination and their implications for public health strategies. Using a representative sample of the adult population of South Tyrol, Italy, including 1388 participants, altruism was assessed in 2023 with the scales of the Elderly Care Research Center (ECRC) and the International Personality Item Pool (IPIP) subscale of the version 5F30F-R1. Its association with demographic variables, vaccination attitudes and personal beliefs in two age groups (18–69 years, 70+ years) was analyzed. The results reveal distinct predictors of altruism across these scales and age groups, suggesting a shift in altruistic attitudes towards vaccination when comparing data from a similar survey conducted in 2021 with the 2023 results. Consequently, the use of altruism scales for different age groups is warranted. This study highlights the need for further research in this field. It concludes that while promoting altruistic behavior to increase vaccine uptake appears to be effective primarily among the younger population, emphasizing personal safety is more appropriate for encouraging vaccination among older individuals. Full article
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12 pages, 262 KiB  
Article
Prospective and Cross-Sectional Factors Predicting Caregiver Motivation to Vaccinate Children with Attention-Deficit/Hyperactivity Disorder against COVID-19: A Follow-Up Study
by Tai-Ling Liu, Ray C. Hsiao, Wen-Jiun Chou and Cheng-Fang Yen
Vaccines 2024, 12(5), 450; https://doi.org/10.3390/vaccines12050450 - 23 Apr 2024
Viewed by 1474
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) have higher risks of contracting COVID-19 and worse outcomes compared with adolescents without ADHD. The most effective method of preventing infection is vaccination. This follow-up study explored the prospective and cross-sectional factors influencing caregiver willingness to vaccinate children [...] Read more.
Adolescents with attention-deficit/hyperactivity disorder (ADHD) have higher risks of contracting COVID-19 and worse outcomes compared with adolescents without ADHD. The most effective method of preventing infection is vaccination. This follow-up study explored the prospective and cross-sectional factors influencing caregiver willingness to vaccinate children with ADHD against COVID-19. Baseline data on caregiver demographics, affiliate stigma, parenting stress, emotional difficulties, beliefs regarding the causes of ADHD, and ADHD symptoms were collected prior to the outbreak of the COVID-19 pandemic in Taiwan. At follow-up, the study assessed caregiver willingness to vaccinate children with ADHD, the challenges caregivers faced in parenting during the pandemic, and ADHD symptoms. The results revealed that caregiver age at baseline was positively associated with a willingness to vaccinate children against COVID-19 at follow-up. By contrast, the belief that ADHD resulted from failures in parental discipline at baseline was negatively associated with caregiver willingness to vaccinate. Parenting challenges were also negatively associated with caregiver willingness to vaccinate. Therefore, the age of caregivers, beliefs about the causes of ADHD, and parenting challenges during the pandemic should be considered when developing interventions to enhance caregiver willingness to vaccinate children with ADHD. Full article
20 pages, 322 KiB  
Article
The Fear of SARS-CoV-2 Infection versus the Perception of COVID-19 Vaccination amongst Older Adults in Urban Areas (CoV-VAC-PL Study): A Polish Community-Based Study
by Mateusz Cybulski, Andrei Shpakou and Urszula Cwalina
Vaccines 2024, 12(3), 223; https://doi.org/10.3390/vaccines12030223 - 21 Feb 2024
Viewed by 1399
Abstract
Background: The COVID-19 pandemic not only adversely impacted physical health but also affected older adults’ mental health. The first news on COVID-19 vaccination made a major breakthrough to the effect of improving older adults’ mood, notwithstanding the fact that vaccinated individuals in this [...] Read more.
Background: The COVID-19 pandemic not only adversely impacted physical health but also affected older adults’ mental health. The first news on COVID-19 vaccination made a major breakthrough to the effect of improving older adults’ mood, notwithstanding the fact that vaccinated individuals in this age group accounted only for 40.6% of the overall vaccination rollout in Poland. This study was aimed at assessing the level of anxiety regarding COVID-19 amongst older adults in Poland and assessing the attitude of older adults toward COVID-19 vaccination. Methods: The study sample encompassed a population of 800 individuals aged 60 years and older randomly picked up from a representative sample of all the residents in 16 voivodeship cities (50 individuals from each of the cities). The research method used in this study was a diagnostic survey, and its technique was based on an author-designed questionnaire and four standardised psychometric scales: the Fear of COVID-19 Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), the Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID-19S), and the Scale to Measure the Perception of SARS-CoV-2 Vaccines Acceptance (the VAC-COVID-19 Scale). Results: The degree of fear of SARS-CoV-2 among seniors equalled 1.03 ± 1.95 in terms of the CAS and 15.61 ± 5.75 in terms of the FCV-19S. Attitudes towards COVID-19 vaccination have proven positive (DrVac-COVID-19S—61.23 ± 12.35; VAC-COVID-19—44.31 ± 7.20). Females scored higher than males to the extent of the scales under consideration. The older the respondents were, the higher the scale score. A group of individuals with higher educational status was characterized by substantially higher scores covering the Knowledge subscale (p < 0.001) and the Autonomy subscale (p = 0.038), as well as a higher total score in terms of the DrVac-COVID-19S (p < 0.001). A group of positive factors including the reasons for COVID-19 vaccination in terms of the VAC-COVID-19 Scale was the only case to prove statistically insignificant relationships between the population size of the city the respondents came from and the scale values under consideration (p = 0.790). Statistically significant relationships were proven between SARS-CoV-2 contraction and fear of COVID-19 as measured by means of the CAS (p < 0.001) as well as between SARS-CoV-2 contraction and the Values subscale (p = 0.017) and the Knowledge subscale (p < 0.001) within the framework of the DrVac-COVID-19S scale and the total score in terms of the DrVac-COVID-19S scale (p = 0.023). No relationship was detected between the Autonomy subscale scores in terms of the DrVac-COVID-19S and the Knowledge subscale scores in terms of the DrVac-COVID-19S. The remaining scales were correlated to the extent of statistical significance. Conclusions: A subjective fear of COVID-19 was measured to be low or moderate within the group under study depending on the scale under consideration, proving declining trends as compared to the results arising from previously conducted studies. Seniors have more often had positive attitudes toward COVID-19 vaccination. The relationship between all of the sociodemographic features under consideration and the feeling of COVID-19 anxiety and between educational status, place of residence, SARS-CoV-2 contraction, COVID-19 vaccination, and the overall attitude toward COVID-19 vaccination indicator was proven to be statistically significant (depending on the scale under consideration). Furthermore, the correlation between the overall results arising from the standardised psychometric scales applied to this study was indicated to be statistically significant. Full article
12 pages, 697 KiB  
Article
Development and Assessment of a Six-Item Index to Gauge Motivation to Receive COVID-19 Vaccination
by Brian Pedersen, Gretchen Thompson, Albert Yao Kouakou, Marie Mujinga, Samuel Nicholes, Andres Martinez, Sohail Agha, Katherine Thanel, Mariame Louise Ouattara, Dorgeles Gbeke and Holly M. Burke
Vaccines 2024, 12(1), 6; https://doi.org/10.3390/vaccines12010006 - 20 Dec 2023
Cited by 3 | Viewed by 3388
Abstract
This study examined the factors influencing vaccine uptake using the Fogg Behavioral Model (FBM) and validated a multi-dimensional index for measuring a key construct in the FBM, motivation, using Confirmatory Factor Analysis (CFA) and Cronbach’s alpha. The research was conducted in Yopougon Est, [...] Read more.
This study examined the factors influencing vaccine uptake using the Fogg Behavioral Model (FBM) and validated a multi-dimensional index for measuring a key construct in the FBM, motivation, using Confirmatory Factor Analysis (CFA) and Cronbach’s alpha. The research was conducted in Yopougon Est, Côte d’Ivoire, and Kinshasa, Democratic Republic of Congo. We aimed to develop a motivation index for COVID-19 vaccination uptake informed by the FBM. The motivation index was developed and refined using interviews and cognitive testing, and then used in baseline and endline surveys to measure the motivation to uptake COVID-19 vaccination among 2173 respondents. The index was simplified to six items validated using Confirmatory Factor Analysis (CFA) and demonstrated strong internal reliability with Cronbach’s alphas of 0.89 for the baseline and 0.77 for the endline. The study’s findings indicate that this motivation index is a valid tool for measuring motivation to receive COVID-19 vaccination, with potential applications in other vaccination campaigns. However, further testing in diverse settings is needed to enhance generalizability, including in rural areas. This research provides valuable insights for designing effective behavior change interventions to increase COVID-19 vaccination rates. Full article
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18 pages, 291 KiB  
Article
Cultural Tightness-Looseness: How Was It Related to Vaccination Behavior among University Students in Japan, the United States, and India?
by Yoko Kawamura, Mio Kato, Rina Miyawaki, Hirono Ishikawa, Jessica Legge Muilenburg and Yuki Azaad Tomar
Vaccines 2023, 11(12), 1821; https://doi.org/10.3390/vaccines11121821 - 5 Dec 2023
Viewed by 1465
Abstract
As a next step to better understand the role of cultural tightness-looseness (CTL), this study aimed to examine whether CTL is associated with COVID-19 vaccination behavior among university students, taking into consideration sociocultural perceptions of vaccination across countries. A global online survey was [...] Read more.
As a next step to better understand the role of cultural tightness-looseness (CTL), this study aimed to examine whether CTL is associated with COVID-19 vaccination behavior among university students, taking into consideration sociocultural perceptions of vaccination across countries. A global online survey was conducted. University students from Japan, the US, and India participated. The average CTL score, three sociocultural perceptions related to COVID-19 vaccination, side effects, infection experience of themselves and family members, and other demographic variables were used to identify the model and to explain the second vaccination status using stepwise logistic regression methods with Akaike Information Criterion (AIC) scores which was for both the total, with the country as a variable, and for each country. Analyses of data from 1289 respondents who received the first vaccine revealed the essential role of CTL in individuals getting the second vaccine, while also revealing differences between countries. Regardless of the limitations, this study adds knowledge about CTL’s roles in the COVID-19 vaccination behavior among young generations and provides insights into public health communication practices for issues like COVID-19. Full article
12 pages, 892 KiB  
Article
Understanding COVID-19 Vaccine Uptake and Hesitancy among People with HIV in Freetown, Sierra Leone: A Cross-Sectional Study
by Peterlyn E. Cummings, Sulaiman Lakoh, Sahr A. Yendewa, Samuel P. E. Massaquoi, Peter B. James, Foday Sahr, Gibrilla F. Deen, Robert A. Salata, Pelema Gevao and George A. Yendewa
Vaccines 2023, 11(11), 1685; https://doi.org/10.3390/vaccines11111685 - 2 Nov 2023
Cited by 3 | Viewed by 1553
Abstract
People with HIV (PWH) incur a higher risk of COVID-19-related morbidity and mortality rates, yet less is known about COVID-19 vaccine uptake and hesitancy in this group. We conducted a cross-sectional study in Freetown, Sierra Leone, from April to June 2022, using the [...] Read more.
People with HIV (PWH) incur a higher risk of COVID-19-related morbidity and mortality rates, yet less is known about COVID-19 vaccine uptake and hesitancy in this group. We conducted a cross-sectional study in Freetown, Sierra Leone, from April to June 2022, using the VAX scale, a validated instrument, to assess attitudes towards COVID-19 vaccination and calculate the hesitancy (VAX) scores. We used generalized linear models to identify the factors associated with vaccine hesitancy. Overall, 490 PWH were enrolled (71.4% female, median age: 38 years, median CD4 count: 412 cells/mm3). About 17.3% received ≥1 dose of a COVID-19 vaccine. The mean VAX score was 43.14 ± 7.05, corresponding to 59.9% participants being vaccine-hesitant. A preference for natural immunity (65.8%) and concerns about profiteering (64.4%) were the commonest reasons for hesitancy, followed by a mistrust of vaccine benefits (61.4%) and worries about future effects (48.0%). In the adjusted regression analysis, being a Muslim (β = 2.563, p < 0.001) and having an urban residence (β = 1.709, p = 0.010) were associated with greater vaccine hesitancy, while testing for COVID-19 was associated with reduced vaccine hesitancy (β = −3.417, p = 0.027). These findings underscore the importance of addressing vaccine hesitancy as a critical element boosting COVID-19 vaccine uptake among PWH. Full article
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18 pages, 321 KiB  
Article
COVID-19 Vaccination Coverage and Factors Influencing Vaccine Hesitancy among Patients with Inborn Errors of Immunity in Latvia: A Mixed-Methods Study
by Zane Lucane, Mirdza Kursite, Kristaps Sablinskis, Linda Gailite and Natalja Kurjane
Vaccines 2023, 11(11), 1637; https://doi.org/10.3390/vaccines11111637 - 25 Oct 2023
Viewed by 1488
Abstract
Background: The European Society for Immunodeficiencies recommends that all patients with inborn errors of immunity (IEI) without contraindications should receive SARS-CoV-2 vaccination. The aim of this study was to investigate the reasons that discourage IEI patients from receiving the recommended vaccination and to [...] Read more.
Background: The European Society for Immunodeficiencies recommends that all patients with inborn errors of immunity (IEI) without contraindications should receive SARS-CoV-2 vaccination. The aim of this study was to investigate the reasons that discourage IEI patients from receiving the recommended vaccination and to assess vaccination coverage among IEI patients in Latvia. Methods: In this multicenter mixed-methods study, the vaccination status of all patients with IEI within two tertiary centers in Latvia was reviewed using electronic health records. Semi-structured interviews were conducted with 16 IEI patients who did not undergo vaccination, and a thematic analysis was performed. Results: A total of 341 patients (49.3% female; median age 19.7 years (IQR:17)) were included in the quantitative part. The proportion of fully vaccinated individuals aged ≥ 12 years was 66.8%–70.9% with patients with selective IgA deficiency and 58.8% with other IEI (χ² = 14.12, p < 0.001). The proportion of fully vaccinated individuals aged 5–11 years was 11.1%. Age was associated with vaccination status: younger patients were found to have a significantly lower likelihood of receiving vaccination (U = 8585, p < 0.001). The five main themes identified were as follows: (1) fear and uncertainty; (2) risk and benefit assessment: COVID-19 vaccine—is it worth it? (3) external influences: the dark horse of the decision-making—people around us; (4) individuals against the system; and (5) beliefs about vaccination and COVID-19. Under-representation of certain IEI groups and recall bias are possible limitations of this study. Conclusions: While most reasons for hesitancy were similar to those previously described in the general population, disease-specific concerns were also identified. Full article
12 pages, 241 KiB  
Article
Hesitancy in COVID-19 Vaccine Uptake and Its Correlated Factors Using Multi-Theory Model among Adult Women: A Cross-Sectional Study in Three States of Somalia
by Adam A. Mohamed, Temesgen F. Bocher, Mohamed A. Magan, Cashington Siameja and Said A. Mohamoud
Vaccines 2023, 11(9), 1489; https://doi.org/10.3390/vaccines11091489 - 14 Sep 2023
Viewed by 1465
Abstract
Background: In developing countries, access to information, awareness, and availability of COVID-19 vaccines are key challenges. Somalia launched the COVID-19 vaccination in March 2021; however, the uptake of the vaccination is slow, which creates fear of further loss of life in the country [...] Read more.
Background: In developing countries, access to information, awareness, and availability of COVID-19 vaccines are key challenges. Somalia launched the COVID-19 vaccination in March 2021; however, the uptake of the vaccination is slow, which creates fear of further loss of life in the country unless intentional and organized campaigning and efforts are made to improve both the availability of the vaccine and its acceptance by the community. This study aimed to understand the current level of awareness, accessibility, trust, and hesitancy toward the COVID-19 vaccine among women in Somalia. Methods: To assess COVID-19 vaccine uptake, acceptance, community awareness, and hesitancy rates in Somalia, we carried out a cross-sectional mixed methods study in three regions of Somalia that were selected randomly out of the 18 regions of Somalia. A multi-theory model (MTM) was developed to identify correlated factors associated with the hesitancy or non-hesitancy toward COVID-19 vaccination among women of all ages (18 years and above). Results: A total of 999 eligible women (333 in each district) of 18–98 years old were interviewed in March 2022. About two-thirds (63.76%) of participants reported hesitancy about receiving the COVID-19 vaccine. The theory model initiation construct indicated that behavioral confidence in the vaccine (b = 0.476, p < 0.001), participatory dialogue (at b = 0.136, p < 0.004), and changes in the physical environment (b = 0.248, p = 0.015) were significantly associated with COVID-19 vaccine acceptance among women who were not hesitant to take the vaccine. Conclusions: The availability of COVID-19 vaccines may not translate into their uptake. The decision to get the vaccine was determined by multiple factors, including the perceived value of the vaccination, previous experience with the vaccine, perceived risk of infection, accessibility and affordability, and trust in the vaccine itself. Public health education programming and messaging must be developed to encourage vaccine uptake among women with varying levels of vaccine hesitancy. Full article
12 pages, 635 KiB  
Article
Attitudes and Practices Related to COVID-19 Vaccination with the Second Booster Dose among Members of Athens Medical Association: Results from a Cross-Sectional Study
by Georgios Zoumpoulis, Paraskevi Deligiorgi, Dimitrios Lamprinos, Panagiotis Georgakopoulos, Evangelos Oikonomou, Gerasimos Siasos, Georgios Rachiotis, Christos Damaskos, Dimitrios Papagiannis, Kostas A. Papavassiliou, George Patoulis, Fotios Patsourakos, Vasiliki Benetou, Elena Riza, Philippos Orfanos, Pagona Lagiou and Georgios Marinos
Vaccines 2023, 11(9), 1480; https://doi.org/10.3390/vaccines11091480 - 12 Sep 2023
Cited by 2 | Viewed by 1222
Abstract
Background: There are limited data on the attitudes and acceptance of the second booster (fourth dose) of the COVID-19 vaccination among physicians. Methods: A cross-sectional, questionnaire-based, online study was conducted among members of the Athens Medical Association (A.M.A.) who were invited to participate [...] Read more.
Background: There are limited data on the attitudes and acceptance of the second booster (fourth dose) of the COVID-19 vaccination among physicians. Methods: A cross-sectional, questionnaire-based, online study was conducted among members of the Athens Medical Association (A.M.A.) who were invited to participate anonymously over the period from January to March 2023. Results: From the 1224 members who participated in the survey, 53.9% did not receive the fourth dose of the COVID-19 vaccine. The main reasons for no vaccination were the lack of obligation to receive the fourth dose, the history of three doses of the COVID-19 vaccine and the lack of sufficient information about the effectiveness of the fourth dose. Over half of the three-dose-vaccinated participants were willing to receive the fourth dose in the near future. Interestingly, the vaccination coverage among participants who had been informed about the fourth dose through scientific sources was low. Conclusions: The low vaccination coverage with the fourth dose reported in this study can lead to broad and serious consequences, such as increase in COVID-19 infections, reduction of available healthcare staff and increased caseloads of COVID-19 in hospitals. Furthermore, hesitant physicians will adversely influence the vaccination uptake among the general population due to their key role in informing and recommending the vaccine. The healthcare system administration should acknowledge and address physician’s concerns through effective communication and better support. Full article
15 pages, 1385 KiB  
Article
Understanding COVID-19 Vaccine Acceptance among Latin American Health Workers: Implications for Designing Interventions
by Tamara Rivera, Jennifer Brustrom, Maite Vera Antelo, E. Benjamin Puertas, Dale A. Rhoda and Martha Velandia-Gonzalez
Vaccines 2023, 11(9), 1471; https://doi.org/10.3390/vaccines11091471 - 10 Sep 2023
Viewed by 1633
Abstract
Health workers (HWs) have a key role in promoting vaccine acceptance. This study draws on the Behavioral and Social Drivers of Vaccination (BeSD) model and our team’s investigation of vaccine hesitancy in a sample of 1197 HWs across 14 Caribbean countries in 2021. [...] Read more.
Health workers (HWs) have a key role in promoting vaccine acceptance. This study draws on the Behavioral and Social Drivers of Vaccination (BeSD) model and our team’s investigation of vaccine hesitancy in a sample of 1197 HWs across 14 Caribbean countries in 2021. We conducted a cross-sectional Internet survey of 6718 HWs across 16 countries in Latin America in spring 2022, after the COVID-19 vaccine had recently become widely available in the region. The survey assessed HWs’ attitudes regarding COVID-19 vaccines and vaccines in general. As a proxy measure of COVID-19 vaccine acceptance, we used the willingness to recommend the COVID-19 vaccine to eligible people. Ninety-seven percent of respondents were COVID-19 vaccine acceptant. Although nearly all respondents felt that the COVID-19 vaccine was safe and effective, 59% expressed concerns about potential adverse effects. Despite uniformly high acceptance of the COVID-19 vaccine overall and across Latin American subregions, acceptance differed by sex, HW profession, and COVID-19 history. Social processes, including actions and opinions of friends, family, and colleagues; actions and opinions of religious leaders; and information seen on social networks shaped many respondents’ opinions of vaccines, and the magnitude of these effects differed across both demographic and geographic subgroups. Information campaigns designed for HWs should underscore the importance of vaccine safety. Messages should be tailored to specific audiences according to the information source each is most likely to consult and trust. Full article
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10 pages, 264 KiB  
Article
Factors Affecting COVID-19 Vaccine Acceptance among Pregnant Women: A Cross Sectional Study from Abha City, Saudi Arabia
by Asma Saad Habbash and Aesha Farheen Siddiqui
Vaccines 2023, 11(9), 1463; https://doi.org/10.3390/vaccines11091463 - 7 Sep 2023
Cited by 2 | Viewed by 1500
Abstract
Background: Pregnant women can get infected with COVID-19 with serious sequelae to them and their fetus. Concerns about COVID-19 vaccination safety to mothers and babies, and doubts about its effectiveness, have hindered vaccine acceptance throughout the COVID-19 crisis. The objective of the [...] Read more.
Background: Pregnant women can get infected with COVID-19 with serious sequelae to them and their fetus. Concerns about COVID-19 vaccination safety to mothers and babies, and doubts about its effectiveness, have hindered vaccine acceptance throughout the COVID-19 crisis. The objective of the current investigation was to estimate COVID-19 acceptance rates among pregnant women in Abha city, Aseer region, Saudi Arabia, and determine its clinical and demographic correlates. Method: Descriptive questionnaire-based cross-sectional survey of a sample of pregnant women attending regular antenatal care services in Abha. We used backward stepwise multiple logistic regression analysis to evaluate the predictability of vaccine acceptance in terms of baseline clinical and demographic factors. Results: The survey included 572 pregnant women. The prevalence of acceptance of COVID-19 vaccine was high (93.7%; 95%CI: 91.7–95.7%). University graduates and women with a later gestational age were more likely to accept vaccination (OR = 6.120, p = 0.009), (t = 2.163, p = 0.036), respectively. Confidence in vaccine safety was associated with better acceptance (OR = 3.431, p = 0.001). Conclusions: The acceptance rate for vaccination among pregnant women in Abha, Saudi Arabia, is higher compared to international rate. However, our results indicate that confidence in vaccine safety was associated with better acceptance. Hence, vaccine safety was the overarching predictor for harboring positive attitudes towards it. Public health policies should capitalize on such positive attitudes and aim for total coverage of pregnant women with COVID-19 vaccination including booster dosages. Full article
11 pages, 258 KiB  
Article
Trust, Interaction with Neighbors, and Vaccination during the COVID-19 Pandemic: A Cross-Sectional Analysis of Chinese Data
by Takashi Oshio and Ruru Ping
Vaccines 2023, 11(8), 1332; https://doi.org/10.3390/vaccines11081332 - 6 Aug 2023
Viewed by 1371
Abstract
The COVID-19 pandemic significantly impacted public health and quality of life, leading to government recommendations for vaccination. Using cross-sectional data from a nationwide population-based survey conducted in China (N = 6860), this study aimed to examine the associations between individual vaccine uptake [...] Read more.
The COVID-19 pandemic significantly impacted public health and quality of life, leading to government recommendations for vaccination. Using cross-sectional data from a nationwide population-based survey conducted in China (N = 6860), this study aimed to examine the associations between individual vaccine uptake and general trust in others, trust in government, and interaction with neighbors. We conducted a multilevel logistic regression analysis to examine the relevance of these factors at the individual and community levels. Among young adults, higher levels of general trust at both levels were positively associated with vaccination, with odds ratios (OR) of 1.35 (95% confidence interval [CI]: 1.07, 1.70) and 1.58 (95% CI: 1.14, 2.18), respectively. We also found a positive association between vaccination and community-level interaction with neighbors, with ORs of 1.55 (95% CI: 1.11, 2.17). In contrast, among older individuals, vaccination was positively associated only with individual-level interaction with neighbors, with an OR of 1.55 (95% CI: 1.15, 2.08). The results indicated that vaccine uptake was associated with an individual’s views of society and the social environment of the community, with substantial variations between the young and the old. Our findings emphasize the significance of public health measures to strengthen neighborhood interactions among older adults. Full article
17 pages, 776 KiB  
Article
Psychosocial Determinants of COVID-19 Vaccine Hesitancy and the Mediating Role of Various Attitudes towards Science
by Jonathan Morgan, Joseph A. Wagoner and Tom Pyszczynski
Vaccines 2023, 11(8), 1310; https://doi.org/10.3390/vaccines11081310 - 31 Jul 2023
Cited by 1 | Viewed by 1286
Abstract
This study examined the way attitudes towards science in the U.S. mediate the relationship between COVID-19 vaccine hesitancy and psychosocial predictors, such as political ideology, religiosity, reactance proneness, dogmatism, perceived communal ostracism, education, and socioeconomic status. We analyzed the structure of people’s attitudes [...] Read more.
This study examined the way attitudes towards science in the U.S. mediate the relationship between COVID-19 vaccine hesitancy and psychosocial predictors, such as political ideology, religiosity, reactance proneness, dogmatism, perceived communal ostracism, education, and socioeconomic status. We analyzed the structure of people’s attitudes towards science, revealing four distinct factors: epistemic confidence, belief that science and technology are beneficial, trust in science in general, and trust in medical science. With all four factors included as mediators in a saturated path analysis, low levels of trust in medical science and low epistemic confidence fully mediated the relationships between nearly all of the psychosocial predictors and COVID-19 vaccine hesitancy. Political conservativism’s negative association with vaccine hesitancy was partially mediated by the same two facets of people’s attitudes towards science. Adding nuance to existing research, we found that trust in science in general was not a significant mediator once all four facets were included in the model. These findings are discussed with a focus on their implications for understanding attitudes towards science and their substantial and complex role in COVID-19 vaccine hesitancy. Full article
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17 pages, 336 KiB  
Article
COVID-19 Vaccine Refusal and Medical Distrust Held by Correctional Officers
by Erin Michelle Turner Kerrison and Jordan M. Hyatt
Vaccines 2023, 11(7), 1237; https://doi.org/10.3390/vaccines11071237 - 13 Jul 2023
Cited by 1 | Viewed by 1862
Abstract
This study explores COVID-19 vaccine acceptance among prison security staff and the extent to which they trust varied sources of information about the vaccines. Cross-sectional survey data were obtained from a state-wide sample of corrections officers (COs, hereafter; n = 1208) in February [...] Read more.
This study explores COVID-19 vaccine acceptance among prison security staff and the extent to which they trust varied sources of information about the vaccines. Cross-sectional survey data were obtained from a state-wide sample of corrections officers (COs, hereafter; n = 1208) in February 2021. Group differences, disaggregated by demographic characteristics, were examined using F-tests and t-tests. Despite the comparatively limited risk of contracting the virus, non-security staff reported they would accept a COVID-19 vaccine at no cost (74%), compared to their more vulnerable CO counterparts (49%). We observed vaccine refusal correlations between COs’ reported gender, age, and length of time working as a CO, but none with their self-reported race. Vaccine refusal was more prevalent among womxn officers, younger officers, and those who had spent less time working as prison security staff. Our findings also suggest that the only trusted source of information about vaccines were family members and only for officers who would refuse the vaccine; the quality of trust placed in those sources, however, was not substantially positive and did not vary greatly across CO racial groups. By highlighting characteristics of the observed gaps in COVID-19 vaccine acceptance between COs and their non-security staff coworkers, as well as between corrections officers of varied demographic backgrounds, these findings can inform the development of responsive and accepted occupational health policies for communities both inside and intrinsically linked to prisons. Full article
16 pages, 286 KiB  
Article
Views and Challenges of COVID-19 Vaccination in the Primary Health Care Sector. A Qualitative Study
by Maria Moudatsou, Areti Stavropoulou, Michael Rovithis and Sofia Koukouli
Vaccines 2023, 11(4), 803; https://doi.org/10.3390/vaccines11040803 - 5 Apr 2023
Cited by 3 | Viewed by 3057
Abstract
COVID-19 has affected the global community as it has severely raised population mortality and morbidity rates. Vaccination was seen as a mechanism against the spread of the pandemic. Yet, there are still several reservations about its adoption. Professionals in the field of health [...] Read more.
COVID-19 has affected the global community as it has severely raised population mortality and morbidity rates. Vaccination was seen as a mechanism against the spread of the pandemic. Yet, there are still several reservations about its adoption. Professionals in the field of health care have a crucial frontline role. The present study uses a qualitative research approach to examine Greek health professionals’ views on vaccination acceptance. According to the key findings, health professionals largely accept vaccination. The main reasons cited were scientific knowledge, a sense of obligation to society, and protection from disease. However, there are still numerous restrictions to adhering to it. This is due to the lack of knowledge of certain scientific disciplines or to misinformation, as well as to religious or political convictions. The issue of trust is central to the acceptance of vaccinations. According to our research, the most adequate strategy to enhance immunization and ensure that it is widely accepted is to promote health educational interventions for professionals working in primary care settings. Full article
16 pages, 859 KiB  
Article
A Qualitative Study Exploring Motivators and Barriers to COVID-19 Vaccine Uptake among Adults in South Africa and Zimbabwe
by Nellie Myburgh, Mamakiri Mulaudzi, Gugulethu Tshabalala, Norest Beta, Kimberley Gutu, Stefanie Vermaak, Charles Lau, Catherine Hill, Lawrence Stanberry, Wilmot James, Shabir Madhi, Tariro Makadzange and Janan Janine Dietrich
Vaccines 2023, 11(4), 729; https://doi.org/10.3390/vaccines11040729 - 25 Mar 2023
Cited by 6 | Viewed by 3932
Abstract
While vaccines are a well-established method of controlling the spread of infectious diseases, vaccine hesitancy jeopardizes curbing the spread of COVID-19. Through the Vaccine Information Network (VIN), this study explored barriers and motivators to COVID-19 vaccine uptake. We conducted 18 focus group discussions [...] Read more.
While vaccines are a well-established method of controlling the spread of infectious diseases, vaccine hesitancy jeopardizes curbing the spread of COVID-19. Through the Vaccine Information Network (VIN), this study explored barriers and motivators to COVID-19 vaccine uptake. We conducted 18 focus group discussions with male and female community members, stratified by country, age group, and—for Zimbabwe only—by HIV status. Participants’ median age across both countries was 40 years (interquartile range of 22–40), and most (65.9%) were female. We conceptualized the key themes within the World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE) 3C (convenience, confidence, complacency) vaccine hesitancy model. Barriers to vaccine uptake—lack of convenience, low confidence, and high complacency—included inaccessibility of vaccines and vaccination sites, vaccine safety and development concerns, and disbelief in COVID-19’s existence. Motivators to vaccine uptake—convenience, confidence, and low complacency—included accessibility of vaccination sites, user-friendly registration processes, trust in governments and vaccines, fear of dying from COVID-19, and knowing someone who had died from or become infected with COVID-19. Overall, vaccine hesitancy in South Africa and Zimbabwe was influenced by inconvenience, a lack of confidence, and high complacency around COVID-19 vaccines. Full article
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17 pages, 1004 KiB  
Article
Assessing COVID-19 Vaccine Booster Hesitancy Using the Modified 5C Scale in Zhejiang Province, China: A Cross-Sectional Study
by Xuan Deng, Yuchen Zhao, Shenyu Wang, Hanqing He, Zhiping Chen, Yang Zhou, Rui Yan, Xuewen Tang, Yao Zhu and Xiaoping Xu
Vaccines 2023, 11(3), 706; https://doi.org/10.3390/vaccines11030706 - 21 Mar 2023
Cited by 5 | Viewed by 2357
Abstract
Following the rollout of a booster campaign to promote immunity against COVID-19 in China, this study aimed to assess booster hesitancy among adults who were fully vaccinated with primary doses across Zhejiang Province. Firstly, the modified 5C scale developed by a German research [...] Read more.
Following the rollout of a booster campaign to promote immunity against COVID-19 in China, this study aimed to assess booster hesitancy among adults who were fully vaccinated with primary doses across Zhejiang Province. Firstly, the modified 5C scale developed by a German research team was assessed for reliability and validity via a pre-survey in Zhejiang Province. Then, a 30-item questionnaire was established to conduct online and offline surveys during 10 November to 15 December 2021. Demographic characteristics and information on previous vaccination experience, vaccine type of primary doses, attitudes towards booster doses and awareness of SARS-CoV-2 infection were collected. Chi-square tests, pairwise comparison and multivariate logistic regression were performed in data analysis. In total, 4039 valid questionnaires were analyzed, with booster hesitancy of 14.81%. Dissatisfaction with previous vaccination experience of primary doses (ORs = 1.771~8.025), less confidence in COVID-19 vaccines (OR = 3.511, 95%CI: 2.874~4.310), younger age compared to the elderly aged 51–60 years old (2.382, 1.274~4.545), lower education level (ORs = 1.707~2.100), weaker awareness of social responsibility of prevention and control of COVID-19 (1.587, 1.353~1.859), inconvenience of booster vaccination (1.539, 1.302~1.821), complacency regarding vaccine efficacy as well as self-health status (1.224, 1.056~1.415) and excessive trade-offs before vaccination (1.184, 1.005~1.398) were positively associated with booster hesitancy. Therefore, intelligent means should be strengthened to optimize vaccination services. More influential experts and other significant figures should be supported to promote timely evidence-based information via various media platforms to reduce public hesitancy and increase booster uptake. Full article
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10 pages, 269 KiB  
Article
Epidemiology of the Acceptance of Anti COVID-19 Vaccine in Urban and Rural Settings in Cameroon
by Cecile Ingrid Djuikoue, Rodrigue Kamga Wouambo, Majeste Mbiada Pahane, Blaise Demanou Fenkeng, Cedric Seugnou Nana, Joelle Djamfa Nzenya, Flore Fotso Kamgne, Cedric Ngalani Toutcho, Benjamin D. Thumamo Pokam and Teke Apalata
Vaccines 2023, 11(3), 625; https://doi.org/10.3390/vaccines11030625 - 10 Mar 2023
Cited by 1 | Viewed by 1794
Abstract
The COVID-19 pandemic rapidly evolved in December 2019 and to prevent its spread, effective vaccines were produced and made available to the population. Despite their availability so far in Cameroon, the vaccination coverage remains low. This study aimed at describing the epidemiology of [...] Read more.
The COVID-19 pandemic rapidly evolved in December 2019 and to prevent its spread, effective vaccines were produced and made available to the population. Despite their availability so far in Cameroon, the vaccination coverage remains low. This study aimed at describing the epidemiology of the acceptance of vaccines against COVID-19 in some urban and rural areas of Cameroon. A cross-sectional, descriptive and analytical survey was conducted from March 2021 to August 2021 targeting unvaccinated individuals from urban and rural area. After receiving appropriate administrative authorizations and an ethical clearance from the Institutional Review Board (or Ethics Committee) of Douala University (N° 3070CEI-Udo/05/2022/M), a cluster sampling at many degrees was performed and a language-adapted questionnaire was completed by each consenting participant. Data were analyzed using Epi info version 7.2.2.6 software and for p-values < 0.05, the difference was considered as statistically significant. Out of 1053 individuals, 58.02% (611/1053) participants were residing in urban and 41.98% (442/1053) in rural areas. Good knowledge relative to COVID-19 was significantly higher in urban areas as compared to rural areas (97.55% vs. 85.07, p < 0.000). The proportion of respondents who intended to accept the anti COVID-19 vaccine was significantly higher in urban areas than rural areas (42.55% vs. 33.26, p = 0.0047). Conversely, the proportion of anti COVID-19 reluctant respondents thinking that the vaccine can induce a disease was significantly higher in rural areas than urban areas (54 (35.07 vs. 8.84, p < 0.0001). The significant determinants of anti-COVID-19 acceptance were the level of education (p = 0.0001) and profession in the rural areas (p ≤ 0.0001), and only the profession (p = 0.0046) in the urban areas. This study globally showed that anti-COVID-19 vaccination remains a major challenge in urban as well as rural areas in Cameroon. We should continue sensitizing and educating the population about vaccine importance in preventing the COVID-19 spread. Full article
11 pages, 625 KiB  
Article
Vaccinated Yet Booster-Hesitant: Perspectives from Boosted, Non-Boosted, and Unvaccinated Individuals
by Cheryl Lin, Brooke Bier, Rungting Tu, John J. Paat and Pikuei Tu
Vaccines 2023, 11(3), 550; https://doi.org/10.3390/vaccines11030550 - 25 Feb 2023
Cited by 7 | Viewed by 2077
Abstract
Though available for all age groups in the US, only about half of those vaccinated have obtained a COVID-19 booster. Similar to the unvaccinated, those vaccinated-but-not-boosted may reduce the effectiveness of widespread viral protection. Booster hesitancy differs from general vaccine hesitancy yet remains [...] Read more.
Though available for all age groups in the US, only about half of those vaccinated have obtained a COVID-19 booster. Similar to the unvaccinated, those vaccinated-but-not-boosted may reduce the effectiveness of widespread viral protection. Booster hesitancy differs from general vaccine hesitancy yet remains less researched. We examined booster perceptions across vaccination status using qualitative methodologies. Four focus groups and 11 individual interviews (total n = 32) revealed nuanced changes and differences compared to the first-dose decision. Booster hesitancy stemmed from questions and surprises. Most vaccinated participants accepted the booster, though to varying degrees: enthusiastically with feelings of appreciation and added confidence, passively as an intuitive next step, indifferently following recommendation—“primed” by the yearly flu shot, and reluctantly with worries. The vaccinated-but-not-boosted group expressed confusion about the need for a new shot and discontentment as to why it was not communicated from the start, which coincided with their uncertainty about ending the pandemic. Inadvertently, booster recommendations further polarized non-vaccinated participants, augmenting their skepticism of the original dosages’ efficacy or necessity and intensifying their distrust of the government. The findings illuminate the need for adjusting vaccination promotions to better tailor communications (e.g., distinguishing its benefits from the first vaccine and emphasizing the continued risk of COVID-19 spread). Future researchers should further explore the vaccine-accepting-yet-booster-hesitant groups’ motivations and risk perceptions to reduce booster rejection. Full article
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14 pages, 742 KiB  
Article
What Motivates the Vaccination Rift Effect? Psycho-Linguistic Features of Responses to Calls to Get Vaccinated Differ by Source and Recipient Vaccination Status
by J. Lukas Thürmer and Sean M. McCrea
Vaccines 2023, 11(3), 503; https://doi.org/10.3390/vaccines11030503 - 21 Feb 2023
Cited by 2 | Viewed by 1849
Abstract
Although vaccination provides substantial protection against COVID, many people reject the vaccine despite the opportunity to receive it. Recent research on potential causes of such vaccine hesitancy showed that those unvaccinated rejected calls to get vaccinated when they stemmed from a vaccinated source [...] Read more.
Although vaccination provides substantial protection against COVID, many people reject the vaccine despite the opportunity to receive it. Recent research on potential causes of such vaccine hesitancy showed that those unvaccinated rejected calls to get vaccinated when they stemmed from a vaccinated source (i.e., a vaccination rift). To mend this vaccination rift, it is key to understand the underlying motivations and psychological processes. To this end, we used the voluntary free-text responses comprised of 49,259 words from the original Austrian large-scale data-set (N = 1170) to conduct in-depth psycho-linguistic analyses. These findings indicate that vaccinated message sources elicited longer responses using more words per sentence and simpler language writing more about things rather than themselves or addressing others directly. Contrary to common assumptions, expressed emotions or indicators of cognitive processing did not differ between message source conditions, but vaccinated sources led to more achievement-related expressions. Participant vaccination did not moderate the observed effects but had differential main effects on psycho-linguistic response parameters. We conclude that public vaccination campaigns need to take the vaccination status of the message source and other societal rifts into account to bolster recipients’ achievement. Full article
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21 pages, 1438 KiB  
Article
Cognitive and Behavioral Factors Predicting the Decision to Vaccinate against COVID-19 in Clinical Psychiatric Population—A Cross-Sectional Survey
by Gabriela Mariana Marcu, Ana Maria Radu, Mihaela Dana Bucuță, Radu Sorin Fleacă, Ciprian Tanasescu, Mihai Dan Roman, Adrian Boicean and Ciprian Ionuț Bacilă
Vaccines 2023, 11(2), 441; https://doi.org/10.3390/vaccines11020441 - 15 Feb 2023
Cited by 3 | Viewed by 1973
Abstract
The spread of the COVID-19 virus created more than a medical crisis, while it also negatively affected the mental health of the general population. This context increased the vulnerability of the psychiatric population. While research interest highly targeted vaccine hesitancy and acceptance, many [...] Read more.
The spread of the COVID-19 virus created more than a medical crisis, while it also negatively affected the mental health of the general population. This context increased the vulnerability of the psychiatric population. While research interest highly targeted vaccine hesitancy and acceptance, many studies focused on trust issues—both in vaccine efficacy and in communication with authorities. Less is known about the psychological underpinnings of the COVID vaccination decision, specifically in the high-uncertainty circumstances due to the novelty of the virus. In a cross-sectional study, we investigated the predictive value of several cognitive (perceived risk, vulnerability, uncertainty, and trust in one’s decision) and behavioral (previous vaccinations, social media use, and practicing preventive behavior) factors, for the vaccination decision against COVID-19, for 252 psychiatric inpatients (data collected between September 2021 and February 2022). Demographics and diagnostics were also considered. We found a significant relationship between the “Perceived risk of vaccination” and the choice of vaccination (χ2(2, N = 252) = 58.59, p ≤ 0.001), and between the “Trust in own decision to vaccinate” and the decision to vaccinate (χ2(2, N = 252) = 31,5, p ≤ 0.001). The overall regression model was statistically significant (χ2 (9, N = 252) = 97.1, p < 0.001), with between 30% and 45% of the variance in the odds of a positive decision explained by the predictor set. The model coefficients analysis showed that an individual with a psychiatric disorder but with higher confidence in their decision had significant (p < 0.001) increased odds of the decision to vaccinate against COVID-19 by 893%. A former voluntary vaccination did not significantly associate with the decision to vaccinate against COVID-19 (χ2(1, N = 252) = 2.74, p > 0.05) in this special population. No other behavioral factors, diagnosis, or demographics were significant as predictors, for the clinical psychiatric population surveyed, except the educational level. Implications for future vaccination acceptance of this special population are discussed. Full article
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13 pages, 993 KiB  
Article
COVID-19 Vaccine Status, Intent, Hesitancy, and Disease-Related Beliefs in People with Multiple Sclerosis
by Lisa Grech, Alastair Kwok, Mike Nguyen, Antony Winkel, Ernest Butler, Michelle Allan, Nathan Bain, Eva Segelov and on behalf of the MSVACCS Investigators
Vaccines 2023, 11(2), 410; https://doi.org/10.3390/vaccines11020410 - 10 Feb 2023
Cited by 3 | Viewed by 1827
Abstract
Background: People with multiple sclerosis (MS) are susceptible to severe COVID-19 outcomes. They were included as a priority group for the Australian COVID-19 vaccine roll-out in early 2021. However, vaccine hesitancy remains a complex barrier to vaccination in this population group, which may [...] Read more.
Background: People with multiple sclerosis (MS) are susceptible to severe COVID-19 outcomes. They were included as a priority group for the Australian COVID-19 vaccine roll-out in early 2021. However, vaccine hesitancy remains a complex barrier to vaccination in this population group, which may be partly related to disease relapse concerns following COVID-19 vaccination. This study examined the COVID-19 vaccination status, intent, hesitancy, and disease-related beliefs in people with MS. Methods: An online survey was conducted with people with MS receiving care at two Australian health services between September and October 2021. It collected sociodemographic and disease-specific characteristics and responses to validated scales that assessed vaccine hesitancy and general and MS-related vaccine beliefs. Results: Of the 281 participants [mean age 47.7 (SD 12.8) years; 75.8% females], most (82.9%) had received at least one COVID-19 vaccine dose. Younger participants were less likely to be vaccinated, as were those within 1–5 years of disease duration. After controlling for age, disease duration was not associated with vaccination status. Unvaccinated participants were more likely to report less willingness to receive the COVID-19 vaccine, higher vaccine complacency and lower vaccine confidence, greater MS-related vaccine complacency, and higher MS and treatment interaction concerns. Conclusions: People with MS reported a high vaccination rate, despite general and MS-specific COVID-19 vaccine concerns. Greater MS-specific concerns were reported by those who indicated that their MS was not well-controlled and their MS impacted their daily activities. By understanding the factors that influence vaccine hesitancy and their interplay with MS disease course and treatment concerns, this can inform tailored interventions and educational messages to address these concerns in people with MS. Clinicians, governments, and community organisations are key partners in delivering these interventions and messages, as ongoing booster doses are needed for this vulnerable population. Full article
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19 pages, 1076 KiB  
Article
Cognitive and Cultural Factors That Affect General Vaccination and COVID-19 Vaccination Attitudes
by Alla Keselman, Catherine Arnott Smith, Amanda J. Wilson, Gondy Leroy and David R. Kaufman
Vaccines 2023, 11(1), 94; https://doi.org/10.3390/vaccines11010094 - 30 Dec 2022
Cited by 10 | Viewed by 7376
Abstract
The development of COVID-19 vaccines is a major scientific accomplishment that has armed communities worldwide with powerful epidemic control tools. Yet, COVID-19 vaccination efforts in the US have been marred by persistent vaccine hesitancy. We used survey methodology to explore the impact of [...] Read more.
The development of COVID-19 vaccines is a major scientific accomplishment that has armed communities worldwide with powerful epidemic control tools. Yet, COVID-19 vaccination efforts in the US have been marred by persistent vaccine hesitancy. We used survey methodology to explore the impact of different cognitive and cultural factors on the public’s general vaccination attitudes, attitudes towards COVID-19 vaccines, and COVID-19 vaccination status. The factors include information literacy, science literacy, attitudes towards science, interpersonal trust, public health trust, political ideology, and religiosity. The analysis suggests that attitudes towards vaccination are influenced by a multitude of factors that operate in a complex manner. General vaccination attitude was most affected by attitudes towards science and public health trust and to a lesser degree by information literacy, science literacy, and religiosity. Attitudes towards COVID-19 vaccines were most affected by public health trust and to a lesser extent by general trust, ideology and attitudes towards science. Vaccination status was most influenced by public health trust. Possible mediating effects of correlated variables in the model need to be further explored. The study underscores the importance of understanding the relationship between public health trust, literacies, and sociocultural factors. Full article
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11 pages, 274 KiB  
Article
The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample
by Melike Kucukkarapinar, Filiz Karadag, Irem Budakoglu, Selcuk Aslan, Onder Ucar, Aysegul Yay Pence, Utku Timurcin, Selim Tumkaya, Cicek Hocaoglu and Ilknur Kiraz
Vaccines 2022, 10(12), 2027; https://doi.org/10.3390/vaccines10122027 - 27 Nov 2022
Cited by 2 | Viewed by 1751
Abstract
Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective [...] Read more.
Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18–30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required. Full article
17 pages, 1008 KiB  
Article
“Maternal Vaccination Greatly Depends on Your Trust in the Healthcare System”: A Qualitative Study on the Acceptability of Maternal Vaccines among Pregnant Women and Healthcare Workers in Barcelona, Spain
by Anna Marín-Cos, Elena Marbán-Castro, Ivana Nedic, Mara Ferrari, Esther Crespo-Mirasol, Laia Ferrer Ventura, Berta Noya Zamora, Victoria Fumadó, Clara Menéndez, Cristina Martínez Bueno, Anna Llupià, Marta López, Anna Goncé and Azucena Bardají
Vaccines 2022, 10(12), 2015; https://doi.org/10.3390/vaccines10122015 - 25 Nov 2022
Cited by 11 | Viewed by 2855
Abstract
The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on [...] Read more.
The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on phenomenology, a methodological approach to understand first-hand experiences, and grounded theory, an inductive approach to analyse data, where theoretical generalisations emerge. Data were collected through semi-structured interviews with pregnant women attending antenatal care services and healthcare workers (HCWs) in Barcelona, Spain. Interviews were audio-recorded, transcribed, and coded, and notes were taken. Inductive thematic analysis was performed, and data were manually coded. Pertussis was reported as the most trusted vaccine among pregnant women due to its long-standing background as a recommended vaccine in pregnancy. The influenza vaccine was regarded as less important since it was perceived to cause mild disease. The COVID-19 vaccine was the least trustworthy for pregnant women due to uncertainties about effectiveness, health effects in the mid- and long-term, the fast development of the vaccine mRNA technology, and the perceptions of limited data on vaccine safety. However, the necessity to be vaccinated was justified by pregnant women due to the exceptional circumstances of the COVID-19 pandemic. The recommendations provided by HCW and the established relationship between the HCW, particularly midwives, and pregnant women were the main factors affecting decision-making. The role of mass media was perceived as key to helping provide reliable messages about the need for vaccines during pregnancy. Overall, vaccines administered during pregnancy were perceived as great tools associated with better health and improved quality of life. Pregnancy was envisioned as a vulnerable period in women’s lives that required risk–benefits assessments for decision-making about maternal vaccinations. A holistic approach involving the community and society was considered crucial for health education regarding maternal vaccines in support of the work conducted by HCWs. Full article
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9 pages, 672 KiB  
Article
Rapid Protocol Development, Study Startup and Enrolment of a Prospective Study of COVID-19 Vaccination for Patients with Cancer: A Collaborative Approach
by Amy Body, Vivienne Milch, Lynda McSorley, Luxi Lal, Elizabeth Ahern, Regina Ryan, Gayle Jones, Dorothy Keefe and Eva Segelov
Vaccines 2022, 10(12), 2003; https://doi.org/10.3390/vaccines10122003 - 24 Nov 2022
Viewed by 1766
Abstract
Background: COVID-19 is an unprecedented global health emergency. It has been highly disruptive for patients with cancer, both due to an increased burden of severe illness and due to pressure on healthcare systems. COVID-19 vaccination has been an important public health measure for [...] Read more.
Background: COVID-19 is an unprecedented global health emergency. It has been highly disruptive for patients with cancer, both due to an increased burden of severe illness and due to pressure on healthcare systems. COVID-19 vaccination has been an important public health measure for this patient group. Aim: The aim of this study was to describe the rapid design and startup of a multicentre study of COVID-19 vaccine response for vulnerable patients with cancer. Study startup: We set up a multicentre prospective observational study of COVID-19 vaccination response for Australian patients with cancer. Due to intensive collaboration between health services, the funding body and laboratories, we were able to develop a protocol and enrol the first patient within 52 days of the initial study proposal. Rapid startup was further enabled by prompt availability of funding and by high-level engagement of institutional review boards, allowing expedited review. Study enrolment: We rapidly enroled more than 500 patients, 80% within 4 months of study opening. Engagement and follow-up were maintained throughout the course of up to five serial vaccination doses. Conclusion: Our study is an example of intensive collaboration inspired by the COVID-19 pandemic and may serve as an example of an agile research response to real-time public health challenges. Full article
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12 pages, 861 KiB  
Article
Strengthening the Link between Vaccine Predispositions and Vaccine Advocacy through Certainty
by Borja Paredes, Miguel A. Martín Cárdaba, Lorena Moreno, Nerea Cano, Pablo Briñol, Ubaldo Cuesta and Richard E. Petty
Vaccines 2022, 10(11), 1970; https://doi.org/10.3390/vaccines10111970 - 20 Nov 2022
Cited by 4 | Viewed by 3345
Abstract
Background. Instruments designed to assess individual differences in predispositions towards vaccination are useful in predicting vaccination-related outcomes. Despite their importance, there is relatively little evidence regarding the conditions under which these instruments are more predictive. The current research was designed to improve the [...] Read more.
Background. Instruments designed to assess individual differences in predispositions towards vaccination are useful in predicting vaccination-related outcomes. Despite their importance, there is relatively little evidence regarding the conditions under which these instruments are more predictive. The current research was designed to improve the ability of these kinds of instruments to predict vaccination advocacy by considering the certainty associated with the responses to vaccination scales. Method. Across two studies, participants completed the Beliefs about Medicines Questionnaire BMQ scale (Study 1) or the Vaccination Attitudes Examination (VAX) scale (Study 2). The certainty participants had in their responses to each scale was either measured (Study 1) or manipulated (Study 2). Intentions to advocate in favor of vaccination served as the criterion measure in both studies. Results. As expected, the scales significantly predicted vaccination advocacy, contributing to enhancing the predictive validity of the instruments used in the studies. Most relevant, certainty moderated the extent to which these scales predicted vaccination advocacy, with greater consistency between the initial scores and the subsequent advocacy willingness obtained for those with higher certainty. Conclusions. Certainty can be useful to predict when the relationship between vaccination-related cognitions (i.e., beliefs or attitudes) and advocacy willingness is likely to be stronger. Full article
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19 pages, 317 KiB  
Article
Assessment of COVID-19 Anxiety Levels and Attitudes to COVID-19 Vaccine among Older Adults in Poland: A Pilot Study
by Mateusz Cybulski, Zyta Beata Wojszel, Aleksandra Wojszel, Sara Jahel, Paulina Sliwinska and Elzbieta Krajewska-Kulak
Vaccines 2022, 10(11), 1918; https://doi.org/10.3390/vaccines10111918 - 13 Nov 2022
Cited by 3 | Viewed by 1772
Abstract
Background: The fear of being infected with the SARS-CoV-2 has become widespread, especially among older adults. Information campaigns to promote mass vaccination against COVID-19 are a key element in controlling and preventing the spread of the COVID-19 pandemic. However, their success primarily depends [...] Read more.
Background: The fear of being infected with the SARS-CoV-2 has become widespread, especially among older adults. Information campaigns to promote mass vaccination against COVID-19 are a key element in controlling and preventing the spread of the COVID-19 pandemic. However, their success primarily depends on vaccination coverage in a given population. The aim of this study was to assess the severity of COVID-19 anxiety and attitudes towards COVID-19 vaccines among older adults in Poland. Methods: This pilot study was conducted among a total of 127 older participants, including 108 students (85%) of Third Age Universities in Bialystok and 19 patients (15%) of the Department and Clinic of Geriatrics of the Hospital of the Ministry of Internal Affairs and Administration in Bialystok. The study used a diagnostic survey based on an author-designed questionnaire and four standardized psychometric tools: The Fear of COVID-19 Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), The Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S), and Scale to Measure the Perception of SARS-CoV-2 Vaccines Acceptance (The VAC-COVID-19 Scale). Results: COVID-19 vaccination coverage in the study group was 88.2%, with three doses in most cases. We found a negative vaccination status only in women taking part in the study. Men scored significantly higher on DrVac-COVID19S and its Value subscale, and markedly lower on FCV-19S. We did not observe significant differences in the scales’ scores between age groups. Respondents recruited from the Third Age Universities had significantly higher scores than geriatric clinic patients in the Knowledge subscale of DrVac-COVID19S. In the case of FCV-19S, no correlation with the results obtained in other scales used in the study was found. Additionally, no correlation was found between CAS scores and the following scales: DrVac-COVID19S (total), DrVac-COVID19S Knowledge (K) subscale, DrVac-COVID19S Autonomy (A) subscale and VAC-COVID-19-Scale-positive subscale. The other scales were strongly correlated with each other—the correlations were statistically significant. Conclusions: Subjective COVID-19 anxiety in the study group was moderate. Seniors were more likely to show positive vaccine attitudes, as confirmed by the percentage of respondents vaccinated against COVID-19 with at least one dose. However, there is still a percentage of unvaccinated individuals in the population of seniors; therefore, measures should be taken to motivate this age group and encourage preventive vaccination against COVID-19. Furthermore, representative studies on COVID-19 anxiety and attitudes towards the COVID-19 vaccine among Polish seniors are needed to determine a more precise prevalence of these phenomena and potential correlations on a national level. Full article
15 pages, 303 KiB  
Article
A Social Cognitive Theory Approach to Understanding Parental Attitudes and Intentions to Vaccinate Children during the COVID-19 Pandemic
by Ying Zhu, Michael Beam, Yue Ming, Nichole Egbert and Tara C. Smith
Vaccines 2022, 10(11), 1876; https://doi.org/10.3390/vaccines10111876 - 7 Nov 2022
Cited by 1 | Viewed by 3566
Abstract
The distribution of the COVID-19 vaccine represents a path towards global health after a worldwide pandemic. Yet, the U.S. response to the vaccination rollout has been politically polarized. The aim of this paper is to contribute to the understanding of the contextual factors [...] Read more.
The distribution of the COVID-19 vaccine represents a path towards global health after a worldwide pandemic. Yet, the U.S. response to the vaccination rollout has been politically polarized. The aim of this paper is to contribute to the understanding of the contextual factors that influence parents’ attitudes towards health officials and their intention to vaccinate children, focusing on communication behaviors, personal factors, and geographic locations. We use Bandura’s triadic reciprocal determinism (TRD) model which posits reciprocal influence between personal factors, environmental factors, and behaviors. We found that personal factors (having younger children and identifying as Republican partisans), and the behavioral factor of conservative news use were significantly related to more negative attitudes towards health officials and lower vaccination intentions. Conversely, Democrats and liberal news use were significantly related to warmer attitudes and greater vaccination intentions. The environmental factor of geographic location across four states with different partisan dynamics was not significantly related to attitudes and behavioral intentions. Results from a post-hoc analysis show that news media use and partisanship were the strongest correlates of parents’ attitudes towards health officials. This evidence points to the politicization of the COVID-19 vaccine being a key consideration regarding vaccine uptake. Full article
15 pages, 1513 KiB  
Article
Prevalence and Factors Associated with Caregivers’ Hesitancy in Immunizing Dependent Older Adults with COVID-19 Vaccines: A Cross-Sectional Survey
by Saran Thanapluetiwong, Sirintorn Chansirikarnjana, Piangporn Charernwat, Krittika Saranburut and Pichai Ittasakul
Vaccines 2022, 10(10), 1748; https://doi.org/10.3390/vaccines10101748 - 19 Oct 2022
Cited by 2 | Viewed by 1859
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccinations have been proven to prevent hospitalization and mortality. However, some caregivers may be hesitant to authorize COVID-19 vaccination of people under their care. Our study aimed to evaluate factors associated with caregiver hesitancy to authorize vaccination of [...] Read more.
Background: Coronavirus disease 2019 (COVID-19) vaccinations have been proven to prevent hospitalization and mortality. However, some caregivers may be hesitant to authorize COVID-19 vaccination of people under their care. Our study aimed to evaluate factors associated with caregiver hesitancy to authorize vaccination of dependent older adults. Method: We conducted a cross-sectional telephone survey of vaccine hesitancy among caregivers of dependent older patients in the geriatric clinic of Ramathibodi Hospital. Caregivers were contacted and interviewed by trained interviewers from 20 June to 25 July 2021. Results: The study enrolled 318 participants with a mean age of 55.9 years. The majority of the participants were the patients’ children (86.5%). In total, 39.9% of participants were hesitant to authorize COVID-19 vaccination of the older adults under their care. Factors associated with caregiver vaccine hesitation were uneasiness, anxiety, agitation, sadness, and worry in association with social distancing, refusal to receive a COVID-19 vaccine, and concern about vaccine manufacturers. Conclusion: The prevalence of caregiver hesitancy to allow older adults to undergo COVID-19 vaccination was relatively high, and several factors associated with this vaccine hesitancy were identified. These findings may aid efforts toward COVID-19 vaccination of dependent older adults. Full article
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20 pages, 495 KiB  
Article
Intolerance of Uncertainty and Attitudes towards Vaccination Impact Vaccinal Decision While Perceived Uncertainty Does Not
by Clémence Brun, Alexis Akinyemi, Laurène Houtin, Oulmann Zerhouni, Richard Monvoisin and Nicolas Pinsault
Vaccines 2022, 10(10), 1742; https://doi.org/10.3390/vaccines10101742 - 18 Oct 2022
Cited by 4 | Viewed by 2085
Abstract
The COVID-19 pandemic illustrated that intolerance of uncertainty (IU) can hinder problem-solving and lead to avoidance of ambiguous situations. Furthermore, people tend to lack confidence in decisions made in ambiguous contexts. We wanted to investigate the impact of IU on intentions to get [...] Read more.
The COVID-19 pandemic illustrated that intolerance of uncertainty (IU) can hinder problem-solving and lead to avoidance of ambiguous situations. Furthermore, people tend to lack confidence in decisions made in ambiguous contexts. We wanted to investigate the impact of IU on intentions to get vaccinated, to vaccinate one’s children, and to recommend the vaccine in situations with varying degrees of perceived uncertainty. We first conducted a pretest to select six scenarios with different levels of perceived uncertainty. In the core study, 485 participants answered for each of the six scenarios whether they would get vaccinated, vaccinate their children (or imagine doing so, for individuals without children), and whether they would recommend the vaccine. They also completed the IUS-12 (Intolerance of Uncertainty scale) and the VAX (Vaccination Attitudes Examination). Results showed that perceived uncertainty did not influence our measures, but the IUS-12 and VAX predicted the difference in score between the most and least uncertain scenarios. An indirect effect of the IUS-12 on decision confidence through the VAX was found, but with no direct effect. We conclude that, even if future studies should refine these results, Public Policies should be more focused on factors such as IU and attitudes toward vaccination. Full article
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11 pages, 283 KiB  
Article
Acceptance, Hesitancy, and Refusal in Anti-COVID-19 Vaccination: A Cluster Analysis Aiming at the Typology behind These Three Concepts
by Darie Cristea, Dragoș-Georgian Ilie, Claudia Constantinescu and Valeriu Fîrțală
Vaccines 2022, 10(9), 1496; https://doi.org/10.3390/vaccines10091496 - 8 Sep 2022
Cited by 8 | Viewed by 9502
Abstract
This paper presents the findings of a study aiming at an innovative typology of attitudes towards COVID-19 vaccination. The proposed typology tries to go beyond the common sociological studies who divide the public into three categories: pro-vaxxers, anti-vaxxers, and hesitants. Our purpose is [...] Read more.
This paper presents the findings of a study aiming at an innovative typology of attitudes towards COVID-19 vaccination. The proposed typology tries to go beyond the common sociological studies who divide the public into three categories: pro-vaxxers, anti-vaxxers, and hesitants. Our purpose is obtaining a more complex typology using cluster analysis. The article is based on a nation-wide survey conducted in Romania. The sample of the survey was statistically representative to the population of Romania and was composed of 1002 participants. A k-means algorithm for classifying cases was used to identify how the studied population structures itself when it comes to attitudes towards COVID-19 vaccination. We see hesitancy as an expression of concern or doubt about the value or safety of the vaccination, but also as fear or dis(trust) in the authorities, or as disinterest. We found out that the Romanian public falls into three categories regarding the attitude towards COVID-19 vaccination: the “non-fanatical” pro-vaxxers, the anti-vaxxers, and those without a clear opinion (uninterested and/or undecided). What we usually call “vaccine hesitancy” can be found, depending on motivation or type of hesitancy, in both of the last two clusters. Full article
9 pages, 860 KiB  
Article
COVID-19 Vaccine Booster Dose Willingness among Patients with Inflammatory Bowel Disease on Infliximab and Vedolizumab: A Cross-Sectional Study
by Mohammad Shehab, Fatema Alrashed and Ahmad Alfadhli
Vaccines 2022, 10(8), 1166; https://doi.org/10.3390/vaccines10081166 - 22 Jul 2022
Cited by 5 | Viewed by 1912
Abstract
Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive [...] Read more.
Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive a third (booster) dose among patients with inflammatory bowel disease (IBD). Methods: A cross-sectional study was performed at an IBD tertiary care center. Patients were recruited at the infusion room from 1 January 2022 to 31 March 2022. The primary outcome was the prevalence of a third (booster) dose of the BNT162b2 vaccine in infliximab- or vedolizumab-treated patients with IBD. The secondary outcome evaluated whether the prevalence of a third (booster) dose of the BNT162b2 vaccine differed based on type of COVID-19 vaccine, gender, age, type of biologic therapy, and citizenship. Results: In total, 499 patients with IBD were included in this study. The median age was 34.5 years, and 60% had ulcerative colitis (UC). Among the study participants, 302 (60.5%) patients were vaccinated with BNT162b2, and 197 (39.5%) were vaccinated with ChAdOx1 nCoV-19. Of the total number of participants, 400 (80.2%) were receiving infliximab, and 99 (19.8%) were receiving vedolizumab. Overall, 290 (58.1%) of the included patients were willing to receive the third (booster) dose. Patients vaccinated with BNT162b2 were more likely to be willing to receive a booster dose compared to patients vaccinated with ChAdOx1 nCoV-19 (201 (66.5%) vs. 103 (52.0%), p = 0.014). Infliximab-treated patients were more likely to be willing to receive a booster dose compared to patients receiving vedolizumab (310 (77.5%) vs. 62 (62.6%), p = 0.002). There was no statistical difference in willingness to receive a booster dose in terms of age, nationality, or gender. Conclusions: The percentage of patients with IBD willing to receive or having already received a third (booster) dose of BNT162b2 vaccine was lower compared to the general population. In addition, patients who received two doses of BNT162b2 vaccines were more likely to be willing to receive a third (booster) dose compared to patients who received ChAdOx1 nCoV-19. Patients treated with infliximab were more likely to be willing to receive a third (booster) dose of COVID-19 vaccine. Full article
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14 pages, 702 KiB  
Article
Attitudes to Vaccine Mandates among Late Adopters of COVID-19 Vaccines in Zimbabwe
by Azure Tariro Makadzange, Patricia Gundidza, Charles Lau, Janan Dietrich, Norest Beta, Nellie Myburgh, Nyasha Elose, Chiratidzo Ndhlovu, Wilmot James and Lawrence Stanberry
Vaccines 2022, 10(7), 1090; https://doi.org/10.3390/vaccines10071090 - 7 Jul 2022
Cited by 5 | Viewed by 2856
Abstract
Despite sufficient supply, <25% of the population in sub-Saharan Africa has received at least one dose of COVID-19 vaccine. Vaccine mandates have previously been effective in increasing vaccine uptake. Attitudes to COVID-19 vaccine mandates and vaccines for children in African populations are not [...] Read more.
Despite sufficient supply, <25% of the population in sub-Saharan Africa has received at least one dose of COVID-19 vaccine. Vaccine mandates have previously been effective in increasing vaccine uptake. Attitudes to COVID-19 vaccine mandates and vaccines for children in African populations are not well understood. We surveyed late-adopters presenting for COVID-19 vaccination one year after program initiation in Zimbabwe. Logistic regression models were developed to evaluate factors associated with attitudes to mandates. In total, 1016 adults were enrolled; 690 (67.9%) approved of mandating vaccination for use of public spaces, 686 (67.5%) approved of employer mandates, and 796 (78.3%) approved of mandating COVID-19 vaccines for schools. Individuals of lower economic status were twice as likely as high-income individuals to approve of mandates. Further, 743 (73.1%) participants indicated that they were extremely/very likely to accept vaccines for children. Approval of vaccine mandates was strongly associated with perceptions of vaccine safety, effectiveness, and trust in regulatory processes that approved vaccines. Vaccine hesitancy is an important driver of low vaccine coverage in Africa and can be mitigated by vaccine mandates. Overall, participants favored vaccine mandates; however, attitudes to mandates were strongly associated with level of education and socioeconomic status. Full article
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11 pages, 256 KiB  
Article
Anti-SARS-CoV-2 Vaccination Campaign: Risk Perception, Emotional States, and Vaccine Hesitancy in a Sample of Adolescents’ Vaccinated Parents in Southern Italy
by Giulia Savarese, Luna Carpinelli, Anna De Chiara, Claudio Giordano, Matilde Perillo, Domenico Fornino, Francesco De Caro, Mario Capunzo and Giuseppina Moccia
Vaccines 2022, 10(6), 958; https://doi.org/10.3390/vaccines10060958 - 16 Jun 2022
Cited by 7 | Viewed by 2127
Abstract
Background: The international strategic plan for COVID-19 vaccines remains the practical option for the protection of health. However, vaccine hesitancy remains an obstacle to full population vaccination, with rapid developments in COVID-19 vaccines and concerns about efficacy acting as influencing factors. Aim: The [...] Read more.
Background: The international strategic plan for COVID-19 vaccines remains the practical option for the protection of health. However, vaccine hesitancy remains an obstacle to full population vaccination, with rapid developments in COVID-19 vaccines and concerns about efficacy acting as influencing factors. Aim: The present study investigated the perception of vaccine hesitancy among parents of adolescents in order to explore the reasons and related emotional states. Methods: In January–March 2022, an online questionnaire was administered to a sample of parents who brought their children to the vaccine center of a local health unit, ASL Salerno (Campania, Italy). Results: The participants were 1105 parents (F = 64.6%; mean age = 47.37 years, SD = 7.52) of adolescents (F = 47.6%; mean age = 14.83 years, SD = 1.72). All parents had received the COVID-19 vaccine. Regarding the vaccination schedule, 46.8% believed that children receive more vaccinations than they should; 25.1% believed that it is better to develop immunity rather than get vaccinated; 41.2% believed that their child could have side effects; 29.6% were very concerned that vaccines were unsafe, while 35.3% believed vaccines do not prevent disease; 21.5% were very reluctant about pediatric vaccines; and 23.8% did not trust the information received. Conclusions: In order to increase vaccination and reduce the prevalence of vaccine hesitancy, it is essential to support the value of vaccination among all parents and make information more accessible and usable through competent pediatricians. Full article
15 pages, 510 KiB  
Article
Impact of Vaccine and Immunity Passports in the Context of COVID-19: A Time Series Analysis in Overseas France
by Samuel d’Almeida
Vaccines 2022, 10(6), 852; https://doi.org/10.3390/vaccines10060852 - 26 May 2022
Cited by 2 | Viewed by 6616
Abstract
(1) Background: By summer 2021, overseas France turned COVID-19 vaccine and immunity certificates into passports to open travel bubbles. Subsequently, its territories set French records for both COVID-19 and 6-month excess all-cause mortality. (2) Methods: Official time series were collected to compare time [...] Read more.
(1) Background: By summer 2021, overseas France turned COVID-19 vaccine and immunity certificates into passports to open travel bubbles. Subsequently, its territories set French records for both COVID-19 and 6-month excess all-cause mortality. (2) Methods: Official time series were collected to compare time correlations between air traffic and COVID-19 transmission and mortality in overseas France, before and after the implementation of immunity passports. (3) Results: Air traffic initially had a reversed relationship with COVID-19, which transitioned into a leader–follower relationship with the introduction of immunity passports. Essentially, air traffic increased 16 days before COVID-19 cases increased (r = 0.61) and 26 days before deaths increased (r = 0.31) in Martinique, 26 days (r = 0.72) and 40 days (r = 0.82) before in Guadeloupe, and 29 days (r = 0.60) and 31 days (r = 0.41) before in Réunion upon introduction of immunity passports. Moreover, air traffic became as correlated as community transmission to COVID-19 mortality in Guadeloupe. (4) Conclusions: Since the introduction of immunity passports, air traffic has been pacesetting COVID-19 within one month for transmission, and within an additional two weeks for mortality in overseas France. Responding to WHO’s call for real-world evidence, this study suggests that COVID-19 passports are not commensurate with health system goals. Full article
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13 pages, 738 KiB  
Article
Serious Underlying Medical Conditions and COVID-19 Vaccine Hesitancy: A Large Cross-Sectional Analysis from Australia
by Daphne Day, Lisa Grech, Mike Nguyen, Nathan Bain, Alastair Kwok, Sam Harris, Hieu Chau, Bryan Chan, Richard Blennerhassett, Louise Nott, Nada Hamad, Annette Tognela, David Hoffman, Amelia McCartney, Kate Webber, Jennifer Wong, Craig Underhill, Brett Sillars, Antony Winkel, Mark Savage, Bao Sheng Loe, Daniel Freeman, Eva Segelov and on behalf of the CANVACCS, DIABVACCS and MSVACCS Investigatorsadd Show full author list remove Hide full author list
Vaccines 2022, 10(6), 851; https://doi.org/10.3390/vaccines10060851 - 26 May 2022
Cited by 17 | Viewed by 4030
Abstract
As COVID-19 vaccinations became available and were proven effective in preventing serious infection, uptake amongst individuals varied, including in medically vulnerable populations. This cross-sectional multi-site study examined vaccine uptake, hesitancy, and explanatory factors amongst people with serious and/or chronic health conditions, including the [...] Read more.
As COVID-19 vaccinations became available and were proven effective in preventing serious infection, uptake amongst individuals varied, including in medically vulnerable populations. This cross-sectional multi-site study examined vaccine uptake, hesitancy, and explanatory factors amongst people with serious and/or chronic health conditions, including the impact of underlying disease on attitudes to vaccination. A 42-item survey was distributed to people with cancer, diabetes, or multiple sclerosis across ten Australian health services from 30 June to 5 October 2021. The survey evaluated sociodemographic and disease-related characteristics and incorporated three validated scales measuring vaccine hesitancy and vaccine-related beliefs generally and specific to their disease: the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-Six. Among 4683 participants (2548 [54.4%] female, 2108 [45.0%] male, 27 [0.6%] other; mean [SD] age, 60.6 [13.3] years; 3560 [76.0%] cancer, 842 [18.0%] diabetes, and 281 [6.0%] multiple sclerosis), 3813 (81.5%) self-reported having at least one COVID-19 vaccine. Unvaccinated status was associated with younger age, female sex, lower education and income, English as a second language, and residence in regional areas. Unvaccinated participants were more likely to report greater vaccine hesitancy and more negative perceptions toward vaccines. Disease-related vaccine concerns were associated with unvaccinated status and hesitancy, including greater complacency about COVID-19 infection, and concerns relating to vaccine efficacy and impact on their disease and/or treatment. This highlights the need to develop targeted strategies and education about COVID-19 vaccination to support medically vulnerable populations and health professionals. Full article
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18 pages, 433 KiB  
Article
Missed Opportunities for Vaccination and Associated Factors among Children Attending Primary Health Care Facilities in Cape Town, South Africa: A Pre-Intervention Multilevel Analysis
by Chukwudi A. Nnaji, Charles S. Wiysonge, Abdu A. Adamu, Maia Lesosky, Hassan Mahomed and Duduzile Ndwandwe
Vaccines 2022, 10(5), 785; https://doi.org/10.3390/vaccines10050785 - 16 May 2022
Cited by 5 | Viewed by 4133
Abstract
Despite the substantial efforts at ensuring universal access to routine immunisation services among children in South Africa, major gaps in immunisation coverage remain. This study assessed the magnitude of missed opportunities for vaccination (MOV) and associated factors among children aged 0–23 months attending [...] Read more.
Despite the substantial efforts at ensuring universal access to routine immunisation services among children in South Africa, major gaps in immunisation coverage remain. This study assessed the magnitude of missed opportunities for vaccination (MOV) and associated factors among children aged 0–23 months attending primary health care (PHC) facilities in Cape Town. We used multilevel binomial logistic regression models to explore individual and contextual factors associated with MOV, with children aged 0–23 months at Level 1, nested within PHC facilities (Level 2). A total of 674 children and their caregivers were enrolled. MOV prevalence was 14.1%, ranging from 9.1% to 18.9% across sub-districts. Dose-specific MOV prevalence was highest for the second dose of measles vaccine (9.5%) and lowest for the first dose of rotavirus vaccine (0.6%). The likelihood of a child experiencing MOV was significantly associated with caregivers’ low level of education (Odds ratio (OR) = 3.53, 95% credible interval (CrI): 1.13–11.03), recent receipt of immunisation messages (OR = 0.46, 95%CrI: 0.25–0.87), shared immunisation decision making by both parents (OR = 0.21, 95%CrI: 0.07–0.62) and health facility staff number (OR = 0.18, 95%CrI: 0.06–0.61). The burden of MOV among children in Cape Town is influenced by individual and contextual factors, which provide important opportunities for quality improvement and broader strategies to improve routine immunisation service delivery. Full article
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10 pages, 238 KiB  
Article
COVID-19 Vaccine Hesitancy among Behavioral Risk Takers
by Monideepa B. Becerra and Benjamin J. Becerra
Vaccines 2022, 10(5), 767; https://doi.org/10.3390/vaccines10050767 - 12 May 2022
Cited by 12 | Viewed by 2692
Abstract
The COVID-19 pandemic has emerged as a major public health issue, with vaccines serving as a vital preventive strategy to lower the global burden. Yet, despite national and local mandates, key sectors of the population continue to demonstrate lower compliance rates. In the [...] Read more.
The COVID-19 pandemic has emerged as a major public health issue, with vaccines serving as a vital preventive strategy to lower the global burden. Yet, despite national and local mandates, key sectors of the population continue to demonstrate lower compliance rates. In the United States, young adults have the lowest vaccination rates among the adult population. The goal of our study was to utilize the largest state-health survey to assess the key determinants of such hesitancy in order to create targeted interventions for the most at-risk groups to ensure equitable outcomes in disease prevention. We utilized the latest available California Health Interview Survey, a population-based complex probability survey, to evaluate determinants of vaccine hesitancy among young adults. Survey-weighted descriptive statistics, bivariate statistics, and multivariable logistic regression analyses were conducted. All statistical tests used p less than 0.05 to determine statistical significance. A total of 1203 respondents, representative of 4,027,462 young adults (ages 18–25 years) were included in our study. Our primary findings note that 24% of participants reported they would not be willing to take the COVID-19 vaccination. Prevalence of vaccine hesitancy was also significantly higher among young adults who were current smokers (including electronic cigarettes), when compared to non-current smokers (36% vs. 22%). Further, the highest prevalence was also noted among young adults who identified as African-American (51%), had a high school degree or less (34%), those who were overweight or obese (28%), and reported a poor health status (22%). Multivariable regression analysis demonstrated that current smokers, as compared to non-current smokers, had more than double the odds of reporting COVID-19 vaccine hesitancy. African-American young adults or young adults with a high school degree or less were both independently associated with at least a three-fold increase in vaccine hesitancy. Participants with psychological distress, however, were more likely to be accepting of the vaccine. Public health efforts to improve vaccine compliance need targeted efforts, including building trust in the healthcare system for African-Americans and promoting easier access and knowledge of vaccines among those with a high school degree or less, as well as young-adults who are currently smoking, with such efforts targeting behavioral interventions focused on risk aversion. Full article
13 pages, 271 KiB  
Article
Second Wave of the Study of Taiwanese Caregivers of Children with ADHD in the COVID-19 Pandemic: Intentions to Vaccinate Their Children for COVID-19, and Related Factors
by Ching-Shu Tsai, Liang-Jen Wang, Ray C. Hsiao and Cheng-Fang Yen
Vaccines 2022, 10(5), 753; https://doi.org/10.3390/vaccines10050753 - 11 May 2022
Cited by 8 | Viewed by 2168
Abstract
The second wave of the Study of Taiwanese Caregivers of Children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the COVID-19 Pandemic was conducted at the time of a severe COVID-19 outbreak. The aims of this study were to compare the level of the intentions of [...] Read more.
The second wave of the Study of Taiwanese Caregivers of Children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the COVID-19 Pandemic was conducted at the time of a severe COVID-19 outbreak. The aims of this study were to compare the level of the intentions of caregivers of children with ADHD to vaccinate their children between the first and second waves of study, as well as to examine the COVID-19 pandemic and non-COVID-19 pandemic factors related to caregivers’ intentions. In total, 252 caregivers of children with ADHD completed the structured questionnaires, including the Drivers of COVID-19 Vaccination Acceptance Scale; the Risk Perception of the COVID-19 Scale; caregivers’ Difficulties in Asking Their Children to Adopt Self-Protective Behavior Scale; the Brief Symptom Rating Scale; the Parental Bonding Instrument; the Swanson, Nolan, and Pelham version IV Scale; and the questionnaires for the intentions to vaccinate their children and child’s medication use for treating ADHD. The results demonstrated that 82.5% of caregivers reported their willingness to vaccinate their children definitely or under doctors’ recommendation; the level of intentions to vaccinate significantly increased compared with that of caregivers in the first wave of the study. Caregivers’ drivers of COVID-19 vaccination uptake, namely, values, impact, and autonomy but not knowledge; being male caregivers; being caregivers of girls; and the older age of the children were positively associated with caregiverscaregivers’ intentions. The specific intervention programs for enhancing caregivers’ intentions should be specified according to the sex and age of caregivers and of the children with ADHD. The Drivers of COVID-19 Vaccination Uptake should be also the target of intervention for enhancing caregivers’ intentions through strengthening caregivers’ acceptance of the COVID-19 vaccines’ values, positive impact and autonomy to vaccinate their children. Full article
13 pages, 466 KiB  
Article
Adverse Mentions, Negative Sentiment, and Emotions in COVID-19 Vaccine Tweets and Their Association with Vaccination Uptake: Global Comparison of 192 Countries
by Jungmi Jun, Ali Zain, Yingying Chen and Sei-Hill Kim
Vaccines 2022, 10(5), 735; https://doi.org/10.3390/vaccines10050735 - 8 May 2022
Cited by 14 | Viewed by 5131
Abstract
Background: Many countries show low COVID-19 vaccination rates despite high levels of readiness and delivery of vaccines. The public’s misperceptions, hesitancy, and negative emotions toward vaccines are psychological factors discouraging vaccination. At the individual level, studies have revealed negative perceptual/behavioral outcomes of [...] Read more.
Background: Many countries show low COVID-19 vaccination rates despite high levels of readiness and delivery of vaccines. The public’s misperceptions, hesitancy, and negative emotions toward vaccines are psychological factors discouraging vaccination. At the individual level, studies have revealed negative perceptual/behavioral outcomes of COVID-19 information exposure via social media where misinformation and vaccine fear flood. Objective: This study extends research context to the global level and investigates social media discourse on the COVID-19 vaccine and its association with vaccination rates of 192 countries in the world. Methods: COVID-19 vaccine tweets were compared by country in terms of (1) the number per million Twitter users, (2) mentions of adverse events—death, side-effects, blood clots, (3) negative sentiment (vs. positive), and (4) fear, sadness, or anger emotions (vs. joy). Artificial intelligence (AI) was adopted to classify sentiment and emotions. Such tweets and covariates (COVID-19 morbidity and mortality rates, GDP, population size and density, literacy rate, democracy index, institutional quality, human development index) were tested as predictors of vaccination rates in countries. Results: Over 21.3 million COVID-19 vaccine tweets posted between November 2020 and August 2021 worldwide were included in our analysis. The global average of COVID-19 vaccine tweets mentioning adverse events was 2% for ‘death’, 1.15% for ‘side-effects’, and 0.80% for ‘blood clots’. Negative sentiment appeared 1.90 times more frequently than positive sentiment. Fear, anger, or sadness appeared 0.70 times less frequently than joy. The mention of ‘side-effects’ and fear/sadness/anger emotions appeared as significant predictors of vaccination rates, along with the human development index. Conclusions: Our findings indicate that global efforts to combat misinformation, address negative emotions, and promote positive languages surrounding COVID-19 vaccination on social media may help increase global vaccination uptakes. Full article
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15 pages, 1277 KiB  
Article
Factors Influencing the Acceptance of COVID-19 Vaccines in a Country with a High Vaccination Rate
by Daniela Toro-Ascuy, Nicolás Cifuentes-Muñoz, Andrea Avaria, Camila Pereira-Montecinos, Gilena Cruzat, Katherine Peralta-Arancibia, Francisco Zorondo-Rodríguez and Loreto F. Fuenzalida
Vaccines 2022, 10(5), 681; https://doi.org/10.3390/vaccines10050681 - 25 Apr 2022
Cited by 21 | Viewed by 3571
Abstract
Control of the COVID-19 pandemic largely depends on the effectiveness of the vaccination process. An understanding of the factors that underlie the willingness to accept vaccination contributes pivotal information to controlling the pandemic. We analyzed the association between the willingness to accept the [...] Read more.
Control of the COVID-19 pandemic largely depends on the effectiveness of the vaccination process. An understanding of the factors that underlie the willingness to accept vaccination contributes pivotal information to controlling the pandemic. We analyzed the association between the willingness to accept the available COVID-19 vaccines and vaccine determinants amidst the Chilean vaccination process. Individual-level survey data was collected from 744 nationally representative respondents and multivariate regression models were used to estimate the association between outcome and explanatory variables. We found that trust in COVID-19 vaccines, scientists, and medical professionals significantly increased the willingness to: accept the vaccines and booster doses, as well as annual vaccinations and the vaccination of children. Our results are critical to understanding the acceptance of COVID-19 vaccines in the context of a country with one of the world’s highest vaccination rates. We provide useful information for decision-making and policy design, in addition to establishing guidelines regarding how to effectively explain vaccination programs to citizens. Full article
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14 pages, 254 KiB  
Article
COVID-19 Vaccine Hesitancy among Arab Americans
by Mira H. Kheil, Deepti Jain, Jamil Jomaa, Brandon Askar, Yasmeen Alcodray, Shatha Wahbi, Salar Brikho, Ali Kadouh, Deanna Harajli, Zain N. Jawad, Ziad Fehmi, Malaak Elhage, Tala Tawil, Omar Fehmi, Suma J. Alzouhayli, Deema Ujayli, Noor Suleiman, Omar Kazziha, Rawan Saleh, Evi Abada, Anita Shallal, Seongho Kim, Vijaya Arun Kumar, Marcus Zervos, Michele L. Cote and Rouba Ali-Fehmiadd Show full author list remove Hide full author list
Vaccines 2022, 10(4), 610; https://doi.org/10.3390/vaccines10040610 - 14 Apr 2022
Cited by 16 | Viewed by 2988
Abstract
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this [...] Read more.
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total of 73% reported willingness to receive a booster, and 72% plan to give their children the vaccine. On multivariate analysis, respondents were more likely to be vaccine-hesitant if they were hesitant about receiving any vaccine in general. They were less likely to be vaccine-hesitant if they were immigrants, over the age of 40, up to date on their general vaccination and if they believed that COVID-19 vaccines are safe and effective in preventing an infection. The belief that all vaccines are effective at preventing diseases was also associated with lower hesitancy. (4) Conclusions: This sample of AAs have higher vaccination rates and are more willing to vaccinate their children against COVID-19 when compared to the rest of the population. However, a reemergence of hesitancy might be arising towards the boosters. Full article
14 pages, 274 KiB  
Article
Perceived COVID-19 Vaccine Pressure in the Caribbean: Exploring a New Stressor–Strain Phenomenon in the Pandemic
by Dwayne Devonish and Teixiera Dulal-Arthur
Vaccines 2022, 10(2), 238; https://doi.org/10.3390/vaccines10020238 - 3 Feb 2022
Cited by 3 | Viewed by 2563
Abstract
This research introduced the new construct of ‘perceived COVID-19 vaccine pressure’ (i.e., the psychological strain associated with societal demands on vaccine taking) and examined the initial psychometric properties of a newly proposed measure. The study surveyed 411 Barbadian respondents to examine their level [...] Read more.
This research introduced the new construct of ‘perceived COVID-19 vaccine pressure’ (i.e., the psychological strain associated with societal demands on vaccine taking) and examined the initial psychometric properties of a newly proposed measure. The study surveyed 411 Barbadian respondents to examine their level of perceived COVID-19 vaccine pressure using an online survey modality. The results revealed strong and robust psychometric properties for the scale and its unidimensionality. Younger and employed respondents as well as those working in the tourism and hospitality and government (public) sectors experienced the greatest internalised vaccine pressure relative to other respondent groups. Only initial/preliminary evidence of the scale’s validity and reliability was revealed by this cross-sectional study. A follow-up study (using CFA on a new sample) is needed to provide stronger evidence for its validity and reliability. Understanding the dynamics of perceived or internalised vaccine pressure might help explain the positive or negative effects of societal pressure and its implications for vaccine hesitancy and other vaccine-related attitudes and behaviours. The study is the first to conceptually discuss and empirically examine the mental health strain occasioned by societal demands placed on individuals to take a COVID-19 vaccine. Full article
14 pages, 1884 KiB  
Article
What Determines Vaccine Hesitancy: Recommendations from Childhood Vaccine Hesitancy to Address COVID-19 Vaccine Hesitancy
by Farren Rodrigues, Suzanne Block and Suruchi Sood
Vaccines 2022, 10(1), 80; https://doi.org/10.3390/vaccines10010080 - 6 Jan 2022
Cited by 29 | Viewed by 8248
Abstract
Vaccine hesitancy is a prevalent and ongoing issue. However, due to the COVID-19 pandemic, additional attention has been brought to the topic of vaccine hesitancy. Vaccine hesitancy is a threat to the population’s health globally. This article aims to acquire insights from previous [...] Read more.
Vaccine hesitancy is a prevalent and ongoing issue. However, due to the COVID-19 pandemic, additional attention has been brought to the topic of vaccine hesitancy. Vaccine hesitancy is a threat to the population’s health globally. This article aims to acquire insights from previous literature to determine what works to increase vaccine uptake and how we can apply this knowledge to increase COVID-19 vaccine uptake. Research has focused chiefly on childhood vaccination and the hesitancy of caregivers. After conducting an extensive literature review, we have created a conceptual model of indicators that influence vaccine uptake for health providers and caregivers, which can also be used for vaccine recipients. Overall, the reasons for vaccine hesitancy are complex; therefore, a multifaceted approach is needed to address it. Understanding the factors that affect vaccine hesitancy will aid in addressing hesitancy and, in turn, lead to an increase in vaccine uptake. Full article
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9 pages, 560 KiB  
Article
COVID-19 Vaccine Hesitancy among Patients with Inflammatory Bowel Disease Receiving Biologic Therapies in Kuwait: A Cross-Sectional Study
by Mohammad Shehab, Yasmin Zurba, Ali Al Abdulsalam, Ahmad Alfadhli and Sara Elouali
Vaccines 2022, 10(1), 55; https://doi.org/10.3390/vaccines10010055 - 31 Dec 2021
Cited by 11 | Viewed by 2769
Abstract
Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, [...] Read more.
Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients receiving biologic therapies for IBD. Methods: A single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center in Kuwait. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from 1 June 2021 until 31 October 2021 were retrieved. Patients who received infliximab or vedolizumab at least six weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based on sex, age, type of biologic therapy and nationality. Results: The total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). Of the total, 112 (40.0%) patients were diagnosed with ulcerative colitis and 168 (60.0%) with Crohn’s disease. The number of ulcerative colitis patients who were vaccinated was 49 (43.8%) and the number of Crohn’s disease patients who were vaccinated was 68 (40.5%). The median age was 33.2 years and BMI was 24.8 kg/m2. With respect to the total number of patients, 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, patients above the age 50 were more likely to receive the vaccine than patients below the age of 50 (95.6% vs. 31.2% p < 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs. 25.0%, p < 0.001). There was no statistical difference between patients on infliximab and vedolizumab with regard to prevalence of vaccination (40.0% vs 48.0%, p = 0.34). Conclusion: The overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than that of the general population and world health organization (WHO) recom-mendation. Female patients, patients above the age of 50, and expatriates were more likely to receive the vaccine. Physicians should reinforce the safety and efficacy of COVID-19 vaccines among patients, especially IBD patients on biologic therapies, who express hesitancy towards them. Full article
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13 pages, 256 KiB  
Article
Acceptability of the COVID-19 Vaccine among Adults in Saudi Arabia: A Cross-Sectional Study of the General Population in the Southern Region of Saudi Arabia
by Yahya S. Alqahtani
Vaccines 2022, 10(1), 41; https://doi.org/10.3390/vaccines10010041 - 29 Dec 2021
Cited by 12 | Viewed by 2810
Abstract
Vaccines afford protection against infectious diseases. However, a sizeable part of the population refuse vaccinations and continue to dispute the evidence supporting vaccinations. The objective of this study was to determine the prevalence of COVID-19 vaccination uptake and its determinants among the Saudi [...] Read more.
Vaccines afford protection against infectious diseases. However, a sizeable part of the population refuse vaccinations and continue to dispute the evidence supporting vaccinations. The objective of this study was to determine the prevalence of COVID-19 vaccination uptake and its determinants among the Saudi population in the southern region of Saudi Arabia. A cross-sectional survey studied COVID-19 vaccine acceptance in adults in Saudi Arabia, targeting the general population in the southwestern region. Data were collected through an online survey questionnaire tool. All data were analysed using SPSS version 23.0. The majority (57.29%) of the participants were willing to receive the new COVID-19 vaccine, whereas almost 64% believed it is necessary to take the COVID-19 vaccine to protect oneself and that the vaccine is safe, efficient and effective. The data showed that perceived risk of COVID-19 (p = 0.015), history of previous vaccination against seasonal influenza (p = 0.000), and trust in the healthcare system (p = 0.025) were significant predictors for COVID-19 vaccine acceptance. We conclude that participants’ trust in the healthcare system, perceived risk of contracting COVID-19, and history of previous vaccination against seasonal influenza were significant predictors for COVID-19 vaccine acceptance. Knowing the acceptance rates for the COVID-19 vaccination can aid state agencies, medical practitioners, and other entities in reducing the impact of vaccine avoidance. Full article
9 pages, 574 KiB  
Article
The Role of Risk Perception in Students’ COVID-19 Vaccine Uptake: A Longitudinal Study
by Femke Hilverda and Manja Vollmann
Vaccines 2022, 10(1), 22; https://doi.org/10.3390/vaccines10010022 - 24 Dec 2021
Cited by 33 | Viewed by 4933
Abstract
Since COVID-19 vaccine uptake was found to be especially low among young adults, the present study investigated COVID-19 risk perception as predictor of COVID-19 vaccination intention and actual COVID-19 vaccine uptake among this age group. More specifically, it was tested whether cognitive risk [...] Read more.
Since COVID-19 vaccine uptake was found to be especially low among young adults, the present study investigated COVID-19 risk perception as predictor of COVID-19 vaccination intention and actual COVID-19 vaccine uptake among this age group. More specifically, it was tested whether cognitive risk perception predicts vaccination uptake successively via affective risk perception and vaccination intention. In total, 680 students (65.9% female) between 17 and 28 years participated in this longitudinal online study. COVID-19 cognitive and affective risk perception, COVID-19 vaccination intention, and actual COVID-19 vaccine uptake were measured in t1: November/December 2020, t2: March 2021, and t3: June/July 2021, respectively. The mediation analysis revealed a significant indirect effect of perceived severity at t1 on vaccine uptake at t3 via worry at t1 and vaccination intention at t2. Stronger perceptions of perceived severity of COVID-19 were related to more worry about COVID-19, which led to a higher vaccination intention, which, in turn, increased the chance of COVID-19 vaccine uptake. To increase vaccine uptake among young adults it might be fruitful to emphasize the severity of COVID-19. However, one should take into account that tapping into fear works best when messages also include efficacy statements. Full article
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17 pages, 1317 KiB  
Article
Factors Influencing Australian Healthcare Workers’ COVID-19 Vaccine Intentions across Settings: A Cross-Sectional Survey
by Jessica Kaufman, Kathleen L. Bagot, Monsurul Hoq, Julie Leask, Holly Seale, Ruby Biezen, Lena Sanci, Jo-Anne Manski-Nankervis, J. Simon Bell, Jane Munro, Carol Jos, Darren Suryawijaya Ong, Jane Oliver, Jane Tuckerman and Margie Danchin
Vaccines 2022, 10(1), 3; https://doi.org/10.3390/vaccines10010003 - 21 Dec 2021
Cited by 19 | Viewed by 5920
Abstract
Healthcare workers’ COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey [...] Read more.
Healthcare workers’ COVID-19 vaccination coverage is important for staff and patient safety, workforce capacity and patient uptake. We aimed to identify COVID-19 vaccine intentions, factors associated with uptake and information needs for healthcare workers in Victoria, Australia. We administered a cross-sectional online survey to healthcare workers in hospitals, primary care and aged or disability care settings (12 February–26 March 2021). The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework informed survey design and framing of results. Binary regression results adjusted for demographics provide risk differences between those intending and not intending to accept a COVID-19 vaccine. In total, 3074 healthcare workers completed the survey. Primary care healthcare workers reported the highest intention to accept a COVID-19 vaccine (84%, 755/898), followed by hospital-based (77%, 1396/1811) and aged care workers (67%, 243/365). A higher proportion of aged care workers were concerned about passing COVID-19 to their patients compared to those working in primary care or hospitals. Only 25% felt they had sufficient information across five vaccine topics, but those with sufficient information had higher vaccine intentions. Approximately half thought vaccines should be mandated. Despite current high vaccine rates, our results remain relevant for booster programs and future vaccination rollouts. Full article
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10 pages, 260 KiB  
Article
COVID-19 Vaccination Acceptance among Health Science Students in Morocco: A Cross-Sectional Study
by Mohamed Khalis, Mouna Boucham, Amy Luo, Abdelghafour Marfak, Soukaina Saad, Camara Mariama Aboubacar, Soukaina Ait El Haj, Manar Jallal, Fatima-Zahra Aazi, Hafida Charaka and Chakib Nejjari
Vaccines 2021, 9(12), 1451; https://doi.org/10.3390/vaccines9121451 - 8 Dec 2021
Cited by 8 | Viewed by 4077
Abstract
While students in the health sciences occupy pivotal roles in the Moroccan COVID-19 response and vaccination campaigns, factors associated with COVID-19 vaccine acceptability among students have not been reported. This study aimed to determine the willingness and identify predictive attitudes and beliefs of [...] Read more.
While students in the health sciences occupy pivotal roles in the Moroccan COVID-19 response and vaccination campaigns, factors associated with COVID-19 vaccine acceptability among students have not been reported. This study aimed to determine the willingness and identify predictive attitudes and beliefs of COVID-19 vaccine acceptance among health science students in Morocco. A cross-sectional, self-administered online questionnaire was conducted among students of the Mohammed VI University of Health Sciences in Casablanca, Morocco in January 2021. In total, 1272 students participated. Univariate and multivariate logistic regression models were used to calculate odds ratios and 95% confidence intervals. Overall, 26.9% of participants reported being willing to receive the COVID-19 vaccine. Between genders, male students were more likely to accept the vaccine. Regarding individual attitudes and beliefs about COVID-19 infection, students with greater confidence in COVID-19 information, and higher perceived likelihood and perceived severity of infection were more likely to be willing to get the vaccine. Concerning a COVID-19 vaccine, students who reported lower levels of perceived harm and higher levels of perceived vaccine effectiveness were more willing to get vaccinated. Our findings help guide future efforts to tailor communication and identify strategies to increase COVID-19 vaccine uptake among students. Full article
10 pages, 691 KiB  
Article
Perceptions towards COVID-19 Vaccines and Willingness to Vaccinate in Nepal
by Deepak Subedi, Saurav Pantha, Sanju Subedi, Anil Gautam, Asmita Gaire, Deepak Sapkota, Sachin Sapkota, Milan Kandel, Aabishkar Parajuli, Harishchandra Ghimire, Shristi Ghimire, Janardan Devkota and Santosh Dhakal
Vaccines 2021, 9(12), 1448; https://doi.org/10.3390/vaccines9121448 - 7 Dec 2021
Cited by 11 | Viewed by 6482
Abstract
Vaccination is the most effective preventive measure of COVID-19 available at present, but its success depends on the global accessibility of vaccines and the willingness of people to be vaccinated. As the vaccination rollouts are increasing worldwide, it is important to assess public [...] Read more.
Vaccination is the most effective preventive measure of COVID-19 available at present, but its success depends on the global accessibility of vaccines and the willingness of people to be vaccinated. As the vaccination rollouts are increasing worldwide, it is important to assess public perception and willingness towards vaccination, so that the aim of mass vaccination will be successful. This study aimed to understand public perception towards COVID-19 vaccines and their willingness to get vaccinated in Nepal. This cross-sectional online survey was conducted among 1196 residents of Nepal in August 2021; most of the participants of this online survey were young adults (18–47 years) with university-level education. A total of 64.5% (771/1196) of the participants perceived COVID-19 vaccines to be safe and risk-free, while 68.6% (820/1196) agreed that vaccination would be efficient in the fight against this pandemic. Most of the participants (841/1196, 70.3%) disagreed that people are getting COVID-19 vaccines easily in Nepal, while they agree with the prioritization of older adults and healthcare workers for vaccination. A total of 61.1% (731/1196) of the participants had received at least one dose of the vaccine. Among the unvaccinated, 93.3% (434/465) were willing to get vaccinated when their turn came. The higher confidence of younger adults in vaccines and the vaccination process is encouraging, as that can help educate others who are hesitant or are not positive towards the idea of receiving vaccines. Dissemination of correct and current information, acquisition of enough doses of vaccines, and equitable distribution of vaccines will be required to achieve successful completion of the COVID-19 vaccination campaign in Nepal. Full article
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13 pages, 945 KiB  
Article
COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination
by Maria Wieteska-Miłek, Sebastian Szmit, Michał Florczyk, Beata Kuśmierczyk-Droszcz, Robert Ryczek and Marcin Kurzyna
Vaccines 2021, 9(12), 1395; https://doi.org/10.3390/vaccines9121395 - 25 Nov 2021
Cited by 15 | Viewed by 5074
Abstract
The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim [...] Read more.
The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19. Full article
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19 pages, 951 KiB  
Article
Determinants of COVID-19 Vaccine Acceptance among the Adult Population of Bangladesh Using the Health Belief Model and the Theory of Planned Behavior Model
by Muhammad Mainuddin Patwary, Mondira Bardhan, Asma Safia Disha, Mehedi Hasan, Md. Zahidul Haque, Rabeya Sultana, Md. Riad Hossain, Matthew H. E. M. Browning, Md. Ashraful Alam and Malik Sallam
Vaccines 2021, 9(12), 1393; https://doi.org/10.3390/vaccines9121393 - 25 Nov 2021
Cited by 82 | Viewed by 13378
Abstract
Vaccination is undoubtedly one of the most effective strategies to halt the COVID-19 pandemic. The current study aimed to investigate the acceptance of COVID-19 vaccination and its associated factors using two health behavior change frameworks: the Health Belief Model (HBM) and the Theory [...] Read more.
Vaccination is undoubtedly one of the most effective strategies to halt the COVID-19 pandemic. The current study aimed to investigate the acceptance of COVID-19 vaccination and its associated factors using two health behavior change frameworks: the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). A total of 639 Bangladeshi adults (mean age: 24 years) participated in a cross-sectional online study between July and August 2021. The questionnaire covered questions regarding vaccine intentions, sociodemographic features, health status, perceived trust in/satisfaction with health authorities, reasons for vaccine hesitancy, and factors related to the health behavior change frameworks. Hierarchical logistic regression was employed to determine associations between these predictors and vaccine acceptance. The intention to get a COVID-19 vaccination was expressed among 85% of the participants. In fully adjusted models, students and respondents with more normal body weights reported higher intentions to get vaccinated. Respondents were also more likely to seek vaccination if they reported greater levels of perceived susceptibility, benefits, and cues to action, as well as lower levels of barriers and self-efficacy. Fear of future vaccine side effects was the most common reason for COVID-19 vaccine hesitancy and was expressed by 94% of the vaccine-hesitant respondents. These factors should be considered by health authorities in Bangladesh and perhaps other countries when addressing the plateauing COVID-19 vaccination rates in many populations. Full article
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12 pages, 1109 KiB  
Article
Investigating the Influence of Vaccine Literacy, Vaccine Perception and Vaccine Hesitancy on Israeli Parents’ Acceptance of the COVID-19 Vaccine for Their Children: A Cross-Sectional Study
by Yulia Gendler and Lani Ofri
Vaccines 2021, 9(12), 1391; https://doi.org/10.3390/vaccines9121391 - 24 Nov 2021
Cited by 63 | Viewed by 5548
Abstract
Vaccination is currently the most effective strategy for combating COVID-19. COVID-19 vaccines were introduced to the adult population in Israel in early December 2020 and have been available for children aged 12–15 since June 2021. Our study aimed at assessing the influence of [...] Read more.
Vaccination is currently the most effective strategy for combating COVID-19. COVID-19 vaccines were introduced to the adult population in Israel in early December 2020 and have been available for children aged 12–15 since June 2021. Our study aimed at assessing the influence of vaccine literacy, perception, hesitancy, and behavior on Israeli parents’ intentions to have their children vaccinated. Using an anonymous online questionnaire, we recruited 520 parents; 70.4% of the parents indicated that they would get their children vaccinated. The participants’ COVID-19 vaccination status was the only socio-demographic factor significantly associated with COVID-19 vaccination acceptability (OR = 32.89; 95%CI = [13.11, 82.54]). The most common sources of information regarding the COVID-19 vaccine were health-care providers and the Internet. Parents who intend to vaccinate their children had higher mean levels of vaccine literacy (2.99 ± 0.47 vs. 3.07 ± 0.44 respectively, p = 0.06), more positive perception of the vaccine (mean scores of 2.26 ± 0.75 vs. 3.44 ± 0.68 respectively, p < 0.001), and lower perceived vaccine hesitancy (7.53 ± 2.37 vs. 4.68 ± 2.71 respectively, p < 0.001) than parents who do not intend to do so. Vaccine behavior was measured using the 5C model of psychological antecedents. All 5C components were significantly correlated with parents’ willingness to vaccinate their children. Understanding of parents’ willingness to have their children receive the COVID-19 vaccine and the barriers to and facilitators of the vaccination is crucial, as vaccination of children aged 5–11 has recently been approved by the FDA. Providing the population with reliable information regarding the COVID-19 vaccine is an important measure in the attempt to increase COVID-19 vaccine acceptance. Full article
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13 pages, 2476 KiB  
Article
Impact of Anxiety on Readiness for COVID-19 Vaccination among Polish Nursing Undergraduate Students: Nationwide Cross-Sectional Study
by Joanna Gotlib, Mariusz Jaworski, Dominik Wawrzuta, Tomasz Sobierajski and Mariusz Panczyk
Vaccines 2021, 9(12), 1385; https://doi.org/10.3390/vaccines9121385 - 24 Nov 2021
Cited by 4 | Viewed by 3565
Abstract
The COVID-19 pandemic had a huge impact on the mental health of people around the world, and it increased the level of fear of infection and anxiety about the consequences of the disease caused by the SARS-CoV-2 virus. We examined the relationship between [...] Read more.
The COVID-19 pandemic had a huge impact on the mental health of people around the world, and it increased the level of fear of infection and anxiety about the consequences of the disease caused by the SARS-CoV-2 virus. We examined the relationship between the level of anxiety among nursing students and their knowledge about COVID-19 vaccination. In addition, we explored the correlations among the level of anxiety, knowledge about vaccination, and the willingness to vaccinate against COVID-19. A total of 790 undergraduate nursing students participated in the study. The results demonstrated that the level of anxiety among the surveyed nursing students was low; 40% of the study participants did not report any anxiety at all, 30% reported mild anxiety, 20% reported moderate anxiety, and 9% reported severe anxiety. At the time of the study, 77.2% of the participants were already vaccinated against COVID-19. Student knowledge about vaccination against COVID-19 was high and anxiety levels were low, with no direct correlation between the knowledge of vaccination and the severity of anxiety. Full article
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17 pages, 2464 KiB  
Article
Data-Driven Decision Making and Proactive Citizen–Scientist Communication: A Cross-Sectional Study on COVID-19 Vaccination Adherence
by Emil Syundyukov, Martins Mednis, Linda Zaharenko, Eva Pildegovica, Ieva Danovska, Svjatoslavs Kistkins, Abraham Seidmann, Arriel Benis, Valdis Pirags and Lilian Tzivian
Vaccines 2021, 9(12), 1384; https://doi.org/10.3390/vaccines9121384 - 24 Nov 2021
Cited by 2 | Viewed by 3583
Abstract
Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between [...] Read more.
Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between scientists and the general population, and to use it for an exploratory study on factors associated with vaccination readiness. The digital platform was developed in Latvia and was equipped with dynamic consent management. During a period of six weeks 467 participants were enrolled in the population-based cross-sectional exploratory study using this platform. We assessed demographics, COVID-19-related behavioral and personal factors, and reasons for vaccination. Logistic regression models adjusted for the level of education, anxiety, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with vaccination readiness. In the fully adjusted multiple logistic regression model, factors associated with vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), feelings of social responsibility (OR = 1.61 [1.16; 2.22]), and trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]). The assessment of a large number of participants in a six-week period show the potential of a digital platform to create a data-driven dialogue on vaccination readiness. Full article
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12 pages, 541 KiB  
Article
Vaccinating against COVID-19: The Correlation between Pro-Vaccination Attitudes and the Belief That Our Peers Want to Get Vaccinated
by Darie Cristea, Dragoș-Georgian Ilie, Claudia Constantinescu and Valeriu Fîrțală
Vaccines 2021, 9(11), 1366; https://doi.org/10.3390/vaccines9111366 - 20 Nov 2021
Cited by 14 | Viewed by 19110
Abstract
This study verifies whether there is a strong correlation between the pro-vaccination, against COVID-19 attitude of the respondents and their belief that most of those around them want to be vaccinated against COVID-19. For this purpose, we analyzed data from a sociological survey [...] Read more.
This study verifies whether there is a strong correlation between the pro-vaccination, against COVID-19 attitude of the respondents and their belief that most of those around them want to be vaccinated against COVID-19. For this purpose, we analyzed data from a sociological survey conducted in April 2021 in Romania. The sample size was of 1001 respondents, the selection process was randomized and the population included in the sample is representative of the socio-demographic structure of Romania. The tool used to collect the data was CATI (telephonic interview). In order to test the existence of these correlations we performed the following tests: Chi-Square test, Kendall τ, Spearman ρ tests and Freeman’s z-test. The pro-vaccination attitude strongly correlates with the perception of subjects that their primary group accepts vaccination and even correlates with the perception that the general public is rather pro-vaccination. The vaccination decision is closely linked to the social relations system and the rules of the community in which the subject lives. In this paper we discuss the correlation between attitude and belief, not the existence of a causal relation between the two of them. Full article
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11 pages, 230 KiB  
Article
Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors
by Paul Kwok Ming Poon, Weiju Zhou, Dicken Cheong Chun Chan, Kin On Kwok and Samuel Yeung Shan Wong
Vaccines 2021, 9(11), 1319; https://doi.org/10.3390/vaccines9111319 - 13 Nov 2021
Cited by 13 | Viewed by 3073
Abstract
Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods [...] Read more.
Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods: We conducted a cross-sectional online survey of all family doctors in the Hong Kong College of Family Physicians between June and July 2021. Their practice of making COVID-19 recommendation to patients was assessed. Based on the Health Belief Model, factors associated with doctors’ recommendation practices were explored and examined. Multivariate logistic regression models were used to investigate the factors, including COVID-19 vaccine attributes, associated with doctors’ practices in making recommendations. Their own vaccination status and psychological antecedents to vaccine hesitancy were measured. Results: A total of 312 family doctors responded (a 17.6% response rate). The proportion of doctors who had received COVID-19 vaccines was 90.1%. The proportion of doctors who would recommend all patients without contraindications for the vaccination was 64.4%. The proportion of doctors who would proactively discuss COVID-19 vaccines with patients was 52.9%. Multivariate logistic regression analysis showed that doctors’ own COVID-19 vaccination status was the strongest predictor of family doctors making a recommendation to patients (aOR 12.23 95% CI 3.45–43.33). Longer duration of practice, willingness to initiate the relevant discussion with patients and less worry about vaccine side effects on chronic illness patients were the other factors associated with making a COVID-19 vaccination recommendation. Conclusions: Family doctors should be encouraged to get vaccinated themselves and initiate discussions with patients about COVID-19 vaccines. Vaccine safety data on patients with chronic illness, training and guidelines for junior doctors may facilitate the COVID-19 vaccination recommendation practices of family doctors. Full article
10 pages, 637 KiB  
Article
COVID-19 Vaccination Behavior of People Living with HIV: The Mediating Role of Perceived Risk and Vaccination Intention
by Li Qi, Li Yang, Jie Ge, Lan Yu and Xiaomei Li
Vaccines 2021, 9(11), 1288; https://doi.org/10.3390/vaccines9111288 - 6 Nov 2021
Cited by 10 | Viewed by 2929
Abstract
The COVID-19 vaccination behavior of people living with HIV (PLWH) was examined via a cross-sectional web-based survey of PLWH aged 18 years and older. The survey was conducted from l May to 20 June 2021. The survey included social demographic information; vaccination behavior [...] Read more.
The COVID-19 vaccination behavior of people living with HIV (PLWH) was examined via a cross-sectional web-based survey of PLWH aged 18 years and older. The survey was conducted from l May to 20 June 2021. The survey included social demographic information; vaccination behavior (B); and questions related to perceived usefulness (PU), perceived risk (PR), subjective norms (SNs), perceived behavior control (PBC), and behavior intention (BI). The associations between the questionnaire variables and COVID-19 vaccination behavior were assessed by calculating the descriptive data, correlation analysis, and structural equation modeling. In total, 43.71% of the 350 eligible respondents had received a COVID-19 vaccine. The differences in COVID-19 vaccination behavior according to age, gender, religious belief, marital status, income, education level, and occupation were not obvious (p > 0.05). PU had a significantly negative effect on PR (p < 0.05). PR had a significantly negative effect on BI (p < 0.05). SNs had a significantly positive effect on BI (p < 0.05). BI had a significantly positive effect on B (p < 0.05). PR fully mediated the effects of PU on BI, BI fully mediated the effects of PR on B, and BI fully mediated the effects of SNs on B (p < 0.05). Health policymakers and medical workers should provide more information about the risks of vaccine application to improve the vaccination behavior of PLWH. Full article
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13 pages, 716 KiB  
Article
Differences in Sources of Information, Risk Perception, and Cognitive Appraisals between People with Various Latent Classes of Motivation to Get Vaccinated against COVID-19 and Previous Seasonal Influenza Vaccination: Facebook Survey Study with Latent Profile Analysis in Taiwan
by Yi-Lung Chen, Yen-Ju Lin, Yu-Ping Chang, Wen-Jiun Chou and Cheng-Fang Yen
Vaccines 2021, 9(10), 1203; https://doi.org/10.3390/vaccines9101203 - 19 Oct 2021
Cited by 8 | Viewed by 3212
Abstract
The present study aimed (1) to identify distinct latent classes of motivation to get vaccinated against coronavirus disease 2019 (COVID-19) and previous seasonal influenza vaccination among people in Taiwan and (2) to examine the roles of sources of information, risk perception, and cognitive [...] Read more.
The present study aimed (1) to identify distinct latent classes of motivation to get vaccinated against coronavirus disease 2019 (COVID-19) and previous seasonal influenza vaccination among people in Taiwan and (2) to examine the roles of sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 in these classes. We recruited 1047 participants through a Facebook advertisement. The participants’ motivation to get vaccinated against COVID-19, previous seasonal influenza vaccination, sources of information about COVID-19 vaccination, risk perception of COVID-19, and cognitive appraisals of vaccination against COVID-19 were determined. We examined the participants’ motivation for COVID-19 vaccination and previous seasonal influenza vaccination through latent profile analysis. Four latent classes of motivation were identified: participants with high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those with high motivation for COVID-19 vaccination but low seasonal influenza vaccination, those with low motivation for COVID-19 vaccination but high seasonal influenza vaccination, and those with low motivation for COVID-19 vaccination and low seasonal influenza vaccination. Compared with participants in the latent class of high motivation for COVID-19 vaccination and high seasonal influenza vaccination, those in the other three latent classes had lower levels of positive appraisals of COVID-19 vaccination; participants in the latent class of low motivation for COVID-19 vaccination and low seasonal influenza vaccination had lower risk perception of COVID-19 and were also less likely to obtain information about COVID-19 vaccination from the internet, friends, and family members. The various motivations and behaviors for vaccination, sources of information, risk perception, and cognitive appraisals of vaccination against COVID-19 should be considered in intervention programs aiming to increase people’s motivation to get vaccinated against COVID-19. Full article
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17 pages, 1422 KiB  
Article
Predicting COVID-19 Vaccination Intention: The Determinants of Vaccine Hesitancy
by Nuno Fernandes, Daniela Costa, Diogo Costa, José Keating and Joana Arantes
Vaccines 2021, 9(10), 1161; https://doi.org/10.3390/vaccines9101161 - 11 Oct 2021
Cited by 39 | Viewed by 7673
Abstract
Do people want to be vaccinated against COVID-19? Herd immunity is dependent on individuals’ willingness to be vaccinated since vaccination is not mandatory. Our main goal was to investigate people’s intention to be vaccinated and their intentions to vaccinate their children. Moreover, we [...] Read more.
Do people want to be vaccinated against COVID-19? Herd immunity is dependent on individuals’ willingness to be vaccinated since vaccination is not mandatory. Our main goal was to investigate people’s intention to be vaccinated and their intentions to vaccinate their children. Moreover, we were interested in understanding the role of the personal characteristics, psychological factors, and the lockdown context on that decision. Therefore, we conducted an online survey during the lockdown in Portugal (15 January 2021 until 14 March 2021). Participants completed a socio-demographic questionnaire, questions about their intentions of being vaccinated, concerns about the vaccine, a COVID-19 attitudes and beliefs scale, a COVID-19 vaccine attitudes and beliefs scale, and the Domain-Specific Risk-Taking (DOSPERT) Scale. Our results showed that from the 649 participants, 63% of the participants reported being very likely to have the vaccine, while 60% reported being very likely to vaccinate their children. We conducted two linear regression models, explaining 65% of the variance for personal vaccination and 56% of the variance for children vaccination. We found that the COVID-19 vaccine general beliefs and attitudes were the main determinants of vaccination intention. Additionally, our proposed artificial neural network model was able to predict with 85% accuracy vaccination intention. Thus, our results suggest that psychological factors are an essential determinant of vaccination intention. Thus, public policy decision makers may use these insights for predicting vaccine hesitancy and designing effective vaccination communication strategies. Full article
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12 pages, 276 KiB  
Article
Vaccine Refusal in the Czech Republic Is Associated with Being Spiritual but Not Religiously Affiliated
by Alice Kosarkova, Klara Malinakova, Jitse P. van Dijk and Peter Tavel
Vaccines 2021, 9(10), 1157; https://doi.org/10.3390/vaccines9101157 - 10 Oct 2021
Cited by 23 | Viewed by 3730
Abstract
A strong reduction in the deleterious effects of the COVID-19 pandemic can be achieved by vaccination. Religiosity and spirituality (R/S) may play an important role in vaccine acceptance. However, evidence is lacking for the associations with religious conspiracy theories (RCT) in a non-religious [...] Read more.
A strong reduction in the deleterious effects of the COVID-19 pandemic can be achieved by vaccination. Religiosity and spirituality (R/S) may play an important role in vaccine acceptance. However, evidence is lacking for the associations with religious conspiracy theories (RCT) in a non-religious environment. This study investigated the associations between R/S and RCT about COVID-19 vaccination and the links of R/S with vaccine refusal and hesitancy. A sample of Czech adults (n = 459) participated in the survey. We measured R/S, RCT, religious fundamentalism, and COVID-19 vaccination intentions. We found spirituality to be significantly associated with RCT belief, with odds ratios (OR) of 2.12 (95% confidence interval [CI] 1.42–3.19). A combination of R/S groups revealed that spirituality with non-religious affiliation was associated with higher beliefs in RCT, with ORs from 3.51 to 7.17. Moreover, associations were found between spirituality with non-religious affiliation [OR 2.22(1.33–7.76)] with vaccine refusal. Our findings showed associations of spirituality and religious fundamentalism with RCT about COVID-19 vaccination. Furthermore, spirituality was linked to a higher possibility of vaccine refusal. Understanding these associations may help prevent the development of RCT and negative impact of spirituality on vaccine intentions and contribute to the effectiveness of the vaccination process. Full article
16 pages, 322 KiB  
Article
Attitudes and Intentions toward COVID-19 Vaccination among Spanish Adults: A Descriptive Cross-Sectional Study
by Diego Gabriel Mosteiro-Miguéns, Daniel De Bernardo Roca, Eva María Domínguez-Martís, Natalia Vieito-Pérez, Pilar Álvarez-Padín and Silvia Novío
Vaccines 2021, 9(10), 1135; https://doi.org/10.3390/vaccines9101135 - 4 Oct 2021
Cited by 4 | Viewed by 2745
Abstract
Vaccination against SARS-CoV-2 is postulated as the most effective measure to control the COVID-19 pandemic. However, the use of other protection measures is necessary to efficiently combat the spread of the virus. The aim of the present study was to determine the attitudes [...] Read more.
Vaccination against SARS-CoV-2 is postulated as the most effective measure to control the COVID-19 pandemic. However, the use of other protection measures is necessary to efficiently combat the spread of the virus. The aim of the present study was to determine the attitudes and intentions toward COVID-19 vaccination among non-regular social media users in Spain and to analyze how these factors could condition the acceptance of other personal protective measures once an individual has received the COVID-19 vaccine. A cross-sectional design was used in this work. In total, 719 subjects, ≥18 years old and of both sexes, were recruited from primary public healthcare centers to self-complete a questionnaire between March and April 2021. The majority of participants had a positive attitude toward vaccination and showed high levels of intention to be vaccinated. Likewise, except those participants who considered the vaccine to be the most effective measure to fight the COVID-19 pandemic, the rest of the participants highlighted the importance of continuing to limit social interactions and/or wearing masks even after being vaccinated. Since vaccination can create a perception of total immunity against SARS-CoV-2, it is necessary that healthcare staff organize effective awareness campaigns on the importance of maintaining personal protective measures until vaccination coverage is greater. Full article
11 pages, 266 KiB  
Article
Factors Related to Caregiver Intentions to Vaccinate Their Children with Attention-Deficit/Hyperactivity Disorder against COVID-19 in Taiwan
by Ching-Shu Tsai, Ray C. Hsiao, Yu-Min Chen and Cheng-Fang Yen
Vaccines 2021, 9(9), 983; https://doi.org/10.3390/vaccines9090983 - 2 Sep 2021
Cited by 18 | Viewed by 2633
Abstract
The aims of this study were to examine the proportion of caregivers who were hesitant to vaccinate their children with attention-deficit/hyperactivity disorder (ADHD) against coronavirus disease 2019 (COVID-19) and the factors related to caregiver intentions to vaccinate their children against COVID-19. In total, [...] Read more.
The aims of this study were to examine the proportion of caregivers who were hesitant to vaccinate their children with attention-deficit/hyperactivity disorder (ADHD) against coronavirus disease 2019 (COVID-19) and the factors related to caregiver intentions to vaccinate their children against COVID-19. In total, 161 caregivers of children with ADHD were recruited in this study. The caregivers completed an online questionnaire to provide data regarding their intention to vaccinate their children against COVID-19, concerns about the effectiveness and safety of vaccines, unfavorable family attitudes toward vaccines, and children’s medication use for ADHD and comorbid psychopathology. The factors related to caregiver intentions to vaccinate their child were examined using linear regression analysis. The results indicated that 25.5% of caregivers were hesitant to vaccinate their children with ADHD, and 11.8% refused to vaccinate their children against COVID-19. The caregivers’ concerns about the safety of vaccines and children’s regular use of medication for ADHD were negatively associated with caregiver intentions to vaccinate, whereas the children’s comorbid conduct or oppositional defiant problems were positively associated with the caregiver intentions to vaccinate. An intervention that enhances caregiver intentions to vaccinate their children with ADHD against COVID-19 by addressing the related factors found in this study is warranted. Full article
8 pages, 681 KiB  
Communication
Willingness to Get the COVID-19 Vaccine among Residents of Slum Settlements
by Juan P. Aguilar Ticona, Nivison Nery, Jr., Renato Victoriano, Mariam O. Fofana, Guilherme S. Ribeiro, Emanuele Giorgi, Mitermayer G. Reis, Albert I. Ko and Federico Costa
Vaccines 2021, 9(9), 951; https://doi.org/10.3390/vaccines9090951 - 26 Aug 2021
Cited by 25 | Viewed by 4288
Abstract
Slum residents are more vulnerable to COVID-19 infection. Without a specific treatment, vaccination became the main strategy against COVID-19. In this study, we determined the rate and factors associated with the willingness to get vaccinated against COVID-19 among slum residents and their main [...] Read more.
Slum residents are more vulnerable to COVID-19 infection. Without a specific treatment, vaccination became the main strategy against COVID-19. In this study, we determined the rate and factors associated with the willingness to get vaccinated against COVID-19 among slum residents and their main reasons associated with the vaccine intention. The study was conducted in Pau da Lima, a slum community in Salvador Brazil. In total, 985 residents were interviewed. Among them 66.0% (650/985) were willing to get vaccinated, 26.1% (257/985) were hesitant to take the vaccine and 7.9% (78/285) were not sure. The main reasons cited for vaccine hesitancy or being unsure were concerns about vaccine efficacy and potential side effects. In contrast, the main reasons cited for wanting the vaccine were the high incidence of COVID-19 cases and participants’ self-perception of their own health history. Multivariate analysis identified that COVID-19 vaccine hesitancy was associated with younger age and low social capital, summarized as low perceived importance of vaccination to protect one’s family, friends and community. Slum residents have been less willing to vaccinate than the general population. Social capital presents a critical opportunity in the design of communication campaigns to increase COVID-19 vaccine acceptance in slum settings. Full article
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11 pages, 263 KiB  
Article
The Credibility of Health Information Sources as Predictors of Attitudes toward Vaccination—The Results from a Longitudinal Study in Poland
by Katarzyna Stasiuk, Mateusz Polak, Dariusz Dolinski and Jozef Maciuszek
Vaccines 2021, 9(8), 933; https://doi.org/10.3390/vaccines9080933 - 23 Aug 2021
Cited by 15 | Viewed by 3347
Abstract
Background: The research focused on the relationships between attitudes towards vaccination and the trust placed in different sources of information (science, experts and the information available on the Internet) before and during COVID-19. Method: A longitudinal design was applied with the first measurement [...] Read more.
Background: The research focused on the relationships between attitudes towards vaccination and the trust placed in different sources of information (science, experts and the information available on the Internet) before and during COVID-19. Method: A longitudinal design was applied with the first measurement in February 2018 (N = 1039). The second measurement (N = 400) was carried out in December 2020 to test if the pandemic influenced the trust in different sources of information. Results: The final analyses carried out on final sample of 400 participants showed that there has been no change in trust in the Internet as a source of knowledge about health during the pandemic. However, the trust in science, physicians, subjective health knowledge, as well as the attitude towards the vaccination has declined. Regression analysis also showed that changes in the level of trust in physicians and science were associated with analogous (in the same direction) changes in attitudes toward vaccination. The study was also focused on the trust in different sources of health knowledge as possible predictors of willingness to be vaccinated against SARS-nCoV-2. However, it appeared that the selected predictors explained a small part of the variance. This suggests that attitudes toward the new COVID vaccines may have different sources than attitudes toward vaccines that have been known to the public for a long time. Full article

Review

Jump to: Research, Other

38 pages, 3524 KiB  
Review
Global COVID-19 Vaccine Acceptance: A Systematic Review of Associated Social and Behavioral Factors
by Choudhary Sobhan Shakeel, Amenah Abdul Mujeeb, Muhammad Shaheer Mirza, Beenish Chaudhry and Saad Jawaid Khan
Vaccines 2022, 10(1), 110; https://doi.org/10.3390/vaccines10010110 - 12 Jan 2022
Cited by 119 | Viewed by 10161
Abstract
COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and [...] Read more.
COVID-19 vaccines have met varying levels of acceptance and hesitancy in different parts of the world, which has implications for eliminating the COVID-19 pandemic. The aim of this systematic review is to examine how and why the rates of COVID-19 vaccine acceptance and hesitancy differ across countries and continents. PubMed, Web of Science, IEEE Xplore and Science Direct were searched between 1 January 2020 and 31 July 2021 using keywords such as “COVID-19 vaccine acceptance”. 81 peer-reviewed publications were found to be eligible for review. The analysis shows that there are global variations in vaccine acceptance among different populations. The vaccine-acceptance rates were the highest amongst adults in Ecuador (97%), Malaysia (94.3%) and Indonesia (93.3%) and the lowest amongst adults in Lebanon (21.0%). The general healthcare workers (HCWs) in China (86.20%) and nurses in Italy (91.50%) had the highest acceptance rates, whereas HCWs in the Democratic Republic of Congo had the lowest acceptance (27.70%). A nonparametric one-way ANOVA showed that the differences in vaccine-acceptance rates were statistically significant (H (49) = 75.302, p = 0.009*) between the analyzed countries. However, the reasons behind vaccine hesitancy and acceptance were similar across the board. Low vaccine acceptance was associated with low levels of education and awareness, and inefficient government efforts and initiatives. Furthermore, poor influenza-vaccination history, as well as conspiracy theories relating to infertility and misinformation about the COVID-19 vaccine on social media also resulted in vaccine hesitancy. Strategies to address these concerns may increase global COVID-19 vaccine acceptance and accelerate our efforts to eliminate this pandemic. Full article
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13 pages, 878 KiB  
Review
Determinants of Obtaining COVID-19 Vaccination among Health Care Workers with Access to Free COVID-19 Vaccination: A Cross-Sectional Study
by Mariam R. Elkhayat, Maiada K. Hashem, Ahmed T. Helal, Omar M. Shaaban, Ahmed K. Ibrahim, Taghreed S. Meshref, Hussein Elkhayat, Mohamed Moustafa, Mohammed Nahed Attia Mohammed, Azza M. Ezzeldin, Hebatallah G. Rashed, Alaa Bazeed, Islam H. Ibrahim, Ahmed Mokhtar Mahmoud, Moaiad Eldin Ahmed Mohamed, Reem Sayad and Shimaa A. Elghazally
Vaccines 2022, 10(1), 39; https://doi.org/10.3390/vaccines10010039 - 29 Dec 2021
Cited by 6 | Viewed by 3190
Abstract
Introduction: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine’s unpredictability. Aims: To study the determinants [...] Read more.
Introduction: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine’s unpredictability. Aims: To study the determinants of the attitudes of healthcare workers (HCWs) to receiving or refusing to receive the vaccine. Methods: The current study adopted an interviewed questionnaire between June and August 2021. A total of 341 HCWs currently working at Assiut University hospitals offered to receive the vaccine were included. Results: Only half of the HCWs (42%) accepted the COVID-19 vaccine. The most common reason that motivated the HCWs was being more susceptible than others to infection (71.8%). On other hand, the common reasons for refusing included: previously contracted the virus (64.8%); did not have time (58.8%); warned by a doctor not to take it (53.8%). Nearly one-third of nonaccepting HCWs depended on television, the Internet, and friends who refused the vaccine for information (p < 0.05). In the final multivariate regression model, there were six significant predictors: sex, job category, chronic disease, being vaccinated for influenza, and using Assiut University hospital staff and the Ministry of Health as sources of information (p < 0.05). Conclusion: Misinformation and negative conceptions are still barriers against achieving the desired rate of vaccination, especially for vulnerable groups such as HCWs. Full article
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12 pages, 256 KiB  
Review
Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake
by Michael Vallis, Simon Bacon, Kim Corace, Keven Joyal-Desmarais, Sherri Sheinfeld Gorin, Stefania Paduano, Justin Presseau, Joshua Rash, Abebaw Mengistu Yohannes and Kim Lavoie
Vaccines 2022, 10(1), 7; https://doi.org/10.3390/vaccines10010007 - 22 Dec 2021
Cited by 13 | Viewed by 5016
Abstract
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a [...] Read more.
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families. Full article

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15 pages, 262 KiB  
Data Descriptor
COVID-19 Vaccination Personas in Syria: Evidence from a Cross-Sectional Survey
by Zlatko Nikoloski, Elnur Aliyev, Robert E. S. Bain, Leonardo Menchini, Sahar Hegazi, Mai Zalkha, Shaza Mouawad, Neha Kapil and Amaya M. Gillespie
Vaccines 2023, 11(6), 1109; https://doi.org/10.3390/vaccines11061109 - 16 Jun 2023
Cited by 3 | Viewed by 1446
Abstract
Achieving a high level of COVID-19 vaccination coverage in a conflict-affected setting is challenging. The objective of this paper is to shed further light on the main determinants of vaccination coverage using a large, cross-sectional sample (October–November 2022) of over 17,000 adults in [...] Read more.
Achieving a high level of COVID-19 vaccination coverage in a conflict-affected setting is challenging. The objective of this paper is to shed further light on the main determinants of vaccination coverage using a large, cross-sectional sample (October–November 2022) of over 17,000 adults in Syria. We find evidence that certain demographic and socioeconomic characteristics describe a core set of vaccination personas. Men, older respondents, and those who are more educated and trust information received from healthcare authorities are more likely to be vaccinated. Healthcare workers in this sample are highly vaccinated. Furthermore, respondents with more positive views towards COVID-19 vaccines are also more likely to be willing to be vaccinated. By contrast, respondents who believe that vaccines are associated with significant side effects are also more likely to refuse vaccination. In addition, younger respondents and women, as well as those with a lower level of education, are more likely to refuse to be vaccinated. Respondents with a neutral attitude towards vaccines are also more likely to be undecided, whereas respondents who are refusing to get vaccinated are more likely to trust the information received from private doctors, private clinics, as well as social media and, more broadly, the internet. Full article
10 pages, 1286 KiB  
Brief Report
Prevalence and Motivators of Getting a COVID-19 Booster Vaccine in Canada: Results from the iCARE Study
by Camille Léger, Frédérique Deslauriers, Vincent Gosselin Boucher, Meghane Phillips, Simon L. Bacon and Kim L. Lavoie
Vaccines 2023, 11(2), 291; https://doi.org/10.3390/vaccines11020291 - 28 Jan 2023
Cited by 5 | Viewed by 2293
Abstract
Studies have shown that the protection afforded by COVID-19 vaccines against hospitalization and death decreases slowly over time due to the emergence of new variants and waning immunity. Accordingly, booster doses remain critical to minimizing the health impacts of the pandemic. This study [...] Read more.
Studies have shown that the protection afforded by COVID-19 vaccines against hospitalization and death decreases slowly over time due to the emergence of new variants and waning immunity. Accordingly, booster doses remain critical to minimizing the health impacts of the pandemic. This study examined the prevalence rate, sociodemographic determinants, and motivators of getting a COVID-19 booster vaccine within the Canadian population. We recruited a representative sample of 3001 Canadians aged 18+ years as part of the iCARE study using an online polling form between 20 January and 2 February 2022. Participants self-reported their booster status and were dichotomized into two groups: those who did vs. did not receive at least one booster dose. A total of 67% of participants received a booster dose. Chi-square analyses revealed that older age (p < 0.001) and having a chronic disease diagnosis (p < 0.001) were associated with being more likely to get a booster. Boosted individuals reported motivators tied to efficacy and altruism, whereas non-boosted individuals reported motivators tied to efficacy and safety. Results suggest that messaging will require careful tailoring to address the identified behavioral motivators among non-boosted individuals who emphasize safety and efficacy of additional vaccine doses. Full article
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11 pages, 2410 KiB  
Brief Report
Vaccine Communication: Appeals and Messengers Most Effective for COVID-19 Vaccine Uptake in Ukraine
by Gretchen Schulz, Kristian Balgobin, Alexandra Michel and Rupali J. Limaye
Vaccines 2023, 11(2), 279; https://doi.org/10.3390/vaccines11020279 - 28 Jan 2023
Cited by 4 | Viewed by 2254
Abstract
Throughout the COVID-19 pandemic, vaccine communication has been a challenge, particularly as some populations may be highly distrustful of information from public health or government institutions. To better understand the different communication needs in Ukraine, an online survey panel of 168 Ukrainian participants [...] Read more.
Throughout the COVID-19 pandemic, vaccine communication has been a challenge, particularly as some populations may be highly distrustful of information from public health or government institutions. To better understand the different communication needs in Ukraine, an online survey panel of 168 Ukrainian participants viewed six COVID-19 vaccination ads with three variations on vaccine messaging appeals (potential economic impacts of COVID-19 infection COVID-19 disease outcomes, and social norms related to vaccination) and two different messengers (a peer or a health provider). The ad featuring a health outcome appeal delivered by a healthcare provider was most favored (n = 53, 31.6%); however, across demographic categories, including vaccine hesitancy categories, participants expressed high levels of approval for all six variations of the COVID-19 vaccine ads. When participants ranked reasons why someone may not accept the COVID-19 vaccine, the most prevalent beliefs identified were that the vaccine was not safe, and that the vaccine was not effective. Findings from this study suggest that vaccine appeals focused on health outcomes delivered by healthcare providers are preferred by most individuals in Ukraine; however, individuals are motivated by a myriad of factors suggesting that for vaccine messaging to be most effective, communication should be varied in both appeal and messenger. Full article
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8 pages, 267 KiB  
Brief Report
High Stress Levels and Trust toward the Government Are Associated with More Positive Attitudes toward COVID-19 Vaccines among French Students: A Pilot Study
by Clémence Brun, Oulmann Zerhouni, Laurène Houtin, Alexis Akinyemi, Carla Aimé-Jubin, Jordane Boudesseul and Nicolas Pinsault
Vaccines 2022, 10(9), 1377; https://doi.org/10.3390/vaccines10091377 - 24 Aug 2022
Cited by 2 | Viewed by 1628
Abstract
Mistrust in COVID-19 vaccines may hinder vaccination campaigns. We looked at cognitive determinants of vaccination intentions against COVID-19. We were interested in (i) the effects of stress and (ii) the effects of self-protection systems on attitudes and intentions to get COVID-19 vaccines. We [...] Read more.
Mistrust in COVID-19 vaccines may hinder vaccination campaigns. We looked at cognitive determinants of vaccination intentions against COVID-19. We were interested in (i) the effects of stress and (ii) the effects of self-protection systems on attitudes and intentions to get COVID-19 vaccines. We conducted an online observational pilot study with 203 participants and used self-report questionnaires to assess perceived stress and vulnerability to disease, beliefs about a dangerous world, pandemic-related stressors, living conditions, attitudes and intentions toward the vaccines and trust in government management of the COVID-19 pandemic. The participants reporting high levels of trust in government and high levels of stress were more likely to have positive attitudes toward COVID-19 vaccines, although these two effects are at least partially independent of each other. We discuss how to improve the communication around COVID-19 vaccine policies. Full article
8 pages, 2760 KiB  
Brief Report
Educational Inequalities in COVID-19 Vaccination: A Cross-Sectional Study of the Adult Population in the Lazio Region, Italy
by Giulia Cesaroni, Enrico Calandrini, Maria Balducci, Giovanna Cappai, Mirko Di Martino, Chiara Sorge, Emanuele Nicastri, Nera Agabiti and Marina Davoli
Vaccines 2022, 10(3), 364; https://doi.org/10.3390/vaccines10030364 - 25 Feb 2022
Cited by 19 | Viewed by 2697
Abstract
Several studies reported socioeconomic inequalities during the COVID-19 pandemic. We aimed at investigating educational inequalities in COVID-19 vaccination on 22 December 2021. We used the cohort of all residents in the Lazio Region, Central Italy, established at the beginning of the pandemic to [...] Read more.
Several studies reported socioeconomic inequalities during the COVID-19 pandemic. We aimed at investigating educational inequalities in COVID-19 vaccination on 22 December 2021. We used the cohort of all residents in the Lazio Region, Central Italy, established at the beginning of the pandemic to investigate the effects of COVID-19. The Lazio Region has 5.5 million residents, mostly distributed in the Metropolitan Area of Rome (4.3 million inhabitants). We selected those aged 35 years or more who were alive and still residents on 22 December 2021. The cohort included data on sociodemographic, health characteristics, COVID-19 vaccination (none, partial, or complete), and SARS-CoV-2 infection. We used adjusted logistic regression models to analyze the association between level of education and no vaccination. We investigated 3,186,728 subjects (54% women). By the end of 2021, 88.1% of the population was fully vaccinated, and 10.3% were not vaccinated. There were strong socioeconomic inequalities in not getting vaccinated: compared with those with a university degree, residents with a high school degree had an odds ratio (OR) of 1.29 (95% confidence interval, CI, 1.27–1.30), and subjects with a junior high or primary school attainment had an OR = 1.41 (95% CI: 1.40–1.43). Since a comprehensive vaccination against COVID-19 could help reduce socioeconomic inequalities raised with the pandemic, further efforts in reaching the low socioeconomic strata of the population are crucial. Full article
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