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Marinda E, Mathentamo Q, Coulson N, Parker S, Dmc Katoto P, Houston G, Magampa M, Pillay N, Ngungu M, Wiysonge CS, van Rooyen H. Impact evaluation of a youth led intervention to increase COVID-19 vaccine uptake in Kwazulu-Natal, South Africa. Vaccine 2024; 42:2089-2098. [PMID: 38423816 DOI: 10.1016/j.vaccine.2024.02.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND COVID-19 vaccination rates in South Africa remain low at 51% of the adult population being fully vaccinated, defined as having two shorts of the COVID-19 vaccine with or without a booster. To improve vaccine uptake, a community-based intervention was tested in a high vaccine hesitancy community in South Africa. Trained community youths used social media, face to face interactions, door to door and neighbourhood outreach activities to deliver the intervention. METHODS To assess if the intervention had an impact, data was collected before the intervention and after the intervention in two districts, Wentworth an intervention site and Newlands East a control site. Both districts are in KwaZulu Natal Province, South Africa. The following outcomes, changes on perceptions and knowledge about COVID-19, intention to get vaccinated for those who were not fully vaccinated and vaccination uptake were assessed using difference-in-difference methods applied through Augmented Inverse-Probability Weighting and contrasts of Potential Outcome Means (POM). RESULTS One thousand, one hundred and fifty (1 150) participants agreed to take part in the study at baseline, and 916 (80%) were followed up after the 9-week intervention period. Intention to get vaccinated for COVID-19 was higher (difference-in-difference, DID 20%, 95% CI 6% - 35% higher), more people were fully vaccinated (DID 10%, 95% CI 0% - 20%) or partially vaccinated (DID 16%, 95% CI 6% - 26%) in Wentworth the intervention site compared to Newlands East, the control site. There were noticeable increases on the percentage of study participants indicating trust on the Government's COVID 19 programme, from 24% at baseline to 48% after the intervention in the intervention group than in the control group, 26% baseline and 29% at follow-up. There was a 10% (absolute) increase on the percentage of participants' saying they believed health care workers provided reliable information, 58% at baseline and 68% at follow-up in the intervention group, but there was little change in the control group 56% and 57% for baseline and follow-up respectively. CONCLUSION The youth-led intervention implemented in Wentworth, a community with a high rate of vaccine hesitancy, was effective in increasing vaccination uptake. Given the low COVID-19 vaccine coverage in South Africa and across the African region, as well as the new emerging variant of concern (XBB 1.5), there is an urgent need to scale up such intervention at the community level to address persistent misinformation and promote vaccine equality.
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Affiliation(s)
- Edmore Marinda
- Human Sciences Research Council, Pretoria, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg 2050, South Africa.
| | | | - Nancy Coulson
- The Sarraounia Public Health Trust, Johannesburg 2193, South Africa; Wits Mining Institute, University of the Witwatersrand, Johannesburg 2050, South Africa
| | | | - Patrick Dmc Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7505, South Africa
| | | | | | - Nirvana Pillay
- School of Public Health, University of the Witwatersrand, Johannesburg 2050, South Africa; The Sarraounia Public Health Trust, Johannesburg 2193, South Africa
| | - Mercy Ngungu
- Human Sciences Research Council, Pretoria, South Africa
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7501, South Africa; HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban, 4001, South Africa
| | - Heidi van Rooyen
- Human Sciences Research Council, Pretoria, South Africa; SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
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Alam Z, Mohamed S, Nauman J, Al-Rifai RH, Ahmed LA, Elbarazi I. Hesitancy toward vaccination against COVID-19: A scoping review of prevalence and associated factors in the Arab world. Hum Vaccin Immunother 2023; 19:2245720. [PMID: 37594508 PMCID: PMC10443971 DOI: 10.1080/21645515.2023.2245720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023] Open
Abstract
Despite widespread availability of vaccines against SARS-CoV-2 virus, the cause of Coronavirus Disease 2019 (COVID-19), its uptake in many Arab countries is relatively low. This literature review aimed to scope evidence on COVID-19 vaccine hesitancy (VH) in the Arab world. A total of 134 articles reporting prevalence of COVID-19 VH and associated factors, conducted in any of the 22 Arab League countries, were reviewed. COVID-19 VH prevalence ranged from 5.4% to 83.0%. Female gender, young age, low education level and lack of previous influenza vaccine uptake were most commonly reported to be associated with COVID-19 VH. The most-reported personal concerns contributing toward VH were related to the rapid development, safety and side effects of vaccine, as well as an overall lack of trust in government policies toward pandemic control and widespread conspiracy theories. Tailored interventions to enable the distribution of trusted information and enhance public acceptance of immunization are warranted.
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Affiliation(s)
- Zufishan Alam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Salma Mohamed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Javaid Nauman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Tejero LMS, Seva RR, Petelo Ilagan BJ, Almajose KL. Determinants of COVID-19 vaccination decision among Filipino adults. BMC Public Health 2023; 23:851. [PMID: 37165332 PMCID: PMC10170431 DOI: 10.1186/s12889-023-15712-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 04/19/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND With a number of vaccines against COVID-19 now widely available globally, it is opportune to determine what tips the decision to get vaccinated. In most countries like the Philippines where the government provides these vaccines for free to all its citizens, their COVID-19 vaccine awareness and COVID-19 information sources as well as their socio-demographic profile were considered as primary factors that could possibly affect vaccination decisions. Participants' income level was considered as a possible financial consideration that can affect vaccination decision as transport to vaccination sites might entail costs to them. METHODS This study used a cross sectional survey design wherein participants came from all regions of the Philippines. An online questionnaire was voluntarily answered by Filipinos aged 18-80 years of age. RESULTS A total of 2,268 participated in the survey with 1,462 having complete responses which were included in the analysis. Those who are younger, with higher educational attainment, with public health insurance, with employers requiring vaccination, high awareness about COVID-19 vaccination, and high vaccine confidence are more likely to get vaccinated. On the other hand, those with long-standing illness and those residing outside the national capital region are less likely to get vaccinated. CONCLUSION Vaccination decisions among Filipinos are determined by their age, educational attainment, health insurance, employer requirement, high awareness of the disease, and a high level of vaccine confidence.
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Affiliation(s)
| | - Rosemary Ruiz Seva
- Industrial and Systems Engineering, De La Salle University, Manila, Philippines
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Romate J, Rajkumar E, Gopi A, Abraham J, Rages J, Lakshmi R, Jesline J, Bhogle S. What Contributes to COVID-19 Vaccine Hesitancy? A Systematic Review of the Psychological Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2022; 10:vaccines10111777. [PMID: 36366286 PMCID: PMC9698528 DOI: 10.3390/vaccines10111777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/06/2022] Open
Abstract
Vaccine hesitancy plays a crucial role in worldwide pandemic-control efforts. The multifaceted nature of vaccine hesitancy entails many psychological factors that are widely discussed in the literature, although few studies specifically compile these factors. Thus, this systematic review aims to synthesize the psychological factors contributing to vaccine hesitancy. As per the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, a systematic search was conducted on electronic databases PubMed, Scopus, Science Direct, PsycNET, and Web of Science, and a manual search was conducted on Google Scholar. Out of the 2289 articles obtained, 79 studies that met the inclusion criteria were deemed eligible for the review. The findings highlight appraisals of the COVID-19 pandemic, vaccine safety and side effects, vaccine confidence/trust, trust in government and healthcare professionals, scepticism around vaccine production, conspiracy beliefs, emotions, and information and knowledge about the vaccine as the major psychological factors contributing to vaccine hesitancy. Concerningly, misinformation on COVID-19 vaccination spread through social media platforms, increasing vaccine hesitancy. Recommendations for government authorities, healthcare professionals, and implications for future research are also outlined.
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Affiliation(s)
- John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
- Correspondence:
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - John Abraham
- St. John’s Medical College, St. John’s National Academy of Health Sciences, Bangalore 560034, India
| | - John Rages
- Government College of Teacher Education, Calicut 673004, India
| | - R. Lakshmi
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Joshy Jesline
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Sudha Bhogle
- Psychology & Head, Student Solutions, Eduquity Career Technologies, Bangalore 560095, India
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Abd HA, Kasim AA, Shareef LG. Serum levels of α1-antitrypsin, interleukin-1β and interleukin-6 in Iraqi COVID-19 patients: A cross-sectional study. F1000Res 2022; 11:921. [DOI: 10.12688/f1000research.124473.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background: More than half of the individuals diagnosed with coronavirus disease 2019 (COVID-19) have been found to have high levels of interleukin (IL)-6. A recent report showed that more elevated serum IL-6 level predicts COVID-19 disease severity and patients’ clinical outcomes. Therefore, this study aimed to compare the serum levels of α1-antitrypsin (AAT), IL-1β, and IL-6 between COVID-19 patients and healthy individuals. Methods: During the data collection phase, 90 individuals were enrolled, 45 healthy controls, and 45 patients confirmed with COVID-19 using reverse transcription-quantitative PCR (RT-qPCR) at a specialized isolation hospital in Baghdad between November 2021 and March 2022. In this cross-sectional research, venous blood samples were taken, and serum was isolated and stored for quantitative ELISA measurements of AAT, IL-1β, and IL-6 (ELISA). IBM SPSS version 24 was used to analyze the data. Results: This study revealed a significant increase in the serum levels of AAT, IL-1β, and IL-6 in the COVID-19 patients' group compared to the healthy control group with p-values < 0.001 for each of these markers. Conclusions: AAT concentrations were higher during COVID-19; this elevation is essential during infection. IL-1β and IL-6 levels were also elevated during the infection period; however, dysregulated high levels may lead to cytokine release syndrome. Therefore, these three biomarkers can be regarded as diagnostically crucial parameters.
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Abstract
Background: People with coronavirus disease 2019 (COVID-19) are frequently at higher risk of developing cardiovascular and metabolic disorders, which are strongly related to the development of long-term illness and higher mortality. These effects may be caused by several interrelated processes, including the IL-6 driven cytokine storm or uncontrolled angiotensin II stimulation. In addition, the direct viral infection of cardiac myocytes is thought to cause cardiac injury because it increases metabolic demand, activates the immune system, and causes vasculature disruption. The objective of this study was to determine whether there is a relationship between cardiac troponin-T (cTnT) and low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio values with COVID-19. Methods: During the data collection stage, 90 participants were included, 45 healthy controls and 45 hospitalized patients diagnosed with COVID-19 using reverse transcription-quantitative PCR (RT-qPCR). Each participant provided 5 ml venous blood to begin analyzing cTnT and LDL-C:HDL-C ratio levels in their blood to see whether there is an association between the level of any of these markers and COVID-19 infection using SPSS version 23. Results: This research reported a significant rise in the measured values of cTnT and LDL-C:HDL-C ratio in patients' blood compared to controls, with P-values of 0.025 and 0.000, respectively, in which alpha values < 0.05, These biomarkers hold the promise in predicting COVID-19 severity, and early treatment may help reduce complications. Conclusions: Due to the fact that cTn is a diagnostic marker of disease activity and a strong independent predictor of negative events, its usage in emergency rooms may well be advantageous. If cTn is elevated, hospitalization may be indicated. A difference in the blood LDL-C:HDL-C ratio of COVID-19 patients demonstrated an association with the illness. Because lipid studies are inexpensive and reliable to do, they may aid clinicians in identifying the severity of COVID-19.
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Parthasarathi A, Puvvada RK, Shankar M, Siddaiah JB, Ganguly K, Upadhyay S, Mahesh PA. Willingness to Accept the COVID-19 Vaccine and Related Factors among Indian Adults: A Cross-Sectional Study. Vaccines (Basel) 2022; 10. [PMID: 35891259 DOI: 10.3390/vaccines10071095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 01/22/2023] Open
Abstract
To achieve herd immunity to a disease, a large portion of the population needs to be vaccinated, which is possible only when there is broad acceptance of the vaccine within the community. Thus, policymakers need to understand how the general public will perceive the vaccine. This study focused on the degree of COVID-19 vaccine hesitancy and refusal and explored sociodemographic correlations that influence vaccine hesitancy and refusal. A cross-sectional online survey was conducted among the adult population of India. The survey consisted of basic demographic questions and questions from the Vaccination Attitudes Examination (VAX) Scale. Multinomial logistical regression was used to identify correlates of vaccine hesitancy and refusal. Of the 1582 people in the study, 9% refused to become vaccinated and 30.8% were hesitant. We found that both hesitancy and refusal predictors were nearly identical (lower socioeconomic status, female gender, and older age groups), except for three groups (subjects aged 45−64 years, those with approximate income <10,000 INR/month, and those residing in rural households) that showed slightly higher odds of vaccine hesitancy than refusal. We need to address the underlying sociodemographic determinants and formulate public awareness programs to address specific subgroups that are at higher risk of rejecting the vaccine and convert those who are undecided or hesitant into those willing to accept the vaccine.
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