651
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COVID-19 vaccines: rapid development, implications, challenges and future prospects. Hum Cell 2021; 34:711-733. [PMID: 33677814 PMCID: PMC7937046 DOI: 10.1007/s13577-021-00512-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023]
Abstract
COVID-19 has affected millions of people and put an unparalleled burden on healthcare systems as well as economies throughout the world. Currently, there is no decisive therapy for COVID-19 or related complications. The only hope to mitigate this pandemic is through vaccines. The COVID-19 vaccines are being developed rapidly, compared to traditional vaccines, and are being approved via Emergency Use Authorization (EUA) worldwide. So far, there are 232 vaccine candidates. One hundred and seventy-two are in preclinical development and 60 in clinical development, of which 9 are approved under EUA by different countries. This includes the United Kingdom (UK), United States of America (USA), Canada, Russia, China, and India. Distributing vaccination to all, with a safe and efficacious vaccine is the leading priority for all nations to combat this COVID-19 pandemic. However, the current accelerated process of COVID-19 vaccine development and EUA has many unanswered questions. In addition, the change in strain of SARS-CoV-2 in UK and South Africa, and its increasing spread across the world have raised more challenges, both for the vaccine developers as well as the governments across the world. In this review, we have discussed the different type of vaccines with examples of COVID-19 vaccines, their rapid development compared to the traditional vaccine, associated challenges, and future prospects.
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652
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Serrazina F, Sobral Pinho A, Cabral G, Salavisa M, Correia AS. Willingness to be vaccinated against COVID-19: An exploratory online survey in a Portuguese cohort of multiple sclerosis patients. Mult Scler Relat Disord 2021; 51:102880. [PMID: 33740481 PMCID: PMC7932878 DOI: 10.1016/j.msard.2021.102880] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 01/12/2023]
Abstract
Background Little is known about MS patients’ acceptability of a COVID-19 vaccine. Objective and methods An online survey was conducted among MS patients to study COVID-19 vaccine acceptability and its associated factors. Results and conclusion Among 256 participants, 80.9% of the patients were either definitely or probably willing to receive a COVID-19 vaccine. Most hesitant patients would consider being vaccinated under physician recommendation. Older patients and those with comorbidities seem to be more willing to get vaccinated. Moreover, vaccine acceptability was associated with participants’ convictions and concerns about COVID-19, as well as previous vaccination practices.
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Affiliation(s)
- Filipa Serrazina
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
| | - André Sobral Pinho
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Gonçalo Cabral
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Manuel Salavisa
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Ana Sofia Correia
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; CEDOC, NOVA Medical School, NMS, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
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653
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Alfageeh EI, Alshareef N, Angawi K, Alhazmi F, Chirwa GC. Acceptability of a COVID-19 Vaccine among the Saudi Population. Vaccines (Basel) 2021; 9:226. [PMID: 33807732 PMCID: PMC7999879 DOI: 10.3390/vaccines9030226] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 01/24/2023] Open
Abstract
To investigate the associated factors underlying vaccination intentions for Coronavirus Disease 2019 (COVID-19), an online cross-sectional survey was conducted among adults 18 years or over in the Kingdom of Saudi Arabia. Data were collected between 8 and 14 December 2020. A logistic regression analysis was employed to examine and identify the variables associated with vaccination intentions for COVID-19, with the odds ratio (OR) and 95% confidence interval (CI) also calculated. A total of 2137 respondents completed the questionnaire. Overall, about 48% of Saudi adults were willing to receive the COVID-19 vaccine. Participants had stronger intentions to receive a vaccination if they resided in the southern region (OR: 1.95; 95% CI: 1.21-3.14), received the seasonal influenza vaccination in the past (OR: 1.52; 95% CI: 1.17-1.97), believed in mandatory COVID-19 vaccination (OR: 45.07; 95% CI: 31.91-63.65), or reported high levels of concern about contracting COVID-19 (OR: 1.91; 95% CI: 1.29-2.81). Participants were less likely to have an intention to be vaccinated if they had a history of vaccine refusal (OR: 0.28; 95% CI: 0.19-0.40). The low acceptance rate among the Saudi population should be targeted with multifaceted interventions aimed at raising awareness and emphasizing the safety and efficacy of the COVID-19 vaccine.
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Affiliation(s)
- Eman Ibrahim Alfageeh
- Primary Health Care Centers Affairs Administration, East Jeddah General Hospital, Jeddah 22253, Saudi Arabia;
| | - Noor Alshareef
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah 80200, Saudi Arabia; (K.A.); (F.A.)
| | - Khadijah Angawi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah 80200, Saudi Arabia; (K.A.); (F.A.)
| | - Fahad Alhazmi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah 80200, Saudi Arabia; (K.A.); (F.A.)
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654
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Taylor T, Yazdany J, Gianfrancesco MA. The racial/ethnic and sociocultural aspects of the pandemic in rheumatology. Best Pract Res Clin Rheumatol 2021; 35:101665. [PMID: 33648855 PMCID: PMC7891072 DOI: 10.1016/j.berh.2021.101665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The disproportionate impact of coronavirus-2019 (COVID-19) on communities of color is gaining global attention. Current research demonstrates that historically marginalized populations are experiencing disproportionate levels of SARS-Cov-2 infection and adverse clinical outcomes. However, research examining whether COVID-19 outcomes vary by race and ethnicity within the rheumatic disease population is limited. This paper will review data showing how SARS-CoV-2 infection has differentially affected racial and ethnic minorities in the general population and those with rheumatic disease. We will also highlight disparities in rheumatic disease risk and severity that existed prior to the pandemic, and discuss recent work examining severe outcomes of COVID-19 in rheumatic disease patients by race and ethnicity. Finally, we propose several actionable steps for the rheumatology community to address COVID-19 health disparities, which may have long-term effects on patients with rheumatic disease.
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Affiliation(s)
- Tiffany Taylor
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA.
| | - Jinoos Yazdany
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA.
| | - Milena A Gianfrancesco
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA.
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655
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Machida M, Nakamura I, Kojima T, Saito R, Nakaya T, Hanibuchi T, Takamiya T, Odagiri Y, Fukushima N, Kikuchi H, Amagasa S, Watanabe H, Inoue S. Acceptance of a COVID-19 Vaccine in Japan during the COVID-19 Pandemic. Vaccines (Basel) 2021; 9:210. [PMID: 33802285 PMCID: PMC8002097 DOI: 10.3390/vaccines9030210] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 01/20/2023] Open
Abstract
Vaccination could be a key protective measure against coronavirus disease 2019 (COVID-19), and it is important to understand the acceptability of the COVID-19 vaccine among the general public. However, there is no study on the acceptance of a COVID-19 vaccine in Japan. Therefore, this study aimed to describe the COVID-19 vaccine acceptance and hesitancy situation in Japan and assess the factors associated with such issues. This was a cross-sectional study based on an internet survey completed by 2956 people. Participants were asked to indicate how likely they were to get vaccinated for COVID-19. In addition, the participants responded to questions regarding sociodemographic factors, attitudes, and beliefs regarding COVID-19 infection and vaccination. The proportion of participants with a high likelihood of getting a COVID-19 vaccine was 62.1%. Multiple logistic regression analysis showed that vaccine acceptance was lower among several sociodemographic groups, such as women, adults aged 20-49 years, and those with a low-income level. Several psychological factors, especially the perceived effectiveness of the COVID-19 vaccine, and willingness to protect others by getting oneself vaccinated, were associated with vaccine acceptance. Our results indicate that the perceived effectiveness of the vaccine and willingness to protect others may play an important role in the acceptance of the COVID-19 vaccine.
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Affiliation(s)
- Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo 160-0023, Japan; (I.N.); (H.W.)
| | - Itaru Nakamura
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo 160-0023, Japan; (I.N.); (H.W.)
| | - Takako Kojima
- Department of International Medical Communications, Tokyo Medical University, Tokyo 160-0023, Japan;
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Miyagi 980-0845, Japan; (T.N.); (T.H.)
| | - Tomoya Hanibuchi
- Graduate School of Environmental Studies, Tohoku University, Miyagi 980-0845, Japan; (T.N.); (T.H.)
| | - Tomoko Takamiya
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Yuko Odagiri
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Hidehiro Watanabe
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo 160-0023, Japan; (I.N.); (H.W.)
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
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656
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Madison AA, Shrout MR, Renna ME, Kiecolt-Glaser JK. Psychological and Behavioral Predictors of Vaccine Efficacy: Considerations for COVID-19. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 16:191-203. [PMID: 33501900 PMCID: PMC7841255 DOI: 10.1177/1745691621989243] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine candidates are being evaluated, with the goal of conferring immunity on the highest percentage of people who receive the vaccine as possible. It is noteworthy that vaccine efficacy depends not only on the vaccine but also on characteristics of the vaccinated. Over the past 30 years, a series of studies has documented the impact of psychological factors on the immune system's vaccine response. Robust evidence has demonstrated that stress, depression, loneliness, and poor health behaviors can impair the immune system's response to vaccines, and this effect may be greatest in vulnerable groups such as the elderly. Psychological factors are also implicated in the prevalence and severity of vaccine-related side effects. These findings have generalized across many vaccine types and therefore may be relevant to the SARS-CoV-2 vaccine. In this review, we discuss these psychological and behavioral risk factors for poor vaccine responses, their relevance to the COVID-19 pandemic, as well as targeted psychological and behavioral interventions to boost vaccine efficacy and reduce side effects. Recent data suggest these psychological and behavioral risk factors are highly prevalent during the COVID-19 pandemic, but intervention research suggests that psychological and behavioral interventions can increase vaccine efficacy.
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Affiliation(s)
- Annelise A. Madison
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Psychology, The Ohio State University
| | - M. Rosie Shrout
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
| | - Megan E. Renna
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- The Comprehensive Cancer Center, The Ohio State University College of Medicine
| | - Janice K. Kiecolt-Glaser
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine
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657
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Teixeira da Silva D, Biello K, Lin WY, Valente PK, Mayer KH, Hightow-Weidman L, Bauermeister JA. COVID-19 Vaccine Acceptance among an Online Sample of Sexual and Gender Minority Men and Transgender Women. Vaccines (Basel) 2021; 9:204. [PMID: 33804530 PMCID: PMC7999863 DOI: 10.3390/vaccines9030204] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 12/14/2022] Open
Abstract
Sexual and gender minority (SGM) populations are particularly vulnerable to poor COVID-19 outcomes and are more likely to experience stigma and medical mistrust that may impact COVID-19 vaccine acceptance. This study examined the prevalence of COVID testing and diagnosis and assessed COVID-19 vaccine acceptance among a large sample of SGM. Participants were recruited as part of an online cross-sectional study focused on an HIV biomedical prevention technology willingness in the United States at increased risk for HIV sero-conversion. Multivariate linear analysis was conducted to examine COVID-19 vaccine acceptance. The study sample included 1350 predominately gay (61.6%), Black (57.9%), cis-gender (95.7%) males with a mean age of 32.9 years. Medical mistrust and social concern regarding COVID-19 vaccine stigma were significantly associated with decreased COVID-19 vaccine acceptance, and altruism was significantly associated with increased vaccine acceptance. Black participants were significantly less likely to accept a COVID-19 vaccine, and Asian participants were significantly more likely to accept a vaccine, compared to White peers. As the planning of COVID-19 vaccine rollout efforts is conceptualized and designed, these data may inform equitable implementation strategies and prevent worsening health inequities among SGM populations.
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Affiliation(s)
- Daniel Teixeira da Silva
- Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Katie Biello
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI 02912, USA; (K.B.); (P.K.V.)
- Fenway Health, Boston, MA 02215, USA;
| | - Willey Y. Lin
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Pablo K. Valente
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI 02912, USA; (K.B.); (P.K.V.)
| | - Kenneth H. Mayer
- Fenway Health, Boston, MA 02215, USA;
- Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Lisa Hightow-Weidman
- Department of Medicine, School of Medicine, University of North Carolina—Chapel Hill, Chapel Hill, NC 27517, USA;
| | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA;
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658
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Finney Rutten LJ, Zhu X, Leppin AL, Ridgeway JL, Swift MD, Griffin JM, St Sauver JL, Virk A, Jacobson RM. Evidence-Based Strategies for Clinical Organizations to Address COVID-19 Vaccine Hesitancy. Mayo Clin Proc 2021; 96:699-707. [PMID: 33673921 PMCID: PMC7772995 DOI: 10.1016/j.mayocp.2020.12.024] [Citation(s) in RCA: 177] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/28/2020] [Indexed: 12/24/2022]
Abstract
The success of vaccination programs is contingent upon irrefutable scientific safety data combined with high rates of public acceptance and population coverage. Vaccine hesitancy, characterized by lack of confidence in vaccination and/or complacency about vaccination that may lead to delay or refusal of vaccination despite the availability of services, threatens to undermine the success of coronavirus disease 2019 (COVID-19) vaccination programs. The rapid pace of vaccine development, misinformation in popular and social media, the polarized sociopolitical environment, and the inherent complexities of large-scale vaccination efforts may undermine vaccination confidence and increase complacency about COVID-19 vaccination. Although the experience of recent lethal surges of COVID-19 infections has underscored the value of COVID-19 vaccines, ensuring population uptake of COVID-19 vaccination will require application of multilevel, evidence-based strategies to influence behavior change and address vaccine hesitancy. Recent survey research evaluating public attitudes in the United States toward the COVID-19 vaccine reveals substantial vaccine hesitancy. Building upon efforts at the policy and community level to ensure population access to COVID-19 vaccination, a strong health care system response is critical to address vaccine hesitancy. Drawing on the evidence base in social, behavioral, communication, and implementation science, we review, summarize, and encourage use of interpersonal, individual-level, and organizational interventions within clinical organizations to address this critical gap and improve population adoption of COVID-19 vaccination.
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Affiliation(s)
- Lila J Finney Rutten
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Xuan Zhu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Aaron L Leppin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Jennifer L Ridgeway
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Melanie D Swift
- Department of Health Sciences Research, Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Jennifer L St Sauver
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Epidemiology, Mayo Clinic, Rochester, MN
| | - Abinash Virk
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN
| | - Robert M Jacobson
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN; Department of Medicine, and Division of Community Pediatric and Adolescent Medicine and Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
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659
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Nguyen LH, Joshi AD, Drew DA, Merino J, Ma W, Lo CH, Kwon S, Wang K, Graham MS, Polidori L, Menni C, Sudre CH, Anyane-Yeboa A, Astley CM, Warner ET, Hu CY, Selvachandran S, Davies R, Nash D, Franks PW, Wolf J, Ourselin S, Steves CJ, Spector TD, Chan AT. Racial and ethnic differences in COVID-19 vaccine hesitancy and uptake. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.02.25.21252402. [PMID: 33655271 PMCID: PMC7924296 DOI: 10.1101/2021.02.25.21252402] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Racial and ethnic minorities have been disproportionately impacted by COVID-19. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy and limited access may result in disparities in uptake. METHODS We performed a cohort study among U.S. and U.K. participants in the smartphone-based COVID Symptom Study (March 24, 2020-February 16, 2021). We used logistic regression to estimate odds ratios (ORs) of COVID-19 vaccine hesitancy (unsure/not willing) and receipt. RESULTS In the U.S. ( n =87,388), compared to White non-Hispanic participants, the multivariable ORs of vaccine hesitancy were 3.15 (95% CI: 2.86 to 3.47) for Black participants, 1.42 (1.28 to 1.58) for Hispanic participants, 1.34 (1.18 to 1.52) for Asian participants, and 2.02 (1.70 to 2.39) for participants reporting more than one race/other. In the U.K. ( n =1,254,294), racial and ethnic minorities had similarly elevated hesitancy: compared to White participants, their corresponding ORs were 2.84 (95% CI: 2.69 to 2.99) for Black participants, 1.66 (1.57 to 1.76) for South Asian participants, 1.84 (1.70 to 1.98) for Middle East/East Asian participants, and 1.48 (1.39 to 1.57) for participants reporting more than one race/other. Among U.S. participants, the OR of vaccine receipt was 0.71 (0.64 to 0.79) for Black participants, a disparity that persisted among individuals who specifically endorsed a willingness to obtain a vaccine. In contrast, disparities in uptake were not observed in the U.K. CONCLUSIONS COVID-19 vaccine hesitancy was greater among racial and ethnic minorities, and Black participants living in the U.S. were less likely to receive a vaccine than White participants. Lower uptake among Black participants in the U.S. during the initial vaccine rollout is attributable to both hesitancy and disparities in access.
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Affiliation(s)
- Long H. Nguyen
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amit D. Joshi
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David A. Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jordi Merino
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard. Cambridge, MA, USA
| | - Wenjie Ma
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Chun-Han Lo
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sohee Kwon
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kai Wang
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mark S. Graham
- School of Biomedical Engineering & Imaging Sciences, King’s College London. London, U.K
| | | | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, U.K
| | - Carole H. Sudre
- School of Biomedical Engineering & Imaging Sciences, King’s College London. London, U.K
| | - Adjoa Anyane-Yeboa
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Christina M. Astley
- Broad Institute of MIT and Harvard. Cambridge, MA, USA
- Computational Epidemiology Lab and Division of Endocrinology, Boston Children’s Hospital and Harvard Medical School. Boston, MA, USA
| | - Erica T. Warner
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | | | - Denis Nash
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Paul W. Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King’s College London. London, U.K
| | - Claire J. Steves
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, U.K
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, U.K
| | - Andrew T. Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health. Boston, MA, USA
- Massachusetts Consortium on Pathogen Readiness, Cambridge, MA, USA
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660
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Doherty IA, Pilkington W, Brown L, Billings V, Hoffler U, Paulin L, Kimbro KS, Baker B, Zhang T, Locklear T, Robinson S, Kumar D. COVID-19 Vaccine Hesitancy in Underserved Communities of North Carolina. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33655265 DOI: 10.1101/2021.02.21.21252163] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background In the United States, underserved communities including Blacks and Latinx are disproportionately affected by COVID-19, and widespread vaccination is critical for curbing this pandemic. This study sought to estimate the prevalence of COVID-19 vaccine hesitancy, describe attitudes related to vaccination, and identify correlates among racial minority and marginalized populations across 9 counties in North Carolina. Methods We conducted a cross-sectional survey with a self-administered questionnaire distributed at free COVID-19 testing events in underserved rural and urban communities from August 27 - December 15, 2020. Vaccine hesitancy was defined as the response of "no" or "don't know/not sure" to whether the participant would get the COVID-19 vaccine as soon as it became available. Results The sample comprised 948 participants including 27.7% Whites, 59.6% Blacks, 12.7% Latinx, and 63% female. Thirty-two percent earned <$20K annually, 60% owned a computer and ∼80% had internet access at home. The prevalence of vaccine hesitancy was 68.9% including 62.7%, 74%, and 59.5% among Whites, Blacks, and Latinx, respectively. Between September and December, the largest decline in vaccine hesitancy occurred among Whites (27.5 percentage points), followed by Latinx (17.6) and the smallest decline was among Black respondents (12.0). 51.2% of the respondents reported vaccine safety concerns, 23.7% wanted others to get of the respondents reported they would trust health care providers with information about the COVID-19 vaccine. Factors associated with hesitancy in multivariable logistic regression included being female (OR=1.90 95%CI[1.36, 2.64]), being Black (OR=1.68 [1.106 2.45]), calendar month (OR=0.76 [0.63, 0.92]), safety concerns (OR=4.28 [3.06, 5.97]), and government distrust (OR=3.57 [2.26, 5.63]). Conclusions This study reached underserved minority populations in a number of different locations to investigate COVID-19 vaccine hesitancy. We built on existing relationships and further engaged the community, stake holders and health department to provide free COVID-19 testing. This direct approach permitted assessment of vaccine hesitancy (which was much higher than national estimates), distrust, and safety concerns. Highlights This study surveyed 948 adults at COVID-19 testing sites in 9 counties of North Carolina between August 27 and December 15, 2020 where vaccine hesitancy was widespread including 74% in Blacks, 62.7% in Whites and 59.5% in Latinx.Vaccine hesitancy declined over time but remained high for Blacks.On-site surveys conducted in underserved areas that were paper-based and self-administered permitted reaching adults with no internet (17%), no cell phone (20%), no computer (40%) and yearly incomes less than 20K (31%).Widespread vaccine hesitancy in predominately minority communities of NC must be addressed to successfully implement mass COVID-19 vaccination programs.
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Gan L, Chen Y, Hu P, Wu D, Zhu Y, Tan J, Li Y, Zhang D. Willingness to Receive SARS-CoV-2 Vaccination and Associated Factors among Chinese Adults: A Cross Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1993. [PMID: 33670821 PMCID: PMC7922368 DOI: 10.3390/ijerph18041993] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/13/2022]
Abstract
Vaccination is a key strategy to prevent the pandemic caused by the coronavirus disease 2019 (COVID-19). This study aims to investigate the willingness of Chinese adults to be vaccinated against COVID-19 and further explore the factors that may affect their willingness. We used a self-design anonymous questionnaire to conduct an online survey via the Sojump. A total of 1009 valid questionnaires were analyzed. The age of the participants ranged from 18 to 74. Among them, 609 (60.4%, 95%CI: 57.4-63.4%) were willing to receive the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Logistic regression analysis results showed that the age of 30-49 (OR = 2.042, 95%CI: 1.098-3.799), universities and colleges education (OR = 1.873, 95% CI = 1.016-3.451), master degree or above education (OR = 1.885, 95%CI = 1.367-2.599), previous influenza vaccination history (OR = 2.176, 95%CI: 1.474-3.211), trust in the effectiveness of the vaccine (OR = 6.419, 95%CI: 3.717-11.086), and close attention to the latest news of the vaccine (OR = 1.601, 95%CI: 1.046-2.449) were facilitative factors that affected their willingness to be vaccinated. More than half of the adults in China would be willing to receive a SARS-CoV-2 vaccine. Middle-aged people with higher education, those who had been vaccinated against influenza, and those who believed that COVID-19 vaccine was effective and paid close attention to it were more willing to be vaccinated. Our findings can provide reference for the implementation of vaccination and the prevention of COVID-19 in China. More studies are needed after the vaccine is launched.
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Affiliation(s)
- Lin Gan
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
| | - Yan Chen
- Medical College, Shaoguan University, Shaoguan 512000, Guangdong, China;
| | - Peipei Hu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
| | - Dawei Wu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
| | - Yajuan Zhu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
| | - Jinlin Tan
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
| | - Yufen Li
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
| | - Dingmei Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; (L.G.); (P.H.); (D.W.); (Y.Z.); (J.T.); (Y.L.)
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Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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663
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Sallam M. COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines (Basel) 2021; 9:160. [PMID: 33669441 PMCID: PMC7920465 DOI: 10.3390/vaccines9020160] [Citation(s) in RCA: 1032] [Impact Index Per Article: 344.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 12/29/2022] Open
Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan; ; Tel.: +962-79-184-5186
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
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Kuter BJ, Browne S, Momplaisir FM, Feemster KA, Shen AK, Green-McKenzie J, Faig W, Offit PA. Perspectives on the receipt of a COVID-19 vaccine: A survey of employees in two large hospitals in Philadelphia. Vaccine 2021; 39:1693-1700. [PMID: 33632563 PMCID: PMC7885691 DOI: 10.1016/j.vaccine.2021.02.029] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 12/18/2022]
Abstract
Background Health care personnel have been identified by the ACIP as a priority group for COVID-19 vaccination. We conducted a survey in November-December 2020 at two large, academic hospitals in Philadelphia to evaluate the intention of hospital employees to be vaccinated. Methods The survey was sent electronically to all employees (clinical and nonclinical staff) at a children’s hospital and an adult hospital. The survey was voluntary and confidential. Questions focused on plans to receive a COVID-19 vaccine when available, reasons why employees would/would not get vaccinated, when employees planned to be vaccinated, vaccine safety and efficacy features that would be acceptable, and past history of receipt of other vaccines by the employee and family. Responses were analyzed using univariate and multiple logistic regression methods. Results A total of 12,034 hospital employees completed the survey (a 34.5% response rate). Overall, 63.7% of employees reported that they planned to receive a COVID-19 vaccine, 26.3% were unsure, and 10.0% did not plan to be vaccinated. Over 80% of those unsure or unwilling to be vaccinated expressed concerns about vaccine side effects and the vaccines’ newness. In multivariable logistic regression, persons planning to take a COVID-19 vaccine were more likely to be older, male, more educated, Asian or White, up-to-date on vaccinations, without direct patient contact, and tested for COVID-19 in the past. No significant difference in intention to be vaccinated was found between those with higher versus lower levels of exposure to COVID-19 patients or the number of previous exposures to patients with COVID-19. Conclusions While the majority of hospital employees are planning to receive a COVID-19 vaccine, many are unsure or not planning to do so. Further education of hospital employees about the safety, efficacy, and value of the currently available COVID-19 vaccines is critical to vaccine acceptance in this population.
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Affiliation(s)
- Barbara J Kuter
- Vaccine Education Center, Children's Hospital of Philadelphia, United States.
| | - Safa Browne
- Vaccine Education Center, Children's Hospital of Philadelphia, United States
| | | | - Kristen A Feemster
- Vaccine Education Center, Children's Hospital of Philadelphia, United States
| | - Angela K Shen
- Vaccine Education Center, Children's Hospital of Philadelphia, United States
| | | | - Walter Faig
- Children's Hospital of Philadelphia, United States
| | - Paul A Offit
- Vaccine Education Center, Children's Hospital of Philadelphia, United States
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665
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Zhang Y, Fisk RJ. Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States. ACTA ACUST UNITED AC 2021; 5:51-55. [PMID: 33585053 PMCID: PMC7871809 DOI: 10.1016/j.glohj.2021.02.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/05/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Abstract
To date, the United States (U.S.) has been the most heavily impacted country by the coronavirus disease 2019 (COVID-19). By November 30, 2020, when this paper was written, 13.5 million cases were reported in the U.S. with over 268 000 deaths. Historically, vaccines have been one of the most effective and efficient technical tools for controlling a communicable disease. While the development of these vaccines has certainly been a challenge, it could be more challenging to achieve robust vaccine uptake because of many barriers. In this review, we focused on two types of barriers documented from long-term experience in the U.S.: structural and attitudinal. Structural barriers are systemic issues that impact one's ability to access a service, and they include time, transportation, cost, and clinic or outlet location; while attitudinal barriers are beliefs or perceptions that impact the willingness of at-risk individuals to seek out and/or accept a service. In the context of vaccination they include beliefs about the communicable disease, beliefs about vaccines, fear, and trust in healthcare and governmental agencies. Of the attitudinal barriers, public trust is a barrier that is of particular importance. In addition to affecting reception of vaccines, it may exacerbate disparities and reduce the likelihood of success of a vaccination program. Recommendations are made to overcome attitudinal barriers to help improve the effectiveness of vaccination programs for COVID-19 control in the U.S., such as building public support through bipartisan endorsements and leveraging social media platforms to promote vaccination.
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Affiliation(s)
| | - Rebecca J Fisk
- Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA
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666
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Robinson E, Jones A, Lesser I, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. Vaccine 2021; 39:2024-2034. [PMID: 33722411 PMCID: PMC7867398 DOI: 10.1016/j.vaccine.2021.02.005] [Citation(s) in RCA: 312] [Impact Index Per Article: 104.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/18/2022]
Abstract
Background Widespread uptake of COVID-19 vaccines will be essential to controlling the COVID-19 pandemic. Vaccines have been developed in unprecedented time and quantifying levels of hesitancy towards vaccination among the general population is of importance. Methods Systematic review and meta-analysis of studies using large nationally representative samples (n ≥ 1000) to examine the percentage of the population intending to vaccinate, unsure, or intending to refuse a COVID-19 vaccine when available. Generic inverse meta-analysis and meta-regression were used to pool estimates and examine time trends. PubMed, Scopus and pre-printer servers were searched from January-November 2020. Registered on PROSPERO (CRD42020223132). Findings Twenty-eight nationally representative samples (n = 58,656) from 13 countries indicate that as the pandemic has progressed, the percentage of people intending to vaccinate decreased and the percentage of people intending to refuse vaccination increased. Pooled data from surveys conducted during June-October suggest that 60% (95% CI: 49% to 69%) intend to vaccinate and 20% (95% CI: 13% to 29%) intend to refuse vaccination, although intentions vary substantially between samples and countries (I2 > 90%). Being female, younger, of lower income or education level and belonging to an ethnic minority group were consistently associated with being less likely to intend to vaccinate. Findings were consistent across higher vs. lower quality studies. Interpretation Intentions to be vaccinated when a COVID-19 vaccine becomes available have been declining across countries and there is an urgent need to address social inequalities in vaccine hesitancy and promote widespread uptake of vaccines as they become available. Funding N/A.
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Affiliation(s)
- Eric Robinson
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool L69 7ZA, UK.
| | - Andrew Jones
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool L69 7ZA, UK
| | - India Lesser
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool L69 7ZA, UK
| | - Michael Daly
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
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667
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Burger AE, Reither EN, Mamelund SE, Lim S. Black-white disparities in 2009 H1N1 vaccination among adults in the United States: A cautionary tale for the COVID-19 pandemic. Vaccine 2021; 39:943-951. [PMID: 33454136 PMCID: PMC7800135 DOI: 10.1016/j.vaccine.2020.12.069] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prior research has highlighted racial and ethnic disparities in H1N1 vaccination in the United States. Our study adds to this literature by utilizing an intersectionality framework to examine the joint influence of race and sex on H1N1 vaccination beliefs and behaviors among non-Hispanic blacks and non-Hispanic whites (hereafter blacks and whites). METHODS Using data from the National H1N1 Flu Survey of U.S. adults, we measured differences in beliefs about the safety and efficacy of the H1N1 vaccine among black women, black men, white women, and white men. We then estimated a series of nested logistic regression models to examine how race/sex vaccination disparities were influenced by health beliefs, socioeconomic status (SES), pre-existing conditions, and healthcare. RESULTS Black respondents were more likely than white respondents to express reservations about the safety and efficacy of the H1N1 vaccine. Consistent with those beliefs, white females reported the highest rate of H1N1 vaccination (28.4%), followed by white males (26.3%), black males (21.6%), and black females (17.5%). Differences in health beliefs, SES, pre-existing conditions, and healthcare explained lower odds of H1N1 vaccination among white men and black men, relative to white women. However, black women experienced 35-45% lower odds of vaccination than white women across all models, highlighting the intersectional nature of these associations. DISCUSSION The 2009 H1N1 influenza pandemic provides a cautionary tale about the distribution of new vaccines across large populations with diverse racial, sex, and socioeconomic characteristics. Despite differences between the H1N1 and COVID-19 pandemics, our study warns that many black Americans will forego COVID-19 vaccines unless swift action is taken to address black-white disparities in access to vital resources. Public health stakeholders can also encourage widespread adoption of COVID-19 vaccines by tailoring health promotion messages for different groups of racial minorities, especially groups like black women who face intersecting disadvantages.
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Affiliation(s)
- Andrew E Burger
- Brigham Young University-Idaho, 525 S 2nd E, Rexburg, ID 83420, United States.
| | - Eric N Reither
- Utah State University, 0730 Old Main Hill, Logan, UT 84322, United States
| | - Svenn-Erik Mamelund
- OsloMet, Centre for Welfare and Labor Research, Stensberggata 26, 0170 Oslo, Norway
| | - Sojung Lim
- Utah State University, 0730 Old Main Hill, Logan, UT 84322, United States
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668
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McGill AR, Kahlil R, Dutta R, Green R, Howell M, Mohapatra S, Mohapatra SS. SARS-CoV-2 Immuno-Pathogenesis and Potential for Diverse Vaccines and Therapies: Opportunities and Challenges. Infect Dis Rep 2021; 13:102-125. [PMID: 33557330 PMCID: PMC7931091 DOI: 10.3390/idr13010013] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel coronavirus that emerged from Wuhan, China in late 2019 causing coronavirus disease-19 (COVID-19). SARS-CoV-2 infection begins by attaching to angiotensin-converting enzyme 2 receptor (ACE2) via the spike glycoprotein, followed by cleavage by TMPRSS2, revealing the viral fusion domain. Other presumptive receptors for SARS-CoV-2 attachment include CD147, neuropilin-1 (NRP1), and Myeloid C-lectin like receptor (CLR), each of which might play a role in the systemic viral spread. The pathology of SARS-CoV-2 infection ranges from asymptomatic to severe acute respiratory distress syndrome, often displaying a cytokine storm syndrome, which can be life-threatening. Despite progress made, the detailed mechanisms underlying SARS-CoV-2 interaction with the host immune system remain unclear and are an area of very active research. The process's key players include viral non-structural proteins and open reading frame products, which have been implicated in immune antagonism. The dysregulation of the innate immune system results in reduced adaptive immune responses characterized by rapidly diminishing antibody titers. Several treatment options for COVID-19 are emerging, with immunotherapies, peptide therapies, and nucleic acid vaccines showing promise. This review discusses the advances in the immunopathology of SARS-CoV-2, vaccines and therapies under investigation to counter the effects of this virus, as well as viral variants.
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Affiliation(s)
- Andrew R. McGill
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Roukiah Kahlil
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Rinku Dutta
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Ryan Green
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Mark Howell
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Subhra Mohapatra
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Shyam S. Mohapatra
- Department of Veterans Affairs, James A. Haley Veterans Hospital, Tampa, FL 33612, USA; (A.R.M.); (R.K.); (R.D.); (R.G.); (M.H.)
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
- Pharmacy Graduate Programs, Taneja College, MDC30, 12908 USF Health Drive, Tampa, FL 33612, USA
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Shekhar R, Sheikh AB, Upadhyay S, Singh M, Kottewar S, Mir H, Barrett E, Pal S. COVID-19 Vaccine Acceptance among Health Care Workers in the United States. Vaccines (Basel) 2021; 9:vaccines9020119. [PMID: 33546165 PMCID: PMC7913135 DOI: 10.3390/vaccines9020119] [Citation(s) in RCA: 325] [Impact Index Per Article: 108.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Acceptance of the COVID-19 vaccine will play a major role in combating the pandemic. Healthcare workers (HCWs) are among the first group to receive vaccination, so it is important to consider their attitudes about COVID-19 vaccination to better address barriers to widespread vaccination acceptance. Methods: We conducted a cross sectional study to assess the attitude of HCWs toward COVID-19 vaccination. Data were collected between 7 October and 9 November 2020. We received 4080 responses out of which 3479 were complete responses and were included in the final analysis. Results: 36% of respondents were willing to take the vaccine as soon as it became available while 56% were not sure or would wait to review more data. Only 8% of HCWs do not plan to get vaccine. Vaccine acceptance increased with increasing age, education, and income level. A smaller percentage of female (31%), Black (19%), Lantinx (30%), and rural (26%) HCWs were willing to take the vaccine as soon as it became available than the overall study population. Direct medical care providers had higher vaccine acceptance (49%). Safety (69%), effectiveness (69%), and speed of development/approval (74%) were noted as the most common concerns regarding COVID-19 vaccination in our survey.
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Affiliation(s)
- Rahul Shekhar
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (R.S.); (S.U.); (E.B.); (S.P.)
| | - Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (R.S.); (S.U.); (E.B.); (S.P.)
- Correspondence:
| | - Shubhra Upadhyay
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (R.S.); (S.U.); (E.B.); (S.P.)
| | - Mriganka Singh
- Department of Medicine, University Hospitals, Case Western Reserve University, Cleveland, OH 44139, USA;
| | - Saket Kottewar
- Department of Medicine, Division of Hospital Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA;
| | - Hamza Mir
- Data Analyst, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA;
| | - Eileen Barrett
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (R.S.); (S.U.); (E.B.); (S.P.)
| | - Suman Pal
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (R.S.); (S.U.); (E.B.); (S.P.)
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670
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Thaker J. The Persistence of Vaccine Hesitancy: COVID-19 Vaccination Intention in New Zealand. JOURNAL OF HEALTH COMMUNICATION 2021; 26:104-111. [PMID: 33719898 DOI: 10.1080/10810730.2021.1899346] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Building public trust and willingness to vaccinate against COVID-19 is as important as developing an effective vaccine. However, a significant minority of the public are unwilling or hesitant to take a COVID-19 vaccine, when available. A nationally representative sample survey (N = 1040) was conducted in July 2020 in New Zealand to identify factors associated with COVID-19 vaccine intention. A 14-item general vaccine hesitancy scale was tested and found to be significantly associated with COVID-19 vaccine intention. A communication campaign from trusted scientific experts, with information that addresses prevailing concerns about vaccines, is likely to help increase COVID-19 vaccine uptake.
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Affiliation(s)
- Jagadish Thaker
- School of Communication, Journalism & Marketing, Massey University, Wellington, New Zealand
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671
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Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Editor's Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. Int J Nurs Stud 2021; 114:103854. [PMID: 33326864 PMCID: PMC7831770 DOI: 10.1016/j.ijnurstu.2020.103854] [Citation(s) in RCA: 394] [Impact Index Per Article: 131.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND A healthy healthcare system requires healthy healthcare workers. Protecting healthcare workers including nurses against COVID-19 is crucial, and vaccination could be a viable future option. However, vaccine hesitancy remains a global challenge. Nurses, as a trustworthy and creditable source of vaccine-related information, may build public confidence in vaccination. Hence, research on vaccine hesitancy among nurses is warranted. OBJECTIVES This study estimated nurses' influenza vaccination behaviors and intention to receive COVID-19 vaccine when available, and examined their corresponding 5C psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility). To investigate the impact of COVID-19-related work demands, the mediation effects of work stress on the association between work demands and COVID-19 vaccination intention were also examined. DESIGN Cross-sectional online survey SETTINGS: Nurses were invited to participate via the promotion of a professional nursing organization and by personal referrals during the COVID-19 outbreak in Hong Kong between mid-March and late April 2020. PARTICIPANTS 1,205 eligible nurses (mean age = 40.79, SD = 10.47; 90% being female) were included in the analyses. METHODS Demographics, influenza vaccination, intention to have COVID-19 vaccine, the 5C vaccine hesitancy components, work stress and COVID-19-related work demands (insufficient supply of personal protective equipment, involvement in isolation rooms, and unfavorable attitudes towards workplace infection control policies) were reported in the survey. RESULTS The influenza vaccine uptake rate and the proportion intending to take COVID-19 vaccine were 49% and 63%, respectively. Influenza vaccination was associated with working in public hospitals and all 5C constructs (more confidence, more collective responsibility and less complacency, constraints, and calculation), whereas stronger COVID-19 vaccination intention was associated with younger age, more confidence, less complacency and more collective responsibility. COVID-19-related demands were associated with greater work stress, and hence stronger COVID-19 vaccination intention. CONCLUSION The potential uptake rate of COVID-19 vaccine among nurses was suboptimal to achieve herd immunity. The 5C constructs were useful in predicting influenza vaccination and, to a lesser extent, the intention to take COVID-19 vaccine. The uncertain attributes such as effectiveness, side effects, and effective duration of the COVID-19 vaccine may contribute to this discrepancy. With less work stress among nurses in the post-pandemic period, the intention to take COVID-19 vaccine will likely drop. The 5C constructs should be infused in vaccination campaigns. While a COVID-19 vaccine could be ready soon, the nursing profession may not be ready to accept it. More research work is needed to boost the uptake rate. TWEETABLE ABSTRACT Less than two-third of nurses intended to take COVID-19 vaccine when available. While a COVID-19 vaccine could be ready soon, nursing profession is not ready to accept it.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
| | - Kin-Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, China
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Arthur Tang
- Department of Software, Sungkyunkwan University, Seoul, South Korea
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shui Shan Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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672
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Seale H, Heywood AE, Leask J, Sheel M, Durrheim DN, Bolsewicz K, Kaur R. Examining Australian public perceptions and behaviors towards a future COVID-19 vaccine. BMC Infect Dis 2021; 21:120. [PMID: 33509104 PMCID: PMC7840792 DOI: 10.1186/s12879-021-05833-1] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/22/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND As immunisation program launches have previously demonstrated, it is essential that careful planning occurs now to ensure the readiness of the public for a COVID-19 vaccine. As part of that process, this study aimed to understand the public perceptions regarding a future COVID-19 vaccine in Australia. METHODS A national cross-sectional online survey of 1420 Australian adults (18 years and older) was undertaken between 18 and 24 March 2020. The statistical analysis of the data included univariate and multivariable logistic regression model analysis. RESULTS Respondents generally held positive views towards vaccination. Eighty percent (n = 1143) agreed with the statement that getting myself vaccinated for COVID-19 would be a good way to protect myself against infection. Females (n = 614, 83%) were more likely to agree with the statement than males (n = 529, 78%) (aOR = 1.4 (95% CI: 1.1-1.8); P = 0.03), while 91% of those aged 70 years and above agreed compared to 76% of 18-29-year-olds (aOR = 2.3 (95% CI:1.2-4.1); P = 0.008). Agreement was also higher for those with a self-reported chronic disease (aOR = 1.4 (95% CI: 1.1-2.0); P = 0.04) and among those who held private health insurance (aOR = 1.7 (95% CI: 1.3-2.3); P < 0.001). Beyond individual perceptions, 78% stated that their decision to vaccinate would be supported by family and friends. CONCLUSION This study presents an early indication of public perceptions towards a future COVID-19 vaccine and represents a starting point for mapping vaccine perceptions. To support an effective launch of these new vaccines, governments need to use this time to understand the communities concerns and to identify the strategies that will support engagement.
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Affiliation(s)
- Holly Seale
- Faculty of Medicine, School of Population Health, University of New South Wales, Level 2, Samuels Building, Sydney, NSW, 2052, Australia.
| | - Anita E Heywood
- Faculty of Medicine, School of Population Health, University of New South Wales, Level 2, Samuels Building, Sydney, NSW, 2052, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton, ACT, Canberra, Australia
| | - David N Durrheim
- School of Medicine and Public Health, University of Newcastle, Wallsend, NSW, Australia
| | - Katarzyna Bolsewicz
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Wallsend, NSW, Australia
| | - Rajneesh Kaur
- Office of Medical Education, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Office of Medical Education, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
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673
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Ehde DM, Roberts MK, Herring TE, Alschuler KN. Willingness to obtain COVID-19 vaccination in adults with multiple sclerosis in the United States. Mult Scler Relat Disord 2021; 49:102788. [PMID: 33508570 PMCID: PMC7825851 DOI: 10.1016/j.msard.2021.102788] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 01/22/2023]
Abstract
Background: As vaccines for the coronavirus become available, it will be important to know the rate of COVID-19 vaccine acceptability in adults with multiple sclerosis (MS), given that vaccination will be a key strategy for preventing SARS-CoV-2 infections. Using a national sample of adults with MS in the United States obtained early in the COVID-19 pandemic, the current study aimed to: (1) assess willingness to get a COVID-19 vaccine when available; (2) determine demographic, MS, and psychosocial correlates of vaccine willingness; and (3) measure where people with MS get their COVID-19 information and their perceived trustworthiness of such sources, which may influence COVID-19 vaccine willingness. Methods: Adults with MS (N = 486) living in the United States completed a cross-sectional online survey (between 10 April 2020 and 06 May 2020) about their willingness to receive a COVID-19 vaccination once available. Participants also completed measures to describe the sample and to assess factors potentially related to vaccine willingness, including demographics, MS-specific variables, psychological measures, COVID-19 information sources, and perceived trustworthiness of their information sources. Results: Approximately two-thirds of the participants (66.0%) reported a willingness to obtain a future COVID-19 vaccine, whereas 15.4%of the sample was unwilling. Greater willingness to receive the vaccine was associated with having a higher level of education and holding a higher perception of one's risk of catching COVID-19. Participants reported accessing COVID-19 information from many different sources. Approximately a third (31.6%) of the sample reported getting their information from healthcare providers. Healthcare providers and the National MS Society had the highest perceived trustworthiness for COVID-19 information. The perceived trustworthiness of information sources was highly associated with vaccine willingness. Conclusion: Early in the pandemic, willingness to get a COVID-19 vaccine was not universal in this large sample or people living with MS. Vaccine willingness was associated with a few variables including education level, perceived risk for COVID-19 infection, and trust in COVID-19 information sources. These results have important implications for guiding healthcare providers and the MS community as COVID-19 vaccines become widely available.
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Affiliation(s)
- Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | - Michelle K Roberts
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Tracy E Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Kevin N Alschuler
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA; Department of Neurology, University of Washington, Seattle, WA, USA
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674
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Attwell K, Lake J, Sneddon J, Gerrans P, Blyth C, Lee J. Converting the maybes: Crucial for a successful COVID-19 vaccination strategy. PLoS One 2021; 16:e0245907. [PMID: 33471821 PMCID: PMC7817004 DOI: 10.1371/journal.pone.0245907] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Broad community acceptance of a COVID-19 vaccination will be critical for effectively halting the spread of the virus. In this study, we focus on factors that differentiate those who are undecided from those who are either willing or unwilling to accept a prospective COVID-19 vaccine. METHODS An online survey in May 2020 assessed Australian adults' willingness to receive a COVID-19 vaccine (yes, maybe, no). A multinomial logistical regression of responses (N = 1,313) was used to identify correlates of vaccine willingness between the three groups. RESULTS 65% were willing to vaccinate, with 27% being in the 'maybe' category. Respondents were more likely to be in the 'maybe' than the 'yes' group when they perceived COVID-19 to be less severe, had less trust in science, were less willing to vaccinate for influenza, and were female. They were more likely to be in the 'maybe' than 'no' group when they perceived COVID-19 as severe, and less likely to be a hoax, had more trust in science, and greater willingness to vaccinate for influenza. A repeat of the survey in November 2020 with a subset of participants found fewer of them saying yes to the vaccine (56%) and more saying maybe (31%). CONCLUSIONS The effectiveness of any COVID-19 vaccine rollout will be reliant on maximizing uptake. The significant number of people who remain undecided about whether or not to get a COVID-19 vaccine, despite the ongoing devastating consequences of the virus for individuals, communities, and economies, is concerning. Our findings aid current research seeking to inform policy regarding how to convince the undecided to vaccinate.
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Affiliation(s)
- Katie Attwell
- School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
| | - Joshua Lake
- Centre for Human and Cultural Values, University of Western Australia, Perth, Western Australia, Australia
| | - Joanne Sneddon
- Centre for Human and Cultural Values, University of Western Australia, Perth, Western Australia, Australia
| | - Paul Gerrans
- Centre for Human and Cultural Values, University of Western Australia, Perth, Western Australia, Australia
| | - Chris Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Department of Paediatric Infectious Diseases, Perth Children’s Hospital, Perth, Western Australia, Australia
- Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Perth, Western Australia, Australia
| | - Julie Lee
- Centre for Human and Cultural Values, University of Western Australia, Perth, Western Australia, Australia
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675
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Li D, Gaynor SM, Quick C, Chen JT, Stephenson BJK, Coull BA, Lin X. Identifying US Counties with High Cumulative COVID-19 Burden and Their Characteristics. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2020.12.02.20234989. [PMID: 33300014 PMCID: PMC7724685 DOI: 10.1101/2020.12.02.20234989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED Identifying areas with high COVID-19 burden and their characteristics can help improve vaccine distribution and uptake, reduce burdens on health care systems, and allow for better allocation of public health intervention resources. Synthesizing data from various government and nonprofit institutions of 3,142 United States (US) counties as of 12/21/2020, we studied county-level characteristics that are associated with cumulative case and death rates using regression analyses. Our results showed counties that are more rural, counties with more White/non-White segregation, and counties with higher percentages of people of color, in poverty, with no high school diploma, and with medical comorbidities such as diabetes and hypertension are associated with higher cumulative COVID-19 case and death rates. We identify the hardest hit counties in US using model-estimated case and death rates, which provide more reliable estimates of cumulative COVID-19 burdens than those using raw observed county-specific rates. Identification of counties with high disease burdens and understanding the characteristics of these counties can help inform policies to improve vaccine distribution, deployment and uptake, prevent overwhelming health care systems, and enhance testing access, personal protection equipment access, and other resource allocation efforts, all of which can help save more lives for vulnerable communities. SIGNIFICANCE STATEMENT We found counties that are more rural, counties with more White/non-White segregation, and counties with higher percentages of people of color, in poverty, with no high school diploma, and with medical comorbidities such as diabetes and hypertension are associated with higher cumulative COVID-19 case and death rates. We also identified individual counties with high cumulative COVID-19 burden. Identification of counties with high disease burdens and understanding the characteristics of these counties can help inform policies to improve vaccine distribution, deployment and uptake, prevent overwhelming health care systems, and enhance testing access, personal protection equipment access, and other resource allocation efforts, all of which can help save more lives for vulnerable communities.
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676
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Trust in a COVID-19 vaccine in the U.S.: A social-ecological perspective. Soc Sci Med 2021; 270:113684. [PMID: 33485008 PMCID: PMC7834519 DOI: 10.1016/j.socscimed.2021.113684] [Citation(s) in RCA: 201] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/27/2020] [Accepted: 01/03/2021] [Indexed: 01/12/2023]
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677
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Srivastava A, Sharma A. Perceptions and beliefs on vaccination for COVID-19 in Delhi: A cross-sectional study. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2021. [DOI: 10.4103/injms.injms_57_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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678
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Alqudeimat Y, Alenezi D, AlHajri B, Alfouzan H, Almokhaizeem Z, Altamimi S, Almansouri W, Alzalzalah S, Ziyab AH. Acceptance of a COVID-19 Vaccine and Its Related Determinants among the General Adult Population in Kuwait. Med Princ Pract 2021; 30:262-271. [PMID: 33486492 PMCID: PMC8089409 DOI: 10.1159/000514636] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/21/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the acceptance of a coronavirus disease 2019 (COVID-19) vaccine among the general adult population in Kuwait and assess its determinants. SUBJECTS AND METHODS A web-based cross-sectional study was conducted by enrolling adults living in Kuwait (n = 2,368; aged ≥21 years). Acceptance of a COVID-19 vaccine was inferred if participants indicated that they "definitely or probably will accept vaccination against COVID-19 once a vaccine is available." Associations were explored by applying a modified Poisson regression to estimate and infer adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI). RESULTS In total, 53.1% (1,257/2,368) of the participants were willing to accept a COVID-19 vaccine once available. Male subjects were more willing to accept a COVID-19 vaccine than females (58.3 vs. 50.9%, p < 0.001). Subjects who viewed vaccines in general to have health-related risks were less willing to accept vaccination (aPR = 0.39, 95% CI: 0.35-0.44). Moreover, participants who previously received an influenza vaccine were more likely to accept a COVID-19 vaccine (aPR = 1.44, 95% CI: 1.31-1.58). Willingness to get vaccinated against COVID-19 increased as the self-perceived chances of contracting the infection increased (p < 0.001). CONCLUSION Overall, 53.1% of the study participants demonstrated willingness to get vaccinated against COVID-19. We found several factors influencing the level of acceptance. Since vaccination appears to be an essential preventive measure that can halt the COVID-19 pandemic, factors relating to low vaccine acceptance need to be urgently addressed by public health strategies.
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Affiliation(s)
- Yosor Alqudeimat
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Deema Alenezi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Bedour AlHajri
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Heba Alfouzan
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Zain Almokhaizeem
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Saba Altamimi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Waleed Almansouri
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Sayed Alzalzalah
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
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679
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Lin C, Tu P, Beitsch LM. Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review. Vaccines (Basel) 2020; 9:16. [PMID: 33396832 PMCID: PMC7823859 DOI: 10.3390/vaccines9010016] [Citation(s) in RCA: 469] [Impact Index Per Article: 117.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 12/31/2022] Open
Abstract
While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing survey design influences and evaluating context to inform policies and practices. Data sources included academic literature (PubMed, Embase, and PsycINFO following PRISMA guidelines), news and official reports published by 20 October 2020. Two researchers independently screened potential peer-reviewed articles and syndicated polls for eligibility; 126 studies and surveys were selected. Declining vaccine acceptance (from >70% in March to <50% in October) with demographic, socioeconomic, and partisan divides was observed. Perceived risk, concerns over vaccine safety and effectiveness, doctors' recommendations, and inoculation history were common factors. Impacts of regional infection rates, gender, and personal COVID-19 experience were inconclusive. Unique COVID-19 factors included political party orientation, doubts toward expedited development/approval process, and perceived political interference. Many receptive participants preferred to wait until others have taken the vaccine; mandates could increase resistance. Survey wording and answer options showed influence on responses. To achieve herd immunity, communication campaigns are immediately needed, focusing on transparency and restoring trust in health authorities.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, 2204 Erwin Rd, Durham, NC 27705, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, 2204 Erwin Rd, Durham, NC 27705, USA;
| | - Leslie M. Beitsch
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 W. Call St, Tallahassee, FL 32306, USA;
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680
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Szilagyi PG, Thomas K, Shah MD, Vizueta N, Cui Y, Vangala S, Kapteyn A. National Trends in the US Public's Likelihood of Getting a COVID-19 Vaccine-April 1 to December 8, 2020. JAMA 2020; 325:2774711. [PMID: 33372943 PMCID: PMC7772743 DOI: 10.1001/jama.2020.26419] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/21/2020] [Indexed: 01/01/2023]
Affiliation(s)
| | - Kyla Thomas
- Dornsife College of Letters Arts and Sciences Center for Economic and Social Research, University of Southern California, Los Angeles
| | - Megha D. Shah
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology, Los Angeles, California
| | | | - Yan Cui
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology, Los Angeles, California
| | - Sitaram Vangala
- Department of Medicine Statistics Core, University of California, Los Angeles
| | - Arie Kapteyn
- Dornsife College of Letters Arts and Sciences Center for Economic and Social Research, University of Southern California, Los Angeles
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681
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Lucia VC, Kelekar A, Afonso NM. COVID-19 vaccine hesitancy among medical students. J Public Health (Oxf) 2020; 43:445-449. [PMID: 33367857 PMCID: PMC7799040 DOI: 10.1093/pubmed/fdaa230] [Citation(s) in RCA: 292] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Medical students are among the group of frontline healthcare providers likely to be exposed to COVID-19 patients. It is important to achieve high COVID-19 vaccination coverage rates in this group as soon as a vaccine is available. As future healthcare providers, they will be entrusted with providing vaccine recommendations and counseling vaccine-hesitant patients. METHODS This project used self-report to assess vaccine hesitancy and acceptance among medical students towards the novel COVID-19 vaccine. RESULTS Nearly all participants had positive attitudes towards vaccines and agreed they would likely be exposed to COVID-19; however, only 53% indicated they would participate in a COVID-19 vaccine trial and 23% were unwilling to take a COVID-19 vaccine immediately upon FDA approval. Students willing to immediately take the vaccine were more likely to trust public health experts, have fewer concerns about side effects and agree with vaccine mandates (P < 0.05). Concern for serious side effects was independently predictive of lower odds of intent to participate in a COVID-19 vaccine trial (AOR = 0.41, P = 0.01). CONCLUSION This is the first study to evaluate COVID-19 vaccine hesitancy among US medical students and highlights the need for an educational curriculum about the safety and effectiveness to promote uptake of the COVID-19 vaccine.
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Affiliation(s)
- Victoria C Lucia
- Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Arati Kelekar
- Internal Medicine, Beaumont Health, Royal Oak, MI 48073, USA and Oakland University William Beaumont School of Medicine, Rochester, MI 49309, USA
| | - Nelia M Afonso
- Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
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682
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Affiliation(s)
- Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
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683
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Qiao S, Tam CC, Li X. Risk exposures, risk perceptions, negative attitudes toward general vaccination, and COVID-19 vaccine acceptance among college students in South Carolina. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 33269360 DOI: 10.1101/2020.11.26.20239483] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Growing attention has been paid to vaccination in control of the COVID-19 pandemic and young adults is one of the key populations for vaccination. Advanced understanding of young adults' willingness to take a COVID-19 vaccine and the potential factors influencing their vaccine intention will contribute to the development and implementation of effective strategies to promote COVID-19 vaccine uptake among this group. The current study investigated how risk exposures and risk perceptions of COVID-19 (e.g., perceived susceptibility, severity, and fear of COVID-19) as well as negative attitudes toward general vaccination were related to COVID vaccine acceptance among college students based on online survey data from 1062 college students in South Carolina . Hierarchical linear regression was used to examine the association of these factors with COVID-19 vaccine acceptance controlling for key demographics. Results suggested that perceived severity and fear of COVID-19 were positively associated with vaccine acceptance, while higher level of risk exposures (work/study place exposure) and negative attitude toward general vaccination were associated with low vaccine acceptance. Our findings suggested that we need tailored education messages for college students to emphasize the severity of COVID-19, particularly potential long-term negative consequences on health, address the concerns of side effects of general vaccines by dispelling the misconception, and target the most vulnerable subgroups who reported high level of risk exposures while showed low intention to take the vaccine. Efforts are warranted to increase college students' perceived susceptibility and severity and promote their self-efficacy in health management and encourage them to take protective behaviors including vaccine uptake.
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684
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Daly M, Robinson E. Willingness to vaccinate against COVID-19 in the US: Longitudinal evidence from a nationally representative sample of adults from April-October 2020. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.27.20239970. [PMID: 33269354 PMCID: PMC7709168 DOI: 10.1101/2020.11.27.20239970] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction Vaccines against COVID-19 have been developed in unprecedented time. However, the effectiveness of any vaccine is dictated by the proportion of the population willing to be vaccinated. In this observational population-based study we examined intentions to be vaccinated against COVID-19 over the course of the pandemic. Methods We analyzed longitudinal data from a nationally representative sample of 7,547 US adults enrolled in the Understanding America Study (UAS). Participants reporting being willing, undecided and unwilling to get vaccinated against coronavirus across 13 assessments conducted from April-October, 2020. Public attitudes to vaccination against the coronavirus were also assessed. Results Willingness to vaccinate declined from 71% in April to 53.6% in October. This was explained by an increase in the percentage of participants undecided about vaccinating (from 10.5% to 14.4%) and the portion of the sample unwilling to vaccinate (from 18.5% to 32%). The population subgroups most likely to be undecided/unwilling to vaccinate were those without a degree (undecided: RRR=2.47, 95% CI: 2.04-3.00; unwilling: RRR=1.92, 95% CI: 1.67-2.20), Black participants (undecided: RRR=2.18, 95% CI: 1.73-2.74; unwilling: RRR=1.98, 95% CI: 1.63-2.42), and females (undecided: RRR=1.41, 95% CI: 1.20-1.65; unwilling: RRR=1.29, 95% CI: 1.14-1.46). Those aged 65+, those on high incomes, and other race/ethnicity participants were least likely to be undecided or unwilling to vaccinate. Concerns about potential side effects of a vaccine were common. Conclusions Intentions to be vaccinated against coronavirus have declined rapidly during the pandemic and close to half of Americans are undecided or unwilling to be vaccinated.
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Affiliation(s)
- Michael Daly
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Eric Robinson
- Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
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Human Vaccines & Immunotherapeutics: news. Hum Vaccin Immunother 2020; 16:2580-2581. [DOI: 10.1080/21645515.2020.1851114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Head KJ, Kasting ML, Sturm LA, Hartsock JA, Zimet GD. A National Survey Assessing SARS-CoV-2 Vaccination Intentions: Implications for Future Public Health Communication Efforts. SCIENCE COMMUNICATION 2020; 42:698-723. [PMID: 38602991 PMCID: PMC7520657 DOI: 10.1177/1075547020960463] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
With SARS-CoV-2 vaccines under development, research is needed to assess intention to vaccinate. We conducted a survey (N = 3,159) with U.S. adults in May 2020 assessing SARS-CoV-2 vaccine intentions, intentions with a provider recommendation, and sociodemographic and psychosocial variables. Participants had high SARS-CoV-2 vaccine intentions (M = 5.23/7-point scale), which increased significantly with a provider recommendation (M = 5.47). Hierarchical linear regression showed that less education and working in health care were associated with lower intent, and liberal political views, altruism, and COVID-19-related health beliefs were associated with higher intent. This work can inform interventions to increase vaccine uptake, ultimately reducing COVID-19-related morbidity and mortality.
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Affiliation(s)
- Katharine J Head
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | - Lynne A Sturm
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jane A Hartsock
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Gregory D Zimet
- Indiana University School of Medicine, Indianapolis, IN, USA
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