When a COVID-19 vaccine is ready, will we all be ready for it?

A mental health survey among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China

BACKGROUND

The sporadic coronavirus disease (COVID-19) epidemic has placed enormous psychological stress on people, especially clinicians. The objective of this study was to examine depression, anxiety, quality of life (QOL), and related social psychological factors among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China and to provide a reference for formulating reasonable countermeasures.

METHODS

In this cross-sectional study, demographic information, COVID-19-related questions, anxiety (Generalized Anxiety Disorder-7, GAD-7), depression (Patient Health Questionnaire-9, PHQ-9), insomnia (Insomnia Severity Index, ISI), stress (Perceived Stress Scale-10, PSS-10), and QOL (World Health Organization Quality of Life-brief version, WHOQOL-BREF) were collected. Binary logistic regression analysis was used to test the relationships between anxiety and/or depression and other related problems. Multiple linear regression analysis was used to test the relationships among factors influencing QOL.

RESULTS

A total of 146 young front-line clinicians were included. The prevalence rates of depression, anxiety, and anxiety-depression comorbidity were 37.7% (95% CI = 29.7-45.6%), 26.0% (95% CI = 18.8-33.2%), and 24.0% (95% CI = 17.0-31.0%), respectively. Severe stress (OR = 1.258, 95% CI = 1.098-1.442, P < 0.01) and insomnia (OR = 1.282, 95% CI = 1.135-1.447, P < 0.01) were positively correlated with depression. Severe stress (OR = 1.487, 95% CI = 1.213-1.823, P < 0.01) and insomnia (OR = 1.131, 95% CI = 1.003-1.274, P < 0.05) were positively correlated with anxiety. Severe stress (OR = 1.532, 95% CI = 1.228-1.912, P < 0.01) was positively correlated with anxiety-depression comorbidity. However, insomnia (OR = 1.081, 95% CI = 0.963-1.214, P > 0.05) was not correlated with anxiety-depression comorbidity. The belief that the vaccine will stop the COVID-19 pandemic (OR = 0.099, 95% CI = 0.014-0.715, P < 0.05) was negatively correlated with anxiety and anxiety-depression comorbidity (OR = 0.101, 95% CI = 0.014-0.744, P < 0.05). Severe stress (B = -0.068, 95% CI = -0.129 to -0.007, P < 0.05) and insomnia (B = -0.127, 95% CI = -0.188 to -0.067, P < 0.01) were negatively correlated with QOL. The belief that the vaccine could provide protection (B = 1.442, 95% CI = 0.253-2.631, P < 0.05) was positively correlated with QOL.

CONCLUSIONS

The prevalence of depression, anxiety, and even anxiety-depression comorbidity was high among young front-line clinicians in high-risk areas during the COVID-19 sporadic epidemic in China. Various biological and psychological factors as well as COVID-19-related factors were associated with mental health issues and QOL. Psychological intervention should evaluate these related factors and formulate measures for these high-risk groups.

Changes in Vaccine Hesitancy in Japan across Five Months during the COVID-19 Pandemic and Its Related Factors

Although vaccination is a particularly important countermeasure against the coronavirus disease 2019 (COVID-19), vaccine hesitancy may be a barrier to an effective vaccination program. It is understood that attitude towards vaccines is not a simple binominal decision between hesitancy and acceptance, but a continuum with a wide range of related factors. It is also likely to change depending on the present situation. Therefore, this study aimed to examine changes in vaccination attitudes across a five-month period during the COVID-19 pandemic and the factors associated with these changes. We conducted a web-based survey with 1000 participants in Japan in September 2021 and examined the relationship between attitudes regarding vaccination and sociodemographic, behavioral, and psychological variables. In addition, we also retrospectively asked for vaccination attitudes as of April 2021. Over the course of five months, we found that vaccine acceptance rates increased from 40.6% to 85.5%. Health-related behaviors such as regular influenza vaccination and medical checkups were consistently associated with vaccine acceptance. Moreover, psychological variables, such as anxiety and risk perception, were associated with changes in vaccination attitudes. As these attitudes can vary depending on time and circumstances, continuous interdisciplinary efforts are required to ensure effective vaccine programs.

Influence of rapid COVID-19 vaccine development on vaccine hesitancy

Introduction

In the race to deploy vaccines to prevent COVID-19, there is a need to understand factors influencing vaccine hesitancy. Secondary risk theory is a useful framework to explain this, accounting for concerns about vaccine efficacy and safety.

Methods

During the first week of July, 2020, participants (N = 216) evaluated one of three different hypothetical vaccine scenarios describing an FDA-approved vaccine becoming available “next week,” “in one year,” or “in two years.” Dependent variables were perceived vaccine efficacy, self-efficacy, perceived vaccine risk, and vaccination willingness. Covariates included vaccine conspiracy beliefs, science pessimism, media dependency, and perceived COVID-19 risk. Data analysis employed multiple analysis of covariance (MANCOVA).

Results

Perceived vaccine efficacy was lowest for the next-week vaccine (η²_p = .045). Self-efficacy was higher for the two-year vaccine than the next-week vaccine (η²_p = .029). Perceived vaccine risk was higher for the next-week vaccine than for the one-year vaccine (η²_p = .032). Vaccination willingness did not differ among experimental treatments. In addition, vaccine conspiracy beliefs were negatively related to perceived vaccine efficacy (η²_p = .142), self-efficacy (η²_p = .031), and vaccination willingness (η²_p = .143) and positively related to perceived vaccine risk (η²_p = .216).

Conclusions

The rapid development of the COVID-19 vaccine may have heightened public concerns over efficacy, availability, and safety. However, the current findings showed a general willingness to take even the most rapidly developed vaccine. Nonetheless, there remains a need to communicate publicly and transparently about vaccine efficacy and safety and work to reduce vaccine conspiracy beliefs.

Willingness, beliefs, and barriers regarding the COVID-19 vaccine in Saudi Arabia: a multiregional cross-sectional study

Background

The coronavirus disease 2019 (COVID-19) has spread worldwide, and the vaccine remains the ultimate cornerstone to overcoming its long-term impact. Vaccine hesitancy might obstruct the effort to achieve herd immunity and eradicate the virus. We assessed Saudi Arabian individuals’ willingness, beliefs, and barriers regarding the COVID-19 vaccine and their adherence to preventive measures during and after the pandemic.

Methods

A self-administered electronic validated questionnaire was distributed among the five major regions in Saudi Arabia between November and December 2020. The questionnaire addressed the sociodemographic data, beliefs, potential barriers, parents’ acceptance of COVID-19 vaccination for their children, and adherence to protective measures during and after the pandemic.

Results

Of 8,056 participants, 4,218 (52.4%) of a non-representative sample were willing to be vaccinated against COVID-19. Being a young adult, male, having less than a high school degree, being a smoker, having a chronic disease, and having a history of seasonal influenza vaccine uptake were positive predictors of COVID-19 vaccine acceptance. Hesitant participants reported concerns about vaccine side effects and safety as the main barriers to accepting the COVID-19 vaccine. Some refusers (26.1%) declared that they would reconsider vaccination only if the safety and effectiveness of the vaccine were reported by more studies.

Conclusions

Our study revealed a promising willingness to accept the vaccine among the population, with positive beliefs and attitudes toward COVID-19 vaccination. However, a considerable proportion of the population was reluctant to accept the vaccine. Thus, publicly providing information about vaccine safety and implementing health education programs is crucial for increasing the public’s confidence in the vaccine.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12875-021-01606-6.

"Please, you go first!" preferences for a COVID-19 vaccine among adults in the Netherlands

Background

Vaccination is generally considered the most direct way to restoring normal life after the outbreak of COVID-19, but the available COVID-19 vaccines are simultaneously embraced and dismissed. Mapping factors for vaccine hesitancy may help the roll-out of COVID-19 vaccines and provide valuable insights for future pandemics.

Objectives

We investigate how characteristics of a COVID-19 vaccine affect the preferences of adult citizens in the Netherlands to take the vaccine directly, to refuse it outright, or to wait a few months and first look at the experiences of others.

Methods

An online sample of 895 respondents participated between November 4th and November 10th, 2020 in a discrete choice experiment including the attributes: percentage of vaccinated individuals protected against COVID-19, month in which the vaccine would become available and the number of cases of mild and severe side effects. The data was analysed by means of panel mixed logit models.

Results

Respondents found it important that a safe and effective COVID-19 vaccine becomes available as soon as possible. However, the majority did not want to be the first in line and would rather wait for the experiences of others. The predicted uptake of a vaccine with the optimal combination of attributes was 87%, of whom 55% preferred to take the vaccine after a waiting period. This latter group tends to be lower-educated. Older respondents gave more weight to vaccine effectiveness than younger respondents.

Conclusions

The willingness to take a COVID-19 vaccine is high among adults in the Netherlands, but a considerable proportion prefers to delay their decision to vaccinate until experiences of others are known. Offering this wait-and-see group the opportunity to accept the invitation at a later moment may stimulate vaccination uptake. Our results further suggest that vaccination campaigns targeted at older citizens should focus on the effectiveness of the vaccine.

The coronavirus disease 2019 (COVID-19) vaccination psychological antecedent assessment using the Arabic 5c validated tool: An online survey in 13 Arab countries

BACKGROUND

Following the emergency approval of the coronavirus disease 2019 (COVID-19) vaccines, research into its vaccination hesitancy saw a substantial increase. However, the psychological behaviors associated with this hesitancy are still not completely understood. This study assessed the psychological antecedents associated with COVID-19 vaccination in the Arab population.

METHODOLOGY

The validated Arabic version of the 5C questionnaire was distributed online across various social media platforms in Arabic-speaking countries. The questionnaire had three sections, namely, socio-demographics, COVID-19 related infection and vaccination, and the 5C scale of vaccine psychological antecedents of confidence, complacency, constraints, calculation, and collective responsibility.

RESULTS

In total, 4,474 participants with a mean age of 32.48 ± 10.76 from 13 Arab countries made up the final sample, 40.8% of whom were male. Around 26.7% of the participants were found to be confident about the COVID-19 vaccination, 10.7% indicated complacency, 96.5% indicated they had no constraints, 48.8% had a preference for calculation and 40.4% indicated they had collective responsibility. The 5C antecedents varied across the studied countries with the confidence and collective responsibility being the highest in the United Arab Emirates (59.0% and 58.0%, respectively), complacency and constraints in Morocco (21.0% and 7.0%, respectively) and calculation in Sudan (60.0%). The regression analyses revealed that sex, age, educational degrees, being a health care professional, history of COVID-19 infection and having a relative infected or died from COVID-19 significantly predicted the 5C psychological antecedents by different degrees.

CONCLUSION

There are wide psychological antecedent variations between Arab countries, and different determinants can have a profound effect on the COVID-19 vaccine's psychological antecedents.

Improving compliance with physical distancing across religious cultures in Israel

BACKGROUND

Physical distancing contains the corona virus, but compliance with physical distancing across religious minorities in Israel has been shown to be relatively poorer than in the majority population. This study tests the power of messages as drivers of willingness to comply with physical distancing across religious minorities in Israel during the first wave of the COVID-19 from March till June 2020.

METHODS

896 Israeli Muslims, Druze, Bedouins, Jewish Orthodox, Christians, and Jewish Seculars participated in this conjoint-based experimental design. The size of the total sample and of the subgroups is consistent with the suggested size in conjoint analysis studies, particularly when aiming at stability of coefficients rather than stability of means. The dependent variable was 'willingness to comply'. Independent variables were known contributors to compliance: perceived risk, practices of physical distancing, ways to assure compliance, and the agent communicating the policy.

RESULTS

A regression analysis indicated minor differences in the power of messages across groups despite dramatic cultural differences amongst them. We identified three distinct mindsets that transcend religious cultures from the responses of the study subjects to various messages and named them "pandemic observers," "obedient followers," and "sensitive interpreters." Compliance of "Pandemic Observers" (n = 306) may be improved by messages such as, "Dangerous virus spreading wildly" and "Health experts suggest what to do but the government is reactive rather than proactive" (β = 14, p < .005). Compliance of "Obedient Followers" (n = 242) may be driven by the messages "Socialize and work only from home, using the internet, e.g. zoom/Skype" and "Everyone should stay 2 m. (6 ft.) apart" (β = 16, p < .0050). Compliance of "Sensitive Interpreters" (n = 249) may be improved by messages such as, "Only people who are 60 and over are to be allowed to buy groceries during first 2 h from opening" and by using the media to publicize the official health policy (β = 8; p < .005).

CONCLUSIONS

Mindset-assignment reflects how people think rather than their religious affiliation. A personal viewpoint identifier was developed to predict mindset-assignment and enable health authorities to enhance compliance through mindset-tailored messages for members of each mindset segment. We recommend that health authorities and policy makers consider these different personality types, which range across religious minorities and emphasize the messages that each type responds to in developing and implementing a communication plan to improve physical distancing as an important public health measure.

The obstacles to combat against COVID-19 pandemic and the remedies: Bangladesh scenario

BACKGROUND

Bangladesh has been going through the austerity of the unique COVID-19 for more than a year like several other nations in the world in spite of concerted efforts taken by the government along with other concerned authorities who have advocated compulsory guidelines involving social distancing procedures accompanied by lockdown to have control over the pandemic. In this paper, the barriers faced by the government to protect people from the COVID-19 pandemic have been investigated. Also, the number of daily infected people against the number of daily tests has been underlined to comprehend the overall pandemic picture in Bangladesh.

DESIGN AND METHODS

A descriptive study has been carried out to investigate the obstacles to tackle the COVID-19 pandemic for this country. The intensity of the outbreaks of the pandemic in this country is stated from March 8, 2020, to February 12, 2021. Secondary data have been employed from different sources to serve the goals of the study.

RESULTS

The poor management in the health sector of Bangladesh has been an issue of major concern during the early stage of COVID-19 which incorporates deficiency of medical equipment, lack of facilities for testing COVID-19, poor patient management, and uncertainty in the medication system. Finally, some recommendations have been proposed for the concerned organizations to tackle the current pandemic and as well in the future.

CONCLUSIONS

To control this COVID-19 pandemic, it is necessary to find the difficulties and discover the remedies which have been done in this paper for the Bangladesh perspective.

Will Americans Get Vaccinated? Predicting COVID-19 Vaccine Uptake Rates Under Contingent Scenarios

OBJECTIVES

Amid a pandemic, vaccines represent a promising solution for mitigating public health and economic crises, and an improved understanding of individuals' vaccination intentions is crucial to design optimal immunization campaigns. This study predicts uptake rates for different COVID-19 vaccine specifications and identifies personal characteristics that moderate an individual's responsiveness to vaccine attributes.

METHODS

We developed an online survey with contingent specifications of a COVID-19 vaccine, varying in effectiveness, risks of side effects, duration of immunity, and out-of-pocket cost. Using population-averaged logit models, we estimated vaccine uptake rates that account for uncertainty, heterogeneity across respondents, and interactions between vaccine and personal characteristics.

RESULTS

We obtained 3047 completed surveys. The highest uptake rate for an annual vaccine, 62%, is predicted when vaccine effectiveness is 80% to 90%, side effects are minimal, and the vaccine is provided at zero cost, with decreases seen in the uptake rate for less effective vaccines, for example, 50% for 50% to 60% effectiveness. Moreover, we found that Americans' response to vaccine effectiveness depends on their self-reported concern, that is, concerned respondents report a higher willingness to get vaccinated. Our findings also indicate that COVID-19 vaccine uptake rates decrease with vaccine cost and that responsiveness to vaccine cost is moderated by income.

CONCLUSIONS

Although providing the COVID-19 vaccine at zero cost will motivate many individuals to get vaccinated, a policy focused exclusively on vaccine cost may not be enough to reach herd immunity thresholds. Although those concerned with COVID-19 will participate, further evidence is needed on how to incentivize participation among the unconcerned (43%) to prevent further pandemic spread.

Knowledge, Attitudes and Perception toward COVID-19 Vaccines among Adults in Jazan Province, Saudi Arabia

Background: Saudi Arabia is one of the countries that initiated early vaccination programs despite the global challenges concerning the availability of COVID-19 vaccines. Massive vaccination campaigns have been undertaken in the country; however, negative perception and hesitancy toward vaccines may exist which could reduce public response to vaccination. Further, studies evaluating the current perception and attitude toward COVID-19 vaccines are scarce. Thus, this study aims to assess the community attitudes and perceptions toward COVID-19 vaccines in Jazan Province, Saudi Arabia. Methods: A cross-sectional, retrospective study using an online questionnaire was conducted among the public in Jazan, the southern region of Saudi Arabia. General and demographic data were collected, and perception and attitude toward COVID-19 vaccines were evaluated. Results: Most participants in this study were female (67%) with a median age of 23 years. The majority held a bachelor’s degree, and they trusted the Saudi healthcare system. Our survey showed that 67% of the study participants had positive perceptions toward COVID-19 vaccines, a finding that is significantly associated with receiving the influenza vaccine in the past, the existence of trust on the current healthcare system and holding positive beliefs toward the effectiveness of the current COVID-19 vaccines in reducing the risk of infection, complication, and mortality. Conclusions: The proportion of the public in Jazan who believed in the COVID-19 vaccine effectiveness is not inferior from similar international reports. Thus, national awareness programs toward the effectiveness of the vaccine could be enhanced to accelerate vaccination coverage. Further, nationwide surveys are warranted to include larger populations from different communities to assess the overall perception toward COVID-19 vaccines in the whole country.

Coronavirus Disease 2019 Vaccine Hesitancy in the Kurdistan Region: A Cross-Sectional National Survey

It has been a few months since the first batch of Coronavirus Disease 2019 (COVID-19) vaccines arrived in the Kurdistan region, and the priority was given to health workers at the forefront of the treatment of COVID-19 patients. The rollout is slow, and there is little evidence to suggest that the whole Kurdistan region is vaccinated anytime soon. This comprehensive and national survey was conducted to investigate the perception of the people of the Kurdistan region towards COVID-19 vaccine hesitancy. An adjusted valid and dependable questionnaire was deployed via social media platforms (Facebook and Viber) to invite participants aged 18 and over from the residents of the four provinces of the Kurdistan region. A total of 450 individuals participated in this study. The majority of the participants were male (54.4%) who were aged 26-40 years with bachelor's degrees (44.3%). Moreover, they were full-time employees (37.8%) with a household income of 0-$5,000 (53.3%). They were the residence of urban regions (81.9%) and Sulaymaniyah province (87.7%). On the probability of getting a COVID-19 vaccine shot, the responses were very likely (26.7%), somewhat likely (24.9%), not likely (20%), and definitely not (28.4%). The vaccine hesitancy prevalence was high among individuals aged 26-40, students with low incomes, unemployed, and those from the suburban areas, while respondents with the least perceived threat to get infected with the COVID-19 in the next year had the highest level of vaccine hesitancy. It is evident that vaccine hesitancy is high, and multiple strategies across the Kurdistan region needed to be implemented to encourage people to get vaccinated; therefore, scientific communication is necessary with the help of mass media.

Population preferences and attitudes towards COVID-19 vaccination: a cross-sectional study from Pakistan

BACKGROUND

While vaccine development is itself a challenge; ensuring optimal vaccine uptake at population level can present an even more significant challenge. Therefore, this study aimed to assess the Pakistani population's attitude and preferences towards the Coronavirus disease 2019 (COVID-19) vaccine.

METHOD

A cross-sectional study was carried out through an online self-administered questionnaire from 27 September 2020 to 11 October 2020. A total of 883 people responded to the survey. The questionnaire included the participants' socio-demographic variables, attitudes, beliefs towards the COVID-19 vaccine and acceptance and rejection of vaccination, and reasons for them. Logistic regression analysis was used to analyze the predictors for vaccine acceptance and willingness to pay for the vaccine.

RESULTS

A majority (70.8%) of respondents will accept the COVID-19vaccine if available, and 66.8% showed a positive attitude towards vaccination. Monthly family income, education level, self-diagnosis of COVID-19 or a friend, family member, or colleague are significant factors influencing the acceptance of COVID-19 vaccination. The dogma of being naturally immune to COVID-19 was a key reason for the refusal of the vaccine. Less than half (48%) of those who refuse will vaccinate themselves if government officials have made it compulsory. A third (33.9%) of participants were willing to pay up to (7 USD) 1000 Pkr (Pakistani Rupees) for the vaccine.

CONCLUSION

The population's positive attitude should be improved by increasing awareness and eradicating false myths about vaccines through large-scale campaigns.

Public Knowledge, Attitude, and Perception towards COVID-19 Vaccination in Saudi Arabia

Coronavirus disease-19 (COVID-19) is a highly contagious infection that mainly affects the respiratory system of patients. To date, more than 10 million people have been affected by this virus, and Saudi Arabia has also reported over 210 million cases. At present, there is no established treatment for COVID-19. Vaccination is one of the ways to defeat the pandemic. Recent reports have indicated rare but serious adverse events after vaccination, causing an anxious response from the general public worldwide. Therefore, this study was aimed at evaluating the knowledge, attitude, and perception of the COVID-19 vaccine among the Saudi population. This study is a cross-sectional, web-based online survey conducted using a snowball sampling technique. A self-administered questionnaire prepared in Arabic and English was used to collect feedback from the general population on their knowledge, attitudes, and perceptions about the COVID-19 vaccine. Participants (n = 2022) from different regions of the country replied to the questions. The responses to the questions were recorded on a spreadsheet and analyzed using the SPSS software. Statistical analysis was performed using one-way ANOVA and non-parametric tests to draw conclusions about the results. Multivariate stepwise regression analysis was performed to determine the association between the knowledge, attitude, and perception scores and the demographic variables. p < 0.05 was used to indicate the significance of the data. The data from the study indicated that most of the participants were males (81%), between 18 and 59 years of age (85.9%), Saudi nationals (98.3%), and possessed graduation or above as a qualification (62.9%). The results suggest that a major portion of respondents have satisfactory knowledge (76%), a positive attitude (72.4%), and perception (71.3%) towards the use of COVID-19 vaccines. Their responses can be categorized as between 'good' and 'fair'. However, 30-40% of respondents lacked information about COVID-19 vaccination availability for under 18-year-olds as well as for pregnant women, in addition to the lack of knowledge about the serious unreported adverse reactions and long-term protection offered by the vaccine against coronavirus. The correlation analysis between the variables (p > 0.05) indicated that the response to the KAP domains has no direct relationship. The survey results suggest that most of the Saudi population has sound knowledge and a positive attitude and perception. Since the COVID-19 vaccines have been approved for use in pregnancy and above 12-year-old children by health authorities, the lack of information shown by a significant percentage of participants requires strategies to update this information. Awareness programs targeting all sections of the population must be continued to provide all the updates, including vaccinations for pregnant women and children.

COVID-19 vaccine-taking hesitancy among Bangladeshi people: knowledge, perceptions and attitude perspective

Several novel efforts have been put forth to make a readily available vaccine against the global pandemic of COVID-19. However, there seems to appear vaccine-taking hesitancy among the general people. Against this backdrop, this current study sets to assess the vaccine-taking intention, ways to overcome the vaccine-taking reluctance among Bangladeshi people and explore their knowledge, perceptions, and attitude toward the COVID-19 vaccine. To this end, this study leveraged on a cross-sectional survey, which was consisted of 1377 respondents covering the eight divisions of Bangladesh. The descriptive statistical method and ordinal logistics regression were employed to explore and rationalize our study outlined objectives. Empirical findings revealed that approximately 71% of the respondents had adequate knowledge about the COVID-19 vaccine, whereas 46% of the respondents were willing to be vaccinated against COVID-19 while the rest of the respondents were hesitant to take the vaccine. However, concern about the potential side effects was one of the core reasons for vaccine-taking hesitancy. Assuring the common people about vaccine safety and efficacy, along with easing the registration procedure, can ameliorate people's confidence to get vaccinated. Meanwhile, about 60% of the respondents believed that a vaccine could help Bangladesh win the battle against COVID-19 and will allow back to normal life. Although the government has taken some pragmatic action steps to promote the vaccination rate, it is recommended that the mass vaccination program should be extended to the grassroots level with proper extension community support and easing the registration process.

Revealing Public Opinion Towards COVID-19 Vaccines With Twitter Data in the United States: Spatiotemporal Perspective

BACKGROUND

The COVID-19 pandemic has imposed a large, initially uncontrollable, public health crisis both in the United States and across the world, with experts looking to vaccines as the ultimate mechanism of defense. The development and deployment of COVID-19 vaccines have been rapidly advancing via global efforts. Hence, it is crucial for governments, public health officials, and policy makers to understand public attitudes and opinions towards vaccines, such that effective interventions and educational campaigns can be designed to promote vaccine acceptance.

OBJECTIVE

The aim of this study was to investigate public opinion and perception on COVID-19 vaccines in the United States. We investigated the spatiotemporal trends of public sentiment and emotion towards COVID-19 vaccines and analyzed how such trends relate to popular topics found on Twitter.

METHODS

We collected over 300,000 geotagged tweets in the United States from March 1, 2020 to February 28, 2021. We examined the spatiotemporal patterns of public sentiment and emotion over time at both national and state scales and identified 3 phases along the pandemic timeline with sharp changes in public sentiment and emotion. Using sentiment analysis, emotion analysis (with cloud mapping of keywords), and topic modeling, we further identified 11 key events and major topics as the potential drivers to such changes.

RESULTS

An increasing trend in positive sentiment in conjunction with a decrease in negative sentiment were generally observed in most states, reflecting the rising confidence and anticipation of the public towards vaccines. The overall tendency of the 8 types of emotion implies that the public trusts and anticipates the vaccine. This is accompanied by a mixture of fear, sadness, and anger. Critical social or international events or announcements by political leaders and authorities may have potential impacts on public opinion towards vaccines. These factors help identify underlying themes and validate insights from the analysis.

CONCLUSIONS

The analyses of near real-time social media big data benefit public health authorities by enabling them to monitor public attitudes and opinions towards vaccine-related information in a geo-aware manner, address the concerns of vaccine skeptics, and promote the confidence that individuals within a certain region or community have towards vaccines.

COVID-19 vaccine hesitancy and willingness to pay: Emergent factors from a cross-sectional study in Nigeria

Introduction

Prior to the COVID-19 pandemic, it took at least several years to develop vaccines for prevention of infectious diseases. The COVID-19 vaccine is the first to be developed within a period of one year. The expediency associated with the development of the COVID-19 vaccine has however been hampered by vaccine hesitancy and other relevant factors that could influence consequent immunisation. This study aimed at investigating factors associated with vaccine hesitancy and willingness to pay for COVID-19 vaccination.

Methods

A cross-sectional approach was used to undertake online and physical data collection with a validated questionnaire.

Results

A total of 1767 valid responses were received, female participants were in the minority (42.2%), majority (54.9%) of the study participants were between the ages of 18 and 30 years, and more than half (53.8%) of the participants were educated up to first degree level. Slightly above half (52.9%) of the study participants indicated that they were worried about side effects that may be associated with COVID-19 vaccines, and this may likely prevent them from taking the vaccine. A strong majority (85.1%) of the study participants indicated that COVID-19 vaccine should be administered at no cost to citizens. Only a quarter (26%) of the participants were willing to pay a fee for COVID-19 vaccination. Also, older participants and those that had been previously infected with COVID-19 were more likely to pay for COVID-19 vaccination.

Conclusion

This study provides critical insights which could influence immunisation efforts during the pandemic. An early understanding of population perceptions of the COVID-19 vaccine can be invaluable in designing successful campaigns. This is even more critical, given supply limitations, access issues and vaccines' inequity occasioned by the international scramble.

To Vaccinate or Not to Vaccinate-This Is the Question among Swiss University Students

The speed and innovation of the COVID-19 vaccine development has been accompanied by insecurity and skepticism. Young adults’ attitude to vaccination remains under investigation, although herd immunity cannot be reached without them. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate vaccination intention in 1478 students in the sixth survey wave (January 2021), including vaccination intention, psychological antecedents of vaccine hesitancy, trust in government’s vaccination strategy, and vaccination history. Associations with vaccination intention were analyzed with multivariate ordinal regression and predicted margins were calculated adjusting for gender, age, anxiety, health profession, and subjective health status. A third was decided (yes 25.1%, no 7.6%), and 68% were unsure about getting the COVID-19 vaccine when available. Next to demographic characteristics, vaccination history (influenza vaccination OR = 1.39; 95% CI: 1.06–1.83, travel vaccination OR = 1.29; 95% CI: 1.04–1.60), trust in vaccination strategy (OR = 2.40; 95% CI: 1.89–3.05), and 5C dimensions were associated with vaccination intention: confidence (OR = 2.52; 95% CI: 2.09–3.03), complacency (OR = 0.79; 95% CI: 0.66–0.96), calculation (OR = 0.79; 95% CI: 0.70–0.89), constraints (OR = 1.18; 95% CI: 0.99–1.41), and collective responsibility (OR = 4.47; 95% CI: 3.69–5.40). Addressing psychological antecedents and strengthening trust in official strategies through targeted campaigns and interventions may increase decisiveness and result in higher vaccination rates.

What is the extent of COVID-19 vaccine hesitancy in Bangladesh? A cross-sectional rapid national survey

OBJECTIVES

To assess COVID-19 vaccine hesitancy in Bangladesh and identify population subgroups with higher odds of vaccine hesitancy.

DESIGN

A nationally representative cross-sectional survey was used for this study. Descriptive analyses helped to compute vaccine hesitancy proportions and compare them across groups. Multiple logistic regression analyses were performed to compute the adjusted OR.

SETTING

Bangladesh.

PARTICIPANTS

A total of 1134 participants from the general population, aged 18 years and above participated in this study.

OUTCOME MEASURES

Prevalence and predictors of vaccine hesitancy.

RESULTS

Of the total participants, 32.5% showed COVID-19 vaccine hesitancy. Hesitancy was high among respondents who were men, over 60, unemployed, from low-income families, from central Bangladesh, including Dhaka, living in rented houses, tobacco users, politically affiliated, doubtful of the vaccine's efficacy for Bangladeshis and those who did not have any physical illnesses in the past year. In the multiple logistic regression models, transgender respondents (adjusted OR, AOR=3.62), married individuals (AOR=1.49), tobacco users (AOR=1.33), those who had not experienced any physical illnesses in the past year (AOR=1.49), those with political affiliations with opposition parties (AOR=1.48), those who believed COVID-19 vaccines would not be effective for Bangladeshis (AOR=3.20), and those who were slightly concerned (AOR=2.87) or not concerned at all (AOR=7.45) about themselves or a family member getting infected with COVID-19 in the next year were significantly associated with vaccine hesitancy (p<0.05).

CONCLUSIONS

Given the high prevalence of COVID-19 vaccine hesitancy, in order to guarantee that COVID-19 vaccinations are widely distributed, the government and public health experts must be prepared to handle vaccine hesitancy and increase vaccine awareness among potential recipients. To address these issues and support COVID-19 immunisation programs, evidence-based educational and policy-level initiatives must be undertaken especially for the poor, older and chronically diseased individuals.

Determinants of COVID-19 vaccine acceptance and hesitancy: a cross-sectional study in Saudi Arabia

Several COVID-19 vaccines have been developed in unprecedented time by research centers and pharmaceutical companies. This study aimed to determine COVID-19 vaccine acceptance and hesitancy rates and investigated the factors that influence vaccine acceptance and hesitancy. A cross-sectional research was conducted among adults in Saudi Arabia between January and March 2021 to determine willingness to receive a COVID-19 vaccine. A self-administered questionnaire was designed to explore the participants' COVID-19 vaccine acceptance and hesitancy. Categorical variables are described by frequency and percentage. A cross-tabulation analysis using the chi-squared test was performed to find associations between sociodemographic characteristics and vaccine acceptance and hesitancy. Logistic regression analysis was performed for variables that were found to be significant by the chi-squared test. A descriptive analysis of the 531 participants showed that 61.8% were willing to get the COVID-19 vaccine, while 38.2% were not. COVID-19 vaccine hesitancy was higher among women (44.9%), those 34-49 years of age (47.9%), those who were married (41.9%), employed (39.7%), had lower educational attainment (40%), and urban dwellers (40.8%). The main reason for COVID-19 vaccine acceptance was to protect oneself and others, while concerns about vaccine safety were the main reason for vaccine hesitancy. Statically significant associations were found between vaccine acceptance and age (p = .002) and gender (p = .03). Our study revealed a high prevalence of COVID-19 vaccine hesitancy (38.2%). Several sociodemographic characteristics were related to hesitancy, which may hinder the promotion of vaccine uptake. Public health campaigns is recommended to promote COVID-19 vaccine uptake.

Factors associated with the willingness and acceptance of SARS-CoV-2 vaccine from adult subjects in China

Aim: We aimed to investigate factors affecting the willingness and acceptance of the SARS-CoV-2 vaccination among adults in China and sources of knowledge about the vaccine.Methods: A cross-sectional, web-based survey was conducted from September 8th to 15th, 2020, comprising of 23 questions. Binary logistic regression analysis was performed to examine factors associated with vaccination willingness and acceptance.Results: A total of 983 questionnaires were included and 81.3% of the participants were willing to receive the SARS-CoV-2 vaccine. With a "bachelor degree or above" (OR = 0.56, p = 0.020) and believing that the vaccine would not cause SARS-CoV-2 infection (OR = 0.50, p = 0.003) were associated with an increased willingness. Aged :30 years (OR = 0.38, p = 0.001), and believing that the vaccine would not cause SARS-CoV-2 infection (OR = 0.52, p = 0.004) were associated with higher acceptance; while from Henan province (OR = 2.49, p < 0.001), not willing to vaccinate (OR = 3.86, p < 0.001), not suffering from chronic diseases (OR = 2.25, p = 0.013), and thinking it was not safe and effective in preventing COVID-19 (OR = 1.94, p = 0.001) were correlated with a lower acceptance.Conclusions: In conclusion, age, education, and vaccine perception might be key factors affecting the vaccine willingness and acceptance. Triggering positive perception of vaccine, especially by targeting those aged <30 years, or those with below bachelor degree, or without chronic diseases might be key approaches for improving the willingness and acceptance of vaccine in China.

Willingness to vaccinate against Covid-19: A qualitative study involving older adults from Southern Switzerland

BACKGROUND

The Covid-19 pandemic is causing unprecedented disruption and suffering to people across the globe, with a disproportionate toll on the elderly. The development and equitable distribution of a vaccine seems to be the most promising and sustainable route ahead. The goal of this study was to explore older adults' attitudes towards and beliefs regarding the Covid-19 vaccination in Southern Switzerland.

METHODS

We conducted a qualitative study employing telephone interviews to understand older adults' attitudes towards and beliefs about the Covid-19 vaccine. No Covid-19 vaccine had yet been approved at the moment of data collection. A convenience and snowball sample of 19 participants was recruited. Participants had to be at least 65 years old, without any hearing impairments, and be resident in the Canton of Ticino.

RESULTS

Most participants were women (n = 12), Swiss nationals (n = 14), retired (n = 18), resident in urban areas (n = 14), and had obtained a secondary school degree (n = 14). The average age was 75 (SD = 6.04; range = 64-85). We found that the majority of participants were in favor of the vaccination and highlighted its positive consequences, such as the abandonment of current freedom-limiting protective measures. Those participants who were against or unsure about the vaccination had concerns regarding the novelty of the vaccine and its impact on its safety and efficacy, stated they would prefer other protective measures rather than the vaccination, and identified contextual and individual drivers of their concerns.

CONCLUSIONS

Independently from the outbreak's trajectory, efforts to foster vaccination acceptance should focus on the benefit of relapsing freedom-limiting protective measures. Vaccination strategies should be grounded in an evidence-based, participatory approach, ongoing community engagement, trust-building activities, and communication about vaccine developments and how the vaccine will be combined with other outbreak response measures.

Caregivers' Willingness to Vaccinate Their Children Against COVID-19 in Saudi Arabia: A Cross-Sectional Survey

Background In early 2021, vaccination against COVID-19 became one of the most important measures needed to control the pandemic. Objectives This study aimed to investigate the levels of acceptance and factors affecting the decisions among Saudi parents and caregivers of children under 12 for getting them vaccinated. Design and setting A cross-sectional survey of 1000 caregivers and parents was carried out from May 2021 to June 2021. The participants were from the eastern, central, southern, western, and northern provinces of Saudi Arabia. Materials and methods The data were collected and managed using Microsoft Excel (Microsoft® Corp., Redmond, WA) and analyzed using SPSS version 23 (IBM Corp., Armonk, NY). Results Of the 1000 respondents, 281 (28.1%) reported they would vaccinate their children, 346 (34.6%) rejected vaccination, and 373 (37.3%) were not sure. Most caregivers (24.1%; n = 241) reported protecting children as the principal reason for accepting vaccination. Regarding those rejecting the vaccine, the most common concern was that children might experience side effects (42.9%; n = 429). Limitations The acceptance of the COVID-19 vaccine is dynamic and changes with legislations and public awareness policies. Conclusions COVID-19 vaccine acceptance for children was low at the time of this study compared to the United Kingdom and United States. To achieve vaccination coverage that is adequate for herd immunity in Saudi Arabia, intense educational and awareness strategies are needed.

The mediating role of health literacy on the relationship between health care system distrust and vaccine hesitancy during COVID-19 pandemic

This study explores the mediating role of health literacy on the association between health care system distrust and vaccine hesitancy. An online survey including Personal Information Form, Health Care System Distrust Scale, Vaccine Hesitancy Scale, and Health Literacy Scale were applied to 620 participants. The degree of applying mask-wearing, hygiene rule and physical distance, and the level of COVID-19 vaccine literacy were modeled with hierarchical multiple regression analysis to have a deeper analysis of participants’ actions towards COVID-19 vaccine hesitancy. It was found that health care system distrust and health literacy were the most important variables that had an impact on vaccine hesitancy. Based on the mediation analysis, the total effect of health care system distrust on vaccine hesitancy was statistically significant. Participants who held a low level of health literacy and a high perception of the health care system distrust experienced more vaccine hesitancy. The findings suggested the health literacy mediated the relationship between health care system distrust and vaccine hesitancy. Health authorities need to consider the dynamic and complex factors around the health care system distrust and health literacy to reduce vaccine hesitancy during COVID-19.

Beliefs and barriers associated with COVID-19 vaccination among the general population in Saudi Arabia

BACKGROUND

Developing a vaccine against COVID-19 is considered a key strategy to end the pandemic. However, public acceptance is reliant on beliefs and perception toward the vaccine. Therefore, the study aimed to assess the beliefs and barriers associated with COVID-19 vaccination among the Saudi population.

METHODS

An online self-administered questionnaire was distributed across the main regions of Saudi Arabia on May 2020. The questionnaire addressed the socio-demographic variables, beliefs toward COVID-19 vaccination, and potential barriers that may prevent participants from being vaccinated. The association between COVID-19 vaccine acceptance and sociodemographic variables were analyzed. Logistic regression analysis was used to identify the predicting variables of vaccine acceptance.

RESULTS

Out of 3101 participants, 44.7% were accepting of COVID-19 vaccination if available, whereas 55.3% admitted hesitancy. Younger, male, who received seasonal influenza vaccine were more likely to accept taking the vaccine. The study found that concerns about side effects were the key barrier for vaccine acceptance. Furthermore, the majority of refusers may accept the vaccine if additional studies confirmed safety and effectiveness.

CONCLUSION

Results can be utilized in planning vaccination campaigns while waiting for vaccine development.

The Long and Winding Road: Uptake, Acceptability, and Potential Influencing Factors of COVID-19 Vaccination in Austria

Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy. Methods: To assess the current vaccine acceptability in Austria and its influencing factors, an online survey was created and comprised fifteen questions segmented into a sociodemographic part and the acceptance and influencing factors of the approval of the COVID-19 vaccine. Results: In total, 70% of the 1350 respondents thought that the COVID-19 vaccine is an effective way to prevent and control the virus, while 13% disagreed and 17% were uncertain. Further, 71% approved the rapid development and rollout of the vaccine, while 55% were willing to accept the vaccine as soon as it became available, 18% did not want to get the vaccine, 17% wanted to delay, and 10% were already vaccinated. Conclusions: The results show a generally positive attitude towards the new COVID-19 vaccine. The doctor’s recommendation greatly influences the decision-making process, and tailored vaccine information can support a higher vaccine coverage.

Interest in COVID-19 vaccine trials participation among young adults in China: Willingness, reasons for hesitancy, and demographic and psychosocial determinants

With the demand for rapid COVID-19 vaccine development and evaluation, this paper aimed to describe the prevalence and correlates of willingness to participate in COVID-19 vaccine trials among university students in China. A cross-sectional survey with 1912 Chinese university students was conducted during March and April 2020. Bivariate and multivariate analyses were performed to identify variables associated with willingness to participate. The majority of participants (64.01%) indicated willingness to participate in COVID-19 vaccine trials. Hesitancy over signing informed consent documents, concerns over time necessary for participating in a medical study, and perceived COVID-19 societal stigma were identified as deterrents, whereas lower socioeconomic status, female gender, perception of likely COVID-19 infection during the pandemic, and COVID-19 prosocial behaviors were facilitative factors. Further, public health mistrust and hesitancy over signing informed consent documents had a significant interactive effect on vaccine trial willingness. High standards of ethical and scientific practice are needed in COVID-19 vaccine research, including providing potential participants full and accurate information and ensuring participation free of coercion, socioeconomic inequality, and stigma. Attending to the needs of marginalized groups and addressing psychosocial factors including stigma and public health mistrust may also be important to COVID-19 vaccine development and future uptake.

Willingness to get the COVID-19 vaccine among patients with rheumatic diseases, healthcare workers and general population in Turkey: a web-based survey

OBJECTIVES

Vaccination against COVID-19 emerges as an effective strategy for combating the pandemic. While many of our patients with rheumatic diseases (RD) wonder whether it is safe to get the vaccine, vaccine hesitancy is rising among the general population. We assessed the willingness to get vaccination and its probable predictors among patients with RD compared to healthcare workers and a sample from the general population.

METHODS

We conducted a web-based questionnaire survey in a cross-sectional design in 3 groups of participants just before the mass vaccination program in Istanbul, Turkey. The questionnaire sought socio-demographic variables, COVID-19 related risk factors, willingness to get vaccination, and concerns and thoughts about vaccine. COVID-19 anxiety scale (CAS) was also evaluated.

RESULTS

We studied in total 732 patients with RD (Group 1), 763 individuals representing general population (Group 2) and 320 hospital workers (Group 3). Dysfunctional anxiety related to COVID-19 was found in 4.9%, 3.8% and 4.1%, in Group 1, 2 and 3, respectively. Of the patients with RD, 29.2% were willing to be vaccinated, 19.0% were unwilling and 51.8% were undecided. These were somewhat similar among the general population (yes: 34.6%, no: 23.3% and unsure: 42.1%), with significantly less undecided individuals (p < 0.001). On the other hand, hospital workers were significantly more willing (yes: 52.5%, no: 20.9% and unsure: 26.6%) (p < 0.001). Main concerns were probable side effects, unknown scientific results and having no trust. Being male, older age, working in a hospital, not having contracted COVID-19 and high scores on CAS were found to be independently associated with willingness.

CONCLUSIONS

The low rate of vaccine acceptance among patients with RD, as well as general population sampling is worrying. Healthcare policies should aim to implement communication, promote confidence and increase demand for COVID-19 vaccine.

The COVID-19 pandemic face mask waste: A blooming threat to the marine environment

Recently, the COVID-19 disease spread has emerged as a worldwide pandemic and cause severe threats to humanity. The World Health Organisation (WHO) releases guidelines to help the countries to reduce the spread of this virus to the public, like wearing masks, hand hygiene, social distancing, shutting down all types of public transports, etc. These conditions led to a worldwide economic fall drastically, and on the other hand, indirect environmental benefits like global air quality improvement and decreased water pollution are also pictured. Currently, use of face masks is part of a comprehensive package of the prevention and control measures that can limit the spread of COVID-19 since there is no clinically proven drugs or vaccine available for COVID-19. Mostly, face masks are made of petroleum-based non-renewable polymers that are non-biodegradable, hazardous to the environment and create health issues. This study demonstrates the extensive use of the face mask and how it affects human health and the marine ecosystem. It has become a great challenge for the government sectors to impose strict regulations for the proper disposal of the masks as medical waste by the public. Neglecting the seriousness of this issue may lead to the release of large tonnes of micro-plastics to the landfill as well as to the marine environment where mostly end-up and thereby affecting their fauna and flora population vastly. Besides, this study highlights the COVID-19 spread, its evolutionary importance, taxonomy, genomic structure, transmission to humans, prevention, and treatment.

Myths and conspiracy theories on vaccines and COVID-19: Potential effect on global vaccine refusals

The current coronavirus disease 2019 (COVID-19) pandemic is one of the international crises and researchers are working collaboratively to develop a safe and effective COVID-19 vaccine. The World Health Organization recognizes vaccine hesitancy as the world's top threat to public health safety, particularly in low middle-income countries. Vaccine hesitancy can be due to a lack of knowledge, false religious beliefs, or anti-vaccine misinformation. The current situation regarding anti-vaccine beliefs is pointing towards dreadful outcomes. It raises the concern that will people believe and accept the new COVID-19 vaccines despite all anti-vaccine movements and COVID-19-related myths and conspiracy theories. This review discusses the possible detrimental impacts of myths and conspiracy theories related to COVID-19 and vaccine on COVID-19 vaccine refusals as well as other vaccine programs.

Covid-19, the anti-vaccine movement and immunization challenges in Brazil

AIMS: The COVID-19 pandemic suddenly and significantly increased hospitalizations for pneumonia with systemic inflammatory disease. Since its appearance, COVID-19 has affected more than 200 countries, with more than 90 million cases and almost 2 million deaths. So far, there is no quality evidence regarding the specific pharmacological therapy for COVID-19; most treatments usually involve off-label use of existing drugs and have unproven efficacy. The global effort converges on the development of a vaccine; however, the greatest challenge is to achieve collective immunization in the face of increasing vaccination hesitancy.METHODS: This study investigated the impact of vaccine hesitancy movements on the goal of COVID-19 immunization in Brazil. An integrative bibliographic review was performed with an electronic search on PubMed and SciELO that yielded 13.535 articles. Inclusion and exclusion criteria were applied which included 29 interventional and descriptive studies.RESULTS: The results of the 29 studies revealed that the most frequent reasons for hesitation is skepticism about the true interests of the industry and politicians, the lack of trust in research, and inaccurate information on social media.CONCLUSION: The main factors that lead the population not to believe in vaccines were the real interests of industry and politicians, lack of confidence in research, and the amount of false information that circulates massively on social media and because of that it is possible that Brazil will face some challenges in achieving collective immunity due to the anti-vaccine movement.

The Persistence of Vaccine Hesitancy: COVID-19 Vaccination Intention in New Zealand

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.

Willingness to get the COVID-19 vaccine with and without emergency use authorization

BACKGROUND

This study assessed psychosocial predictors of U.S. adults' willingness to get a future COVID-19 vaccine and whether these predictors differ under an emergency use authorization (EUA) release of the vaccine.

METHODS

A survey of 788 U.S. adults was conducted to explore the relationships between demographics and psychosocial predictors of intent to get a future COVID-19 vaccine as well as willingness to get such a vaccine under EUA.

RESULTS

Significant predictors of COVID-19 vaccine uptake intentions were education, having insurance, scoring high on subjective norms, a positive attitude toward the vaccine, as well as high perceived susceptibility to COVID-19, high perceived benefits of the vaccine, scoring low on barriers to the vaccine, and scoring high on self-efficacy. Predictors of willingness to take a COVID-19 vaccine under EUA were age, race/ethnicity, positive subjective norms, high perceived behavioral control, positive attitudes toward the vaccine, as well as high perceived susceptibility to COVID-19, high perceived benefits of the vaccine, low barriers to the vaccine, and scoring high on self-efficacy for getting the vaccine. Concerns about rushed vaccine development appear to reduce vaccine uptake intent, as well as willingness to get the vaccine under EUA.

CONCLUSIONS

COVID-19 vaccine-related messages should both address concerns about the vaccine and its development and reinforce benefits of the vaccine (both factors significant in both models). Vaccine efforts may need to go beyond just communications campaigns correcting misinformation about a COVID-19 vaccine to also focus on re-establishing public trust in government agencies.

Immunoinformatics Approach for the Identification and Characterization of T Cell and B Cell Epitopes towards the Peptide-Based Vaccine against SARS-CoV-2

Presently, immunoinformatics is playing a significant role in epitope identification and vaccine designing for various critical diseases. Using immunoinformatics, several scientists are trying to identify and characterize T cell and B cell epitopes as well as design peptide-based vaccine against SARS-CoV-2. In this review article, we have tried to discuss the importance in adaptive immunity and its significance for designing the SARS-CoV-2 vaccine. Moreover, we have attempted to illustrate several significant key points for utilizing immunoinformatics for vaccine designing, such as the criteria for selection and identification of epitopes, T cell epitope, and B cell epitope prediction and different emerging tools/databases for immunoinformatics. In the current scenario, a few immunoinformatics studies have been performed for various infectious pathogens and related diseases. Thus, we have also summarized and included these current immunoinformatics studies in this review article. Finally, we have discussed about the probable T cell and B cell epitopes and their identification and characterization for vaccine designing against SARS-CoV-2.

Should the SARS-CoV-2 vaccine be mandatory for nurses? An ethical debate

The COVID-19 pandemic has had a devastating impact on the UK, as well as many other countries around the world, affecting all aspects of society. Nurses and other health and care professionals are a group particularly exposed to the virus through their work. Evidence suggests that vaccines form the most promising strategy for fighting this pandemic. Should vaccination against be mandatory for nurses and other health professionals? This article explores this question using an ethical framework.

Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents

Rationale

Many countries were and are still struggling with the COVID-19 emergency. Despite efforts to limit the viral transmission, the vaccine is the only solution to ending the pandemic. However, vaccine hesitancy could reduce coverage and hinder herd immunity.

Objective

People's intention to get vaccinated can be shaped by several factors, including risk perception which, in turn, is influenced by affect. The present work aimed at investigating how risk perception and some factors associated with the decision to comply with vaccination modulated vaccine acceptance for COVID-19 as compared to seasonal influenza, and how these have varied during the lockdown phases.

Method

The study followed the main phases of the emergency in Italy, investigating the intention to get vaccinated against flu and against SARS-CoV-2 (if a vaccine was available) before, during and after the first national lockdown, covering the period from the end of February to the end of June 2020. We investigated the effect of risk perception and other predictors on the decision of getting vaccinated.

Results

Compared to the pre-lockdown phase, during the lockdown more people were willing to get vaccinated for COVID-19, regardless of their beliefs about vaccines, and as risk perception increased, so did the intention to accept the vaccine. The acceptance of the flu vaccine increased after the re-opening phase. In addition, the intention to get vaccinated against COVID-19 and against flu increased if there was previous flu vaccination behavior but decreased with increasing doubts about the vaccines in general.

Conclusions

The observation of vaccination intentions across the three main phases of the emergency allows important considerations regarding psychological, affect, and demographic determinants useful to tailor public health communication to improve public response to future epidemics.

Myths and conspiracy theories on vaccines and COVID-19: Potential effect on global vaccine refusals

The current coronavirus disease 2019 (COVID-19) pandemic is one of the international crises and researchers are working collaboratively to develop a safe and effective COVID-19 vaccine. The World Health Organization recognizes vaccine hesitancy as the world's top threat to public health safety, particularly in low middle-income countries. Vaccine hesitancy can be due to a lack of knowledge, false religious beliefs, or anti-vaccine misinformation. The current situation regarding anti-vaccine beliefs is pointing towards dreadful outcomes. It raises the concern that will people believe and accept the new COVID-19 vaccines despite all anti-vaccine movements and COVID-19-related myths and conspiracy theories. This review discusses the possible detrimental impacts of myths and conspiracy theories related to COVID-19 and vaccine on COVID-19 vaccine refusals as well as other vaccine programs.

Vaccine acceptance among college students in South Carolina: Do information sources and trust in information make a difference?

BACKGROUND

To control the COVID-19 pandemic, governments need to ensure a successful large-scale administration of COVID-19 vaccines when safe and efficacious vaccines become available. Vaccine acceptance could be a critical factor influencing vaccine uptake. Health information has been associated with vaccine acceptance. For college students who are embracing a digital era and being exposed to multimedia, the sources of COVID-19 vaccine information and their trust in these sources may play an important role in shaping their acceptance of vaccine uptake.

METHODS

In September 2020, we conducted an online survey among 1062 college students in South Carolina to understand their perceptions and attitudes toward COVID-19 vaccination. Descriptive analysis and linear regression analysis were used to investigate vaccine information sources among college students and examine how COVID-19 vaccine acceptance was associated with information source and trust level in each source.

RESULTS

The top three sources of COVID-19 vaccine information were health agencies (57.7%), mass media (49.5%), and personal social networks (40.5%). About 83.1% of the participants largely or always trusted scientists, 73.9% trusted healthcare providers, and 70.2% trusted health agencies. After controlling for key demographics, vaccine acceptance was positively associated with scientists as information sources but negatively associated with pharmaceutical companies as sources. Higher trust levels in mass media, health agencies, scientists, and pharmaceutical companies was significantly associated with higher COVID-19 vaccine acceptance. However, trust in social media was negatively associated with vaccine acceptance.

DISCUSSION

College students use multiple sources to learn about upcoming COVID-19 vaccines including health agencies, personal networks, and social media. The level of trust in these information sources play a critical role in predicting vaccine acceptance. Trust in health authorities and scientists rather than social media is related to higher level vaccine acceptance. Our findings echo the call for restoring trust in government, healthcare system, scientists, and pharmaceutical industries in the COVID-19 era and highlight the urgency to dispel misinformation in social media. Effective strategies are needed to disseminate accurate information about COVID-19 vaccine from health authorities and scientific research to improve vaccine communication to the public and promote COVID-19 vaccine uptake.

Invited Editorial. COVID-19 Vaccine: Hope and reality

Nil

Caregiver willingness to vaccinate their children against COVID-19: Cross sectional survey

BACKGROUND

More than 100 COVID-19 vaccine candidates are in development since the SARS-CoV-2 genetic sequence was published in January 2020. The uptake of a COVID-19 vaccine among children will be instrumental in limiting the spread of the disease as herd immunity may require vaccine coverage of up to 80% of the population. Prior history of pandemic vaccine coverage was as low as 40% among children in the United States during the 2009 H1N1 influenza pandemic.

PURPOSE

To investigate predictors associated with global caregivers' intent to vaccinate their children against COVID-19, when the vaccine becomes available.

METHOD

An international cross sectional survey of 1541 caregivers arriving with their children to 16 pediatric Emergency Departments (ED) across six countries from March 26 to May 31, 2020.

RESULTS

65% (n = 1005) of caregivers reported that they intend to vaccinate their child against COVID-19, once a vaccine is available. A univariate and subsequent multivariate analysis found that increased intended uptake was associated with children that were older, children with no chronic illness, when fathers completed the survey, children up-to-date on their vaccination schedule, recent history of vaccination against influenza, and caregivers concerned their child had COVID-19 at the time of survey completion in the ED. The most common reason reported by caregivers intending to vaccinate was to protect their child (62%), and the most common reason reported by caregivers refusing vaccination was the vaccine's novelty (52%).

CONCLUSIONS

The majority of caregivers intend to vaccinate their children against COVID-19, though uptake will likely be associated with specific factors such as child and caregiver demographics and vaccination history. Public health strategies need to address barriers to uptake by providing evidence about an upcoming COVID-19 vaccine's safety and efficacy, highlighting the risks and consequences of infection in children, and educating caregivers on the role of vaccination.

A global survey of potential acceptance of a COVID-19 vaccine

Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 48.1% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so.

Survey data from across 19 countries reveal heterogeneity in attitudes toward acceptance of a COVID-19 vaccine and suggest that trust in government is associated with vaccine confidence.

Caregivers' Willingness to Accept Expedited Vaccine Research During the COVID-19 Pandemic: A Cross-sectional Survey

Purpose

This study determined the predictors of caregivers' willingness to accept an accelerated regulatory process for the development of vaccines against coronavirus disease 2019 (COVID-19).

Methods

An international cross-sectional survey was administered to 2557 caregivers of children in 17 pediatric emergency departments (EDs) across 6 countries from March 26, 2020, to June 30, 2020. Caregivers were asked to select 1 of 4 choices with which they most agreed regarding a proposed COVID-19 vaccine–approval process, in addition to questions regarding demographic characteristics, the ED visit, and attitudes about COVID-19. Univariate analyses were conducted using the Mann–Whitney U test for comparing non–normally distributed continuous variables, an independent t test for comparing normally distributed continuous variables, and a χ² or Fisher exact test for categorical variables. Multivariate logistic regression analysis was used for determining independent factors associated with caregivers' willingness to accept abridged development of a COVID-19 vaccine. A P value of <0.05 was considered significant.

Findings

Almost half (1101/2557; 43%) of caregivers reported that they were willing to accept less rigorous testing and postresearch approval of a new COVID-19 vaccine. Independent factors associated with caregivers' willingness to accept expedited COVID-19 vaccine research included having children who were up to date on the vaccination schedule (odds ratio [OR] = 1.72; 95% CI, 1.29–2.31), caregivers' concern about having had COVID-19 themselves at the time of survey completion in the ED (OR = 1.1; 95% CI, 1.05–1.16), and caregivers' intent to have their children vaccinated against COVID-19 if a vaccine were to become available (OR = 1.84; 95% CI, 1.54–2.21). Compared with fathers, mothers completing the survey were less likely to approve of changes in the vaccine-development process (OR = 0.641; 95% CI, 0.529–0.775).

Implications

Less than half of caregivers in this worldwide sample were willing to accept abbreviated COVID-19 vaccine testing. As a part of an effort to increase acceptance and uptake of a new vaccine, especially in order to protect children, public health strategies and individual providers should understand caregivers' attitudes toward the approval of a vaccine and consult them appropriately.

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Half of caregivers accept an abridged process for rapid COVID-19 vaccine approval.

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Seeking fast approval associated with caregiver’s gender, intent to vaccinate child.

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Concern about own COVID-19 infection associated with preferring expedited approval.

Withdrawn: Vaccine hesitancy among Maltese Healthcare workers toward influenza and novel COVID-19 vaccination

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Interest in COVID-19 vaccine trials participation among young adults in China: Willingness, reasons for hesitancy, and demographic and psychosocial determinants

BACKGROUND

With the demand for rapid COVID-19 vaccine development and evaluation, this paper aimed to describe the prevalence and correlates of willingness to participate in COVID-19 vaccine trials among university students in China.

METHODS

A cross-sectional survey with 1,912 Chinese university students was conducted during March and April 2020. Bivariate and multivariate analyses were performed to identify variables associated with willingness to participate.

RESULTS

The majority of participants (64.01%) indicated willingness to participate in COVID-19 vaccine trials. Hesitancy over signing informed consent documents, concerns over time necessary for participating in a medical study, and perceived COVID-19 societal stigma were identified as deterrents, whereas lower socioeconomic status, female gender, perception of likely COVID-19 infection during the pandemic, and COVID-19 prosocial behaviors were facilitative factors. Further, public health mistrust and hesitancy over signing informed consent documents had a significant interactive effect on vaccine trial willingness.

CONCLUSIONS

High standards of ethical and scientific practice are needed in COVID-19 vaccine research, including providing potential participants full and accurate information and ensuring participation free of coercion, socioeconomic inequality, and stigma. Attending to the needs of marginalized groups and addressing psychosocial factors including stigma and public health mistrust may also be important to COVID-19 vaccine development and future uptake.