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Alhassan RK, Aberese-Ako M, Doegah PT, Immurana M, Dalaba MA, Manyeh AK, Klu D, Acquah E, Ansah EK, Gyapong M. COVID-19 vaccine hesitancy among the adult population in Ghana: evidence from a pre-vaccination rollout survey. Trop Med Health 2021; 49:96. [PMID: 34915939 PMCID: PMC8674411 DOI: 10.1186/s41182-021-00357-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has already claimed over four million lives globally and over 800 deaths in Ghana. The COVID-19 vaccine is a key intervention towards containing the pandemic. Over three billion doses of the vaccine have already been administered globally and over 800,000 doses administered in Ghana, representing less than 5% vaccination coverage. Fear, uncertainty, conspiracy theories and safety concerns remain important threats to, a successful rollout of the vaccine if not managed well. Objective Ascertain the predictors of citizens’ probability of participating in a COVID-19 vaccine trial and subsequently accept the vaccine when given the opportunity. Methodology The study was an online nation-wide survey among community members (n = 1556) from 18th September to 23rd October, 2020 in the 16 regions in Ghana. Binary probit regression analysis with marginal effect estimations was employed to ascertain the predictors of community members’ willingness to participate in a COVID-19 vaccine trial and uptake the vaccine. Results Approximately 60% of respondents said they will not participate in a COVID-19 vaccine trial; 65% will take the vaccine, while 69% will recommend it to others. Willingness to voluntarily participate in COVID-19 vaccine trial, uptake the vaccine and advise others to do same was higher among adults aged 18–48 years, the unmarried and males (p < 0.05). Significant predictors of unwillingness to participate in the COVID-19 vaccine trial and uptake of the vaccine are: married persons, females, Muslims, older persons, residents of less urbanised regions and persons with lower or no formal education (p < 0.05). Predominant reasons cited for unwillingness to participate in a COVID-19 vaccine trial and take the vaccine included fear, safety concerns, lack of trust in state institutions, uncertainty, political connotations, spiritual and religious beliefs. Conclusion The probability of accepting COVID-19 vaccine among the adult population in Ghana is high but the country should not get complacent because fear, safety and mistrust are important concerns that have the potential to entrench vaccine hesitancy. COVID-19 vaccine rollout campaigns should be targeted and cognisant of the key predictors of citizens’ perceptions of the vaccine. These lessons when considered will promote Ghana’s efforts towards vaccinating at least 20 million people to attain herd immunity. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-021-00357-5.
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Affiliation(s)
- Robert Kaba Alhassan
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana. .,Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana.
| | - Matilda Aberese-Ako
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | | | - Mustapha Immurana
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | | | - Alfred Kwesi Manyeh
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Desmond Klu
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Evelyn Acquah
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Evelyn Korkor Ansah
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
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Klugar M, Riad A, Mohanan L, Pokorná A. COVID-19 Vaccine Booster Hesitancy (VBH) of Healthcare Workers in Czechia: National Cross-Sectional Study. Vaccines (Basel) 2021; 9:1437. [PMID: 34960183 PMCID: PMC8705445 DOI: 10.3390/vaccines9121437] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 12/11/2022] Open
Abstract
The emerging SARS-CoV-2 variants and waning vaccine-elicited immunity are two public health challenges that occurred simultaneously and synergistically during the summer of 2021 and led to a surging demand for COVID-19 vaccine booster dose (BD) rollout. This study aimed to evaluate the COVID-19 vaccine booster hesitancy (VBH) among Czech healthcare workers to explore the potential determinants of VBH. A national cross-sectional survey-based study was carried out between 3 and 11 November 2021, using an online self-administered questionnaire (SAQ) that explored the participants' demographic characteristics, COVID-19 infection and vaccine anamneses, willingness to receive COVID-19 vaccine BD, and the psychosocial drivers of VBH. A total of 3454 HCW properly responded to the online SAQ, of which 80.9% were females, 30.3% were medical professionals, and 50.5% were ≤47 years old. Most of the participants were already inoculated against SARS-CoV-2 (95.2%), and BTN162b2 was the most commonly administered vaccine (90.7%). As the study sample was planned to represent the target population, it revealed a high level of BD acceptance (71.3%) among Czech HCW, while 12.2% were still hesitant and 16.6% were against the currently available BD. These results are consistent with other recent results from central Europe. Medical professional, male, and older participants were more likely to accept BD rather than allied health professional, female, and younger participants. The BDs' perceived effectiveness against severe illness, symptomatic infection, and community transmission was a significant and strong predictor for BD acceptance, while the effectiveness against the circulating variants was not that important for our target population. The BDs' perceived safety and ethical dilemmas of vaccine justice should be addressed sufficiently while communicating with HCW and other population groups. The altruistic reasons for BD acceptance, i.e., family protection, patient protection, and community health protection, underpin the recommendation of postponing the COVID-19 vaccine mandating in favour of stressing these altruistic concerns amid public health messaging.
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Affiliation(s)
- Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 625 00 Brno, Czech Republic; (M.K.); (L.M.); (A.P.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
| | - Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 625 00 Brno, Czech Republic; (M.K.); (L.M.); (A.P.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Lekshmi Mohanan
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 625 00 Brno, Czech Republic; (M.K.); (L.M.); (A.P.)
| | - Andrea Pokorná
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, 625 00 Brno, Czech Republic; (M.K.); (L.M.); (A.P.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
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53
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Zheng Y, Shen P, Xu B, Chen Y, Luo Y, Dai Y, Hu Y, Zhou YH. COVID-19 vaccination coverage among healthcare workers in obstetrics and gynecology during the first three months of vaccination campaign: a cross-sectional study in Jiangsu province, China. Hum Vaccin Immunother 2021; 17:4946-4953. [PMID: 34802373 PMCID: PMC8903925 DOI: 10.1080/21645515.2021.1997297] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/22/2021] [Accepted: 10/21/2021] [Indexed: 12/26/2022] Open
Abstract
Before the availability of COVID-19 vaccines, surveys showed that vaccine hesitancy may influence the acceptance of COVID-19 vaccination. In this cross-sectional study, we aimed to investigate COVID-19 vaccination coverage among healthcare workers (HCWs) in obstetrics and gynecology, during the first three-month period of the vaccination campaign after COVID-19 vaccines were approved. A total of 662 eligible HCWs, consisting of 250 HCWs (group one) who participated in a Jiangsu provincial symposium and 412 HCWs (group two) in the department of obstetrics and gynecology, Nanjing Drum Tower Hospital, were invited to answer a 23-question questionnaire. In total, 618 (93.4%) HCWs completed the questionnaire. The vaccine acceptance in group one was higher than that in group two (87.2% [197/226] vs 74.2% [291/392], χ2 = 14.436, P < .001). Overall, 488 (79.0%) HCWs received COVID-19 vaccination and 130 (21.0%) declined vaccination. One-third of the 488 vaccinees were not vaccinated until consulted with others or requested by employers. Adjusted logistic regression analysis showed that the decline of vaccination was associated with worry about the safety of the vaccine (OR 1.920, CI 95% 1.196-3.082; P = .007). The main reason for the decline of COVID-19 vaccination included the concern about vaccine safety, pregnancy preparation, pregnancy, or lactation. These results indicate that more safety data about COVID-19 vaccines, particularly in pregnant or lactating women, are required to promote the acceptance of COVID-19 vaccination. In addition, vaccination requests or mandates by employers may increase the acceptance of COVID-19 vaccines.
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Affiliation(s)
- Yaning Zheng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Ping Shen
- Departments of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Biyun Xu
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yiying Chen
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yuqian Luo
- Departments of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yimin Dai
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yi-Hua Zhou
- Departments of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
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AlKetbi LMB, Elharake JA, Memari SA, Mazrouei SA, Shehhi BA, Malik AA, McFadden SM, Galal B, Yildirim I, Khoshnood K, Omer SB, Memish ZA, AlZarouni AA, AlNeyadi AM, Hosani FA. COVID-19 vaccine acceptance among healthcare workers in the United Arab Emirates. IJID REGIONS (ONLINE) 2021; 1:20-26. [PMID: 35721775 PMCID: PMC8505903 DOI: 10.1016/j.ijregi.2021.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/13/2022]
Abstract
Background COVID-19 vaccine hesitancy among healthcare workers (HCWs) is a threat to any healthcare system. Vaccine hesitancy can increase infection risk among HCWs and patients, while also impacting the patients' decision to accept the vaccine. Our study assessed COVID-19 vaccine acceptance among HCWs in United Arab Emirates (UAE). Methods Using purposive sampling, UAE HCWs registered in the Abu Dhabi Department of Health (DOH) email database were invited to complete an online questionnaire, between November 2020 and February 2021, to understand COVID-19 vaccine acceptance and hesitancy, and trust in sources of information. Simple logistic regression was used to assess the associations between demographic factors with COVID-19 vaccine acceptance. Results Of the 2832 HCWs who participated in the study, 1963 (69.9%) were aged between 25 and 44 years and 1748 (61.7%) were females. Overall, 2525 (89.2%) of the HCW population said they would accept a COVID-19 vaccine. HCWs who were 55+ years of age, male, and physicians/surgeons were more likely to accept a COVID-19 vaccine (OR 3.1, 95% CI 1.5-6.2, p = 0.002; OR 1.8, 95% CI 1.3-2.4, p < 0.001; and OR 1.8, 95% CI 1.1-2.9; p = 0.01, respectively). The most reliable sources for COVID-19 vaccine information were the UAE government (91.6%), healthcare providers (86.8%), health officials (86.3%), and the World Health Organization (WHO; 81.1%). Conclusions COVID-19 vaccine acceptance was high among the UAE HCW population. Several factors were identified as significant determinants of vaccine acceptance. UAE healthcare authorities can utilize these findings to develop public health messaging campaigns for HCWs to best address COVID-19 vaccine concerns - particularly when the government is vaccinating its general population.
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Affiliation(s)
| | - Jad A Elharake
- Yale Institute for Global Health, New Haven, Connecticut 06510, USA.,Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, USA
| | - Shammah Al Memari
- Abu Dhabi Public Health Center, Health Promotion Department, Abu Dhabi, UAE
| | | | - Badreyya Al Shehhi
- Abu Dhabi Public Health Center, Communicable Disease Sector, Abu Dhabi, UAE
| | - Amyn A Malik
- Yale Institute for Global Health, New Haven, Connecticut 06510, USA.,Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, USA
| | - SarahAnn M McFadden
- Yale Institute for Global Health, New Haven, Connecticut 06510, USA.,Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, USA
| | - Bayan Galal
- Yale University, New Haven, Connecticut, 06520, USA
| | - Inci Yildirim
- Yale Institute for Global Health, New Haven, Connecticut 06510, USA.,Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, USA
| | - Kaveh Khoshnood
- Yale School of Public Health, New Haven, Connecticut, 06510, USA
| | - Saad B Omer
- Yale Institute for Global Health, New Haven, Connecticut 06510, USA.,Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, USA.,Yale School of Public Health, New Haven, Connecticut, 06510, USA.,Yale School of Nursing, Orange, Connecticut, 06477, USA
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, the Kingdom of Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, the Kingdom of Saudi Arabia.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amal A AlZarouni
- Academic Affairs Department, Ambulatory Healthcare Services, Abu Dhabi Healthcare Services, Al Ain, UAE
| | - Amna M AlNeyadi
- Academic Affairs Department, Ambulatory Healthcare Services, Abu Dhabi Healthcare Services, Al Ain, UAE
| | - Farida Al Hosani
- Abu Dhabi Public Health Center, Communicable Disease Sector, Abu Dhabi, UAE
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Biswas N, Mustapha T, Khubchandani J, Price JH. The Nature and Extent of COVID-19 Vaccination Hesitancy in Healthcare Workers. J Community Health 2021; 46:1244-1251. [PMID: 33877534 PMCID: PMC8056370 DOI: 10.1007/s10900-021-00984-3] [Citation(s) in RCA: 301] [Impact Index Per Article: 100.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
COVID-19 vaccines were approved in late 2020 and early 2021 for public use in countries across the world. Several studies have now highlighted COVID-19 vaccination hesitancy in the general public. However, little is known about the nature and extent of COVID-19 vaccination hesitancy in healthcare workers worldwide. Thus, the purpose of this study was to conduct a comprehensive worldwide assessment of published evidence on COVID-19 vaccine hesitancy among healthcare workers. A scoping review method was adopted to include a final pool of 35 studies in this review with study sample size ranges from n = 123 to 16,158 (average = 2185 participants per study). The prevalence of COVID-19 vaccination hesitancy worldwide in healthcare workers ranged from 4.3 to 72% (average = 22.51% across all studies with 76,471 participants). The majority of the studies found concerns about vaccine safety, efficacy, and potential side effects as top reasons for COVID-19 vaccination hesitancy in healthcare workers. The majority of the studies also found that individuals who were males, of older age, and doctoral degree holders (i.e., physicians) were more likely to accept COVID-19 vaccines. Factors such as the higher perceived risk of getting infected with COVID-19, direct care for patients, and history of influenza vaccination were also found to increase COVID-19 vaccination uptake probability. Given the high prevalence of COVID-19 vaccine hesitancy in healthcare workers, communication and education strategies along with mandates for clinical workers should be considered to increase COVID-19 vaccination uptake in these individuals. Healthcare workers have a key role in reducing the burden of the pandemic, role modeling for preventive behaviors, and also, helping vaccinate others.
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Affiliation(s)
- Nirbachita Biswas
- Department of Public Health, New Mexico State University, Las Cruces, NM, 88003, USA
| | - Toheeb Mustapha
- Department of Public Health, New Mexico State University, Las Cruces, NM, 88003, USA
| | - Jagdish Khubchandani
- Department of Public Health, New Mexico State University, Las Cruces, NM, 88003, USA.
| | - James H Price
- School of Population Health, University of Toledo, Toledo, OH, 43606, USA
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Green-McKenzie J, Shofer FS, Momplaisir F, Kuter BJ, Kruse G, Bialal U, Behta M, O’Donnell J, Al-Ramahi N, Kasbekar N, Sullivan P, Okala P, Brennan PJ. Factors Associated With COVID-19 Vaccine Receipt by Health Care Personnel at a Major Academic Hospital During the First Months of Vaccine Availability. JAMA Netw Open 2021; 4:e2136582. [PMID: 34851399 PMCID: PMC8637254 DOI: 10.1001/jamanetworkopen.2021.36582] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022] Open
Abstract
Importance Several COVID-19 vaccines have been authorized in the US, yet preliminary evidence suggests high levels of vaccine hesitancy and wide racial, ethnic, and socioeconomic disparities in uptake. Objective To assess COVID-19 vaccine acceptance among health care personnel (HCP) during the first 4 months of availability in a large academic hospital, compare acceptance with previously measured vaccine hesitancy, and describe racial, ethnic, and socioeconomic disparities in vaccine uptake. Design, Setting, and Participants This cross-sectional study included 12 610 HCP who were offered COVID-19 vaccination at a major academic hospital in Philadelphia between December 16, 2020, and April 16, 2021. Exposures For each HCP, data were collected on occupational category, age, sex, race and ethnicity (Asian or Pacific Islander, Black or African American [Black], Hispanic, White, and multiracial), and social vulnerability index (SVI) at the zip code of residence. Main Outcomes and Measures Vaccine uptake by HCP at the employee vaccination clinic. Results The study population included 4173 men (34.8%) and 7814 women (65.2%) (623 without data). A total of 1480 were Asian or Pacific Islander (12.4%); 2563 (21.6%), Black; 452 (3.8%), Hispanic; 7086 (59.6%), White; and 192 (1.6%), multiracial; 717 had no data for race and ethnicity. The mean (SD) age was 40.9 (12.4) years, and 9573 (76.0%) received at least 1 vaccine dose during the first 4 months of vaccine availability. Adjusted for age, sex, job position, and SVI, Black (relative risk [RR], 0.69; 95% CI, 0.66-0.72) and multiracial (RR, 0.80; 95% CI, 0.73-0.89) HCP were less likely to receive vaccine compared with White HCP. When stratified by job position, Black nurses (n = 189; 62.8%), Black HCP with some patient contact (n = 466; 49.9%), and Black HCP with no patient contact (n = 636; 56.3%) all had lower vaccine uptake compared with their White and Asian or Pacific Islander counterparts. Similarly, multiracial HCP with some (n = 26; 52.0%) or no (n = 48; 58.5%) patient contact had lower vaccine uptake. In contrast, Black physicians were just as likely to receive the vaccine as physicians of other racial and ethnic groups. Conclusions and Relevance In this cross-sectional study, more than two-thirds of HCP at a large academic hospital in Philadelphia received a COVID-19 vaccine within 4 months of vaccine availability. Although racial, ethnic, and socioeconomic disparities were seen in vaccine uptake, no such disparities were found among physicians. Better understanding of factors driving these disparities may help improve uptake.
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Affiliation(s)
- Judith Green-McKenzie
- Leonard Davis Institute, Division of Occupational Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Frances S. Shofer
- Epidemiology and Biostatistics Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Florence Momplaisir
- Leonard Davis Institute, Department of Infectious Disease, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Barbara J. Kuter
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Gregory Kruse
- University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Usama Bialal
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Maryam Behta
- University of Pennsylvania Health System, Philadelphia
| | - Judith O’Donnell
- Infection Control, Penn Presbyterian Medical Center, Division of Infectious Diseases, Clinical Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Nida Al-Ramahi
- Office of the Chief Medical Officer and Chief Quality Officer, University of Pennsylvania Health System, Philadelphia
| | | | | | - Philip Okala
- University of Pennsylvania Health System, Philadelphia
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Eisenhauer L, Hansen BR, Pandian V. HPV immunization among young adults (HIYA!) in family practice: A quality improvement project. J Adv Nurs 2021; 78:1366-1376. [PMID: 34806202 DOI: 10.1111/jan.15090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/09/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Abstract
AIMS Thousands of anogenital and oropharyngeal cancers every year might be prevented through increased receipt of vaccination against the human papillomavirus (HPV). This project aimed to (1) increase the rate of HPV vaccination status assessment, and (2) improve HPV vaccine initiation and completion rates among 18 to 26-year-old patients in the family practice setting. DESIGN Quality improvement project, pre/post intervention design. METHODS This project implemented the HIYA! (HPV Immunization among Young Adults) Intervention in a private sports and family practice in central New Jersey. HIYA! implemented 10 pre-, during, and post-visit outcome measures during every family medicine visit with an 18 to 26-year-old patient for HPV. Data collection involved retrospective chart review of every eligible patient during the 12-week implementation period from 17 August to 06 November 2020 and during the same 12-week control period in 2019. RESULTS/FINDINGS One hundred sixteen charts from 2019 and 129 charts from 2020 were reviewed for assessment of HPV vaccination status and HPV vaccine initiation and/or completion. Multivariable logistic regression analysis demonstrated that participants in the control group were 84% less likely to be assessed for HPV vaccination status and were 91% less likely to initiate and complete HPV vaccination compared with the intervention group. CONCLUSION This QI project found HIYA! to be an effective and feasible strategy to improve HPV vaccination rates among 18 to 26-year-old patients in a family practice setting. IMPACT The human papillomavirus (HPV) is the most common sexually transmitted disease in the United States, and causes thousands of cancers annually. Although vaccination against HPV can prevent these cancers, vaccination rates remain low, particularly among young adults ages 18 to 26 years. The positive impact of HIYA! was evident based on its success despite the unique challenges presented during the implementation period due to the COVID-19 pandemic.
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Affiliation(s)
- Lauren Eisenhauer
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Bryan R Hansen
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Vinciya Pandian
- Johns Hopkins University School of Nursing, Outcomes After Critical Illness and Surgery (OACIS), Pulmonary Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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COVID-19 Vaccine Hesitancy and Attitude toward Booster Doses among US Healthcare Workers. Vaccines (Basel) 2021; 9:vaccines9111358. [PMID: 34835289 PMCID: PMC8617683 DOI: 10.3390/vaccines9111358] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 01/06/2023] Open
Abstract
Vaccine reluctance among healthcare workers (HCW) can have widespread negative ramifications, including modeling behavior for the general population and challenges with maintaining a healthy workforce so we can respond to a resurgence of the pandemic. We previously reported that only one-third of HCW were willing to take the vaccine as soon as it became available prior to its Emergency Use Authorization (EUA). Here, we re-examine the attitude toward COVID-19 vaccines among HCW several months after the vaccines have been made widely available. In this study, only 7.9% (n = 107) of respondents were hesitant to take the first or second dose of the vaccine. Younger age (18–40 years) and lower level of education attainment (GED or less) were associated with higher vaccine hesitancy, whereas self-identified Asian racial identity was associated with greater acceptance of COVID-19 vaccination. Among the vaccine-hesitant group, more respondents noted mistrust of regulatory authorities (45.3%), government (48.6%), and pharmaceutical companies (50%) than mistrust of doctors (25.4%). Nearly two-thirds of respondents were concerned that vaccination may be ineffective against new strains and booster doses may be required; however, vaccine-hesitant respondents’ acceptance of a hypothetical booster dose was only 14.3%. Overall, vaccine hesitancy was observed to have demographic predictors similar to those previously reported; the hesitancy of some US HCW to receive booster doses may reflect a general hesitancy to receive other forms of vaccination.
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59
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Okuyan B, Bektay MY, Demirci MY, Ay P, Sancar M. Factors associated with Turkish pharmacists' intention to receive COVID-19 vaccine: an observational study. Int J Clin Pharm 2021; 44:247-255. [PMID: 34761359 PMCID: PMC8579896 DOI: 10.1007/s11096-021-01344-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
Background Pharmacists have been taking part in vaccination services during the COVID-19 pandemic. However, research identifying pharmacists’ intention to get COVID-19 vaccine is limited. Aim The objective of this study was to determine the intention to receive COVID-19 vaccine and to identify the factors related to it based on the Health Belief Model framework among Turkish pharmacists. Method This is an observational study conducted between December 2020 and January 2021. The online survey was sent to all hospital and community pharmacists working in Turkey. Transtheoretical Model of Behaviour Change and Health Belief Model were used for the development of the questionnaire. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with the intention to receive COVID-19 vaccine. Results Among all participants (n = 961), 74.7% had an intention to receive the COVID-19 vaccine. In model 1, perceived susceptibility, perceived severity, perceived benefits, and perceived barriers were associated with their intention to receive the COVID-19 vaccine (p < 0.05). In model 2, the intention to receive COVID-19 vaccine was associated with being male, years of experience in the professional field, not having contracted COVID-19, having a pharmacy staff who had contracted COVID-19, and having had received seasonal flu shot within the previous year (p < 0.05). Conclusion This study highlights the factors related to the intention of the pharmacists to receive COVID-19 vaccines. Health Belief Model is the strongest predictor for vaccination intention and could be used to develop behavioural change techniques to promote vaccination.
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Affiliation(s)
- Betul Okuyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey
| | - Muhammed Yunus Bektay
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey
- Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey
| | - Muhammed Yasir Demirci
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey
| | - Pınar Ay
- Department of Public Health, Faculty of Medicine, Marmara University, 34854, Maltepe, Istanbul, Turkey
| | - Mesut Sancar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, 34854, Maltepe, Istanbul, Turkey.
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Temsah MH, Alhuzaimi AN, Aljamaan F, Bahkali F, Al-Eyadhy A, Alrabiaah A, Alhaboob A, Bashiri FA, Alshaer A, Temsah O, Bassrawi R, Alshahrani F, Chaiah Y, Alaraj A, Assiri RA, Jamal A, Batais MA, Saddik B, Halwani R, Alzamil F, Memish ZA, Barry M, Al-Subaie S, Al-Tawfiq JA, Alhasan K. Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey. Front Public Health 2021; 9:752323. [PMID: 34722451 PMCID: PMC8548678 DOI: 10.3389/fpubh.2021.752323] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines. Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia. Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels. Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents.
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Affiliation(s)
- Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah N Alhuzaimi
- Division of Pediatric Cardiology, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Pediatric Cardiology, Department of Cardiac Sciences, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Feras Bahkali
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulkarim Alrabiaah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad A Bashiri
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Alshaer
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Omar Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Rolan Bassrawi
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fatimah Alshahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yazan Chaiah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia.,Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Rasha Assad Assiri
- Department of Basic Medical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amr Jamal
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.,Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Basema Saddik
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,Department of Community and Family Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Fahad Alzamil
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah Al-Subaie
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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61
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Martin CA, Marshall C, Patel P, Goss C, Jenkins DR, Ellwood C, Barton L, Price A, Brunskill NJ, Khunti K, Pareek M. SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: A cross-sectional study. PLoS Med 2021; 18:e1003823. [PMID: 34739480 PMCID: PMC8570522 DOI: 10.1371/journal.pmed.1003823] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/23/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Healthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce. METHODS AND FINDINGS We conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26-0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62-0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction. CONCLUSIONS Ethnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening.
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Affiliation(s)
- Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom.,Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Colette Marshall
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Prashanth Patel
- Department of Chemical Pathology and Metabolic Diseases, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.,Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Charles Goss
- Department of Occupational Health, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - David R Jenkins
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Claire Ellwood
- Department of Pharmacy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Linda Barton
- Department of Haematology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Arthur Price
- Department of Immunology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Nigel J Brunskill
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.,Department of Nephrology, Leicester General Hospital, Leicester, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom.,Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom.,NIHR Applied Research Collaboration East Midlands, Leicester, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom.,Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom.,NIHR Applied Research Collaboration East Midlands, Leicester, United Kingdom
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62
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Gatto NM, Lee JE, Massai D, Zamarripa S, Sasaninia B, Khurana D, Michaels K, Freund D, Nightingale J, Firek A. Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey. Vaccines (Basel) 2021; 9:vaccines9101152. [PMID: 34696260 PMCID: PMC8540702 DOI: 10.3390/vaccines9101152] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers.
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Affiliation(s)
- Nicole M. Gatto
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (D.M.); (D.F.)
- Correspondence:
| | - Jerusha E. Lee
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Donatella Massai
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (D.M.); (D.F.)
| | - Susanna Zamarripa
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Bijan Sasaninia
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Dhruv Khurana
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Kelsey Michaels
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Deborah Freund
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (D.M.); (D.F.)
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Judi Nightingale
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Anthony Firek
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
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63
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Garg I, Hanif H, Javed N, Abbas R, Mirza S, Javaid MA, Pal S, Shekhar R, Sheikh AB. COVID-19 Vaccine Hesitancy in the LGBTQ+ Population: A Systematic Review. Infect Dis Rep 2021; 13:872-887. [PMID: 34698208 PMCID: PMC8544378 DOI: 10.3390/idr13040079] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/24/2021] [Accepted: 10/02/2021] [Indexed: 12/24/2022] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic has disproportionately impacted lesbian, gay, bisexual, transgender, queer (LGBTQ+) people. Despite developing safe and effective COVID-19 vaccines, LGBTQ+ communities still faces challenges due to inequitable access and vaccine hesitancy. Vaccine hesitancy is a delay in the acceptance or refusal of vaccines despite the availability of vaccination services. Various studies have explored and tried to address factors influencing vaccine hesitancy. However, the LGBTQ+ population remains under- and misrepresented in many of these studies. According to the few studies that have focused on the LGBTQ+ population, several factors influencing vaccine hesitancy have been identified, with the most common factors in studies being concern about vaccine safety, vaccine efficacy, and history of bad experiences with healthcare providers. In order to rebuild the confidence of LGBTQ+ people in vaccines, governments, healthcare policymakers, and healthcare providers need to start by acknowledging, and then resolving, these disparities; building trust; dismantling systemic suppression and discrimination; and prioritizing the inclusion of LGBTQ+ people in research studies and public health policies.
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Affiliation(s)
- Ishan Garg
- Department of Internal Medicine, Maimonides Medical Center, Brooklyn, New York, NY 11219, USA;
| | - Hamza Hanif
- Department of General Surgery, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA;
| | - Nismat Javed
- Department of Medicine, Shifa International Hospital, Islamabad 44000, Pakistan;
| | - Ramsha Abbas
- Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan;
| | - Samir Mirza
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan; (S.M.); (M.A.J.)
| | - Muhammad Ali Javaid
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan; (S.M.); (M.A.J.)
| | - Suman Pal
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (S.P.); (R.S.)
| | - Rahul Shekhar
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (S.P.); (R.S.)
| | - Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA; (S.P.); (R.S.)
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64
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Levi ML, McMillan D, Dhandha V, Allan J, D'ercole F. COVID-19 mRNA vaccination, reactogenicity, work-related absences and the impact on operating room staffing: A cross-sectional study. ACTA ACUST UNITED AC 2021; 25:100220. [PMID: 34604550 PMCID: PMC8479312 DOI: 10.1016/j.pcorm.2021.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/21/2021] [Accepted: 09/25/2021] [Indexed: 11/26/2022]
Abstract
Background The COVID-19 pandemic has caused disruption to healthcare delivery worldwide including in the delivery of surgical services. The introduction of mRNA COVID vaccines and the significant reactogenicity seen with vaccination has caused an unanticipated impact on the operating room workforce via unanticipated paid time off after employee vaccination. Methods A retrospective cross-sectional survey was made available to approximately 33,000 front-line healthcare workers, students and volunteers who were offered voluntary vaccination in a state-wide healthcare system during phase one of the state's vaccine roll-out. The primary study aim was to determine the frequency of unanticipated paid time off, and the secondary study aim was to identify any demographic determinants influencing the need for unanticipated time off work secondary to adverse effects. Results 4009 responses were received, a 12.15% response rate. When looking specifically at individuals who did not proactively schedule themselves for time off after vaccination, we determined that unanticipated paid administrative leave was required for 4.9% and 19.79% of individuals after the first and second doses of vaccine, respectively. The average lengths of absence were 1.66 days and 1.39 days for the first and second doses, respectively. There were no statistically significant differences found in the need for unanticipated leave when compared by vaccine manufacturer, gender, age, ethnicity, or job description. However, individuals with a bachelor's degree demonstrated a significantly higher unanticipated leave requirement than respondents who reported other educational backgrounds. Conclusions The ability to staff operating rooms and other critical healthcare services may be negatively affected as a result of COVID-19 mRNA vaccination reactogenicity and subsequent unanticipated paid administrative leave. For future COVID-19 boosters or during other pandemics in which mRNA vaccination is recommended, employees should proactively schedule their vaccination(s) in conjunction with their work schedules to minimize the impact of reactogenicity and unanticipated time off on the operating room schedule and patient care.
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Affiliation(s)
- Marc L Levi
- Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, Campus Box 7010, Chapel Hill, NC 27599, United States
| | - Daniel McMillan
- Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, Chapel Hill, NC, United States
| | - Vishal Dhandha
- Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, Chapel Hill, NC, United States
| | - Jennifer Allan
- Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, Chapel Hill, NC, United States
| | - Fran D'ercole
- Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, Chapel Hill, NC, United States
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65
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Bragazzi NL. The COVID-19 Pandemic Seen from a Syndemic Perspective: The LGBTQIA2SP+ Community. Infect Dis Rep 2021; 13:865-871. [PMID: 34698177 PMCID: PMC8544476 DOI: 10.3390/idr13040078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/14/2022] Open
Abstract
An adverse condition or a disease can (either directly or indirectly) interact in a synergistic fashion with other adverse conditions or diseases/maladies, and co-cluster together with them: this fundamental observation is at the basis of the term "syndemic" (a portmanteau for "synergistic epidemic") [...].
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Affiliation(s)
- Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON M3J 1P3, Canada
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66
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Woolf K, McManus IC, Martin CA, Nellums LB, Guyatt AL, Melbourne C, Bryant L, Gogoi M, Wobi F, Al-Oraibi A, Hassan O, Gupta A, John C, Tobin MD, Carr S, Simpson S, Gregary B, Aujayeb A, Zingwe S, Reza R, Gray LJ, Khunti K, Pareek M. Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 9:100180. [PMID: 34308406 PMCID: PMC8287519 DOI: 10.1016/j.lanepe.2021.100180] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND In most countries, healthcare workers (HCWs) represent a priority group for vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to their elevated risk of COVID-19 and potential contribution to nosocomial SARS-CoV-2 transmission. Concerns have been raised that HCWs from ethnic minority groups are more likely to be vaccine hesitant (defined by the World Health Organisation as refusing or delaying a vaccination) than those of White ethnicity, but there are limited data on SARS-CoV-2 vaccine hesitancy and its predictors in UK HCWs. METHODS Nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK HCWs. We analysed ethnic differences in SARS-CoV-2 vaccine hesitancy adjusting for demographics, vaccine trust, and perceived risk of COVID-19. We explored reasons for hesitancy in qualitative data using a framework analysis. FINDINGS 11,584 HCWs were included in the cohort analysis. 23% (2704) reported vaccine hesitancy. Compared to White British HCWs (21.3% hesitant), HCWs from Black Caribbean (54.2%), Mixed White and Black Caribbean (38.1%), Black African (34.4%), Chinese (33.1%), Pakistani (30.4%), and White Other (28.7%) ethnic groups were significantly more likely to be hesitant. In adjusted analysis, Black Caribbean (aOR 3.37, 95% CI 2.11 - 5.37), Black African (aOR 2.05, 95% CI 1.49 - 2.82), White Other ethnic groups (aOR 1.48, 95% CI 1.19 - 1.84) were significantly more likely to be hesitant. Other independent predictors of hesitancy were younger age, female sex, higher score on a COVID-19 conspiracy beliefs scale, lower trust in employer, lack of influenza vaccine uptake in the previous season, previous COVID-19, and pregnancy. Qualitative data from 99 participants identified the following contributors to hesitancy: lack of trust in government and employers, safety concerns due to the speed of vaccine development, lack of ethnic diversity in vaccine studies, and confusing and conflicting information. Participants felt uptake in ethnic minority communities might be improved through inclusive communication, involving HCWs in the vaccine rollout, and promoting vaccination through trusted networks. INTERPRETATION Despite increased risk of COVID-19, HCWs from some ethnic minority groups are more likely to be vaccine hesitant than their White British colleagues. Strategies to build trust and dispel myths surrounding the COVID-19 vaccine in these communities are urgently required. Emphasis should be placed on the safety and benefit of SARS-CoV-2 vaccination in pregnancy and in those with previous COVID-19. Public health communications should be inclusive, non-stigmatising and utilise trusted networks. FUNDING UKRI-MRC and NIHR.
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Affiliation(s)
| | | | - Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, United Kingdom
| | - Laura B Nellums
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom
| | - Anna L Guyatt
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Carl Melbourne
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, United Kingdom
| | - Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, United Kingdom
| | - Fatimah Wobi
- Department of Respiratory Sciences, University of Leicester, United Kingdom
| | - Amani Al-Oraibi
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom
| | - Osama Hassan
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom
| | - Amit Gupta
- Oxford University Hospitals NHS Foundation Trust, United Kingdom
| | - Catherine John
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Martin D Tobin
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Sue Carr
- University Hospitals Leicester NHS Trust, Leicester Royal Infirmary, United Kingdom
- General Medical Council, United Kingdom
| | - Sandra Simpson
- Nottinghamshire Healthcare NHS Foundation Trust, United Kingdom
| | - Bindu Gregary
- Lancashire Clinical Research Facility, Royal Preston Hospital, United Kingdom
| | - Avinash Aujayeb
- Respiratory department, Northumbria Specialist Emergency Care Hospital, United Kingdom
| | - Stephen Zingwe
- Research and Development Department, Berkshire Healthcare NHS Foundation Trust, United Kingdom
| | - Rubina Reza
- Derbyshire Healthcare NHS Foundation Trust Centre for Research and Development, Kingsway Hospital site, United Kingdom
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, United Kingdom
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67
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Wake AD. The Acceptance Rate Toward COVID-19 Vaccine in Africa: A Systematic Review and Meta-analysis. Glob Pediatr Health 2021; 8:2333794X211048738. [PMID: 34616860 PMCID: PMC8488505 DOI: 10.1177/2333794x211048738] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/30/2021] [Accepted: 09/07/2021] [Indexed: 01/09/2023] Open
Abstract
Background: The Coronavirus Disease 2019 (COVID-19) pandemic remains serious public issue. COVID-19 vaccine is a vital strategy to prevent this critical pandemic. However, unwillingness to take this vaccine are key barriers to manage the COVID-19 pandemic. The control of this pandemic will depend principally on the people acceptance of COVID-19 vaccine. Therefore, this systematic review and meta-analysis was intended to determine the acceptance rate toward COVID-19 vaccine in Africa. Methods: African Journals OnLine, PubMed, Cochrane Review, HINARI, EMBASE, Google Scholar, Web of Science, and Scopus were used to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Random-effect model, a funnel plot, Egger's test, I 2 statistic, subgroup analysis was done. The study was performed by using a STATA version 11 statistical software. Results: A total of 22 studies with 33,912 study participants were included in this systematic review and meta-analysis. From this finding, the pooled prevalence of acceptance toward COVID-19 vaccine among adults in Africa was 48.93% (95% CI: [39.49, 58.37]). The subgroup analysis revealed that the pooled prevalence of COVID-19 vaccine acceptance among adults in Africa was highest (66.03%, 95% CI [62.84, 69.22]) in Southern Africa, and Lowest (24.28%, 95% CI [3.26, 45.30]) in Northern Africa. Conclusion: This study showed that the estimate of the pooled prevalence of acceptance toward COVID-19 vaccine among adults in Africa was very low. All concerned bodies should be actively involved to improve the acceptance rate of COVID-19 vaccine.
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Malik A, Malik J, Ishaq U. Acceptance of COVID-19 vaccine in Pakistan among health care workers. PLoS One 2021; 16:e0257237. [PMID: 34525110 PMCID: PMC8443053 DOI: 10.1371/journal.pone.0257237] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/27/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Acceptance of the COVID-19 vaccine will impart a pivotal role in eradicating the virus. In Pakistan, health care workers (HCWs) are the first group to receive vaccination. This survey aimed at the level of acceptance to the COVID-19 vaccine and predictors of non-acceptance in HCWs. METHOD This was a cross-sectional study design and data were collected through 3rd December 2020 and February 14th, 2021. An English questionnaire was distributed through social media platforms and administration of affiliate hospitals along with snowball sampling for private hospitals. RESULTS Out of 5,237 responses, 3,679 (70.2%) accepted COVID-19 vaccination and 1,284 (24.5%) wanted to delay until more data was available. Only 5.2% of HCWs rejected being vaccinated. Vaccine acceptance was more in young (76%) and female gender (63.3%) who worked in a tertiary care hospital (51.2%) and were direct patient care providers (61.3%). The reason for rejection in females was doubtful vaccine effectiveness (31.48%) while males rejected due to prior COVID-19 exposure (42.19%) and side effect profile of the vaccine (33.17%). Logistic regression analysis demonstrated age between 51-60 years, female gender, Pashtuns, those working in the specialty of medicine and allied, taking direct care of COVID-19 patients, higher education, and prior COVID-19 infection as the predictors for acceptance or rejection of COVID-19 vaccine. CONCLUSION In conclusion, this survey suggests that early on in a vaccination drive, majority of the HCWs in Pakistan are willing to be vaccinated and only a small number of participants would actually reject being vaccinated.
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Affiliation(s)
- Asmara Malik
- Department of Community Medicine, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Jahanzeb Malik
- Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
| | - Uzma Ishaq
- Department of Hematology, Foundation University Medical College, Islamabad, Pakistan
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Marcelin JR, Swartz TH, Bernice F, Berthaud V, Christian R, da Costa C, Fadul N, Floris-Moore M, Hlatshwayo M, Johansson P, Kullar R, Manning K, McGee EU, Medlin C, Piggott DA, Syed U, Snowden J, Tan T, Abdul-Mutakabbir JC. Addressing and Inspiring Vaccine Confidence in Black, Indigenous, and People of Color During the Coronavirus Disease 2019 Pandemic. Open Forum Infect Dis 2021; 8:ofab417. [PMID: 34580644 PMCID: PMC8385873 DOI: 10.1093/ofid/ofab417] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/06/2021] [Indexed: 12/26/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, we have witnessed profound health inequities suffered by Black, Indigenous, and People of Color (BIPOC). These manifested as differential access to testing early in the pandemic, rates of severe disease and death 2-3 times higher than white Americans, and, now, significantly lower vaccine uptake compared with their share of the population affected by COVID-19. This article explores the impact of these COVID-19 inequities (and the underlying cause, structural racism) on vaccine acceptance in BIPOC populations, ways to establish trustworthiness of healthcare institutions, increase vaccine access for BIPOC communities, and inspire confidence in COVID-19 vaccines.
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Affiliation(s)
- Jasmine R Marcelin
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha Nebraska, USA
| | - Talia H Swartz
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Fidelia Bernice
- Department of Pharmacy, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Vladimir Berthaud
- Division of Infectious Diseases, Meharry Medical College, Nashville, Tennessee, USA
| | - Robbie Christian
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA
| | - Christopher da Costa
- The Coalition for Epidemic Preparedness Innovations, Washington, District of Columbia, USA
| | - Nada Fadul
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha Nebraska, USA
| | - Michelle Floris-Moore
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Matifadza Hlatshwayo
- Division of Infectious Diseases, John Cochrane VA Medical Center, St. Louis, Missouri, USA
| | - Patrik Johansson
- Department of Medical Education and Clinical Sciences, Washington State University, Seattle, Washington, USA
| | - Ravina Kullar
- Expert Stewardship Inc., Newport Beach, California, USA
| | - Kimberly Manning
- Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Edoabasi U McGee
- Philadelphia College of Osteopathic Medicine, School of Pharmacy, Suwanee, Georgia, USA
| | | | - Damani A Piggott
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Uzma Syed
- South Shore Infectious Disease & Travel Medicine Consultants, P.C., Bay Shore, New York, USA
| | - Jessica Snowden
- Division of Pediatric Infectious Disease, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tina Tan
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
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Willingness to Take COVID-19 Vaccines in Ethiopia: An Instrumental Variable Probit Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178892. [PMID: 34501483 PMCID: PMC8431524 DOI: 10.3390/ijerph18178892] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 01/23/2023]
Abstract
This paper analyzed the factors influencing the willingness of Ethiopia’s population to take COVID-19 vaccines. The data included the COVID-19 High Frequency Phone Survey of Households in Ethiopia that were collected in 2021. This paper relied on the 10th round of the survey, which was comprised of 2178 households. The Instrumental Variable Probit regression model was used to analyze the data. The results showed that majority of the respondents (92.33%) would receiveCOVID-19 vaccines, while 6.61% and 1.06% were, respectively, unwilling and unsure. Across the regions of Ethiopia, Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (99.30%), Oromia (97.54%), Tigray (97.04%) and Gambela (95.42%) had the highest proportions of respondents willing to have the vaccine. Vaccine safety concern was the topmost reason for those unwilling to receive the vaccine. The results of the Instrumental Variable Probit regression showed that currently working, age, engagement with non-farm businesses and region of residence significantly influenced the population’s willingness to take the vaccine (p < 0.05). It was concluded that although the willingness be vaccinated was impressive, without everyone being receiving the COVID-19 vaccine, infection risk can still be high; this is due to the persistent mutation of the viral strains. Thus, there is a need to intensify efforts toward addressing the safety issues of COVID-19 vaccines, while efforts to enhance acceptability should focus on the youth population and those who are unemployed.
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COVID-19 Vaccine Hesitancy-A Scoping Review of Literature in High-Income Countries. Vaccines (Basel) 2021; 9:vaccines9080900. [PMID: 34452026 PMCID: PMC8402587 DOI: 10.3390/vaccines9080900] [Citation(s) in RCA: 242] [Impact Index Per Article: 80.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/25/2021] [Accepted: 08/10/2021] [Indexed: 12/21/2022] Open
Abstract
Vaccine hesitancy forms a critical barrier to the uptake of COVID-19 vaccine in high-income countries or regions. This review aims to summarize rates of COVID-19 hesitancy and its determinants in high-income countries or regions. A scoping review was conducted in Medline®, Embase®, CINAHL®, and Scopus® and was reported in accordance with the PRISMA-SCr checklist. The search was current as of March 2021. Studies which evaluated COVID-19 vaccine hesitancy and its determinants in high-income countries (US$12,536 or more GNI per capita in 2019) were included. Studies conducted in low, lower-middle, and upper-middle income countries or regions were excluded. Factors associated with vaccine hesitancy were grouped into four themes (vaccine specific, individual, group, or contextual related factors). Of 2237 articles retrieved, 97 articles were included in this review. Most studies were conducted in U.S. (n = 39) and Italy (n = 9). The rates of vaccine hesitancy across high-income countries or regions ranged from 7-77.9%. 46 studies (47.4%) had rates of 30% and more. Younger age, females, not being of white ethnicity and lower education were common contextual factors associated with increased vaccine hesitancy. Lack of recent history of influenza vaccination, lower self-perceived risk of contracting COVID-19, lesser fear of COVID-19, believing that COVID-19 is not severe and not having chronic medical conditions were most frequently studied individual/group factors associated with increased vaccine hesitancy. Common vaccine-specific factors associated with increased vaccine hesitancy included beliefs that vaccine are not safe/effective and increased concerns about rapid development of COVID-19 vaccines. Given the heterogeneity in vaccine hesitancy definitions used across studies, there is a need for standardization in its assessment. This review has summarized COVID-19 vaccine hesitancy determinants that national policymakers can use when formulating health policies related to COVID-19 vaccination.
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Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations. Vaccines (Basel) 2021; 9:vaccines9080873. [PMID: 34452000 PMCID: PMC8402447 DOI: 10.3390/vaccines9080873] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022] Open
Abstract
Vaccination currently appears to be the only strategy to contain the spread of COVID-19. At the same time, vaccine hesitancy (VH) could limit its efficacy and has, therefore, attracted the attention of Public Health Systems. This systematic review aimed at assessing anti-COVID-19 vaccine acceptance rates worldwide and at identifying populations more prone to vaccine hesitancy, for which specific interventions should be planned. PubMed database was searched using a purposely formulated string. One hundred out of the 9243 studies retrieved were considered pertinent and thus included in the analyses. VH rate was analyzed according to patient geographical origin, ethnicity, age, study setting, and method used for data collection; data from specific populations were separately analyzed. Overall, this study demonstrated significant differences in terms of VH in the general population and in the specific subgroups examined according to geographical, demographic factors, as well as associated comorbidities, underlining the need for purposely designed studies in specific populations from the different countries, to design targeted programs aimed at increasing awareness for confidence and complacency toward COVID-19 vaccines.
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Momplaisir FM, Kuter BJ, Ghadimi F, Browne S, Nkwihoreze H, Feemster KA, Frank I, Faig W, Shen AK, Offit PA, Green-McKenzie J. Racial/Ethnic Differences in COVID-19 Vaccine Hesitancy Among Health Care Workers in 2 Large Academic Hospitals. JAMA Netw Open 2021; 4:e2121931. [PMID: 34459907 PMCID: PMC8406078 DOI: 10.1001/jamanetworkopen.2021.21931] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/15/2021] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE Significant differences in hesitancy to receive COVID-19 vaccination by race/ethnicity have been observed in several settings. Racial/ethnic differences in COVID-19 vaccine hesitancy among health care workers (HCWs), who face occupational and community exposure to COVID-19, have not been well described. OBJECTIVE To assess hesitancy to COVID-19 vaccination among HCWs across different racial/ethnic groups and assess factors associated with vaccine hesitancy. DESIGN, SETTING, AND PARTICIPANTS This survey study was conducted among HCWs from 2 large academic hospitals (ie, a children's hospital and an adult hospital) over a 3-week period in November and December 2020. Eligible participants were HCWs with and without direct patient contact. A 3-step hierarchical multivariable logistic regression was used to evaluate associations between race/ethnicity and vaccine hesitancy controlling for demographic characteristics, employment characteristics, COVID-19 exposure risk, and being up to date with routine vaccinations. Data were analyzed from February through March 2021. MAIN OUTCOMES AND MEASURES Vaccine hesitancy, defined as not planning on, being unsure about, or planning to delay vaccination, served as the outcome. RESULTS Among 34 865 HCWs eligible for this study, 12 034 individuals (34.5%) completed the survey and 10 871 individuals (32.2%) completed the survey and reported their race/ethnicity. Among 10 866 of these HCWs with data on sex, 8362 individuals (76.9%) were women, and among 10 833 HCWs with age data, 5923 individuals (54.5%) were younger than age 40 years. (Percentages for demographic and clinical characteristics are among the number of respondents for each type of question.) There were 8388 White individuals (77.2%), 882 Black individuals (8.1%), 845 Asian individuals (7.8%), and 449 individuals with other or mixed race/ethnicity (4.1%), and there were 307 Hispanic or Latino individuals (2.8%). Vaccine hesitancy was highest among Black HCWs (732 individuals [83.0%]) and Hispanic or Latino HCWs (195 individuals [63.5%]) (P < .001). Among 5440 HCWs with vaccine hesitancy, reasons given for hesitancy included concerns about side effects (4737 individuals [87.1%]), newness of the vaccine (4306 individuals [79.2%]), and lack of vaccine knowledge (4091 individuals [75.2%]). The adjusted odds ratio (aOR) for vaccine hesitancy was 4.98 (95% CI, 4.11-6.03) among Black HCWs, 2.10 (95% CI, 1.63-2.70) among Hispanic or Latino HCWs, 1.48 (95% CI, 1.21-1.82) among HCWs with other or mixed race/ethnicity, and 1.47 (95% CI, 1.26-1.71) among Asian HCWs compared with White HCWs (P < .001). The aOR was decreased among Black HCWs when adjusting for employment characteristics and COVID-19 exposure risk (aOR, 4.87; 95% CI, 3.96-6.00; P < .001) and being up to date with prior vaccines (aOR, 4.48; 95% CI, 3.62-5.53; P < .001) but not among HCWs with other racial/ethnic backgrounds. CONCLUSIONS AND RELEVANCE This study found that vaccine hesitancy before the authorization of the COVID-19 vaccine was increased among Black, Hispanic or Latino, and Asian HCWs compared with White HCWs. These findings suggest that interventions focused on addressing vaccine hesitancy among HCWs are needed.
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Affiliation(s)
- Florence M. Momplaisir
- Division of Infectious Diseases, Department of Medicine Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Barbara J. Kuter
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Fatemeh Ghadimi
- Division of Infectious Diseases, Department of Medicine Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Safa Browne
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Hervette Nkwihoreze
- Division of Infectious Diseases, Department of Medicine Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Kristen A. Feemster
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of Infectious Diseases, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ian Frank
- Division of Infectious Diseases, Department of Medicine Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Walter Faig
- Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania
| | - Angela K. Shen
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Paul A. Offit
- Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of Infectious Diseases, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Judith Green-McKenzie
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Division of Occupational and Environmental Medicine, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Batty GD, Deary IJ, Fawns-Ritchie C, Gale CR, Altschul D. Pre-pandemic cognitive function and COVID-19 vaccine hesitancy: cohort study. Brain Behav Immun 2021; 96:100-105. [PMID: 34022372 PMCID: PMC8133799 DOI: 10.1016/j.bbi.2021.05.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Whereas several predictors of COVID-19 vaccine hesitancy have been reported, the role of cognitive function is largely unknown. Accordingly, our objective was to evaluate the association between scores from an array of cognitive function tests and self-reported vaccine hesitancy after the announcement of the successful testing of the first COVID-19 vaccine (Oxford University/AstraZeneca). METHODS We used individual-level data from a pandemic-focused study ('COVID Survey'), a prospective cohort study nested within United Kingdom Understanding Society ('Main Survey'). In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 11,740 individuals (6702 women) aged 16-95 years. Pre-pandemic scores on general cognitive function, ascertained from a battery of six tests, were captured in 2011/12 wave of the Main Survey. Study members self-reported their intention to take up a vaccination in the COVID-19 Survey. RESULTS Of the study sample, 17.2% (N = 1842) indicated they were hesitant about having the vaccine. After adjustment for age, sex, and ethnicity, study members with a lower baseline cognition score were markedly more likely to be vaccine hesitant (odds ratio per standard deviation lower score in cognition; 95% confidence interval: 1.76; 1.62, 1.90). Adjustment for mental and physical health plus household shielding status had no impact on these results, whereas controlling for educational attainment led to partial attenuation but the probability of hesitancy was still elevated (1.52; 1.37, 1.67). There was a linear association for vaccine hesitancy across the full range of cognition scores (p for trend: p < 0.0001). CONCLUSIONS Erroneous social media reports might have complicated personal decision-making, leading to people with lower cognitive ability being vaccine-hesitant. With individuals with lower cognition also experiencing higher rates of COVID-19 in studies conducted prior to vaccine distribution, these new findings are suggestive of a potential additional disease burden.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, UK.
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, UK
| | | | - Catharine R Gale
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, UK; Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Drew Altschul
- Department of Psychology, University of Edinburgh, UK
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Mogaji E. Marketing the COVID-19 vaccine and the implications for public health. Vaccine 2021; 39:4766-4768. [PMID: 34281742 PMCID: PMC8275479 DOI: 10.1016/j.vaccine.2021.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 01/23/2023]
Abstract
COVID-19 vaccines are new brands of consumer health technology being introduced to the market. Considering consumer behaviour approaches in this time of crisis, the risk of vaccine hesitancy, the call for more transparency and effective messaging to gain trust, and equitable distribution of this vaccine, this is unexplored theoretical terrain. This commentary takes a multidisciplinary approach to understand and theoretically explore the marketing, distribution, and acceptance of the COVID-19 vaccine. The paper integrates marketing principles, including advertisement and branding of consumer health technology with supply chain management, public affairs, and public health. A theoretical framework was presented to illustrate this relationship and key areas of concerns. The practical implications relevant to equity, ethics, education, employment, and the economic impact was presented.
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Affiliation(s)
- Emmanuel Mogaji
- Department of Marketing, Events and Tourism, University of Greenwich, London, United Kingdom.
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Chand AA. COVID-19 and vaccination rollout in Fiji: Challenges caused by digital platform. Int J Surg 2021; 91:106001. [PMID: 34153530 PMCID: PMC8215508 DOI: 10.1016/j.ijsu.2021.106001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/22/2022]
Abstract
Since the beginning of the pandemic, a variety of interventions have reduced SARS-CoV-2 virus infection and mortality, including individual precautions such as wearing proper personal protective equipment (i.e., hand gloves, facemasks, and face shields), social distancing, handwashing, and limiting interpersonal interaction to outside situations. The most promising hope for ending the COVID-19 pandemic is the successful launch of COVID-19 vaccines. In response, this letter to editor will disclose the rollout of COVID-19 vaccination and challenges caused by digital platforms in Fiji.
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Affiliation(s)
- Aneesh A Chand
- School of Information Technology, Engineering, Mathematics and Physics (STEMP), Suva, Fiji.
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Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China. Vaccines (Basel) 2021; 9:vaccines9070704. [PMID: 34199143 PMCID: PMC8310137 DOI: 10.3390/vaccines9070704] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 12/14/2022] Open
Abstract
Surveys showed that vaccine hesitancy may influence the acceptance of COVID-19 vaccines in healthcare workers (HCWs) and the general population. Currently, the actual acceptance of COVID-19 vaccination in HCWs has rarely been reported. In the present survey, we investigated the real-world acceptance of COVID-19 vaccination in HCWs in perinatal medicine during the first three-month period of vaccination in China and to identify the main reason for the decline of vaccination. HCWs (1087) who participated in a Chinese national symposium on perinatal medicine during 16–18 April 2021 were invited to answer a 27-question questionnaire online. A total of 1051 HCWs completed the questionnaire. Of them, 86.2% (906/1051) accepted the COVID-19 vaccination and 13.8% (145/1051) declined the vaccination. Because of the vaccine hesitancy, one-fourth of the vaccinated participants did not accept the vaccination until consulted with others or requested by employers. The main reason for the decline of vaccination in 145 unvaccinated HCWs was the concern about vaccine safety. The results indicate that vaccination request by employers may promote vaccine acceptance. More convincing data on the safety of COVID-19 vaccines appears to be important to increase the acceptance of vaccination.
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Wake AD. The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: "Vaccination Refusal Could Prolong the War of This Pandemic" - A Systematic Review. Risk Manag Healthc Policy 2021; 14:2609-2623. [PMID: 34188572 PMCID: PMC8232962 DOI: 10.2147/rmhp.s311074] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, spreads globally, since its declaration by the World Health Organization (WHO) as a COVID-19 pandemic on March 11, 2020. COVID-19 vaccine is a crucial preventive approach that can halt this pandemic. The present systematic review was aimed to assess the level of willingness to receive COVID-19 vaccine and its associated factors. METHODS A comprehensive literature search was conducted by using various online databases such as PubMed/MEDLINE, HINARI, EMBASE, Google Scholar, Web of Science, Scopus, African journals, and Google for grey literature which were used to search the related articles up to the period of May 08, 2021. RESULTS The overall rate of participants' willingness to receive the COVID-19 vaccine was ranged from 27.7% to 91.3%, which was from Congo and China, respectively. Factors such as age, educational status, gender, income, residency, occupation, marital status, race/ethnicity, perceived risk of COVID-19, trust in healthcare system, health insurance, norms, attitude towards vaccine, perceived benefit of vaccine, perceived vaccine barriers, self-efficacy, up-to-date on vaccinations, tested for COVID-19 in the past, perceived efficacy of the COVID-19 vaccination, recommended for vaccination, political leaning, perceived severity of COVID-19, perceived effectiveness of COVID-19 vaccine, belief that vaccination makes them feel less worried about COVID-19, believing in mandatory COVID-19 vaccination, perceived potential vaccine harms, presence of chronic disease, confidence, COVID-19 vaccine safety concern, working in healthcare field, believing vaccines can stop the pandemic, fear about COVID-19, cues to action, COVID-19 vaccine hesitancy, complacency, and receiving any vaccine in the past 5 years were associated with the willingness of receive COVID-19 vaccine. CONCLUSION There were insufficient levels of willingness to receive COVID-19 vaccine, and several factors were associated with it. Health education should be provided concerning this vaccine to improve the willingness of the community.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Asella, Ethiopia
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Janssen C, Maillard A, Bodelet C, Claudel AL, Gaillat J, Delory T. Hesitancy towards COVID-19 Vaccination among Healthcare Workers: A Multi-Centric Survey in France. Vaccines (Basel) 2021; 9:547. [PMID: 34067490 PMCID: PMC8224571 DOI: 10.3390/vaccines9060547] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 12/27/2022] Open
Abstract
Vaccination programs against COVID-19 are being scaled up. We aimed to assess the effects of vaccine characteristics on vaccine hesitancy among healthcare workers in a multi-center survey conducted within French healthcare facilities from 1 December 2020 to 26 March 2021. We invited any healthcare workers naïve of COVID-19 vaccination to complete an online self-questionnaire. They reported on their socio-demographic characteristics, as well as their perception and beliefs towards vaccination. We measured their willingness to get vaccinated in eight scenarios for candidates' vaccines presented sequentially (1 to 4-point scale). Candidates' vaccines varied for efficacy (25%, 50%, 100%), length of immunization (1 year or lifetime), frequency (<1/100, <1/10,000), and severity (none, moderate, severe) of adverse events. We analyzed 4349 healthcare workers' responses with interpretable questionnaires. The crude willingness to get vaccinated was 53.2% and increased over time. We clustered the trajectories of responses using an unsupervised classification algorithm (k-means) and identified four groups of healthcare workers: those willing to get vaccinated in any scenario (18%), those not willing to get vaccinated at all (22%), and those hesitating but more likely to accept (32%) or reject (28%) the vaccination depending on the scenario. In these last two subgroups, vaccine acceptance was growing with age, educational background and was higher among men with condition. Compared to an ideal vaccine candidate, a 50% reduced efficacy resulted in an average drop in acceptance by 0.8 (SD ± 0.8, -23.5%), while it was ranging from 1.4 (SD ± 1.0, -38.4%) to 2.1 (SD ± 1.0, -58.4%) in case of severe but rare adverse event. The acceptance of a mandatory immunization program was 29.6% overall and was positively correlated to the willingness to get vaccinated, ranging from 2.4% to 60.0%. Even if healthcare workers represent a heterogeneous population, most (80%) could accept the vaccination against COVID-19. Their willingness to get the vaccine increased over time and as immunization programs became available. Among hesitant professionals, the fear of adverse events was the main concern. Targeted information campaigns reassuring about adverse events may increase vaccine coverage, in a population with a strong opinion about mandatory immunization programs.
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Affiliation(s)
- Cécile Janssen
- Centre Hospitalier Annecy Genevois, Infectious Diseases Unit, F-74374 Annecy, France;
| | - Alexis Maillard
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
| | - Céline Bodelet
- Laboratoire Inter-universitaire de Psychologie (LIP-PC2S), Université Grenoble, Alpes 1251 Avenue Centrale, 38400 Saint-Martin-d’Hères, France;
| | - Anne-Laure Claudel
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
| | - Jacques Gaillat
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
| | - Tristan Delory
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
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80
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Comparisons of Motivation to Receive COVID-19 Vaccination and Related Factors between Frontline Physicians and Nurses and the Public in Taiwan: Applying the Extended Protection Motivation Theory. Vaccines (Basel) 2021; 9:vaccines9050528. [PMID: 34065222 PMCID: PMC8160641 DOI: 10.3390/vaccines9050528] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 01/28/2023] Open
Abstract
This study aimed to compare the differences in motivation to receive a COVID-19 vaccination between frontline physicians and nurses and the Taiwanese public. The associations of threat and coping appraisals, as described in Protection Motivation Theory (PMT), with motivation to receive COVID-19 vaccination were compared between these groups, too. We recruited 279 frontline physicians and nurses and 768 members of the public by a Facebook advertisement. Participants’ motivation to receive COVID-19 vaccination, perceived severity of and vulnerability to COVID-19, self-efficacy and response efficacy of COVID-19 vaccination, response cost of COVID-19 vaccination, and knowledge about the mechanism of COVID-19 vaccination in light of PMT were determined. The results demonstrated that frontline health workers had higher motivation to receive COVID-19 vaccination than the public. Response efficacy and knowledge of COVID-19 vaccination were positively associated with motivation to receive COVID-19 vaccination in both frontline health workers and the public, whereas perceived vulnerability, perceived severity, and response cost of COVID-19 vaccination were positively associated with motivation in the public but not in frontline physicians and nurses. The factors related to motivation to receive COVID-19 vaccination should be considered when designing programs to increase motivation to receive COVID-19 vaccination among frontline health workers and the public.
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Aloweidi A, Bsisu I, Suleiman A, Abu-Halaweh S, Almustafa M, Aqel M, Amro A, Radwan N, Assaf D, Abdullah MZ, Albataineh M, Mahasneh A, Badaineh A, Obeidat H. Hesitancy towards COVID-19 Vaccines: An Analytical Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5111. [PMID: 34065888 PMCID: PMC8151245 DOI: 10.3390/ijerph18105111] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/16/2022]
Abstract
Vaccination is the most promising strategy to counter the spread of Coronavirus Disease 2019 (COVID-19). Vaccine hesitancy is a serious global phenomenon, and therefore the aim of this cross-sectional study was to explore the effect of educational background, work field, and social media on attitudes towards vaccination in Jordan. We compared between medical personnel who were in direct contact with patients and non-medical individuals at Jordan University Hospital in terms of demographics, knowledge about COVID-19 vaccines, rumors received via social media, their trust in these vaccines, and the encouraging factors for vaccination. 646 individuals were enrolled in this study, of which 287 (44.4%) were from medical field, and 359 (55.6%) from non-medical field. 226 (35%) were planning to take the vaccine once available, with a positive response from 131 (45.6%) medical field workers, compared to 94 (26.2%) non-medical individuals (p < 0.001). The social media rumor that was believed the most was the unsafety of these vaccines (n = 283; 43.8%). Only 163 (56.8%) of medical persons did not believe any of the circulated rumors, compared to 126 (35.1%) of non-medical persons (p < 0.001). The effect of medical personnel advice (OR = 0.83; 95% CI = 0.70 to 0.98; p = 0.026) and social media (OR = 1.21; 95% CI = 1.04 to 1.41; p = 0.012) were significantly associated with the willingness to take COVID-19 vaccine once available. In conclusion, medical personnel and social media play a crucial role in increasing the society's inclination towards vaccination by providing the community with updated evidence-based information about COVID-19 vaccines as an efficient medical countermeasure and by correcting the previously spread misinformation.
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Affiliation(s)
- Abdelkarim Aloweidi
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Isam Bsisu
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Aiman Suleiman
- Anesthesia and Intensive Care Department, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Sami Abu-Halaweh
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Mahmoud Almustafa
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Mohammad Aqel
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Aous Amro
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Neveen Radwan
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Dima Assaf
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Malak Ziyad Abdullah
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Malak Albataineh
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Aya Mahasneh
- Department of Anesthesia and Intensive Care, School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.A.); (S.A.-H.); (M.A.); (M.A.); (A.A.); (N.R.); (D.A.); Black-diamond-8-@hotmail.com (M.Z.A.); (M.A.); (A.M.)
| | - Ala’a Badaineh
- Department of Anesthesia and Intensive Care, Prince Hamza Hospital, Amman 11947, Jordan;
| | - Hala Obeidat
- Maternal and Child Health Nursing Department, School of Nursing, Mutah University, Karak 61710, Jordan;
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Batty GD, Deary IJ, Fawns-Ritchie C, Gale CR, Altschul D. Pre-pandemic Cognitive Function and COVID-19 Vaccine Hesitancy: Cohort Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.16.21253634. [PMID: 33791726 PMCID: PMC8010758 DOI: 10.1101/2021.03.16.21253634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Background Whereas several predictors of COVID-19 vaccine hesitancy have been examined, the role of cognitive function following the widely publicised development of an inoculation is unknown. Objective To test the association between scores from an array of cognitive function tests and self-reported vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine. Design Setting and Participants We used individual-level data from a pandemic-focused study (COVID Survey), a prospective cohort study nested within Understanding Society (Main Survey). In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 11740 individuals (6702 women) aged 16-95. Pre-pandemic scores on general cognitive function, ascertained from a battery of six tests, were captured in 2011/12 wave of the Main Survey. Measurements Self-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for general cognitive function adjusted for selected covariates. Results Of the study sample, 17.2% (N=1842) indicated they were hesitant about having the vaccine. After adjustment for age, sex, and ethnicity, study members with a lower baseline cognition score were markedly more likely to be vaccine hesitant (odds ratio per standard deviation lower score in cognition; 95% confidence interval: 1.76; 1.62, 1.90). Adjustment for mental and physical health plus household shielding status had no impact on these results, whereas controlling for educational attainment led to partial attenuation but the probability of hesitancy was still elevated (1.52; 1.37, 1.67). There was a linear association for vaccine hesitancy across the full range of cognition scores (p for trend: p<0.0001). Limitations Our outcome was based on intention rather than behaviour. Conclusions Erroneous social media reports might have complicated personal decision-making, leading to people with lower cognitive ability test scores being vaccine-hesitant. With people with lower cognition also experiencing higher rates of COVID-19 in studies conducted prior to vaccine distribution, these new findings are suggestive of a potential additional disease burden.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, UK
| | | | - Catharine R Gale
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UK
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, UK
| | - Drew Altschul
- Department of Psychology, University of Edinburgh, UK
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Intention of healthcare workers to accept COVID-19 vaccination and related factors: A systematic review and meta-analysis. ASIAN PAC J TROP MED 2021. [DOI: 10.4103/1995-7645.332808] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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84
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Malik A, Malik J, Ishaq U. Acceptance of COVID-19 vaccine in Pakistan among health care workers. PLoS One 2021. [PMID: 34525110 DOI: 10.1101/2021.02.23.21252271v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE Acceptance of the COVID-19 vaccine will impart a pivotal role in eradicating the virus. In Pakistan, health care workers (HCWs) are the first group to receive vaccination. This survey aimed at the level of acceptance to the COVID-19 vaccine and predictors of non-acceptance in HCWs. METHOD This was a cross-sectional study design and data were collected through 3rd December 2020 and February 14th, 2021. An English questionnaire was distributed through social media platforms and administration of affiliate hospitals along with snowball sampling for private hospitals. RESULTS Out of 5,237 responses, 3,679 (70.2%) accepted COVID-19 vaccination and 1,284 (24.5%) wanted to delay until more data was available. Only 5.2% of HCWs rejected being vaccinated. Vaccine acceptance was more in young (76%) and female gender (63.3%) who worked in a tertiary care hospital (51.2%) and were direct patient care providers (61.3%). The reason for rejection in females was doubtful vaccine effectiveness (31.48%) while males rejected due to prior COVID-19 exposure (42.19%) and side effect profile of the vaccine (33.17%). Logistic regression analysis demonstrated age between 51-60 years, female gender, Pashtuns, those working in the specialty of medicine and allied, taking direct care of COVID-19 patients, higher education, and prior COVID-19 infection as the predictors for acceptance or rejection of COVID-19 vaccine. CONCLUSION In conclusion, this survey suggests that early on in a vaccination drive, majority of the HCWs in Pakistan are willing to be vaccinated and only a small number of participants would actually reject being vaccinated.
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Affiliation(s)
- Asmara Malik
- Department of Community Medicine, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Jahanzeb Malik
- Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
| | - Uzma Ishaq
- Department of Hematology, Foundation University Medical College, Islamabad, Pakistan
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Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) vaccine acceptance in employees in an integrated health system in the Midwest. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY 2021; 1:e14. [PMID: 36168458 PMCID: PMC9495635 DOI: 10.1017/ash.2021.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 11/07/2022]
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