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de Vries M, Claassen L, Lambooij MS, Timen A. Did the temporary suspension of Vaxzveria vaccinations influence COVID-19 vaccination intentions, vaccination perceptions and trust in the vaccination campaign? A repeated survey study in the Netherlands. Vaccine 2023; 41:1961-1967. [PMID: 36801084 PMCID: PMC9915047 DOI: 10.1016/j.vaccine.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
In spring 2021, several countries, among which the Netherlands, suspended vaccinations against COVID-19 with the Vaxzevria vaccine from AstraZeneca after reports of rare but severe adverse events. This study investigates the influence of this suspension on the Dutch public's perceptions of COVID-19 vaccinations, trust in the government's vaccination campaign, and COVID-19 vaccination intentions. We conducted two surveys in a population of general Dutch public (18 + ), one shortly before the pause of AstraZeneca vaccinations and one shortly thereafter (N eligible for analysis = 2628). Our results suggest no changes in perceptions nor intentions regarding the COVID-19 vaccines in general but do suggest a decline in trust in the government's vaccination campaign. In addition, after the suspension, perceptions of the AstraZeneca vaccines were more negative in comparison to those of COVID-19 vaccinations in general. AstraZeneca vaccination intentions were also considerably lower. These results stress the need to adapt vaccination policies to anticipated public perceptions and responses following a vaccine safety scare, as well as the importance of informing citizens about the possibility of very rare adverse events prior to the introduction of novel vaccines.
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Affiliation(s)
- Marion de Vries
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Liesbeth Claassen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mattijs S Lambooij
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Aura Timen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; VU University, Amsterdam, the Netherlands
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152
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Zhu P, Tatar O, Haward B, Steck V, Griffin-Mathieu G, Perez S, Dubé È, Zimet G, Rosberger Z. Examining an Altruism-Eliciting Video Intervention to Increase COVID-19 Vaccine Intentions in Younger Adults: A Qualitative Assessment Using the Realistic Evaluation Framework. Vaccines (Basel) 2023; 11:vaccines11030628. [PMID: 36992212 DOI: 10.3390/vaccines11030628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
COVID-19 vaccine-induced immunity wanes over time, and with the emergence of new variants, additional “booster” doses have been recommended in Canada. However, booster vaccination uptake has remained low, particularly amongst younger adults aged 18–39. A previous study by our research team found that an altruism-eliciting video increased COVID-19 vaccination intentions. Using qualitative methods, the present study aims to: (1) identify the factors that influence vaccine decision-making in Canadian younger adults; (2) understand younger adults’ perceptions of an altruism-eliciting video designed to increase COVID-19 vaccine intentions; and (3) explore how the video can be improved and adapted to the current pandemic context. We conducted three focus groups online with participants who: (1) received at least one booster vaccine, (2) received the primary series without any boosters, or (3) were unvaccinated. We used deductive and inductive approaches to analyze data. Deductively, informed by the realist evaluation framework, we synthesized data around three main themes: context, mechanism, and intervention-specific suggestions. Within each main theme, we deductively created subthemes based on the health belief model (HBM). For quotes that could not be captured by these subthemes, additional themes were created inductively. We found multiple factors that could be important considerations in future messaging to increase vaccine acceptance, such as feeling empowered, fostering confidence in government and institutions, providing diverse (such as both altruism and individualism) messaging, and including concrete data (such as the prevalence of vulnerable individuals). These findings suggest targeted messaging tailored to these themes would be helpful to increase COVID-19 booster vaccination amongst younger adults.
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Affiliation(s)
- Patricia Zhu
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada
| | - Ben Haward
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Veronica Steck
- Department of Psychology, McGill University, Montreal, QC H3A 1G1, Canada
| | - Gabrielle Griffin-Mathieu
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Samara Perez
- Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada
- Psychosocial Oncology Program, Cedars Cancer Center, McGill University Health Center, Montreal, QC H3A 3J1, Canada
| | - Ève Dubé
- Department of Anthropology, Laval University, Quebec, QC G1V 0A6, Canada
| | - Gregory Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Department of Psychology, McGill University, Montreal, QC H3A 1G1, Canada
- Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada
- Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
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153
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Ford A, Hwang A, Mo AX, Baqar S, Touchette N, Deal C, King D, Earle K, Giersing B, Dull P, Hall BF. Meeting Summary: Global Vaccine and Immunization Research Forum, 2021. Vaccine 2023; 41:1799-1807. [PMID: 36803897 PMCID: PMC9938725 DOI: 10.1016/j.vaccine.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 01/17/2023] [Accepted: 02/09/2023] [Indexed: 02/21/2023]
Abstract
The 2021 Global Vaccine and Immunization Research Forum highlighted the considerable advances and recent progress in research and development for vaccines and immunization, critically reviewed lessons learned from COVID-19 vaccine programs, and looked ahead to opportunities for this decade. For COVID-19, decades of investments in basic and translational research, new technology platforms, and vaccines targeting prototype pathogens enabled a rapid, global response. Unprecedented global coordination and partnership have played an essential role in creating and delivering COVID-19 vaccines. More improvement is needed in product attributes such as deliverability, and in equitable access to vaccines. Developments in other priority areas included: the halting of two human immunodeficiency virus vaccine trials due to lack of efficacy in preventing infection; promising efficacy results in Phase 2 trials of two tuberculosis vaccines; pilot implementation of the most advanced malaria vaccine candidate in three countries; trials of human papillomavirus vaccines given in single-dose regimens; and emergency use listing of a novel, oral poliomyelitis type 2 vaccine. More systematic, proactive approaches are being developed for fostering vaccine uptake and demand, aligning on priorities for investment by the public and private sectors, and accelerating policy making. Participants emphasized that addressing endemic disease is intertwined with emergency preparedness and pandemic response, so that advances in one area create opportunities in the other. In this decade, advances made in response to the COVID-19 pandemic should accelerate availability of vaccines for other diseases, contribute to preparedness for future pandemics, and help to achieve impact and equity under Immunization Agenda 2030.
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Key Words
- bcg, bacille calmette-guérin
- bnab, broadly neutralizing antibody
- cepi, coalition for epidemic preparedness innovations
- chim, controlled human infection model
- ecvp, evidence considerations for vaccine policy
- eua, emergency use authorization
- eul, emergency use listing
- gvap, global vaccine action plan
- gvirf, global vaccine and immunization research forum
- hiv, human immunodeficiency virus
- hpv, human papillomavirus
- ia2030, immunization agenda 2030
- mers, middle east respiratory syndrome
- nopv-2, novel oral poliomyelitis type 2 vaccine
- ppp, public–private partnership
- r&d, research and development
- sars, severe acute respiratory syndrome
- vips, vaccine innovation prioritisation strategy
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Affiliation(s)
- Andrew Ford
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, MSC 9825, Bethesda, MD 20892-9825, USA.
| | - Angela Hwang
- Angela Hwang Consulting, PO Box 6601, Albany, CA 94706, USA.
| | - Annie X. Mo
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, MSC 9825, Bethesda, MD 20892-9825, USA
| | - Shahida Baqar
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, MSC 9825, Bethesda, MD 20892-9825, USA.
| | - Nancy Touchette
- Office of Global Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Carolyn Deal
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, MSC 9825, Bethesda, MD 20892-9825, USA.
| | - Deborah King
- Infectious Disease Health Challenge - Prevention, Wellcome Trust, London NW1 2BE, United Kingdom.
| | - Kristen Earle
- Vaccine Development & Surveillance, Bill & Melinda Gates Foundation, PO Box 23350, Seattle, Washington 98102, USA.
| | - Birgitte Giersing
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland.
| | - Peter Dull
- Vaccine Development & Surveillance, Bill & Melinda Gates Foundation, PO Box 23350, Seattle, Washington 98102, USA.
| | - B. Fenton Hall
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, MSC 9825, Bethesda, MD 20892-9825, USA
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154
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McElfish PA, Selig JP, Scott AJ, Rowland B, Willis DE, Reece S, CarlLee S, Macechko MD, Shah SK. Associations Between General Vaccine Hesitancy and Healthcare Access Among Arkansans. J Gen Intern Med 2023; 38:841-847. [PMID: 36323819 PMCID: PMC9629763 DOI: 10.1007/s11606-022-07859-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Vaccines provide protection against numerous diseases that can cause serious illness and death. However, vaccine hesitancy threatens to undermine progress in reducing preventable diseases and illness. Vaccine hesitancy has been shown to vary by sociodemographic characteristics. However, studies examining associations between healthcare access and vaccine hesitancy are lacking. OBJECTIVE Using a statewide random sample of Arkansas adults, we examined the relationship between general vaccine hesitancy and healthcare access. DESIGN From July 12 to 30, 2021, participants were contacted by landlines and cellular phones using random digit dialing. PARTICIPANTS A total of 1500 Arkansas adults were surveyed. Black/African American and Hispanic/Latinx adults were oversampled to ensure adequate representation. The survey had a cooperation rate of 20%. MAIN MEASURES The dependent variable was an ordinal measure of general vaccine hesitancy. Age, gender, race, education, relationship status, and rural/urban residence were included in the model. Healthcare access was measured across four domains: (1) health insurance coverage; (2) having a primary care provider (PCP); (3) forgoing care due to cost; and (4) time since last routine checkup. The relationship between general vaccine hesitancy and healthcare access was modeled using ordinal logistic regression, controlling for sociodemographic characteristics. KEY RESULTS Mean age was 48.5 years, 51.1% were women, 28% reported a race other than White, and 36.3% held a bachelor's degree or higher. Those with a PCP and those with health insurance had approximately two-thirds the odds of being more hesitant ([OR=0.63, CI=0.47, 0.84] and [OR=0.68; CI=0.49, 0.94]) than those without a PCP and those without health insurance. Participants reporting a routine checkup in the last 2 years were almost half as likely to be more hesitant than those reporting a checkup more than 2 years prior (OR=0.58; CI=0.43, 0.79). CONCLUSIONS Results suggest improving access to health insurance, PCPs, and routine preventative care services may be critical to reducing vaccine hesitancy.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Michael D Macechko
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sumit K Shah
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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155
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Bonner KE, Chyderiotis S, Sicsic J, Mueller JE, Ulrich AK, Toomey T, Horvath KJ, Neaton JD, Basta NE. What motivates adults to accept influenza vaccine? An assessment of incentives, ease of access, messaging, and sources of information using a discrete choice experiment. SSM Popul Health 2023; 22:101384. [PMID: 37008807 PMCID: PMC10060740 DOI: 10.1016/j.ssmph.2023.101384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/15/2023] Open
Abstract
Seasonal influenza vaccination rates remain low, and contribute to preventable influenza cases, hospitalizations, and deaths in the US. While numerous interventions have been implemented to increase vaccine uptake, there is a need to determine which interventions contribute most to vaccine willingness, particularly among age groups with vaccination rates that have plateaued at suboptimal levels. This study aimed to quantify the relative effect of multiple interventions on vaccine willingness to receive influenza vaccine in three age groups using a series of hypothetical situations with different behavioral interventions. We assessed the relative impact of four categories of interventions: source of vaccine messages, type of vaccination messages, vaccination incentives, and ease of vaccine access using a discrete choice experiment. Within each category, we investigated the role of four different attributes to measure their relative contribution to willingness to be vaccinated by removing one option from each of the intervention categories. Among the 1,763 Minnesota residents who volunteered for our study, participants expressed vaccine willingness in over 80% of the scenarios presented. Easy access to drop-in vaccination sites had the greatest impact on vaccine willingness in all age groups. Among the younger age group, small financial incentives also contributed to high vaccine willingness. Our results suggest that public health programs and vaccination campaigns may improve their chances of successfully increasing vaccine willingness if they offer interventions preferred by adults, including facilitating convenient access to vaccination and offering small monetary incentives, particularly for young adults.
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156
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Christou-Ergos M, Wiley KE, Leask J. Association between traumatic life events and vaccine hesitancy: A cross-sectional Australian study. Public Health 2023; 216:1-6. [PMID: 36669258 DOI: 10.1016/j.puhe.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/28/2022] [Accepted: 12/17/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES We sought to identify associations between the experience of traumatic life events and vaccination intention to inform whether trauma-affected individuals require targeted interventions when addressing vaccine hesitancy. STUDY DESIGN We conducted an online cross-sectional survey to identify whether direct or indirect exposure to various traumatic life events and the presence of post-traumatic stress disorder (PTSD) symptoms are associated with willingness to receive a COVID-19 vaccine in an Australian sample. METHODS A national online questionnaire was administered to a representative sample of 1050 Australian adults in September 2021. RESULTS Lower willingness to receive a COVID-19 vaccine was associated with direct experience of a fire or explosion (adjusted odds ratio [aOR]: 0.42; 95% confidence interval [CI]: 0.23-0.78; P = 0.006), direct experience of severe human suffering (aOR:0.39; 95% CI: 0.21-0.71; P = 0.002) and screening positive for PTSD symptoms (aOR:0.52; 95% CI: 0.33-0.82; P = 0.005). Conversely, higher willingness to receive a COVID-19 vaccine was associated with indirect exposure to severe human suffering (aOR: 2.0; 95% CI: 1.21-3.22; P = 0.007). CONCLUSIONS Our findings suggest that the experience of traumatic events and the presence of PTSD symptoms can contribute to vaccination decisions. Our work adds to the growing recognition of the need to effectively mediate the influence of traumatic experiences on encounters within the medical setting and supports the importance of addressing the needs of trauma-affected individuals in their vaccination experiences.
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Affiliation(s)
- Maria Christou-Ergos
- University of Sydney, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, Sydney, NSW, Australia.
| | - Kerrie E Wiley
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, Westmead, NSW, Australia
| | - Julie Leask
- University of Sydney, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, Westmead, NSW, Australia
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157
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Thier K, Wang Y, Adebamowo C, Ntiri SO, Quinn SC, Nan X. Understanding the psychological antecedents of COVID-19 vaccine acceptance among Black Americans: implications for vaccine communication. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:62-74. [PMID: 36919805 DOI: 10.1080/17538068.2022.2117528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Guided by the 5C (confidence, complacency, constraints, calculation, and collective responsibility) model of vaccination behavior, we examine the psychological antecedents of COVID-19 vaccine acceptance (i.e. attitudes and intentions toward COVID-19 vaccination) among Black Americans, a group disproportionately affected by the coronavirus pandemic. METHOD We conducted a national survey of Black Americans (N = 1,497) in February/March 2021. RESULTS We found that, among the five psychological antecedents, three (confidence, calculation - or extensive information searching, and collective responsibility) significantly predicted attitudes toward COVID-19 vaccination and had indirect effects on vaccination intentions through vaccination attitudes. Two antecedents (confidence and collective responsibility) also directly predicted vaccination intentions. Our analysis suggests that a partially mediated model produced better fit than a fully mediated model. CONCLUSIONS Developing culturally tailored interventions for Black Americans that build confidence in COVID-19 vaccines, highlight collective responsibility, and attend to Black Americans' information sources is key to boosting Black Americans' COVID-19 vaccine acceptance. Future research is needed to understand how historical and ongoing racism affects the psychological antecedents of COVID-19 vaccine acceptance among Black Americans.
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Affiliation(s)
- Kathryn Thier
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Yuan Wang
- Department of Communication, University of Maryland, College Park, MD, USA
| | | | - Shana O Ntiri
- School of Medicine, University of Maryland, Baltimore, USA
| | | | - Xiaoli Nan
- Department of Communication, University of Maryland, College Park, MD, USA
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158
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LoBrutto LR, Elwy AR, Miano D, Ann Petrakis B, Kyrish A, Javier S, Erhardt T, Midboe AM, Carbonaro R, Jasuja GK, McInnes DK, Maguire EM, Asch SM, Gifford AL, Clayman ML. Antecedents to COVID-19 vaccine uptake among patients and employees in the Veterans Health Administration. Transl Behav Med 2023; 13:73-84. [PMID: 36448882 DOI: 10.1093/tbm/ibac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The present study sought to understand the antecedents to COVID-19 vaccination among those reporting a change in vaccine intention in order to improve COVID-19 vaccine uptake in the United States. We employed semi-structured interviews and one focus group discussion with vaccinated and unvaccinated Veterans Health Administration (VHA) employees and Veterans at three Veterans' Affairs medical centers between January and June 2021. A subset of these participants (n=21) self-reported a change in COVID-19 vaccine intention and were selected for additional analysis. We combined thematic analysis using the 5C scale (confidence, collective responsibility, complacency, calculation, constraints) as our theoretical framework with a constant comparative method from codes based on the SAGE Working Group on Vaccine Hesitancy. We generated 13 themes distributed across the 5C constructs that appeared to be associated with a change in COVID-19 vaccine intention. Themes included a trusted family member, friend or colleague in a healthcare field, a trusted healthcare professional, distrust of government or politics (confidence); duty to family and protection of others (collective responsibility); perceived health status and normative beliefs (complacency); perceived vaccine safety, perceived risk-benefit, and orientation towards deliberation (calculation); and ease of process (constraints). Key factors in promoting vaccine uptake included a desire to protect family; and conversations with as key factors in promoting vaccine uptake. Constructs from the 5C scale are useful in understanding intrapersonal changes in vaccine intentions over time, which may help public health practitioners improve future vaccine uptake.
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Affiliation(s)
- Lara R LoBrutto
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Jamaica Plain, MA 02130, USA
| | - A Rani Elwy
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02912, USA
| | - Danielle Miano
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Beth Ann Petrakis
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Angela Kyrish
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Sarah Javier
- Bridge QUERI Program, Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA 94025, USA
- Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Taryn Erhardt
- Bridge QUERI Program, Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA 94025, USA
| | - Amanda M Midboe
- Bridge QUERI Program, Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA 94025, USA
- Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Richard Carbonaro
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Guneet K Jasuja
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
- Section of General Internal Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - D Keith McInnes
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA 02118, USA
| | - Elizabeth M Maguire
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Steven M Asch
- Bridge QUERI Program, Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA 94025, USA
- Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Allen L Gifford
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Jamaica Plain, MA 02130, USA
- Section of General Internal Medicine, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA 02118, USA
| | - Marla L Clayman
- Bridge QUERI Program, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan School of Medicine, Worcester, MA 01655, USA
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159
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Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue. J Behav Med 2023; 46:1-8. [PMID: 36802315 PMCID: PMC9942647 DOI: 10.1007/s10865-023-00397-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
The World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue.
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160
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Kaufman J, Steffens MS, Hoq M, King C, Marques MD, Mao K, Bullivant B, Danchin M. Effect of persuasive messaging about COVID-19 vaccines for 5- to 11-year-old children on parent intention to vaccinate. J Paediatr Child Health 2023; 59:686-693. [PMID: 36807943 DOI: 10.1111/jpc.16374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
AIM Uptake of COVID-19 vaccines for children aged 5-11 years old in Australia has plateaued. Persuasive messaging is an efficient and adaptable potential intervention to promote vaccine uptake, but evidence for its effectiveness is varied and dependent on context and cultural values. This study aimed to test persuasive messages to promote COVID-19 vaccines for children in Australia. METHODS A parallel, online, randomised control experiment was conducted between 14 and 21 January 2022. Participants were Australian parents of a child aged 5-11 years who had not vaccinated their child with a COVID-19 vaccine. After providing demographic details and level of vaccine hesitancy, parents viewed either the control message or one of four intervention texts emphasising (i) personal health benefits; (ii) community health benefits; (iii) non-health benefits; or (iv) personal agency. The primary outcome was parents' intention to vaccinate their child. RESULTS The analysis included 463 participants, of whom 58.7% (272/463) were hesitant about COVID-19 vaccines for children. Intention to vaccinate was higher in the community health (7.8%, 95% confidence interval (CI) -5.3% to 21.0%) and non-health (6.9%, 95% CI -6.4% to 20.3%) groups, and lower in the personal agency group (-3.9, 95% CI -17.7 to 9.9) compared to control, but these differences did not reach statistical significance. The effects of the messages among hesitant parents were similar to the overall study population. CONCLUSION Short, text-based messages alone are unlikely to influence parental intention to vaccinate their child with the COVID-19 vaccine. Multiple strategies tailored for the target audience should also be utilised.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kevin Mao
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
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161
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Psychological determinants of COVID-19 vaccine acceptance: A comparison between immigrants and the host population in Japan. Vaccine 2023; 41:1426-1430. [PMID: 36702692 PMCID: PMC9868366 DOI: 10.1016/j.vaccine.2023.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/24/2023]
Abstract
This study explored the differences in COVID-19 vaccination readiness based on the 7C model and its association with vaccine acceptance among foreign-born immigrants, Japan-born immigrants, and locals in Japan. A cross-sectional survey was conducted in October 2021 (n = 3,690). Our results show that COVID-19 vaccination readiness, acceptance, and their relationship differ according to migratory status and nativity. Immigrant participants reported higher general vaccination readiness and acceptability for vaccination against COVID-19 than the Japanese participants, but had lower vaccination coverage, particularly among those born in Japan. The psychological determinants of Japan-born immigrants were more similar to those of Japanese participants than those of foreign-born immigrants. The effects of confidence, complacency, and constraints on COVID-19 vaccine acceptance were strong among all three groups. However, the role of collective responsibility and conspiracy varied by migratory status. This study highlighted the importance of culturally tailored interventions in vaccine delivery to immigrants.
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162
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Lu PJ, Zhou T, Santibanez TA, Jain A, Black CL, Srivastav A, Hung MC, Kriss JL, Schorpp S, Yankey D, Sterrett N, Fast HE, Razzaghi H, Elam-Evans LD, Singleton JA. COVID-19 Bivalent Booster Vaccination Coverage and Intent to Receive Booster Vaccination Among Adolescents and Adults - United States, November-December 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:190-198. [PMID: 36795677 PMCID: PMC9949845 DOI: 10.15585/mmwr.mm7207a5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
COVID-19 vaccine booster doses are safe and maintain protection after receipt of a primary vaccination series and reduce the risk for serious COVID-19-related outcomes, including emergency department visits, hospitalization, and death (1,2). CDC recommended an updated (bivalent) booster for adolescents aged 12-17 years and adults aged ≥18 years on September 1, 2022 (3). The bivalent booster is formulated to protect against the Omicron BA.4 and BA.5 subvariants of SARS-CoV-2 as well as the original (ancestral) strain (3). Based on data collected during October 30-December 31, 2022, from the National Immunization Survey-Child COVID Module (NIS-CCM) (4), among all adolescents aged 12-17 years who completed a primary series, 18.5% had received a bivalent booster dose, 52.0% had not yet received a bivalent booster but had parents open to booster vaccination for their child, 15.1% had not received a bivalent booster and had parents who were unsure about getting a booster vaccination for their child, and 14.4% had parents who were reluctant to seek booster vaccination for their child. Based on data collected during October 30-December 31, 2022, from the National Immunization Survey-Adult COVID Module (NIS-ACM) (4), 27.1% of adults who had completed a COVID-19 primary series had received a bivalent booster, 39.4% had not yet received a bivalent booster but were open to receiving booster vaccination, 12.4% had not yet received a bivalent booster and were unsure about getting a booster vaccination, and 21.1% were reluctant to receive a booster. Adolescents and adults in rural areas had a much lower primary series completion rate and up-to-date vaccination coverage. Bivalent booster coverage was lower among non-Hispanic Black or African American (Black) and Hispanic or Latino (Hispanic) adolescents and adults compared with non-Hispanic White (White) adolescents and adults. Among adults who were open to receiving booster vaccination, 58.9% reported not having received a provider recommendation for booster vaccination, 16.9% had safety concerns, and 4.4% reported difficulty getting a booster vaccine. Among adolescents with parents who were open to getting a booster vaccination for their child, 32.4% had not received a provider recommendation for any COVID-19 vaccination, and 11.8% had parents who reported safety concerns. Although bivalent booster vaccination coverage among adults differed by factors such as income, health insurance status, and social vulnerability index (SVI), these factors were not associated with differences in reluctance to seek booster vaccination. Health care provider recommendations for COVID-19 vaccination; dissemination of information by trusted messengers about the continued risk for COVID-19-related illness and the benefits and safety of bivalent booster vaccination; and reducing barriers to vaccination could improve COVID-19 bivalent booster coverage among adolescents and adults.
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163
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Cunningham-Erves J, George W, Stewart EC, Footman A, Davis J, Sanderson M, Smalls M, Morris P, Clarkson K, Lee O, Brandt HM. COVID-19 Vaccination: Comparison of Attitudes, Decision-Making Processes, and Communication among Vaccinated and Unvaccinated Black Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3481. [PMID: 36834175 PMCID: PMC9960928 DOI: 10.3390/ijerph20043481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND COVID-19 vaccination rates remain suboptimal among Black Americans who disproportionately experience higher hospitalization and death rates than White Americans. METHODS We conducted a multi-method (interviews and surveys) study among 30 Black Americans (n = 16 vaccinated, n = 14 unvaccinated) to explore factors related to vaccination hesitancy, decision-making processes, and communication related to uptake. Participants were recruited by using community-driven approaches, including partner collaborations. Thematic analysis was used to analyze qualitative data, and descriptive and bivariate analysis was used for quantitative data. RESULTS Of those unvaccinated, 79% (n = 11) stated they were delaying and 21% (n = 3) were declining vaccination indefinitely. When asked about the likelihood of vaccine initiation in 6 months and 12 months, 29% (n = 4) and 36% (n = 5), respectively, stated that they would receive the vaccine. The following themes emerged: (1) COVID-19 vaccination hesitancy exists on a continuum; (2) varied decision-making processes for COVID-19 vaccination; (3) motivators among vaccinated individuals; (4) barriers among unvaccinated individuals; (5) retrieving and navigating vaccine information within the COVID-19 infodemic; and (6) parent perspectives on child vaccination. CONCLUSIONS Findings suggest that vaccinated and unvaccinated participants had similar and dissimilar perspectives in decision-making processes and vaccine concerns as shown in the Decision-making Processes for the COVID-19 vaccination (DePC) model. Based on these findings, future studies should further explore how factors influencing decision-making can lead to divergent outcomes for COVID-19 vaccination.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Internal Medicine, Meharry Medical College, School of Medicine, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Whitney George
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 27232, USA
| | - Elizabeth C. Stewart
- Department of Internal Medicine, Meharry Medical College, School of Medicine, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Alison Footman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Jamaine Davis
- Department of Biochemistry and Cancer Biology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Maureen Sanderson
- Department of Family and Community Medicine, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Meredith Smalls
- Meharry Vanderbilt Alliance, 1903 Meharry Boulevard, Nashville, TN 37208, USA
| | - Phillip Morris
- Department of Internal Medicine, Meharry Medical College, School of Medicine, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Kristin Clarkson
- Congregational Health & Education Network, 1818 Albion St, Nashville, TN 37208, USA
| | - Omaran Lee
- Centers for Wellbeing, P.O. Box 330191, Nashville, TN 37203, USA
| | - Heather M. Brandt
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
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164
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Warren BR, Gillette-Walch H, Adler J, Arias R, Klausner JD, Ashing KT, Villa A. Assessment of human papillomavirus vaccination rates of adolescents in California, 2018-2019. Prev Med Rep 2023; 32:102144. [PMID: 36852308 PMCID: PMC9958035 DOI: 10.1016/j.pmedr.2023.102144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/20/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Accurate documentation of state-level human papillomavirus (HPV) vaccination is required for public health planning and to inform corrective actions. To examine the representativeness of the California Immunization Registry, we compared the National Immunization Survey (NIS)-Teen, commercial HMOs in California, Medi-Cal, and California Immunization Registry data for HPV vaccine series completion. Our objectives were to evaluate the vaccine registries, compare and report their completeness, and make recommendations on how to improve and use these studies. Vaccination values were extrapolated for all adolescents aged 13 to 17 years from 2018 to 2019 from NIS-Teen, adolescents aged 13 years from 2018 to 2019 reported in the California Immunization Registry, and adolescents aged 13 years for 2018 for commercial HMOs and Medi-Cal. HPV series completion among 13-year-olds in 2018 for commercial HMOs was 50 %, Medi-Cal was 45 %, and the California Immunization Registry was 28 %, with NIS-Teen rates for 13 to 17-year-olds at 50 % in 2018 and 54 % in 2019. Both rural and urban geographic regions were found to have low completion rates of the HPV series, with trends ranging from 13 % to 45 %. The California Immunization Registry's lower HPV vaccine series completion among 13-year-olds compared to the other reporting sources is most likely due differences in reporting and data collection. Importantly, this data will serve as a comparator for future, similar studies of various sources of HPV vaccination rates following the passing of Bill-1797, which will mandate immunization reporting starting in January 2023.
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Affiliation(s)
- Brooke R. Warren
- School of Medicine, University of California, San Francisco. San Francisco, CA, United States
| | | | - Jaime Adler
- Academy Health. Washington, DC, United States
| | - Raquel Arias
- American Cancer Society. Burbank, CA, United States
| | - Jeffrey D. Klausner
- Division of Disease Prevention, Policy and Global Health, Department of Preventive Medicine, University of Southern California Keck School of Medicine. Los Angeles, CA, United States
| | - Kimlin T. Ashing
- Division of Health Equity, City of Hope Comprehensive Cancer Center. Duarte, CA, United States
| | - Alessandro Villa
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute. Miami, FL, United States,Herbert Wertheim College of Medicine, Florida International University. Miami, FL, United States,Corresponding author at: 8900 N. Kendall Drive Miami, FL 33176, United States.
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165
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Abad N, Messinger SD, Huang Q, Hendrich MA, Johanson N, Fisun H, Lewis Z, Wilhelm E, Baack B, Bonner KE, Kobau R, Brewer NT. A qualitative study of behavioral and social drivers of COVID-19 vaccine confidence and uptake among unvaccinated Americans in the US April-May 2021. PLoS One 2023; 18:e0281497. [PMID: 36763680 PMCID: PMC9917274 DOI: 10.1371/journal.pone.0281497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 01/24/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Around one-third of Americans reported they were unwilling to get a COVID-19 vaccine in April 2021. This focus group study aimed to provide insights on the factors contributing to unvaccinated adults' hesitancy or refusal to get vaccinated with COVID-19 vaccines. METHOD Ipsos recruited 59 unvaccinated US adults who were vaccine hesitant (i.e., conflicted about or opposed to receiving a COVID-19 vaccination) using the Ipsos KnowledgePanel. Trained facilitators led a total of 10 focus groups via video-conference in March and April 2021. Two coders manually coded the data from each group using a coding frame based on the focus group discussion guide. The coding team collaborated in analyzing the data for key themes. RESULTS Data analysis of transcripts from the focus groups illuminated four main themes associated with COVID-19 vaccine hesitancy: lack of trust in experts and institutions; concern about the safety of COVID-19 vaccines; resistance towards prescriptive guidance and restrictions; and, despite personal reluctance or unwillingness to get vaccinated, acceptance of others getting vaccinated. DISCUSSION Vaccine confidence communication strategies should address individual concerns, describe the benefits of COVID-19 vaccination, and highlight evolving science using factural and neutral presentations of information to foster trust.
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Affiliation(s)
- Neetu Abad
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | | | - Qian Huang
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | | | - Nataly Johanson
- Ipsos US Public Affairs, Washington, DC, United States of America
| | - Helen Fisun
- Ipsos US Public Affairs, Washington, DC, United States of America
| | - Zachary Lewis
- Ipsos US Public Affairs, Washington, DC, United States of America
| | - Elisabeth Wilhelm
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Brittney Baack
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Kimberly E. Bonner
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Rosemarie Kobau
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Noel T. Brewer
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America
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166
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Social and demographic patterns of influenza vaccination coverage in Norway, influenza seasons 2014/15 to 2020/21. Vaccine 2023; 41:1239-1246. [PMID: 36639272 DOI: 10.1016/j.vaccine.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
AIMS To examine influenza vaccination coverage among risk groups (RG) and health care workers (HCW), and study social and demographic patterns of vaccination coverage over time. METHODS Vaccination coverage was estimated by self-report in a nationally representative telephone survey among 14919 individuals aged 18-79 years over seven influenza seasons from 2014/15 to 2020/21. We explored whether belonging to an influenza RG (being >=65 years of age and/or having >=1 medical risk factor), being a HCW or educational attainment was associated with vaccination status using logistic regression. RESULTS Vaccination coverage increased from 27 % to 66 % among individuals 65-79 years, from 13 % to 33 % among individuals 18-64 years with >=1 risk factor, and from 9 % to 51 % among HCWs during the study period. Being older, having a risk factor or being a HCW were significantly associated with higher coverage in all multivariable logistic regression analyses. Higher education was also consistently associated with higher coverage, but the difference did not reach significance in all influenza seasons. Educational attainment was not significantly associated with coverage while coverage was at its lowest (2014/15-2017/18), but as coverage increased, so did the differences. Individuals with intermediate or lower education were less likely to report vaccination than those with higher education in season 2018/19, OR = 0.61 (95 % CI 0.46-0.80) and OR = 0.58 (95 % CI 0.41-0.83), respectively, and in season 2019/20, OR = 0.69 (95 % CI 0.55-0.88) and OR = 0.71 (95 % CI 0.53-0.95), respectively. When the vaccine was funded in the COVID-19 pandemic winter of 2020/21, educational differences diminished again and were no longer significant. CONCLUSIONS We observed widening educational differences in influenza vaccination coverage as coverage increased from 2014/15 to 2019/20. When influenza vaccination was funded in 2020/21, differences in coverage by educational attainment diminished. These findings indicate that economic barriers influence influenza vaccination decisions among risk groups in Norway.
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167
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Gallant AJ, Flowers P, Deakin K, Cogan N, Rasmussen S, Young D, Williams L. Barriers and enablers to influenza vaccination uptake in adults with chronic respiratory conditions: applying the behaviour change wheel to specify multi-levelled tailored intervention content. Psychol Health 2023; 38:147-166. [PMID: 34328044 PMCID: PMC9970185 DOI: 10.1080/08870446.2021.1957104] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To specify intervention content to enhance influenza vaccination uptake among adults with chronic respiratory conditions using the Behaviour Change Wheel (BCW). DESIGN Cross-sectional, multi-modal data collection and theory-informed analysis and expert stakeholder engagement. METHODS Content analysis was used to identify barriers and enablers to influenza vaccination from nine focus groups (n = 38), individual interviews (n = 21) and open-ended survey responses (n = 101). The Theoretical Domains Framework (TDF) and the BCW were used to specify evidence-based and theoretically-informed recommendations. Expert stakeholders refined recommendations using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects, and Equity (APEASE) criteria to yield a range of potentially actionable ideas. RESULTS TDF analysis identified perceptions of vaccine side effects (beliefs about consequences [BACons]) was the most common barrier to vaccination, followed by time constraints (environmental context and resources [ECR]) and fear of needles (Emotion). Enablers included protection from influenza (BACons), receiving reminders (ECR) and support from others (Social Influences). These factors mapped to seven BCW intervention functions and 22 behaviour change techniques. CONCLUSIONS Factors affecting vaccine uptake are multifaceted and multileveled. The study suggested a suite of complementary multi-level intervention components to enhance vaccination uptake involving a range of diverse actors, intervention recipients and settings.
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Affiliation(s)
- Allyson J. Gallant
- School of Psychological Sciences & Health, University of Strathclyde, Scotland, UK
| | - Paul Flowers
- School of Psychological Sciences & Health, University of Strathclyde, Scotland, UK
| | - Karen Deakin
- School of Psychological Sciences & Health, University of Strathclyde, Scotland, UK
| | - Nicola Cogan
- School of Psychological Sciences & Health, University of Strathclyde, Scotland, UK
| | - Susan Rasmussen
- School of Psychological Sciences & Health, University of Strathclyde, Scotland, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, Scotland, UK
| | - Lynn Williams
- School of Psychological Sciences & Health, University of Strathclyde, Scotland, UK,CONTACT Lynn Williams School of Psychological Sciences & Health, University of Strathclyde, 40 George Street, Glasgow, ScotlandG1 1QE, UK
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168
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Meng L, Masters NB, Lu PJ, Singleton JA, Kriss JL, Zhou T, Weiss D, Black CL. Cluster analysis of adults unvaccinated for COVID-19 based on behavioral and social factors, National Immunization Survey-Adult COVID Module, United States. Prev Med 2023; 167:107415. [PMID: 36596324 PMCID: PMC9804852 DOI: 10.1016/j.ypmed.2022.107415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
By the end of 2021, approximately 15% of U.S. adults remained unvaccinated against COVID-19, and vaccination initiation rates had stagnated. We used unsupervised machine learning (K-means clustering) to identify clusters of unvaccinated respondents based on Behavioral and Social Drivers (BeSD) of COVID-19 vaccination and compared these clusters to vaccinated participants to better understand social/behavioral factors of non-vaccination. The National Immunization Survey Adult COVID Module collects data on U.S. adults from September 26-December 31,2021 (n = 187,756). Among all participants, 51.6% were male, with a mean age of 61 years, and the majority were non-Hispanic White (62.2%), followed by Hispanic (17.2%), Black (11.9%), and others (8.7%). K-means clustering procedure was used to classify unvaccinated participants into three clusters based on 9 survey BeSD items, including items assessing COVID-19 risk perception, social norms, vaccine confidence, and practical issues. Among unvaccinated adults (N = 23,397), 3 clusters were identified: the "Reachable" (23%), "Less reachable" (27%), and the "Least reachable" (50%). The least reachable cluster reported the lowest concern about COVID-19, mask-wearing behavior, perceived vaccine confidence, and were more likely to be male, non-Hispanic White, with no health conditions, from rural counties, have previously had COVID-19, and have not received a COVID-19 vaccine recommendation from a healthcare provider. This study identified, described, and compared the characteristics of the three unvaccinated subgroups. Public health practitioners, healthcare providers and community leaders can use these characteristics to better tailor messaging for each sub-population. Our findings may also help inform decisionmakers exploring possible policy interventions.
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Affiliation(s)
- Lu Meng
- CDC COVID-19 Response Team; General Dynamics Information Technology Inc., Falls Church, VA, United States of America.
| | - Nina B Masters
- CDC COVID-19 Response Team; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; Epidemic Intelligence Service, CDC, Atlanta, GA, United States of America
| | - Peng-Jun Lu
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - James A Singleton
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Jennifer L Kriss
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America; Leidos Inc., Atlanta, GA, United States of America
| | - Debora Weiss
- CDC COVID-19 Response Team; Division of State and Local Readiness, Center for Preparedness and Response, CDC
| | - Carla L Black
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
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169
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Sprengholz P, Henkel L, Böhm R, Betsch C. Different Interventions for COVID-19 Primary and Booster Vaccination? Effects of Psychological Factors and Health Policies on Vaccine Uptake. Med Decis Making 2023; 43:239-251. [PMID: 36404766 PMCID: PMC9679322 DOI: 10.1177/0272989x221138111] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mitigation of the COVID-19 pandemic requires continued uptake of SARS-CoV-2 vaccines. To increase vaccination intention and uptake, key determinants of primary and booster vaccination need to be understood and potential effects of vaccination policies examined. DESIGN Using experimental data collected in Germany in February 2022 (N = 2701), this study investigated 1) predictors of primary and booster vaccination and 2) potential effects of policies combining vaccination mandates and monetary incentives. RESULTS Compared with unvaccinated participants, those with primary vaccination were less complacent, more often understood the collective protection afforded by vaccination, and less often endorsed conspiracy-based misinformation. Compared with participants with primary vaccination, boosted individuals were even less complacent, exhibited fewer conspiracy-based beliefs, perceived fewer constraints by prioritizing vaccination over other things, and more often favored compliance with official vaccination recommendations. Support for and reactance about vaccination mandates depended on vaccination status rather than policy characteristics, regardless of mandate type or incentives (up to 500 EUR). While unvaccinated individuals rejected policy provisions and declined vaccination, boosted individuals indicated mid-level support for mandates and showed high vaccination intention. Among vaccinated individuals, higher incentives of up to 2000 EUR had a considerable positive effect on the willingness to get boosted, especially in the absence of a mandate. CONCLUSIONS While mandates may be needed to increase primary vaccination, our results indicate that financial incentives could be an alternative to promote booster uptake. However, combining both measures for the same target group seems inadvisable in most cases. HIGHLIGHTS Unvaccinated individuals and people with primary and booster vaccinations differ on psychological dimensions, calling for tailored immunization campaigns.Vaccination intentions depend on vaccination status rather than on mandatory or incentivizing policies.Incentives are unlikely to persuade unvaccinated individuals but may increase booster uptake.Positive effects of incentives decrease when vaccination is mandatory, advising against combination.
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Affiliation(s)
- Philipp Sprengholz
- Media and Communication Science, University of Erfurt, Germany.,Health Communication, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Luca Henkel
- Department of Economics, University of Bonn, Germany
| | - Robert Böhm
- Faculty of Psychology, University of Vienna, Austria.,Department of Psychology, University of Copenhagen, Denmark.,Copenhagen Center for Social Data Science, University of Copenhagen, Denmark
| | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Germany.,Health Communication, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Germany
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170
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Bonner KE, Vashist K, Abad NS, Kriss JL, Meng L, Lee JT, Wilhelm E, Lu PJ, Carter RJ, Boone K, Baack B, Masters NB, Weiss D, Black C, Huang Q, Vangala S, Albertin C, Szilagyi PG, Brewer NT, Singleton JA. Behavioral and Social Drivers of COVID-19 Vaccination in the United States, August-November 2021. Am J Prev Med 2023; 64:865-876. [PMID: 36775756 PMCID: PMC9874048 DOI: 10.1016/j.amepre.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
INTRODUCTION COVID-19 vaccines are safe, effective, and widely available, but many adults in the U.S. have not been vaccinated for COVID-19. This study examined the associations between behavioral and social drivers of vaccination with COVID-19 vaccine uptake in the U.S. adults and their prevalence by region. METHODS A nationally representative sample of U.S. adults participated in a cross-sectional telephone survey in August-November 2021; the analysis was conducted in January 2022. Survey questions assessed self-reported COVID-19 vaccine initiation, demographics, and behavioral and social drivers of vaccination. RESULTS Among the 255,763 respondents, 76% received their first dose of COVID-19 vaccine. Vaccine uptake was higher among respondents aged ≥75 years (94%), females (78%), and Asian non-Hispanic people (94%). The drivers of vaccination most strongly associated with uptake included higher anticipated regret from nonvaccination, risk perception, and confidence in vaccine safety and importance, followed by work- or school-related vaccination requirements, social norms, and provider recommendation (all p<0.05). The direction of association with uptake varied by reported level of difficulty in accessing vaccines. The prevalence of all of these behavioral and social drivers of vaccination was highest in the Northeast region and lowest in the Midwest and South. CONCLUSIONS This nationally representative survey found that COVID-19 vaccine uptake was most strongly associated with greater anticipated regret, risk perception, and confidence in vaccine safety and importance, followed by vaccination requirements and social norms. Interventions that leverage these social and behavioral drivers of vaccination have the potential to increase COVID-19 vaccine uptake and could be considered for other vaccine introductions.
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Affiliation(s)
- Kimberly E Bonner
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Oregon Health Authority Public Health Division, Oregon Health Authority, Portland, Oregon; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kushagra Vashist
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennesse; Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Neetu S Abad
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Kriss
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lu Meng
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; General Dynamics Information Technology Inc, Falls Church, Virginia
| | - James T Lee
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elisabeth Wilhelm
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Peng-Jun Lu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rosalind J Carter
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of the Director, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kwanza Boone
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Goldbelt, Inc., Juneau, Alaska
| | - Brittney Baack
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nina B Masters
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Debora Weiss
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Preparedness and Response (CPR), Division of State and Local Readiness (DSLR), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carla Black
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Caroline
| | - Sitaram Vangala
- Department of Pediatrics, University of California at Los Angeles, Los Angeles, New York
| | - Christina Albertin
- Department of Pediatrics, University of California at Los Angeles, Los Angeles, New York
| | - Peter G Szilagyi
- Department of Pediatrics, University of California at Los Angeles, Los Angeles, New York
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Caroline; Lineberger Comprehensive Cancer Center, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - James A Singleton
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia
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171
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Koskan AM, LoCoco IE, Daniel CL, Teeter BS. Rural Americans' COVID-19 Vaccine Perceptions and Willingness to Vaccinate against COVID-19 with Their Community Pharmacists: An Exploratory Study. Vaccines (Basel) 2023; 11:vaccines11010171. [PMID: 36680016 PMCID: PMC9864964 DOI: 10.3390/vaccines11010171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023] Open
Abstract
In early 2022 in the U.S., rural adults were the least likely to vaccinate against COVID-19 due to vaccine hesitancy and reduced healthcare access. This study explored the factors influencing rural adults' COVID-19 vaccine perceptions and their acceptance of pharmacist-administered vaccination. We utilized phone-based semi-structured interviews with 30 adults living in rural regions of one southwestern state and analyzed the data using a team-based thematic analysis approach. Vaccine-willing participants described knowing other people affected by the virus and their desired protection from the virus. They reported trusting scientific institutions and the government to provide safe vaccines. Vaccine-hesitant populations, however, feared that the COVID-19 vaccine development process had been rushed, compromising the safety of these newer vaccines. Although they differed in the news sources they preferred for receiving COVID-19 vaccine information, both vaccine-willing and vaccine-hesitant participants described trusting local authorities, such as healthcare providers and county government officials, to provide accurate COVID-19 vaccine information. Regarding the acceptability of pharmacist-administered COVID-19 vaccinations, all but one participant described their acceptance of this healthcare delivery approach. Future outreach should leverage rural adults' trust in local sources, including community pharmacists, deemed more convenient access points to healthcare, when addressing vaccine hesitancy.
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Affiliation(s)
- Alexis M. Koskan
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ 85004, USA
- Correspondence:
| | - Iris E. LoCoco
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 550 E Van Buren Street, Phoenix, AZ 85006, USA
| | - Casey L. Daniel
- Department of Family Medicine, Whiddon College of Medicine, University of South Alabama, 5795 USA North Drive, Mobile, AL 36608, USA
| | - Benjamin S. Teeter
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W Markham St., Little Rock, AR 72205, USA
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172
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Moehring A, Collis A, Garimella K, Rahimian MA, Aral S, Eckles D. Providing normative information increases intentions to accept a COVID-19 vaccine. Nat Commun 2023; 14:126. [PMID: 36624092 PMCID: PMC9828376 DOI: 10.1038/s41467-022-35052-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/16/2022] [Indexed: 01/11/2023] Open
Abstract
Despite the availability of multiple safe vaccines, vaccine hesitancy may present a challenge to successful control of the COVID-19 pandemic. As with many human behaviors, people's vaccine acceptance may be affected by their beliefs about whether others will accept a vaccine (i.e., descriptive norms). However, information about these descriptive norms may have different effects depending on the actual descriptive norm, people's baseline beliefs, and the relative importance of conformity, social learning, and free-riding. Here, using a pre-registered, randomized experiment (N = 484,239) embedded in an international survey (23 countries), we show that accurate information about descriptive norms can increase intentions to accept a vaccine for COVID-19. We find mixed evidence that information on descriptive norms impacts mask wearing intentions and no statistically significant evidence that it impacts intentions to physically distance. The effects on vaccination intentions are largely consistent across the 23 included countries, but are concentrated among people who were otherwise uncertain about accepting a vaccine. Providing normative information in vaccine communications partially corrects individuals' underestimation of how many other people will accept a vaccine. These results suggest that presenting people with information about the widespread and growing acceptance of COVID-19 vaccines helps to increase vaccination intentions.
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Affiliation(s)
- Alex Moehring
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA.,MIT Initiative on the Digital Economy, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Avinash Collis
- McCombs School of Business, The University of Texas at Austin, Austin, TX, USA
| | - Kiran Garimella
- School of Communication and Information, Rutgers University, New Brunswick, NJ, USA
| | - M Amin Rahimian
- MIT Initiative on the Digital Economy, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sinan Aral
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA.,MIT Initiative on the Digital Economy, Massachusetts Institute of Technology, Cambridge, MA, USA.,Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Dean Eckles
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA. .,MIT Initiative on the Digital Economy, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA.
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173
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Jiang B, Cao Y, Qian J, Jiang M, Huang Q, Sun Y, Dai P, Yi H, Zhang R, Xu L, Zheng J, Yang W, Feng L. Healthcare Workers' Attitudes toward Influenza Vaccination: A Behaviour and Social Drivers Survey. Vaccines (Basel) 2023; 11:143. [PMID: 36679986 PMCID: PMC9863509 DOI: 10.3390/vaccines11010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to understand the intention and correlation of receiving and recommending influenza vaccine (IV) among healthcare workers (HCWs) in China during the 2022/2023 season using the behavior and social drivers (BeSD) tools. A self-administered electronic survey collected 17,832 participants on a media platform. We investigated the willingness of IV and used multivariate logistic regression analysis to explore its associated factors. The average scores of the 3Cs’ model were compared by multiple comparisons. We also explored the factors that potentially correlated with recommendation willingness by partial regression. The willingness of IV was 74.89% among HCWs, and 82.58% of the participants were likely to recommend it to others during this season. Thinking and feeling was the strongest domain independently associated with willingness. All domains in BeSD were significantly different between the hesitancy and acceptance groups. Central factors in the 3Cs model were significantly different among groups (p < 0.01). HCWs’ willingness to IV recommendation was influenced by their ability to answer related questions (r = 0.187, p < 0.001) after controlling for their IV willingness and perceived risk. HCWs’ attitudes towards IV affect their vaccination and recommendation. The BeSD framework revealed the drivers during the decision-making process. Further study should classify the causes in detail to refine HCWs’ education.
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Affiliation(s)
- Binshan Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yanlin Cao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jie Qian
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Mingyue Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Qiangru Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yanxia Sun
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Peixi Dai
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Heya Yi
- Department of International Affairs, Chinese Preventive Medicine Association, Beijing 100062, China
| | - Run Zhang
- “Breath Circles” Network Platform, Beijing 100026, China
| | - Lili Xu
- Institute for Non-Communicable Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining 810007, China
| | - Jiandong Zheng
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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174
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Guerin RJ, Naeim A, Baxter-King R, Okun AH, Holliday D, Vavreck L. Parental intentions to vaccinate children against COVID-19: Findings from a U.S. National Survey. Vaccine 2023; 41:101-108. [PMID: 36404172 PMCID: PMC9637509 DOI: 10.1016/j.vaccine.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/09/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
We examined parents' COVID-19 vaccination intentions for their children, reasons for not vaccinating, and the potential impact of a school/daycare vaccination requirement or pediatrician's recommendation on vaccination intentions. Two online surveys were conducted in June-July and September-October 2021, before pediatric COVID-19 vaccines were authorized for emergency use in children age < 12 years, with an internet-based, non-probability sample of U.S. adults. Respondents with children (age < 18 years) in the household were asked about their intention (likelihood) of vaccinating these children against COVID-19. Weighted Chi-square tests using a Rao-Scott correction were performed. Vaccinated (45.7 %) versus unvaccinated (6.9 %) parents were almost seven times more likely to have vaccinated their 12-17-year-old children against COVID-19. Approximately 58.4 % of respondents with unvaccinated children ages 2-11 years and 42.4 % of those with children < 2 years said they are "very" or "extremely likely" to vaccinate these children against COVID-19. Female parents were significantly more likely (p < .01 to p < .001) to express lower levels of COVID-19 vaccine intentions. Across all age groups of children unvaccinated against COVID-19, parental vaccine intentions increased with increased household income and education levels. COVID-19 vaccine side effects and safety concerns were primary reasons for not vaccinating children. Strategies including school vaccination requirements and recommendations from pediatricians were shown to increase parental COVID-19 vaccination intentions for some. More research is needed on factors that increase/hinder COVID-19 pediatric vaccine uptake.
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Affiliation(s)
- Rebecca J. Guerin
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1090 Tusculum Ave., MS C-10, Cincinnati, OH 45226, United States,Corresponding author at: 1090 Tusculum Ave. MS C-10, Cincinnati, OH 45226
| | - Arash Naeim
- Center for SMART Health, Clinical and Translational Science Institute, University of California, Los Angeles, 200 Medical Plaza Driveway, Suite 120, Los Angeles, CA 90095, United States.
| | - Ryan Baxter-King
- Department of Political Science, University of California, Los Angeles, 4289 Bunche Hall, Los Angeles, CA 90095-1472, United States.
| | - Andrea H. Okun
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1090 Tusculum Ave., MS C-10, Cincinnati, OH 45226, United States
| | - Derek Holliday
- Department of Political Science, University of California, Los Angeles, 4289 Bunche Hall, Los Angeles, CA 90095-1472, United States.
| | - Lynn Vavreck
- Department of Political Science, University of California, Los Angeles, 4289 Bunche Hall, Los Angeles, CA 90095-1472, United States; Department of Communication, University of California, Los Angeles, 2225 Rolfe Hall, Los Angeles, CA 90095, United States.
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175
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Shapiro JR, Privor-Dumm L, Rosser EN, Leng SX, Klein SL, Morgan R. The intersection of gender and race in older adults' decision to receive COVID-19 vaccines. Vaccine 2023; 41:211-218. [PMID: 36435705 PMCID: PMC9485425 DOI: 10.1016/j.vaccine.2022.09.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/09/2022] [Accepted: 09/13/2022] [Indexed: 02/04/2023]
Abstract
COVID-19 vaccines are essential public health tools for protecting older adults, who are at high risk of severe outcomes associated with COVID-19. Little is known, however, about how older adults approach the decision to receive a COVID-19 vaccine. We hypothesized that intersections between gender and race may provide unique insight into the decision-making process and the factors that lead to vaccine uptake among hesitant individuals. We performed in-depth interviews with 24 older adults who had been vaccinated against COVID-19 and used the framework approach with an intersectional lens to analyze data. Two typologies emerged: eager compliers did not question the need to vaccinate, whereas hesitant compliers were skeptical of the vaccine and underwent a thorough decision-making process prior to vaccination. For eager compliers, the vaccine offered protection from a disease that posed a serious threat, and few risks were perceived. In contrast, hesitant compliers perceived risks associated with the vaccine product or mistrusted the infrastructure that led to rapid vaccine development. Hesitancy was greater among Black participants, and only Black participants reported mistrust in vaccine infrastructure. At the intersection of gender and race, a 'White male effect' was observed, whereby White men perceived the fewest risks associated with the vaccine, and Black women were the most fearful of serious side effects. Nearly all hesitant compliers ultimately got vaccinated due to the threat of COVID-19. Convenient access through vaccine clinics in senior's buildings was pivotal for hesitant compliers and external and internal influences had differential impacts by race and gender. Emphasizing the risk of COVID-19, convenient and accessible opportunities for vaccination, and messages that are targeted to specific groups are likely to increase vaccine uptake among older adults.
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Affiliation(s)
- Janna R. Shapiro
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lois Privor-Dumm
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,International Vaccine Access Centre, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Erica N. Rosser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sean X. Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA,W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L. Klein
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author
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176
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Mathews KO, Norris JM, Phalen D, Malikides N, Savage C, Sheehy PA, Bosward KL. Factors associated with Q fever vaccination in Australian wildlife rehabilitators. Vaccine 2023; 41:201-210. [PMID: 36424259 DOI: 10.1016/j.vaccine.2022.10.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022]
Abstract
Australian wildlife rehabilitators (AWR) are at risk of contracting Q fever, a serious zoonotic disease caused by Coxiella burnetii. Despite Australian government recommendations for AWR to receive Q fever vaccination (QFV), and the availability of a safe and effective vaccine in Australia, shortfalls in vaccine uptake have been observed in AWR. This study aimed to determine factors associated with QFV status and describe AWR attitudes and potential barriers towards QFV. Data were obtained from a nationwide, online, cross-sectional survey of AWR undertaken in 2018. Approximately-three quarters (200/265; 75.5 %) of those that had heard of Q fever were also aware of the Q fever vaccine, and of those, 25.5 % (51/200) were vaccinated. Barriers to QFV, among unvaccinated respondents who had also heard of Q fever and the vaccine (149/200; 74.5 %), included concerns regarding the safety, efficacy, and importance of the Q fever vaccine. Complacency toward vaccination, convenience of vaccination, and a lack of Q fever knowledge were also notable barriers. Only 27.7 % (41/148) of respondents reported having had vaccination recommended to them. Multivariable logistic regression identified that vaccinated AWR were more likely to be aged ≤ 50 years (OR 4.51, 95 % CI: 2.14-10.11), have had a university level education (OR 2.78, 95 % CI: 1.39-5.73), have resided in New South Wales/Australian Capital Territory and Queensland than in other Australian jurisdictions (OR 2.9, 95 % CI: 1.10-8.83 and OR 4.82, 95 % CI: 1.64-16.00 respectively) and have attended an animal birth (OR 2.14, 95 % CI: 1.02-4.73). Knowledge gaps regarding Q fever and QFV in AWR demonstrated the need for interventions to raise the awareness of the potential health consequences of C. burnetii exposure and Q fever prevention. Education programs to allow AWR to develop an informed perspective of Q fever and QFV, coupled with improvements in vaccine affordability and the implementation of programs to enhance accessibility, may also increase vaccine uptake.
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Affiliation(s)
- Karen O Mathews
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Jacqueline M Norris
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Sydney 2006, New South Wales, Australia
| | - David Phalen
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | | | | | - Paul A Sheehy
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia
| | - Katrina L Bosward
- The University of Sydney, Sydney School of Veterinary Science, Faculty of Science, Camden, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Sydney 2006, New South Wales, Australia.
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177
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Christou-Ergos M, Wiley KE, Leask J. Willingness to receive a vaccine is influenced by adverse events following immunisation experienced by others. Vaccine 2023; 41:246-250. [PMID: 36446655 DOI: 10.1016/j.vaccine.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/16/2022] [Indexed: 11/28/2022]
Abstract
An adverse event following immunization (AEFI) can have consequences for an individual's future decision making and may contribute to vaccine hesitancy. AEFIs vary in severity and can be experienced directly (by an individual themselves) or indirectly (through witnessed or recounted events). We sought to measure the prevalence of specific AEFIs and understand which AEFIs have the greatest associations with reduced willingness to receive a vaccine and how injection anxiety may moderate the relationship. We conducted a cross-sectional online survey with both qualitative and quantitative elements in a sample of adults aged 18 years and over in Australia. Nineteen percent of the 1050 respondents reported experiencing an AEFI that they found stressful. Those who experienced an AEFI reported significantly higher levels of injection anxiety than those who did not. Within the group who reported experiencing an AEFI, respondents were significantly less likely to be willing to receive a COVID-19 vaccine if they reported: indirect exposure to an uncommon/rare AEFI compared with other AEFIs (aOR:0.39; 95% CI: 0.18-0.87); indirect exposure to a scientifically unsupported AEFI compared with other AEFIs (aOR:0.18; 95% CI: 0.05-0.57). Direct exposure to an AEFI was not associated with willingness to receive a COVID-19 vaccine. For those who reported experiencing an AEFI, the odds of willingness to receive a COVID-19 vaccine decreased significantly with an increase in injection anxiety (aOR:0.94; 95% CI: 0.9-0.98). Our results suggest that more is needed to mitigate the consequences of AEFIs on vaccine willingness. Empathically acknowledging at a community level, the experience of both real and perceived AEFIs and incorporating accounts of positive vaccination experiences in vaccine hesitancy interventions may be useful.
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Affiliation(s)
- Maria Christou-Ergos
- University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, NSW, Australia.
| | - Kerrie E Wiley
- University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, Westmead Hospital, Westmead, NSW, Australia
| | - Julie Leask
- University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, Westmead Hospital, Westmead, NSW, Australia
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178
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Ferguson E, Bowen S, Lawrence C, Starmer C, Barr A, Davison K, Reynolds C, Brailsford SR. Communicating the move to individualized donor selection policy: Framing messages focused on recipients and safety. Transfusion 2023; 63:171-181. [PMID: 36349898 PMCID: PMC10099824 DOI: 10.1111/trf.17175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Men-who-have-sex-with-men (MSM) have been deferred from donating blood. However, recent evidence supports the adoption of donor screening based on individuals' sexual behavior over population-based criteria. We explore how best to frame communications about adopting this change to minimize any potential negative consequences (e.g., reduced donor numbers). We examine the effectiveness of risk (emphasizing safety vs. emphasizing low risk), and focus (donor vs. recipient) frames on intentions to donate blood (approach) or feeling deterred from donating (avoid), and mechanisms linked to under-reporting sexual behavior. STUDY DESIGN AND METHODS We conducted a 2 (risk frame: risk vs. safety) by 3 (focus: donor vs. recipient vs. both) between-subjects online experiment (n = 2677). The main outcomes were intentions to donate and feelings of being put-off/deterred from donating (both for self and others). We also assessed the extent that forgetting, embarrassment/shame, and question irrelevance were perceived to be associated with under-reporting sexual behavior. RESULTS Frames that focused on safety or a recipient resulted in people reporting being less deterred from donating. Regardless of frame, people from ethnic minorities were more likely to feel deterred. Embarrassment/shame followed by forgetting and perceived irrelevance were the main reasons for under-reporting sexual behaviors, especially in ethnic minorities, and smartphones were perceived as an acceptable memory aid for sexual behavior. DISCUSSION Blood services moving to an individualized policy should frame donor selection in terms of safety and/or a recipient focus, explore sensitivities in ethnic minority communities, consider ways to normalize reporting sexual behavior, and use smartphones as a memory aid.
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Affiliation(s)
- Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK.,National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Sarah Bowen
- School of Economics, University of Nottingham, Nottingham, UK.,Behavioural Practice, KPUK, Westminster, London, UK
| | | | - Chris Starmer
- School of Economics, University of Nottingham, Nottingham, UK
| | - Abigail Barr
- School of Economics, University of Nottingham, Nottingham, UK
| | - Katy Davison
- NHS Blood and Transplant/UK Health Security Agency Epidemiology Unit, UK Health Security Agency London, London, UK
| | - Claire Reynolds
- NHS Blood and Transplant/UK Health Security Agency Epidemiology Unit, NHS Blood and Transplant, London, UK
| | - Susan R Brailsford
- NHS Blood and Transplant/UK Health Security Agency Epidemiology Unit, NHS Blood and Transplant, London, UK
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179
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Mäki KO, Karlsson LC, Kaakinen JK, Schmid P, Lewandowsky S, Antfolk J, Soveri A. Tailoring interventions to suit self-reported format preference does not decrease vaccine hesitancy. PLoS One 2023; 18:e0283030. [PMID: 36943860 PMCID: PMC10030039 DOI: 10.1371/journal.pone.0283030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 02/28/2023] [Indexed: 03/23/2023] Open
Abstract
Individually tailored vaccine hesitancy interventions are considered auspicious for decreasing vaccine hesitancy. In two studies, we measured self-reported format preference for statistical vs. anecdotal information in vaccine hesitant individuals, and experimentally manipulated the format in which COVID-19 and influenza vaccine hesitancy interventions were presented (statistical vs. anecdotal). Regardless of whether people received interventions that were in line with their format preference, the interventions did not influence their vaccine attitudes or vaccination intentions. Instead, a stronger preference for anecdotal information was associated with perceiving the material in both the statistical and the anecdotal interventions as more frustrating, less relevant, and less helpful. However, even if the participants reacted negatively to both intervention formats, the reactions to the statistical interventions were consistently less negative. These results suggest that tailoring COVID-19 and influenza vaccine hesitancy interventions to suit people's format preference, might not be a viable tool for decreasing vaccine hesitancy. The results further imply that using statistics-only interventions with people who hold anti-vaccination attitudes may be a less risky choice than using only anecdotal testimonies.
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Affiliation(s)
- Karl O Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linda C Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Johanna K Kaakinen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Philipp Schmid
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
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180
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Wei Z, Liu Y, Zhang L, Sun X, Jiang Q, Li Z, Wu Y, Fu C. Stages of HPV Vaccine Hesitancy Among Guardians of Female Secondary School Students in China. J Adolesc Health 2023; 72:73-79. [PMID: 36229401 PMCID: PMC9746349 DOI: 10.1016/j.jadohealth.2022.08.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/31/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Female secondary school students are the primary recommended population for human papillomavirus (HPV) vaccines. However, vaccine hesitancy may affect uptake. In this study, we assessed the vaccine hesitancy levels among the guardians of female secondary school students in China. METHODS We developed a questionnaire and conducted cross-sectional surveys among guardians of secondary school girls aged 12-19 years in mainland China based on the Increasing Vaccination Model and the Precaution Adoption Process Model. RESULTS We collected 3,225 valid samples. Among the participating guardians, 53.9% were vaccine hesitant, although only 0.9% had refused HPV vaccines. Some individual characteristics of guardians (e.g. sex, education/income level) were associated with understanding HPV vaccines. Better knowledge of HPV vaccines and communication with reliable sources of information were associated with vaccine nonhesitancy. Practical barriers such as vaccine shortage and busy schedules prevented nonhesitant guardians from vaccinating their children. DISCUSSION A substantial proportion of the guardians surveyed were HPV vaccine hesitant. Promoting HPV knowledge and communication with reliable sources (e.g. clinical doctors) could help fight against vaccine hesitancy.
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Affiliation(s)
- Zheng Wei
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Bloomsbury, London, England, UK,Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, Bloomsbury, London, England, UK
| | - Liuren Zhang
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiu Sun
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qijing Jiang
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhenwei Li
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yue Wu
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chuanxi Fu
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
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Fishman J, Mandell DS, Salmon MK, Candon M. Large and small financial incentives may motivate COVID-19 vaccination: A randomized, controlled survey experiment. PLoS One 2023; 18:e0282518. [PMID: 36930588 PMCID: PMC10022800 DOI: 10.1371/journal.pone.0282518] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/16/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Experts continue to debate how to increase COVID-19 vaccination rates. Some experts advocate for financial incentives. Others argue that financial incentives, especially large ones, will have counterproductive psychological effects, reducing the percent of people who want to vaccinate. Among a racially and ethnically diverse U.S. sample of lower income adults, for whom vaccine uptake has lagged compared with higher income adults, we empirically examine such claims about relatively large and small guaranteed cash payments. METHODS In 2021, we conducted a randomized, controlled experiment among U.S. residents with incomes below $80,000 who reported being unvaccinated against COVID-19. Study participants were randomized to one of four study arms. In two arms, respondents first learned about a policy proposal to pay $1,000 or $200 to those who received COVID-19 vaccination and were then asked if, given that policy, they would want to vaccinate. In the two other arms, respondents received either an educational message about this vaccine or received no vaccine information and were then asked if they wanted to vaccinate for COVID-19. The primary analyses estimated and compared the overall percentage in each study arm that reported wanting to vaccinate for COVID-19. In other analyses, we estimated and compared these percentages for subgroups of interest, including gender, race/ethnicity, and education. MAIN RESULTS Among 2,290 unvaccinated adults, 79.7% (95%CI, 76.4-83.0%) of those who learned about the proposed $1,000 payment wanted to get vaccinated, compared with 58.9% (95%CI, 54.8-63.0%) in the control condition without vaccine information, a difference of 20 percentage points. Among those who learned of the proposed $200 payment, 74.8% (95% CI, 71.3-78.4%) wanted to vaccinate. Among those who learned only about the safety and efficacy of COVID-19 vaccines, 68.9% (95% CI, 65.1-72.7%) wanted to vaccinate. Findings were consistent across various subgroups. DISCUSSION Despite several study limitations, the results do not support concerns that the financial incentive policies aimed to increase COVID-19 vaccination would have counterproductive effects. Instead, those who learned about a policy with a large or small financial incentive were more likely than those in the control condition to report that they would want to vaccinate. The positive effects extended to subgroups that have been less likely to vaccinate, including younger adults, those with less education, and racial and ethnic minorities. Financial incentives of $1,000 performed similarly to those offering only $200.
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Affiliation(s)
- Jessica Fishman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Message Effects Lab, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - David S. Mandell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Mandy K. Salmon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Molly Candon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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182
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Huang Q, Abad N, Bonner KE, Baack B, Petrin R, Hendrich MA, Lewis Z, Brewer NT. Explaining demographic differences in COVID-19 vaccination stage in the United States - April-May 2021. Prev Med 2023; 166:107341. [PMID: 36372280 PMCID: PMC9650505 DOI: 10.1016/j.ypmed.2022.107341] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
COVID-19 vaccine coverage in the US has marked demographic and geographical disparities, but few explanations exist for them. Our paper aimed to identify behavioral and social drivers that explain these vaccination disparities. Participants were a national probability sample of 3562 American adults, recruited from the Ipsos KnowledgePanel. Participants completed an online survey in spring 2021, when COVD-19 vaccination was available for higher-risk groups but not yet available to all US adults. The survey assessed COVID-19 vaccination stage (intentions and vaccine uptake), constructs from the Increasing Vaccination Model (IVM) domains (thinking and feeling, social processes, and direct behavior change), self-reported exposure to COVID-19 vaccine information, and demographic characteristics. Analyses used multiple imputation to address item nonresponse and linear regressions to conduct mediation analyses. Higher COVID-19 vaccination stage was strongly associated with older age, liberal political ideology, and higher income in adjusted analyses (all p < .001). Vaccination stage was more modestly associated with urbanicity, white race, and Hispanic ethnicity (all p < .05). Some key mediators that explained more than one-third of demographic differences in vaccination stage were perceived vaccine effectiveness, social norms, and recommendations from family and friends across most demographic characteristics (all p < .05). Other mediators included safety concerns, trust, altruism, provider recommendation, and information seeking. Access to vaccination, barriers to vaccination, and self-efficacy explained few demographic differences. One of the most reliable explanations for demographic differences in COVID-19 vaccination stage is social processes, including social norms, recommendations, and altruism. Interventions to promote COVID-19 vaccination should address social processes and other domains in the IVM.
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Affiliation(s)
- Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Neetu Abad
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Brittney Baack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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183
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Schneider FH, Campos-Mercade P, Meier S, Pope D, Wengström E, Meier AN. Financial incentives for vaccination do not have negative unintended consequences. Nature 2023; 613:526-533. [PMID: 36631607 PMCID: PMC9833033 DOI: 10.1038/s41586-022-05512-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 11/02/2022] [Indexed: 01/13/2023]
Abstract
Financial incentives to encourage healthy and prosocial behaviours often trigger initial behavioural change1-11, but a large academic literature warns against using them12-16. Critics warn that financial incentives can crowd out prosocial motivations and reduce perceived safety and trust, thereby reducing healthy behaviours when no payments are offered and eroding morals more generally17-24. Here we report findings from a large-scale, pre-registered study in Sweden that causally measures the unintended consequences of offering financial incentives for taking the first dose of a COVID-19 vaccine. We use a unique combination of random exposure to financial incentives, population-wide administrative vaccination records and rich survey data. We find no negative consequences of financial incentives; we can reject even small negative impacts of offering financial incentives on future vaccination uptake, morals, trust and perceived safety. In a complementary study, we find that informing US residents about the existence of state incentive programmes also has no negative consequences. Our findings inform not only the academic debate on financial incentives for behaviour change but also policy-makers who consider using financial incentives to change behaviour.
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Affiliation(s)
| | - Pol Campos-Mercade
- Lund University, Lund, Sweden.
- University of Copenhagen, Copenhagen, Denmark.
| | | | - Devin Pope
- University of Chicago Booth School of Business, Chicago, IL, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - Erik Wengström
- Lund University, Lund, Sweden
- Hanken School of Economics, Helsinki, Finland
| | - Armando N Meier
- Unisanté and Lausanne Center for Health Economics, Behavior, and Policy (LCHE), University of Lausanne, Lausanne, Switzerland.
- Faculty of Business and Economics, University of Basel, Basel, Switzerland.
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Reñosa MDC, Wachinger J, Bärnighausen K, Endoma V, Landicho-Guevarra J, Landicho J, Bravo TA, Aligato M, McMahon SA. Misinformation, infighting, backlash, and an 'endless' recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines. Glob Health Action 2022; 15:2077536. [PMID: 35930464 PMCID: PMC9359158 DOI: 10.1080/16549716.2022.2077536] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Vaccine scares undermine longstanding global health achievements. Remarkably little data has documented the lived experiences of policymakers working amidst vaccine scares and navigating their fallout. As a result, chances and challenges of large-scale national recuperation efforts are poorly understood. Objective This study aims to explore the perspectives of policymakers involved in ongoing efforts to boost vaccine confidence in the Philippines following a 2017 Dengvaxia scare and the current COVID-19 pandemic. Methods Between August and November 2020, we conducted 19 semi-structured narrative interviews with purposively selected policymakers from governmental agencies and non-governmental organizations in the Philippines. Interviews were conducted online, transcribed, and analyzed following the tenets of reflexive thematic analysis. Results We present results as an emerging model that draws on a chronology conveyed by policymakers in their own words. The Dengvaxia scare proved ‘a decisive wedge’ that splintered Filipino society and pitted governmental agencies against one another. The scare stoked distorted vaccination narratives, which were ‘accelerated rapidly’ via social media, and ignited feelings of uncertainty among policymakers of how to convey clear, accurate health messaging and how to prevent drops in care-seeking more broadly. Conclusions Efforts to regain trust placed exceptional burdens on an already-strained health system. Respondent-driven recommendations on how to reinforce vaccine confidence and improve vaccination rollout include: developing clear vaccine messages, fostering healthcare providers’ and policymakers’ communication skills, and rebuilding trust within, toward and across governmental agencies. Further research on how to build enabling environments and rebuild trust in and across institutions remains paramount.
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Affiliation(s)
- Mark Donald C Reñosa
- Heidelberg Institute of Global Health, Ruprecht-Karls Universität Heidelberg, Heidelberg, Germany.,Department of Epidemiology and Biostatistics and Department of Health, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Jonas Wachinger
- Heidelberg Institute of Global Health, Ruprecht-Karls Universität Heidelberg, Heidelberg, Germany
| | - Kate Bärnighausen
- Heidelberg Institute of Global Health, Ruprecht-Karls Universität Heidelberg, Heidelberg, Germany.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Vivienne Endoma
- Department of Epidemiology and Biostatistics and Department of Health, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Jhoys Landicho-Guevarra
- Department of Epidemiology and Biostatistics and Department of Health, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Jeniffer Landicho
- Department of Epidemiology and Biostatistics and Department of Health, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Thea Andrea Bravo
- Department of Epidemiology and Biostatistics and Department of Health, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Mila Aligato
- Department of Epidemiology and Biostatistics and Department of Health, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Shannon A McMahon
- Heidelberg Institute of Global Health, Ruprecht-Karls Universität Heidelberg, Heidelberg, Germany.,International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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185
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Di Castri AM, Halperin DM, Ye L, MacKinnon-Cameron D, Kervin M, Isenor JE, Halperin SA. Healthcare provider awareness, attitudes, beliefs, and behaviors regarding the role of pharmacists as immunizers. Hum Vaccin Immunother 2022; 18:2147356. [PMID: 36472081 PMCID: PMC9762776 DOI: 10.1080/21645515.2022.2147356] [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] [Indexed: 12/12/2022] Open
Abstract
We explored perceptions of healthcare providers in Nova Scotia and New Brunswick about pharmacists as immunizers. Pharmacists' scopes of practice are increasingly broadening to include immunization, and providers and policymakers may find meaning in the lessons we learned. Invitations to participate in our online survey were circulated by professional associations, health authorities, and in social media posts. A total of 204 healthcare providers completed our survey, of whom 59.3% were pharmacists, 17.6% were nurses, and 23.0% were physicians. Nurses (30.6%) and physicians (34.0%) experienced fewer logistical barriers to immunizing compared to pharmacists, 71.1% of whom identified practice logistics as a determinant in offering vaccines to patients (p < .001). Pharmacists were most supportive of the expansion of their own scope of practice to include the provision of vaccines to adults (95.9%) and children as young as five years (92.6%) compared to nurses (72.2% and 69.4%) and physicians (61.7% and 40.4%) (p < .001). Diversity of opinion was evident even among pharmacists about whether they should be permitted to vaccinate children younger than five years. Nurse and physician respondents had lower odds of thinking pharmacists have enough training to vaccinate (p < .001), that vaccines should be given in a pharmacy (p < .001), and of supporting the expansion of pharmacists' scope of practice (p < .001) than pharmacists did in the multivariable analyses. Pharmacists are well-positioned and willing to vaccinate and generally have support from their nurse and physician peers, but logistical challenges and interprofessional complexities persist as barriers to optimizing immunization by pharmacists.
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Affiliation(s)
- Antonia M. Di Castri
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Donna M. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada,CONTACT Donna M. Halperin Canadian Center for Vaccinology, Dalhousie University, IWK Health, and Nova Scotia Health, Halifax, NS, Canada; Rankin School of Nursing, St. Francis Xavier University, PO Box 5000, Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Lingyun Ye
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Donna MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Melissa Kervin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Jennifer E. Isenor
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,Department of Pediatrics, Dalhousie University, Halifax, NS, Canada,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
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186
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Mantina NM, Block Ngaybe M, Johnson K, Velickovic S, Magrath P, Gerald LB, Krupp K, Krauss B, Perez-Velez CM, Madhivanan P. Racial/ethnic disparities in influenza risk perception and vaccination intention among Pima County residents in Arizona. Hum Vaccin Immunother 2022; 18:2154506. [PMID: 36476311 PMCID: PMC9762835 DOI: 10.1080/21645515.2022.2154506] [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] [Indexed: 12/12/2022] Open
Abstract
While influenza cases in Arizona have nearly tripled since 2018, vaccination rates continue to lag. Statewide, Hispanics and African Americans had the lowest vaccination rates despite having higher influenza infection rates than Whites. Given Arizona's racial influenza vaccination disparity and the general increase in vaccination hesitancy due to COVID-19, the purpose of this study was to better understand the influences of seasonal influenza vaccination in Arizona during the COVID-19 pandemic using qualitative methods. Findings from this study revealed that many participants were motivated to get the influenza vaccine to protect their family and close friends. The heightened concern for COVID-19 prompted some Hispanic/Latino focus group discussion participants to consider getting vaccinated. However, many Hispanic/Latino participants also expressed that they stopped getting influenza vaccine due to negative vaccination experiences or concern about sickness following immunization. African American participants primarily discussed receiving the vaccine as part of their routine health visit. Compared to other races, more White participants believed that vaccination was unimportant because they were healthy, and the people they interacted with never got sick. Distinct factors influence risk perception and vaccination intention across different racial/ethnic groups. Effective interventions can account for these factors and be tailored to the target population to maximize vaccination uptake.
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Affiliation(s)
- Namoonga M. Mantina
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA,CONTACT Namoonga M. Mantina Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, AZ85724-5209, USA
| | - Maiya Block Ngaybe
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Kerry Johnson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sonja Velickovic
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Priscilla Magrath
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Lynn B. Gerald
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, IL, USA
| | - Karl Krupp
- Division of Public Health Practice and Translational Research, Mel & Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, USA
| | - Beatrice Krauss
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Carlos M. Perez-Velez
- Division of Epidemiology, Pima County Health Department, Tucson, AZ, USA,Division of Infectious Diseases, Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA,Division of Infectious Diseases, Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
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187
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Carlson SJ, Tomkinson S, Blyth CC, Attwell K. COVID-19 vaccine knowledge, attitudes, and experiences of health care workers in Perth, Western Australia: A qualitative study. PLoS One 2022; 17:e0279557. [PMID: 36584018 PMCID: PMC9803204 DOI: 10.1371/journal.pone.0279557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/11/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Health care workers (HCWs) faced an increased risk of Coronavirus Disease 2019 (COVID-19). Australia's COVID-19 vaccine rollout commenced in February 2021 to priority groups, including HCWs. Given their increased risk, as well as influence on patients' vaccine uptake, it was important that HCWs had a positive COVID-19 vaccination experience, as well as trusting the vaccine safety and efficacy data. METHODS Semi-structured interviews were undertaken with 19 public- and privately-practicing HCWs in Western Australia between February-July 2021. Data were deductively analysed using NVivo 12 and guided by the Capability-Opportunity-Motivation-Behaviour model. RESULTS 15/19 participants had received at least one COVID-19 vaccine. Participants were highly motivated, mostly to protect themselves and to get back to "normal", but also to protect patients. Many had a heightened awareness of COVID-19 severity due hearing from colleagues working in settings more impacted than Western Australia. Participants trusted the COVID-19 vaccine development and approval process; their histories of having to accept vaccines for work helped them to see COVID-19 vaccination as no different. Many recalled initially being unsure of how and when they'd be able to access the vaccine. Once they had this knowledge, half had difficulties with the booking process, and some were unable to access a clinic at a convenient location or time. Participants learnt about COVID-19 vaccination through government resources, health organisations, and their workplace, but few had seen any government campaigns for the wider public. Finally, most had discussed COVID-19 vaccination with their social network. CONCLUSION HCWs in Western Australia demonstrated good knowledge about COVID-19 vaccination, with many reasons to vaccinate themselves and support the vaccination of others. Addressing the barriers identified in this study will be important for planning to vaccinate health workforces during future pandemics.
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Affiliation(s)
- Samantha J. Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Social Sciences, The University of Western Australia, Perth, Western Australia
| | - Sian Tomkinson
- School of Social Sciences, The University of Western Australia, Perth, Western Australia
| | - Christopher C. Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Perth, Western Australia, Australia
- Department of Microbiology, PathWest Laboratory Medicine, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- School of Social Sciences, The University of Western Australia, Perth, Western Australia
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188
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Moosa S, Abdul Raheem R, Riyaz A, Musthafa HS, Naeem AZ. The role of social value orientation in modulating vaccine uptake in the COVID-19 pandemic: A cross-sectional study. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:467. [PMID: 36589254 PMCID: PMC9793809 DOI: 10.1057/s41599-022-01487-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 vaccination is the only pharmaceutical measure available to control the pandemic and move past the current crisis. As such, the Maldives, a small island country, invested heavily on securing and vaccinating the eligible population through an intensive risk communication campaign to create awareness on vaccination benefits. This paper reports on the vaccine coverage after a year of COVID-19 vaccine being introduced into the country, based on data obtained from the Values in Crisis Survey - Wave Two among Maldivian adults (n = 497). The findings show a vaccine coverage of 94%, with only 2.2% of the respondents indicating they will not get vaccinated. No significant differences were observed by age, gender, income earning, educational status or residential area. No significant relationship was observed in vaccine behaviour and confidence in government, health sector and experts. Social value orientations, particularly conservation and self-transcendence value orientations determined positive vaccine behaviour (r s = 0.180, p < 0.01 and 0.136 p < 0.01 respectively), yet conservation was the only predictor that contributed significantly to the regression model (B = 0.158, p < 0.01). The findings indicate that, despite the uncertainties around COVID-19 vaccinations, the prosocial value orientations were instrumental in achieving a high COVID-19 vaccine coverage. Further theoretical and conceptual exploration of vaccine behaviour in crisis situations is needed to inform future pandemic situations. The vaccination rollout and behaviour change strategies also need an examination of social value orientations in order to achieve a high coverage and sustain pro-vaccine behaviour post-pandemic.
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Affiliation(s)
- Sheena Moosa
- The Maldives National University, Male’, Maldives
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189
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Staras SAS, Bylund CL, Mullis MD, Thompson LA, Hall JM, Hansen MD, Fisher CL. Messaging preferences among Florida caregivers participating in focus groups who had not yet accepted the HPV vaccine for their 11- to 12-year-old child. BMC Public Health 2022; 22:2413. [PMID: 36550434 PMCID: PMC9779937 DOI: 10.1186/s12889-022-14852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In the United States, human papillomavirus (HPV) vaccination rates remain low. The President's Cancer Panel suggests that effective messaging about the HPV vaccination focus on the vaccine's safety, efficacy, ability to prevent cancer, and recommendation at ages 11- to 12-years. We aimed to develop messages about HPV vaccine that include the President Cancer Panel's suggestions and were acceptable to caregivers of adolescents. METHODS From August to October 2020, we conducted one-hour, Zoom videoconference focus groups with caregivers who lived in Florida, had an 11- to 12-year-old child, and had not had any of their children receive the HPV vaccine. Focus group moderators asked caregivers to react to three videos of clinician (i.e., MD, DO, APRN, PA) recommendations and three text message reminders. Thematic analysis was conducted using the constant comparative method and led by one author with qualitative analysis expertise. Two additional authors validated findings. RESULTS Caregivers (n = 25 in six groups) were primarily non-Hispanic white (84%) and educated (64% had at least an Associate's degree). Approximately a third of caregivers had delayed (44%) or decided against a vaccine for their child (36%). Caregivers described six preferred message approaches: recognize caregivers' autonomy, balanced benefits and risks, trustworthy sources, increased feasibility of appointment scheduling, information prior to decision point, and preferred personalized information. Caregivers expressed a desire to have the follow-up doses mentioned in the introduction. CONCLUSIONS HPV vaccine messages, whether delivered by a clinician or via text message, will be more acceptable to caregivers if they approach HPV vaccination as the caregivers' decision, and include information from trusted sources to help caregivers make an informed choice.
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Affiliation(s)
- Stephanie A. S. Staras
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Carma L. Bylund
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Michaela D. Mullis
- grid.15276.370000 0004 1936 8091Department of Advertising, College of Journalism and Communications, University of Florida, 2096 Weimer Hall 1885 Stadium Rd, PO BOX 118400, Gainesville, FL 32611 USA
| | - Lindsay A. Thompson
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Department of Pediatrics, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610 USA
| | - Jaclyn M. Hall
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Marta D. Hansen
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Carla L. Fisher
- grid.15276.370000 0004 1936 8091Department of Advertising, College of Journalism and Communications, University of Florida, 2096 Weimer Hall 1885 Stadium Rd, PO BOX 118400, Gainesville, FL 32611 USA
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Omari A, Boone KD, Zhou T, Lu PJ, Kriss JL, Hung MC, Carter RJ, Black C, Weiss D, Masters NB, Lee JT, Brewer NT, Szilagyi PG, Singleton JA. Characteristics of the Moveable Middle: Opportunities Among Adults Open to COVID-19 Vaccination. Am J Prev Med 2022; 64:734-741. [PMID: 36690543 PMCID: PMC9767894 DOI: 10.1016/j.amepre.2022.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Focusing on subpopulations that express the intention to receive a COVID-19 vaccination but are unvaccinated may improve the yield of COVID-19 vaccination efforts. METHODS A nationally representative sample of 789,658 U.S. adults aged ≥18 years participated in the National Immunization Survey Adult COVID Module from May 2021 to April 2022. The survey assessed respondents' COVID-19 vaccination status and intent by demographic characteristics (age, urbanicity, educational attainment, region, insurance, income, and race/ethnicity). This study compared composition and within-group estimates of those who responded that they definitely or probably will get vaccinated or are unsure (moveable middle) from the first and last month of data collection. RESULTS Because vaccination uptake increased over the study period, the moveable middle declined among persons aged ≥18 years. Adults aged 18-39 years and suburban residents comprised most of the moveable middle in April 2022. Groups with the largest moveable middles in April 2022 included persons with no insurance (10%), those aged 18-29 years (8%), and those with incomes below poverty (8%), followed by non-Hispanic Native Hawaiian or other Pacific Islander (7%), non-Hispanic multiple or other race (6%), non-Hispanic American Indian or Alaska Native persons (6%), non-Hispanic Black or African American persons (6%), those with below high school education (6%), those with high school education (5%), and those aged 30-39 years (5%). CONCLUSIONS A sizable percentage of adults open to receiving COVID-19 vaccination remain in several demographic groups. Emphasizing engagement of persons who are unvaccinated in some racial/ethnic groups, aged 18-39 years, without health insurance, or with lower income may reach more persons open to vaccination.
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Affiliation(s)
- Amel Omari
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kwanza D Boone
- Goldbelt C6, Chesapeake, Virginia; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Leidos, Atlanta, Georgia
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Kriss
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mei-Chuan Hung
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Leidos, Atlanta, Georgia
| | - Rosalind J Carter
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carla Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Debora Weiss
- Career Epidemiology Field Offic, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nina B Masters
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James Tseryuan Lee
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Peter G Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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191
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Moore R, Rojo MO, Purvis RS, Marin LP, Yáñez J, Reece S, Wells C, Vaughn B, McElfish PA. Overcoming barriers and enhancing facilitators to COVID-19 vaccination in the Hispanic community. BMC Public Health 2022; 22:2393. [PMID: 36539771 PMCID: PMC9765355 DOI: 10.1186/s12889-022-14825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Hispanic communities in the United States have been disproportionately affected by COVID-19 infections, hospitalizations, and death. Vaccination against COVID-19 is critical for controlling the pandemic; however, higher levels of vaccine hesitancy and reduced vaccine uptake constrain efforts to mitigate the pandemic and could perpetuate disparities. The aim of this study was to understand barriers and facilitators to COVID-19 vaccination through the lived experiences of Hispanic persons living in Arkansas. METHODS Bilingual community partners facilitated recruitment, made initial contact with potential participants, and scheduled interviews and focus groups. Individuals over the age of 18 who identified as Hispanic were invited to participate. Data was collected from 49 participants in 10 individual interviews and five focus groups. This study used a qualitative exploratory design and thematic analysis. RESULTS Five themes emerged as barriers for Hispanic participants: technological literacy and pre-registration, language and literacy, health insurance/health care costs, immigration status, and location and transportation. Three themes emerged as facilitators: workplace vaccination, health care provider recommendations, and engagement through schools. CONCLUSIONS Based on the findings of this study, a multi-modal and flexible approach will be implemented by the authors to address barriers to vaccine uptake among the Hispanic community in Arkansas.
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Affiliation(s)
- Ramey Moore
- grid.411017.20000 0001 2151 0999College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72703 USA
| | - Martha O. Rojo
- grid.241054.60000 0004 4687 1637College of Nursing, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205 USA
| | - Rachel S. Purvis
- grid.411017.20000 0001 2151 0999College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72703 USA
| | - Luis Paganelli Marin
- grid.411017.20000 0001 2151 0999Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72703 USA
| | - Judith Yáñez
- RootED Northwest Arkansas, 610B, E. Emma Ave, Springdale, AR 72764 USA
| | - Sharon Reece
- grid.411017.20000 0001 2151 0999College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72703 USA
| | - Cheryl Wells
- grid.241054.60000 0004 4687 1637College of Nursing, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205 USA
| | - Brittany Vaughn
- grid.411017.20000 0001 2151 0999College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72703 USA
| | - Pearl A. McElfish
- grid.411017.20000 0001 2151 0999College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72703 USA
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Boshra MS, Elgendy MO, Abdelaty LN, Tammam M, Alanazi AS, Alzarea AI, Alsahali S, Sarhan RM. Knowledge, Attitude, and Acceptance of Sinopharm and AstraZeneca's COVID-19 Vaccines among Egyptian Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16803. [PMID: 36554688 PMCID: PMC9778847 DOI: 10.3390/ijerph192416803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND This study aimed to evaluate the Egyptian population's preference and awareness related to available COVID-19 vaccines and to determine different factors that can affect beliefs concerning these vaccines. METHODS A cross-sectional web-based study was carried out among the general population in Egypt. Data collection was conducted via an online questionnaire. RESULTS About 426 subjects participated in the survey. Vaccine preference is nearly equally even (50%) among all respondents. There was no significant difference in vaccine preference according to age, gender, residence, educational level, or social status. About 50% of public respondents mentioned that both AstraZeneca and Sinopharm vaccines do not offer protection against new variant COVID-19 strains. Healthcare workers are the lowest respondents to agree that vaccines offer protection against new COVID-19 variants (10.9%) compared to unemployed respondents (20.3%) and other professions (68.8%) with a statistically significant difference (p < 0.005). Safety of vaccine administration among children below 18 showed statistical differences for gender and educational level predictors. CONCLUSIONS Most of the study population has satisfying knowledge about the COVID-19 vaccine. Continuous awareness campaigns must be carried out so that the people's background is updated with any new information that would help in raising the trust in vaccination.
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Affiliation(s)
- Marian S. Boshra
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt
| | - Marwa O. Elgendy
- Clinical Pharmacy Department, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt
- Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62513, Egypt
| | - Lamiaa N Abdelaty
- Department of Clinical Pharmacy, Faculty of Pharmacy, October 6 University, Giza 12525, Egypt
| | | | - Abdullah S. Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
- Health Sciences Research Unit, Jouf University, Sakaka 72388, Saudi Arabia
| | | | - Saud Alsahali
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia
| | - Rania M. Sarhan
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt
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193
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Montagni I, Pouymayou A, Pereira E, Tzourio C, Schück S, Texier N, González-Caballero JL. Measuring Digital Vaccine Literacy: Development and Psychometric Assessment of the Digital Vaccine Literacy Scale. J Med Internet Res 2022; 24:e39220. [PMID: 36515982 PMCID: PMC9798258 DOI: 10.2196/39220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/18/2022] [Accepted: 09/06/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The use of the internet to look for information about vaccines has skyrocketed in the last years, especially with the COVID-19 pandemic. Digital vaccine literacy (DVL) refers to understanding, trust, appraisal, and application of vaccine-related information online. OBJECTIVE This study aims to develop a tool measuring DVL and assess its psychometric properties. METHODS A 7-item online questionnaire was administered to 848 French adults. Different psychometric analyses were performed, including descriptive statistics, exploratory factor analysis, confirmatory factor analysis, and convergent and discriminant validity. RESULTS We developed the 7-item DVL scale composed of 3 factors (understanding and trust official information; understanding and trust information in social media; and appraisal of vaccine information online in terms of evaluation of the information and its application for decision making). The mean DVL score of the baseline sample of 848 participants was 19.5 (SD 2.8) with a range of 7-28. The median score was 20. Scores were significantly different by gender (P=.24), age (P=.03), studying or working in the field of health (P=.01), and receiving regular seasonal flu shots (P=.01). CONCLUSIONS The DVL tool showed good psychometric proprieties, resulting in a promising measure of DVL.
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Affiliation(s)
- Ilaria Montagni
- Bordeaux Population Health UMRS1219, University of Bordeaux, Institut national de la santé et de la recherche médicale, Bordeaux, France
| | - Aude Pouymayou
- Bordeaux Population Health UMRS1219, University of Bordeaux, Institut national de la santé et de la recherche médicale, Bordeaux, France
| | - Edwige Pereira
- Bordeaux Population Health UMRS1219, University of Bordeaux, Institut national de la santé et de la recherche médicale, Bordeaux, France
| | - Christophe Tzourio
- Bordeaux Population Health UMRS1219, University of Bordeaux, Institut national de la santé et de la recherche médicale, Bordeaux, France
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194
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Jylhä KM, Stanley SK, Ojala M, Clarke EJR. Science Denial. EUROPEAN PSYCHOLOGIST 2022. [DOI: 10.1027/1016-9040/a000487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract. Science denial has adverse consequences at individual and societal levels and even for the future of our planet. The present article aimed to answer the question: What leads people to deny even the strongest evidence and distrust the scientific method? The article provides a narrative review of research on the underpinnings of science denial, with the main focus on climate change denial. Perspectives that are commonly studied separately are integrated. We review key findings on the roles of disinformation and basic cognitive processes, motivated reasoning (focusing on ideology and populism), and emotion regulation in potentially shaping (or not shaping) views on science and scientific topics. We also include research on youth, a group in an important transition phase in life that is the future decision-makers but less commonly focused on in the research field. In sum, we describe how the manifestations of denial can stem from cognitive biases, motivating efforts to find seemingly rational support for desirable conclusions, or attempts to regulate emotions when feeling threatened or powerless. To foster future research agendas and mindful applications of the results, we identify some research gaps (most importantly related to cross-cultural considerations) and examine the unique features or science denial as an object of psychological research. Based on the review, we make recommendations on measurement, science communication, and education.
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Affiliation(s)
| | | | - Maria Ojala
- School of Law, Psychology and Social Work, Örebro University, Sweden
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195
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Attwell K, Hannah A. Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates. Int J Health Policy Manag 2022; 11:2660-2671. [PMID: 35397484 PMCID: PMC9818102 DOI: 10.34172/ijhpm.2022.6518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Vaccine hesitancy is a global problem with diverse local policy responses, from voluntaristic to coercive. Between 2015 and 2017, California, Australia, France, and Italy increased the coerciveness of their childhood vaccine regimes. Despite this apparent convergence, there is little evidence of imposition, policy learning, or diffusion - the drivers that are usually discussed in scholarly literature on policy convergence. The fact that the four governments were oriented across the political spectrum, with quite different political and institutional systems, further indicates an empirical puzzle. METHODS To better understand the drivers of enhanced vaccine mandates, a crucial issue during the coronavirus disease 2019 (COVID-19) global rollout, this article engages with four case studies assembled from qualitative analysis of semi-structured in-country interviews and document analysis between November 2018 and November 2020. Key informants had specific expert knowledge or played a role in the introduction or implementation of the new policies. Interview transcripts were coded inductively and deductively, augmented with extensive analysis of legal, policy, academic and media documents. RESULTS The case analysis identifies two key and interacting elements in government decisions to tighten vaccine mandates: functional and political pressures. Policy-makers in Italy and France were primarily driven by functional challenges, with their vaccination governance systems under threat from reduced population compliance. California and Australia did not face systemic threats to the functioning of their systems, but activists utilised local opportunities to heighten political pressure on decision makers. CONCLUSION In four recent cases of high-income jurisdictions making childhood vaccination policies more coercive, vaccine hesitancy alone could not explain why the policies arose in these jurisdictions and not others, while path dependency alone could not explain why some jurisdictions with mandates made them more coercive. Explanation lies in restrictive mandates being attractive for governments, whether they face systemic functional problems in vaccine governance, or political pressures generated by media and activists. Mandates can be framed as targeting whole populations or localised groups of refusers, and implemented without onerous costs or policy complexity.
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Affiliation(s)
- Katie Attwell
- Political Science and International Relations, School of Social Sciences, University of Western Australia, Perth, WA, Australia
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196
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A call for immediate action to increase COVID-19 vaccination uptake to prepare for the third pandemic winter. Nat Commun 2022; 13:7511. [PMID: 36473855 PMCID: PMC9726862 DOI: 10.1038/s41467-022-34995-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
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197
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Fishman J, Salmon MK, Scheitrum D, Aleks Schaefer K, Robertson CT. Comparative effectiveness of mandates and financial policies targeting COVID-19 vaccine hesitancy: A randomized, controlled survey experiment. Vaccine 2022; 40:7451-7459. [PMID: 35914961 PMCID: PMC9148933 DOI: 10.1016/j.vaccine.2022.05.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 01/28/2023]
Abstract
Experts debate whether COVID-19 vaccine mandates or financial incentives will reduce, rather than increase, interest in vaccination. Among 3,698 unvaccinated U.S. residents, we conducted a randomized, controlled survey-embedded experiment to estimate the absolute and relative psychological effects of vaccine policies specifying: mandates by employers or airlines, bars, and restaurants; lotteries for $1 million, $200,000, or $100,000; guaranteed cash for $1000, $200, or $100; and $1,000 as either a tax credit or penalty. Vaccine intention -the study outcome- predicts uptake and provides insight into the psychological mechanism that is most proximal to behavior (i.e., vaccination). Compared to controls, those who learned about the $1,000 cash reward policy were 17.1 (±5.3)% more likely to want vaccination. Employer mandates are more promising than other mandate policies (8.6 [+/- 7.4]% vs. 1.4 [+/- 6.0]%). The full results suggest that neither mandates nor financial incentives are likely to have counterproductive psychological effects. These policies are not mutually exclusive and, if implemented well, they may increase vaccine uptake.
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Affiliation(s)
- Jessica Fishman
- Message Effects Lab, Perelman School of Medicine & Annenberg School, University of Pennsylvania, Philadelphia, PA, United States,Corresponding author at: Director, Message Effects Lab, University of Pennsylvania, United States
| | - Mandy K. Salmon
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Scheitrum
- Department of Agricultural and Resource Economics, University of Arizona, Tucson, AZ, United States
| | - K. Aleks Schaefer
- Department of Agricultural Economics, Oklahoma State University, Stillwater, OK, United States
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198
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Slotte P, Karlsson LC, Soveri A. Attitudes towards mandatory vaccination and sanctions for vaccination refusal. Vaccine 2022; 40:7378-7388. [PMID: 35688728 DOI: 10.1016/j.vaccine.2022.05.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 01/28/2023]
Abstract
AIMS Investigating attitudes towards mandatory vaccination and sanctions for vaccination refusal in an area with insufficient vaccination coverage may help health authorities to assess which strategies for increasing vaccination coverage are appropriate. This study examines attitudes to vaccine mandates and asks questions regarding what kinds of sanctions could legitimately result from vaccination refusal. It seeks to find out if people's attitudes towards mandates and towards sanctions for vaccination refusal are related to their attitudes to vaccines and the degree of trust they feel towards health care professionals and health care authorities. The study also discusses how the observed attitudes towards mandates may be related to perceptions of autonomy, responsibility, and equitability. METHODS Data collection was carried out in Finland through an online survey in a region with suboptimal vaccine uptake. Statistical analysis was conducted on a sample of 1101 respondents, using confirmatory factor analysis and structural regression analysis. RESULTS Persons hold different views on mandates and sanctions. Importantly, the persons who support vaccination mandates and sanctions for vaccination refusal are to a great degree the same people who have positive attitudes to vaccines and high trust in health care professionals and health authorities. CONCLUSION Trust is a key factor which has a bearing on people's attitudes towards mandates and sanctions for noncompliance. A focus on the reasons for lack of trust, and on how to enhance trust, is a more feasible long-term way (than mandates) to promote large- scale compliance with childhood vaccine programmes in the studied country context.
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Affiliation(s)
- Pamela Slotte
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Tehtaankatu 2, FI-20500 Turku, Finland; Centre of Excellence in Law, Identity and the European Narratives, Siltavuorenpenger 1A, FI-00014 University of Helsinki, Finland.
| | - Linda C Karlsson
- Department of Clinical Medicine, FI-20014 University of Turku, Turku, Finland.
| | - Anna Soveri
- Department of Clinical Medicine, FI-20014 University of Turku, Turku, Finland.
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Pokharel M, Lillie HM, Nagatsuka K, Barbour JB, Ratcliff CL, Jensen JD. Social media narratives can influence vaccine intentions: The impact of depicting regret and character death. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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200
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Uncovering Public Perceptions of Older Adults' Vaccines in Canada: A Study of Online Discussions from National Media Sources. Can J Aging 2022; 41:657-666. [PMID: 35403587 DOI: 10.1017/s0714980822000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study explored how a subsection of Canadians perceive older adults' vaccines through a qualitative analysis of comments posted in response to national online news articles. We used reflexive thematic analysis to analyse 147 comments from 31 news article comments sections published between 2015 and 2020 from five different national online news sources (CBC, National Post, Global News, Globe & Mail, and Huffington Post Canada) that focused on three older adults' diseases and vaccines: influenza, pneumococcal pneumonia, and herpes-zoster. Three themes encompassed the similarities and differences in how these three diseases were discussed: (1) the importance of personal experiences on stated stance in vaccine uptake or refusal, (2) questioning vaccine research and recommendations, and (3) criticisms of the government's unequal vaccine opportunities across different Canadian provinces. Our findings identified that perceptions regarding older adult vaccination were dependent on the vaccine type, and, therefore, we make suggestions for future researchers to build on our findings, particularly the need not to treat the research subject of "older adults' vaccines" as one entity. Gaining a better understanding of how older adults' vaccines are perceived in Canada will enable public health professionals to develop effective communication strategies that should ultimately improve vaccination rates for older adults.
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