US State-Level Legal Interventions Related to COVID-19 Vaccine Mandates

Characteristics of an Older Adult Population Without COVID-19 Infection in a Southeast Minnesota Community

OBJECTIVE

To assess demographic characteristics, public health measures, and health beliefs or behaviors that differentiate participants with a history of the coronavirus disease 2019 (COVID-19) infection from those with no history of COVID-19.

METHODS

A cross-sectional survey-based study nested within a larger prospective cohort study of a community-based sample of 2511 adults was conducted to assess the incidence of viral infections. Community-based adults aged 50 years and older residing in southeast Minnesota who were assessed and self-reported history of COVID-19 infection during the early to mid phase of the COVID-19 pandemic were included; 1758 participants completed the survey between June 6, 2021, and February 7, 2022. Participants were asked to complete a questionnaire containing 42 items related to COVID-19. Odds ratios were calculated for history of COVID-19 to compare sociodemographic factors, current and future health behaviors, and health beliefs, including effective preventive measures and modes of transmission.

RESULTS

We found that certain sociodemographic features and health behaviors (eg, adherence to public health measures, such as COVID-19 vaccination) are associated with protection against COVID-19 infection and that strong beliefs in effective COVID-19 protective measures and modes of transmission (eg, types of social distancing) differentiated those without from those with a history of COVID-19.

CONCLUSION

Depending on the communicability, virulence, and pathogenicity of future COVID-19 variants, local, state, and federal governments must continue to consider the risks and benefits of public health initiatives that take into consideration these protective factors.

Healthcare provider recommendations for COVID-19 vaccination: Prevalence, disparities, and correlates

OBJECTIVE

We assessed healthcare provider recommendations for COVID-19 vaccination, disparities across sociodemographic factors, and associations with health care coverage, social norms, COVID-19 vaccine hesitancy, and Fox News preference.

METHODS

We utilized random sample survey data of Arkansas residents (N = 2201) collected in October 2022 to identify adults with a personal provider who make up the analytical sample of this study (n = 1804).

RESULTS

Over a third (37.2 %; n = 607) of the weighted sample did not receive a recommendation. Adjusted odds of receiving a recommendation were positively associated with health care coverage (aOR=1.66; 95 % CI [1.05, 2.64]) and negatively associated with perceiving "very few" (aOR=0.48; 95 % CI [0.33, 0.72]) or "some but not many" (aOR=0.57; 95 % CI [0.41, 0.80]) rather than "nearly all" people close to them to be vaccinated. Adjusted odds of receiving a recommendation were negatively associated with being very hesitant (vs. not at all hesitant) (aOR=0.65; 95 % CI [0.47, 0.88]).

CONCLUSION

Provider recommendations for COVID-19 vaccination were not provided for a large portion of Arkansas adults, were inconsistently provided across sociodemographic groups, and were associated with health care coverage, social norms, and vaccine hesitancy.

PRACTICE IMPLICATIONS

Intervening on disparities in COVID-19 vaccination may require addressing disparities in provider recommendations.

Acceptance of Seasonal Influenza Vaccine Following COVID-19 Vaccination: A Survey among Israel Defense Forces Soldiers

Data regarding the contribution of COVID-19 vaccine rollouts to real-world uptake of influenza vaccination remains unclear. This cross-sectional survey-based study among Israel Defense Forces (IDF) soldiers aimed to assess the impact of the COVID-19 pandemic and specifically, previous COVID-19 vaccines uptake, on the intention to vaccinate for influenza during 2021-2022 season. Participants engaged in an online survey addressing vaccination history and current vaccine-related preferences. The survey was delivered prior to the initiation of the IDF's annual influenza immunization campaign. A multinomial logistic regression model was applied to analyze factors correlated with unwillingness to receive influenza vaccine. Overall, 825 invitations to participate in the survey were distributed and the overall response rate was 78.5%. Among the 648 participants who replied (61.6% males, median age of 20 years), 51.9% were willing to receive the upcoming influenza vaccine. Factors associated with vaccine reluctance included being female, not receiving the previous season's influenza vaccine, not having a previous diagnosis of COVID-19, and having decreased uptake of COVID-19 vaccines. Among participants not intending to receive an influenza vaccine, 50.3% stated that they are healthy and have no need for the vaccine and 36.2% stated they received too many vaccines over the previous year. The results of this study may suggest that influenza vaccination rates in the post-COVID-19 vaccine era may be reduced due to a perceived "vaccine saturation" phenomenon, owing to the density of COVID-19 vaccine administration. Future interventions such as campaigns related to maximizing influenza vaccination coverage should address repeated doses of COVID-19 vaccine administration.

Emergency powers and the pandemic: Reflecting on state legislative reforms and the future of public health response

The first 2 years of combatting the COVID-19 pandemic necessitated an unprecedented use of emergency powers. States responded with an equally unprecedented flurry of legislative changes to the legal underpinnings of emergency response and public health authorities. In this article, we provide a brief background on the framework and use of governors and state health officials' emergency powers. We then analyze several key themes, including both the enhancement and restriction of powers, emerging from emergency management and public health legislation introduced in state and territorial legislatures. During the 2020 and 2021 state and territorial legislative sessions, we tracked legislation related to the emergency powers of governors and state health officials. Legislators introduced hundreds of bills impacting these powers, some enhancing and others restricting emergency powers. Enhancements included increasing vaccine access and expanding the pool of eligible medical professions that could administer vaccinations, strengthening public health investigation and enforcement authority for state agencies, and preclusion of local orders by orders at the state level. Restrictions included establishing oversight mechanisms for executive actions, limits on the duration of the emergency, limiting the scope of emergency powers allowed during a declared emergency, and other restraints. By -describing these legislative trends, we hope to inform governors, state health officials, -policymakers, and emergency managers about how changes in the law may impact future public health and emergency response capabilities. Understanding this new legal landscape is critical to effectively preparing for future threats.

COVID-19 vaccine Mandates: An Australian attitudinal study

BACKGROUND

The rollout of vaccines against COVID-19 is prompting governments and the private sector to adopt mandates. However, there has been little conceptual analysis of the types of mandates available, nor empirical analysis of how the public thinks about different mandates and why. Our conceptual study examines available instruments, how they have been implemented pre-COVID, and their use for COVID-19 globally. Then, our qualitative study reports the acceptability of such measures in Western Australia, which has experienced very limited community transmission, posing an interesting scenario for vaccine acceptance and acceptability of measures to enforce it.

METHOD

Our conceptual study developed categories of mandates from extant work, news reports, and legislative interventions globally. Then, our empirical study asked 44 West Australians about their attitudes towards potential mandatory policies, with data analysed using NVivo 12.

RESULTS

Our novel studies contribute richness and depth to emerging literature on the types and varying acceptability of vaccine requirements. Participants demonstrated tensions and confusion about whether instruments were incentives or punishments, and many supported strong consequences for non-vaccination even if they ostensibly opposed mandates. Those attached to restrictions for disease prevention were most popular. There were similar degrees of support for mandates imposed by employers or businesses, with participants showing little concern for potential issues of accountability linked to public health decisions delegated to the private sector. Participants mostly supported tightly regulated medical exemptions granted by specialists, with little interest in religious or personal belief exemptions.

CONCLUSION

Our participants are used to being governed by vaccine mandates, and now by rigorous lockdown and travel restrictions that have ensured limited local COVID-19 disease and transmission. These factors appear influential in their general openness to COVID-19 vaccine mandates, especially when linked explicitly to the prevention of disease in high-risk settings.

COVID-19 prevention behaviors, trust, and intent to vaccinate among youth at risk for HIV

The current study examines COVID-19 prevention behaviors and vaccine intentions among 83 youth at high risk for HIV. Most youth self-identified as Latinx (52%), cisgender men (84%), and homosexual (66%). Youth self-reported COVID-19 prevention behaviors and intentions to vaccinate. Participants reported wearing face masks, washing hands, and staying six feet apart, but fewer reported leaving home only for essential needs. About one-third reported that they would not get a vaccine, and lack of trust in their doctors and the government were significantly associated with non-intention. To improve efforts towards herd immunity, interventions to improve health messaging from trusted sources for at-risk youth may be necessary to achieve higher vaccine uptake.