Vaccine hesitancy: Beliefs and barriers associated with COVID-19 vaccination among Egyptian medical students

Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry

Since the launch of the Covid-19 global vaccination campaign, postsecondary institutions have strongly promoted vaccination, often through mandates, and the academic literature has identified "vaccine uptake" among postsecondary students as a problem deserving monitoring, research, and intervention. However, with the admission that vaccines do not stop viral spread, that older-age and co-morbidities are major determinants of poor outcomes, and that many vaccine side effects disproportionately affect the young, it cannot be assumed that a risk-benefit analysis favors vaccinating postsecondary students. Drawing from critical policy studies, I appraise the literature on Covid-19 vaccine uptake in postsecondary education. I find that this literature reflects the "scientific consensus," hardly acknowledging contradictory medical evidence, ignoring coercive elements underlying "vaccine acceptance," and neglecting ethical tensions built into the very design of vaccination policies. I discuss potential explanations for my findings, and their implications for academia's role in society in the COVID-19 era and beyond.

Usage of social media and Covid 19 vaccine hesitancy among medical students in Kericho County

The recent Covid 19 pandemic revealed the global challenge posed by infectious diseases. Vaccines are a crucial tool in preventing pandemics, as evidenced by their success in controlling past outbreaks. The rise of information and communication technology has introduced social media platforms as potential game-changers in both preventing and managing future pandemics. However, these same platforms can also be a double-edged sword, hindering the uptake of essential vaccination services. This study investigated the association between social media use and vaccine hesitancy among medical students. The study was designed as an institution based cross sectional study of 423 medical students in Kenya Medical Training College and University of Kabianga in Kericho County. Stratified sampling was used to decide on the two institutions and systematic random sampling was used to select the study participants. Research administered questionnaires were used to collect data on the socio-demographic characteristics, use of social media platforms, social media campaigns, and uptake of Covid 19 vaccines. The collected data was analyzed using Statistical Package for Social Sciences version 25. Chi square was used to establish the association between the independent variables and uptake of Covid 19 vaccines. The variables that were significantly associated with hesitancy to Covid 19 vaccines were further analyzed using binary logistic regression. The confidence interval (CI) was set at 95% and statistical significance was considered at p < 0.05. The study found significant associations between vaccine hesitancy and several factors, including academic level, preferred social media platform, the influence of social media on attitudes towards vaccines, concerns about vaccine safety and efficacy, and confidence in vaccines. The findings present social media as a potential platform for promotion of vaccines utilization during pandemics when used well.

Knowledge, attitude, and practice of Egyptian medical students towards healthcare workers' recommended vaccines: a nationwide cross-sectional survey

BACKGROUND

Vaccination of healthcare workers (HCWs) is pivotal in decreasing the incidence of contagious infections in hospital settings. In this study, we assessed the knowledge, attitude, and practice regarding HCWs' recommended vaccines among medical students and interns in Egypt.

METHODS

A multicenter, cross-sectional study was conducted using a structured, pilot-tested, and self-administered questionnaire among Egyptian medical students and interns. We invited 1332 participants to our survey using a systematic random sampling that included participants across nine medical schools in Egypt during the 2021-2022 academic year.

RESULTS

Out of 1332 participants, 1141 completed our questionnaire with a response rate of 85.7%. Overall, 43% of the participants had intermediate knowledge (knew 2-3 HCWs' recommended vaccines). Furthermore, 36.7% had received a booster dose of at least one of the HCWs' recommended vaccines over the last 10 years, with only 6.1% having received all recommended vaccines. Hepatitis B vaccine was the most widely known (71%) and received (66.7%). Interns were more likely to know, receive, and recommend HCWs' recommended vaccines. The majority (> 90%) agreed that vaccination is beneficial and safe, with a median score of eight (interquartile range [IQR: Q25-Q75]: 7-9) out of ten for vaccine efficacy and eight (IQR: 7-8) for safety. However, the median score for hesitancy was five (IQR: 2-7). The most common influential and limiting factors for vaccination were scientific facts (60.1%) and fear of vaccine side effects (44.9%).

CONCLUSION

Although medical students in Egypt have good knowledge of and attitudes towards vaccination, there is a gap in their practices. Interventions are needed to improve vaccination uptake among medical students in Egypt.

Factors associated with willingness to receive coronavirus disease vaccination during the pandemic: A nationwide survey in Taiwan

BACKGROUND/PURPOSE

Vaccination is the most important preventive measure to protect people from coronavirus disease 2019 (COVID-19). Governments worldwide have prioritized their vaccination policy against COVID-19. However, there is a lack of relevant research on Taiwanese attitudes and considerations toward COVID-19 vaccination. This study aimed to investigate the cognition, preventive behaviors, and attitudes toward COVID-19 vaccines that influence people's willingness to get vaccinated in Taiwan.

METHODS

From October 1 to 31, 2021, a computer-assisted telephone interview system was used to randomly select Taiwanese people to investigate their COVID-19 preventive behaviors, knowledge, and willingness to be vaccinated.

RESULTS

We included 2000 participants of whom 96.45% showed vaccination willingness. The overall mean age and knowledge scores were 48.6 years and 5.78, respectively. All of the participants chose to wear masks, and 80% chose to be vaccinated to prevent COVID-19. Compared with the non-willing vaccination participants, those with younger ages, higher incomes, and higher knowledge scores regarding masks and vaccination were more likely to be vaccinated. Furthermore, apprehensions about vaccine side effects and negative news about COVID-19 vaccines were the major reasons for vaccination hesitancy.

CONCLUSION

To improve people's willingness to get vaccinated, the government should strive to deliver correct knowledge and refute inappropriate negative information about COVID-19 vaccination. Moreover, recommendation by physicians was an important factor for older individuals to decide on receiving the COVID-19 vaccine, and policies could be implemented from this aspect.

Hesitancy Towards COVID-19 Vaccine Among Students of Medical and Allied Health Sciences in Khyber Pakhtunkhwa

Objective

To measure COVID-19 vaccine hesitancy and its associated factors among medical and allied health sciences students of Khyber Pakhtunkhwa.

Methodology

This cross-sectional survey was conducted online using Google survey platform in March 2021. Study population comprised of medical and allied health sciences students studying in medical/allied health sciences academic institutes in Khyber Pakhtunkhwa. The web-based online link was provided to around 800 students to fill in the questionnaire via email, WhatsApp and/or social media network. Response rate was around 50%. The main outcome variable was vaccine hesitancy. Factors associated with vaccine hesitancy were explored by bivariate and multivariate regression analysis.

Results

Out of 398 medical and allied health sciences students, there were 193 (48.5%) males and 205 (51.5%) females with mean age was 22.6± 2.8 years. The vaccine hesitancy rate was found to be 52.8%. A significant relationship between vaccine hesitancy and gender was observed. Other factors including lack of adequate knowledge about vaccines (p < 0.001), Chinese origin of vaccines (p < 0.001), lack of knowledge that vaccination can reduce the chances of acquiring infection (p < 0.001), fear of potential side effects (p < 0.001) and hidden agenda behind free forceful vaccination (p = 0.045), were found to be main barriers or reasons responsible for COVID-19 vaccine hesitancy among medical and allied health sciences students.

Conclusion

Important associated barriers with COVID-19 vaccine hesitancy included gender, lack of information, fear of side effects, lack of trust in imported and Chinese vaccines, and perception of hidden agenda behind COVID-19 vaccination.

COVID-19 vaccination uptake among healthcare workers in Ghana: A comprehensive analysis of knowledge, attitude, perceived vaccine effectiveness, and health belief model constructs

The novel Coronavirus Disease 19 (COVID-19) caused devastating effects globally, and healthcare workers were among the most affected by the pandemic. Despite healthcare workers being prioritized in COVID-19 vaccination globally and in Ghana, hesitancy to receive the vaccines resulted in delayed control of the pandemic. In Ghana, healthcare workers had a vaccine acceptance of 39.3% before the vaccine rollout. Consequently, this study assessed the uptake of COVID-19 vaccination and associated factors among healthcare workers in Ghana in the post-vaccine roll-out period. This was an analytical cross-sectional study that used a semi-structured questionnaire to collect data on COVID-19 vaccination uptake and influencing factors. 256 healthcare workers were selected in Ayawaso West Municipality of Ghana using a stratified random sampling approach. Descriptive statistics were used to examine socio-demographic factors and Likert scale responses. Bivariable and Multivariable logistic regression were performed using IBM SPSS version 22 to identify predictors of vaccine uptake and a statistical significance was declared at p<0.05. More than three-fourths of participants 220 (85.9%) had received at least one dose of the COVID-19 vaccination, while 36 (14.9%) were hesitant. More than half 139 (54.3%) had adequate knowledge about COVID-19 vaccination and the majority 188 (73.4%) had positive perceptions about its effectiveness. Moreover, 218 (85.2%) of HCWs had a positive attitude towards COVID-19 vaccination. Positive attitude towards COVID-19 vaccination (AOR = 4.3; 95% CI: 1.4, 13.0) and high cues to action (AOR = 5.7; 95% CI: 2.2, 14.8) were the factors that significantly predicted uptake of COVID-19 vaccination among healthcare workers. COVID-19 vaccination among HCWs in Ghana is promising. However, hesitancy to receive the vaccination among a significant proportion of HCWs raises concerns. To ensure vaccination of all healthcare workers, interventions to promote vaccination should target key determinants of vaccination uptake, such as attitude towards the vaccination and cues to action.

Sentiment analysis of Indonesian tweets on COVID-19 and COVID-19 vaccinations

Background

Sentiments and opinions regarding COVID-19 and the COVID-19 vaccination on Indonesian-language Twitter are scarcely reported in one comprehensive study, and thus were aimed at our study. We also analyzed fake news and facts, and Twitter engagement to understand people's perceptions and beliefs that determine public health literacy.

Methods

We collected 3,489,367 tweets data from January 2020 to August 2021. We analyzed factual and fake news using the string comparison method. The difflib library was used to measure similarity. The user's engagement was analyzed by averaging the engagement metrics of tweets, retweets, favorites, replies, and posts shared with sentiments and opinions regarding COVID-19 and COVID-19 vaccination.

Result

Positive sentiments on COVID-19 and COVID-19 vaccination dominated, however, the negative sentiments increased during the beginning of the implementation of restrictions on community activities (PPKM).  The tweets were dominated by the importance of health protocols (washing hands, keeping distance, and wearing masks). Several types of vaccines were on top of the word count in the vaccine subtopic. Acceptance of the vaccination increased during the studied period, and the fake news was overweighed by the facts. The tweets were dynamic and showed that the engaged topics were changed from the nature of COVID-19 to the vaccination and virus mutation which peaked in the early and middle terms of 2021. The public sentiment and engagement were shifted from hesitancy to anxiety towards the safety and effectiveness of the vaccines, whilst changed again into wariness on an uprising of the delta variant.

Conclusion

Understanding public sentiment and opinion can help policymakers to plan the best strategy to cope with the pandemic. Positive sentiments and fact-based opinions on COVID-19, and COVID-19 vaccination had been shown predominantly. However, sufficient health literacy levels could yet be predicted and sought for further study.

Prevalence and determinants to COVID-19 vaccine hesitancy among people living with HIV in Bench Sheko zone, Southwest Ethiopia: A multi-center study

Introduction

In 2019, the World Health Organization (WHO) identified coronavirus disease-2019 (COVID-19) as one of the top 10 threats to global health. Currently, vaccine hesitancy is the most common obstacle to reducing COVID-19 incidence and achieving herd immunity worldwide. Understanding the factors influencing vaccine hesitancy in this specific population is crucial for developing targeted interventions to improve vaccine uptake and protect vulnerable communities. Therefore, this study aimed to evaluate the prevalence and determinants of COVID-19 vaccine hesitancy among people living with human immunodeficiency virus (HIV) who receive care at public health facilities in Bench Sheko Zone, Southwest Ethiopia.

Methods

A multi-center study was employed, involving multiple healthcare facilities within the Bench Sheko Zone from January 1 to 30 February 2023 to assess the prevalence and determinants of hesitancy to COVID-19 vaccination among people living with human deficiency virus (PLHIV). Data were collected by using pre-tested interviewer administered questionnaires and document review, and entered into Epi-data version 3.1 then exported to and analyzed by using SPSS version 24. Statistical significance was assessed by using multivariable logistic regression analysis by determining odds ratios and 95% confidence interval. Multi-Collinearity and model fitness were also checked.

Results

According to the study, the prevalence of COVID-19 vaccine hesitancy was found to be 47.9%, [95% CI, 43.8-52.0]. One significant finding was that younger individuals (age ≤25years) [AOR = 2.30, 95%CI, 1.15-4.57] exhibited a higher level of hesitancy compared to their older counterparts. Additionally, the study identified monthly income≤3000 birr [AOR = 0.57, 95%CI, 0.31-0.92], urban residence [AOR = 0.61, 95%CI, 0.42-0.91], HIV stage one [AOR = 0.44, 95%CI, 0.27-0.73] and human immunodeficiency virus (HIV) clinical stage two of HIV [AOR = 0.60, 95CI, 0.39-0.93] as determinants of vaccine hesitancy.

Conclusion

According to our study finding in southwest Ethiopia, individuals living with HIV were found to have a higher level of hesitancy towards receiving the COVID-19 vaccine as compared with center for disease control and prevention estimate of vaccine hesitancy. The study also identified several factors that contribute to vaccine hesitancy, including age, urban of residence, income level, and HIV clinical stage. Addressing the identified factors in this specific population could decrease the hesitancy. To ensure the success of vaccination campaigns in the region, policymakers and stakeholders should take steps to address these underlying factors and promote greater acceptance of the COVID-19 vaccine among the population.

Corona virus vaccine hesitancy among higher education students in Adama City, Oromia, Ethiopia

Background

Vaccination stands as the most efficient approach for managing the continued transmission of infections and preventing the emergence of novel variants. Coronavirus disease 2019 (COVID-19) vaccine hesitancy poses a significant burden in the fight to achieve herd immunity.

Methods

A cross-sectional study, based on institutional parameters, was conducted among a cohort of 530 higher education students, selected via a simple random sampling method. Study participants were selected using a systematic random sampling technique from February to March 2022. Structured questionnaire data were gathered and subsequently analyzed using SPSS version 21. The strength of the association between various factors and COVID-19 vaccine hesitancy was assessed using the odds ratio along with its 95% confidence interval. Statistical significance was deemed to be present at a p-value of < 0.05.

Result

The prevalence of coronavirus vaccine hesitancy was 47.5%. The factors that were found to be significantly associated with COVID-19 vaccine hesitancy were residential address (AOR = 2.398, 95% CI: 1.476-3.896); agreeing with leaders and groups that do not support COVID-19 vaccination (AOR = 2.292, 95% CI: 1.418-3.704); coming from a community whose leaders support COVID-19 vaccination for young adults (AOR = 0.598, 95% CI: 0.381-0.940), and believing that COVID-19 vaccines are safe (AOR = 0.343,95% CI: 0.168-0.701).

Conclusion

Approximately five out of 10 students who participated in this study were hesitant to get vaccinated against coronavirus. Incorporating messages and initiatives into local plans to specifically target the factors identified in this study is imperative for substantially increasing the COVID-19 vaccine uptake among students in higher education institutions.

Estimating COVID-19 vaccine acceptance in pregnant and lactating women: a cross-sectional study in Lebanon

BACKGROUND

The COVID-19 pandemic highlights vaccination's critical role in reducing morbidity and mortality, depending on public attitude. This study aims to identify the estimates of COVID-19 vaccine acceptance in pregnant and lactating women, as well as associated potential factors.

METHODS

A cross-sectional study was conducted between August and September 2021, through an online survey and with a paper survey distributed in gynecology and pediatric clinics. Pregnant and breastfeeding women aged 18 years and above were recruited. The attitude scale was created specifically for evaluating attitudes towards the COVID-19 vaccine.

RESULTS

In total, 207 women participated, with 132 breastfeeding, 74 pregnant and 1 experiencing both conditions. Of these, one hundred and twenty women (58%) considered themselves at risk for COVID-19 infection. In addition, 51.7% (n = 107) of women expressed the intent to receive the vaccine once available. A multivariable linear regression was conducted taking the COVID-19 vaccination attitude scale as a dependent variable. The results revealed an R-squared value of 0.558, indicating that approximately 55.8% of the variance in the attitude scale was accounted for by the included predictors. The results showed that preventive measures (ß=2.25, 95% Confidence Interval (CI) [1.02; 3.48], p < 0.001), preference for vaccines made in Europe and America (ß=1.23; 95% CI [0.69-1.77], p < 0.001), protect yourself for getting sick (ß=4.22, 95% Confidence Interval (CI) [2.83; 5.61], p < 0.001) and belief in the importance of vaccination for themselves and their baby (ß=3.49; 95% CI [2.01; 4.98], p < 0.001) were associated with a positive attitude towards vaccination. Conversely, experiencing a previous bad reaction to a vaccine (ß= -1.35; 95% CI [0.85-1.85], p < 0.001) and concerns regarding COVID-19 vaccine safety (ß= -4.09; 95% CI [-5.98; -2.21], p < 0.001) were associated with a negative attitude towards vaccination.

CONCLUSION

Our findings reveal that COVID-19 vaccine acceptability among pregnant and breastfeeding women, amidst the pandemic was insufficient to meet community immunity. The identified reasons for vaccine reluctance, notably concerns about safety for both personal health and the health of their pregnancy or newborns, along with insufficient information about the vaccine, underscore the pressing need to address these factors to improve immunization rates.

The impact of health beliefs and trust in health information sources on SARS-CoV-2 vaccine uptake

Background

Health beliefs may mediate the relationship between trust and vaccination decisions, as confidence in online health information has expanded quickly. However, little is known about how health attitudes and trust in health information affect COVID-19 vaccine intention. This study aimed to assess the effect of health beliefs and trust in information sources on the willingness to receive a COVID-19 vaccine among the general public in Saudi Arabia.

Methods

This study was designed and carried out at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Selected items were extracted from the Saudi Residents' Intention to Get Vaccinated Against COVID-19 (SRIGVAC) survey. They were categorized and validated into constructs of a health belief model (the perceived threat of COVID-19, vaccine-related benefits, barriers, and safety concerns) and trust in health information (from online platforms and health authorities/providers). Regression analysis and parallel mediation were used to assess the predictors of vaccination intentions.

Results

Based on the responses of 3,091 participants, vaccine-related barriers and safety concerns negatively influenced vaccination intention, whereas vaccine benefits and the perceived threat of COVID-19 were positively correlated with vaccination intention. Trust in online health information had a direct relationship with intentions (β = 0.09, p < 0.0001) as well as indirect relationships through the perceived benefits (β = 0.095), the perceived barriers (β = -0.029), and the perceived safety concerns toward the vaccine (β = -0.010). The relationship between the willingness to vaccinate and trust in authentic information was fully mediated by all domains of health beliefs, with indirect coefficients of 0.004, 0.310, -0.134, and -0.031 for the perceived threat, vaccine benefits, barriers, and safety concerns, respectively.

Conclusion

The relationship between the willingness to vaccinate and trust in authentic information was fully mediated by all domains of health beliefs. Vaccine coverage in Saudi Arabia can be optimized by targeting the health beliefs of the general public.

Risk Perceptions Regarding COVID-19 and Compliance with Protective Measures of Midwifery and Nursing Senior Students

OBJECTIVE

This study aims to examine the risk perceptions of midwifery and nursing senior students regarding COVID-19 and compliance with vaccination and protective measures.

METHOD

This cross-sectional study was conducted in two academic years on senior midwifery and nursing students (n = 358). In the present study, the descriptive characteristics of the students and the COVID-19 risk perception scale were used.

RESULTS

The students' COVID-19 Risk Perception Scale scores were at a moderate level and a similar level in both years of this study. More than 80% of the students were fully vaccinated, and the family history of COVID-19 was positive in approximately half of them. In the second year of the pandemic, they paid less attention to social distance and avoidance of being indoors.

CONCLUSION

Although the COVID-19 risk perceptions of future health professional students remained at a similar level during the examined period, it was found that in the second year of the pandemic, they started to get used to the process and paid less attention to social protective measures.

Determinants of Non-Acceptance of the COVID-19 Vaccine During Pregnancy in Pregnant and Postpartum Women: A Descriptive Cross-Sectional Study

Objective

The rate of COVID-19 vaccination hesitation among Iranian pregnant women is around 50%. The objective of the present study was to determine the reasons for the refusal of COVID-19 vaccination among pregnant and postpartum women.

Materials and methods

This descriptive cross-sectional study was performed on 304 pregnant and postpartum women in the comprehensive health centers of Yazd, Iran, between October 2022 and April 2023. Researchers collected the data of unvaccinated women through phone calls using a validated questionnaire. Data was collected using a questionnaire consisting of baseline characteristics and reasons for refusing vaccination. Descriptive statistics were used to analyze the data using SPSS version 22.

Results

The mean age of the pregnant and postpartum women participating in this study was 28.31 ± 6.47 years. The most common reasons for refusing the COVID-19 vaccine included fear of harming the fetus (32.2%), fear of side effects in the mother (25.7%), disbelief in COVID-19 disease and vaccine (13.8%), lack of information about the vaccine (12.8%), and negative opinions of the media and society (12.8%). Less common reasons included husband's disagreement (8.2%), history of COVID-19 infection (6.9%), gynecologists' disagreement (6.3%), history of infertility (5.9%), and underlying disease (3.3%). Astonishingly, among participants who did not inject a booster dose of the vaccine, 76% reported they didn't receive any training and recommendation on booster dose injection from health providers.

Conclusion

Findings highlight that the most common reasons for refusing the COVID-19 vaccine were fear of harming the fetus and fear of side effects in the mother.

A deterministic transmission model for analytics-driven optimization of COVID-19 post-pandemic vaccination and quarantine strategies

This study developed a deterministic transmission model for the coronavirus disease of 2019 (COVID-19), considering various factors such as vaccination, awareness, quarantine, and treatment resource limitations for infected individuals in quarantine facilities. The proposed model comprised five compartments: susceptible, vaccinated, quarantined, infected, and recovery. It also considered awareness and limited resources by using a saturated function. Dynamic analyses, including equilibrium points, control reproduction numbers, and bifurcation analyses, were conducted in this research, employing analytics to derive insights. Our results indicated the possibility of an endemic equilibrium even if the reproduction number for control was less than one. Using incidence data from West Java, Indonesia, we estimated our model parameter values to calibrate them with the real situation in the field. Elasticity analysis highlighted the crucial role of contact restrictions in reducing the spread of COVID-19, especially when combined with community awareness. This emphasized the analytics-driven nature of our approach. We transformed our model into an optimal control framework due to budget constraints. Leveraging Pontriagin's maximum principle, we meticulously formulated and solved our optimal control problem using the forward-backward sweep method. Our experiments underscored the pivotal role of vaccination in infection containment. Vaccination effectively reduces the risk of infection among vaccinated individuals, leading to a lower overall infection rate. However, combining vaccination and quarantine measures yields even more promising results than vaccination alone. A second crucial finding emphasized the need for early intervention during outbreaks rather than delayed responses. Early interventions significantly reduce the number of preventable infections, underscoring their importance.

Self-reported side effects of COVID-19 vaccines among the public

Background

The safety, side effects and efficacy profile of COVID-19 vaccines remain subjects of ongoing concern among the public in Malaysia. The aim of this study was to determine the types of adverse effects following immunisation with COVID-19 vaccines and the differences based on various types of COVID-19 vaccines to raise public awareness and reduce vaccine hesitancy among the public.

Methods

A total of 901 Malaysian adults (≥18 years) who received various COVID-19 vaccines were selected to participate in our cross-sectional study through an online survey between December 2021 and January 2022.

Results

A total of 814 (90.3%) of the participants reported ≥1 side effect following COVID-19 immunisation. Of these, the predominant symptoms were swelling at the injection site (n = 752, 83.5%), headache (n = 638, 70.8%), pain or soreness at the injection site (n = 628, 69.7%), fatigue or tiredness (n = 544, 60.4%), muscle weakness (n = 529, 58.7%) and diarrhea (n = 451, 50.1%). Recipients of the Pfizer-BioNTech (Comirnaty ®) vaccine reported the highest number of adverse effects (n = 355, 43.6%), followed by mixed COVID-19 vaccines (n = 254, 31.2%), the Oxford-AstraZeneca (ChAdOx1-®[recombinant]) vaccine (n = 113, 13.9%) and the Sinovac (CoronaVac®) vaccine (n = 90, 11.1%). The study showed that individuals who reported significantly more side effects were of elderly age, female gender and high educational level [P value < 0.05]. Mixed COVID-19 vaccine recipients also reported significantly more local and systemic symptoms after the first dose and third dose when compared with other single vaccine recipients.

Conclusion

This study demonstrated the types of self-reported adverse effects following immunisation with single and mixed COVID-19 vaccines. These findings may provide the side effects of different COVID-19 vaccines with the hope of educating the public on the safety profiles of these vaccines and reducing vaccine hesitancy among the public.

How to Improve People's Intentions Regarding COVID-19 Vaccination in China: A Randomized Controlled Trial

BACKGROUND

The global COVID-19 pandemic has impaired the health and living conditions of millions of people. For governments to formulate policies promoting vaccination behavior, it is important to understand individuals' intentions to vaccinate. This study explores the effectiveness of a brief online intervention based on the Health Action Process Approach (HAPA) in improving individuals' COVID-19 vaccination intention, as well as considering the reasons for their unwillingness to get vaccinated.

METHOD

A total of 1,258 participants were assessed using a questionnaire to determine their phase of vaccination intention (pre-intention, intention, and action). Subsequently, focused on the underlying factors in the pre-intention phase (i.e., task self-efficacy, outcome expectation, and risk perception), a 7-day randomized controlled HAPA intervention (n intervention = 57, n control = 49) was conducted online for individuals who were not willing to get vaccinated. The measurement points included pre- (T1), post- (T2), and 30-day follow-up (T3).

RESULTS

The intervention may effectively improve participants' COVID-19 vaccination intentions; however, it had no impact on their planning and actions involved in taking the vaccine.

CONCLUSIONS

This study provides relevant reference data for government stakeholders to use in developing public awareness campaigns and policies to encourage COVID-19 vaccination.

Factors associated with initial AstraZeneca vaccine knowledge, attitudes, and uptake among hospital nurses: A cross-sectional study in Ghana's Upper East region

The COVID-19 pandemic has caused over 171,657 confirmed cases and 1,462 deaths in Ghana, particularly among frontline health-workers involved in pandemic response. Prevention measures in Ghana include AstraZeneca 'Covishield' vaccination of health-workers, but research on factors affecting uptake of COVID-19 vaccines in Ghana were initially limited. Therefore, this study aimed to analyse knowledge, attitudes, and initial uptake of Covishield among nurses in the War Memorial Hospital in Navrongo, Upper East Region. We conducted a cross-sectional survey of 128 district hospital nurses using simple random sampling. We first calculated descriptive statistics and two composite variables summing either participant knowledge or attitude variables, with a threshold over 50% considered 'sufficient' or 'positive' respectively. We then analysed associations between demographic variables and Covishield knowledge, attitudes, or uptake using binomial logistic regression with a 95% confidence interval and p-value of <0.05 considered significant. All participants had heard of Covishield vaccine, with attitudes toward it generally positive (53%), and uptake high (72%). Reasons cited by the 28% unvaccinated included absence during vaccination, having already been infected with COVID-19, lack of trust in vaccine safety/efficacy, or pregnancy/breastfeeding. Education, residence, and family type were the only demographic factors significantly associated with nurses' knowledge about, attitudes towards, or uptake of COVID-19 vaccination. While 'positive' attitude was significantly associated with higher odds of being vaccinated (AOR 4.75; 95%CI 1.59-14.1), 'sufficient' knowledge was not (AOR 1.33; 95%CI 0.53-3.32). This is the first study in Ghana's resource-constrained Upper East region to examine health-worker perceptions of a novel vaccine and showed nurses' knowledge, attitudes, and uptake of COVID-19 vaccination were good overall. Further research is needed to determine how best to address hesitancy and understand findings that attitudes appeared more relevant than knowledge for uptake. Findings are relevant for local health authorities in improving vaccine availability and strengthening emergency risk communication and management of adverse events following immunisation.

Reported side-effects following Oxford/AstraZeneca COVID-19 vaccine in the north-west province, Iran: A cross-sectional study

While the vaccination was introduced as a promising tool to control the Coronavirus disease 2019 (COVID-19) pandemic, concerns about vaccine-related side effects had grown. Due to the widespread administration of the COVID-19 vaccine worldwide for the first time, it was necessary to evaluate the safety and potential side effects in recipients. This study aims to assess, the incidence of adverse effects following Oxford-AstraZeneca vaccination and identify their related factors. In this cross-sectional survey-based study, 453 volunteers participated, including 235 men and 218 women. The reported adverse reactions from recipients of the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccine were collected by using a questionnaire. The findings showed that the incidence of adverse reactions, such as neurological, systematic, gastrointestinal, respiratory, and local symptoms were significantly higher after the first dose compared to the second dose. Systematic symptoms were the most prevalent reported side effects after the first and second dose injection. The demographical study of participants showed that individuals aged 18-34 and females were more prone to present adverse events following vaccination. However, no significant relationship was found between the occurrence of side effects and the recipients' body mass index. Despite the life-saving role of vaccination against SARS-CoV-2, it may have some adverse reactions in recipients. The severity and frequency of side effects were different. So, they were dependent on several factors, including gender and age. Altogether, post-vaccination adverse reactions were mild and tolerable.

Side Effects Reported by Moroccan Medical Students Who Received COVID-19 Vaccines

BACKGROUND

Low confidence in the safety of COVID-19 vaccines was found to be a key promoter of vaccine reluctance especially among youth. Furthermore, young adults are an important demographic for building herd immunity through vaccination. As a result, their reactions to getting COVID-19 vaccines are crucial in our fight against SARS-CoV-2.

OBJECTIVE

The overall goal of this study was to look into the shortterm side effects experienced by Moroccan medical and pharmacy students after receiving COVID-19 vaccines.

METHODS

A cross-sectional survey-based study to assess the COVID-19 vaccines' short-term AEFIs among Moroccan medical and pharmacy students. The validated questionnaire was delivered in a digital form to explore the side effects (SE) they encountered after the first or the second dose of one of three vaccines namely: AstraZeneca Vaxzevria, PfizerBioNTeck, and SinoPharm vaccines.

RESULTS

There were 510 students in total who took part. After the first and second doses, approximately 72 percent and 78 percent of subjects, respectively, reported no SE. The remainder had localized injection site side effects (26%). Fatigue (21%), fever (19%), headache (17%), and myalgia (16%) were the most common systemic adverse effects after the first dose. There were no serious SEs reported.

CONCLUSION

The majority of the reported AEFIs in our data were mild to moderate in intensity and lasted only one or two days. COVID-19 vaccinations are highly likely safe for young adults, according to the findings of this study.

Hesitancy Over the COVID-19 Vaccine Among Various Healthcare Workers: An International Narrative Review

Healthcare workers (HCWs) are role models in their communities. If they receive the COVID-19 vaccine, many people are likely to follow and have the vaccine. If HCWs are hesitant or resistant to taking the vaccine, this may impede the efforts to implement the vaccine, reach herd immunity, and eliminate the pandemic. In this narrative review, we reviewed previous studies on hesitancy over COVID-19 vaccination among different healthcare professions and people in the medical field, such as primary HCWs, dentists, nurses, and medical students. We reviewed the common reasons and associated factors for hesitancy toward the COVID-19 vaccine among different healthcare professions. The following keywords were used in the database search: COVID-19 AND vaccine AND hesitancy AND healthcare workers. We searched for articles using the PubMed, Scopus, and Google Scholar databases. We found HCW professions with various rates of hesitancy, including primary healthcare center (PHC) workers (50%), medical students (45%), nurses (21%), and dentists (18%). Hesitancy toward booster doses was also found in HCWs who had taken primary doses (2.8% to 26%). Race and ethnicity also influenced hesitancy rates, with Black individuals being the most hesitant group. The most common reasons were concerns about the safety and adverse effects of the vaccine, insufficient information, and a lack of confidence in healthcare policies. Despite varying rates of HCW hesitancy after the vaccine's release, this hesitancy is expected to negatively affect efforts to achieve widespread vaccination. The recommendations to policymakers to address these concerns are raising the awareness of PHC doctors because they are the easiest to reach and are the first line for patient information, improving communication with the HCWs through all channels (e.g., webinars, e-mails, and social media), and inviting HCWs to online meetings or workshops with the healthcare policymakers so the policymakers can listen to their concerns and recommendations. Correctly addressing the issue of HCWs' vaccination hesitancy can support efforts to contain the pandemic.

Kubbara E, A. Bakarman M, Al Amri T, Eid R, Alyazidi N, Alkhamesi A, Alasslany A. Misconceptions about COVID-19 vaccine among adults in Saudi Arabia and their associated factors: A cross-sectional study conducted in 2021

Background

It is of utmost importance for the elements that influence public compliance with vaccination against COVID-19 to be assessed, including misconceptions, rumors, and conspiracy theories. Hence, in this study, we aimed to estimate the distribution of the most common misconceptions regarding COVID-19 vaccines and their predictors in Saudi Arabia.

Methods

We distributed an online questionnaire to participants aged 18 years or older. The survey included two sections. The first section comprised questions related to participants' demographic characteristics, level of education, and their sources of information about COVID-19. The second section assessed participants' perceptions regarding 11 of the most common misconceptions regarding COVID-19 vaccines, rated using a 5-point Likert scale. Using ordinal logistic regression, we conducted an evaluation of the relationships among different predictors including age, sex, educational level, and sources of information, as well as acceptance of misconceptions about vaccination.

Results

The most widely accepted misconception was that the COVID-19 vaccine had severe side effects, with 34.8% of participants believing this misinformation. Factors that were significantly associated with acceptance or non- acceptance of misconceptions were: 1) sex, with female respondents in this survey accepting rumors significantly more often than male respondents (p<0.001); 2) educational level, especially secondary school, was associated with a significantly lower acceptance of misconceptions (p=0.001). In total, 60.5% of participants used social media as their primary source of information, which was also a significant positive predictor of acceptance of misconceptions (p=0.034).

Conclusion

It is of critical importance to increase assurance regarding the safety of COVID-19 vaccines, the issue most likely to involve misconceptions, and to address the elements that affect belief in rumors among the population.

Potential determinants of parental hesitancy to vaccinate their children against COVID-19 infection: a cross-sectional investigation

Coronavirus disease 2019 (COVID-19) vaccination hesitancy has emerged as a substantial concern among the adult population globally. However, limited evidence is available about parental hesitancy to vaccinate their children against COVID-19 within the Pakistani context. Thus, the present investigation aimed to assess parental attitudes, perceptions, and willingness regarding vaccination hesitancy and associated predictors of getting their children vaccinated against COVID-19. We conducted a cross-sectional population-based, self-administered online questionnaire in Punjab, Pakistan, on randomly selected parents between October 2022 and February 2023. The data were collected based on socio-demographics, attitudes, perceptions, and willingness of parents regarding COVID-19 vaccine hesitancy for their children. Adjusted odds ratios with 95% confidence intervals were estimated to identify the predictors of vaccine hesitancy. The findings demonstrated that among 1,478 participants, a total of 40% believed that the COVID-19 vaccine may pose a greater risk to children than adults, while 38% exhibited no concerns. Around 13% of children were not vaccinated in our study sample. More than half expressed hesitancy toward vaccination, and only 35.25% were inclined to get their children vaccinated in our study sample. In addition, only 16% of the parents believed that the COVID-19 vaccination may cause an alteration in their children's DNA. A similar proportion of parents were aware of the significance of getting their children vaccinated and expressed their willingness to vaccinate their children to prevent the COVID-19 infection. However, a higher odds ratio was observed in females with a higher educational background and those in the healthcare profession. In conclusion, healthcare awareness-supporting programs for educating parents should be designed and implemented. These insights might aid in the development of strategies to eradicate barriers in existing coronavirus vaccination programs and may vaccinate a larger child population to reduce the adverse consequences of the pandemic.

Contextual Pathways Linking Cumulative Experiences of Racial Discrimination to Black American Men's COVID Vaccine Hesitancy

The COVID-19 pandemic has revealed and widened racialized health disparities, underscoring the impact of structural inequities and racial discrimination on COVID-19 vaccination uptake. A sizable proportion of Black American men report that they either do not plan to or are unsure about becoming vaccinated against COVID-19. The present study investigated hypotheses regarding the mechanisms by which experiences of racial discrimination are associated with Black American men's COVID-19 vaccine hesitancy. Hypotheses were tested using structural equation modeling with 4 waves of data from 242 Black American men (aged ~ 27) living in resource-poor communities in the rural South. Study findings revealed that racial discrimination was indirectly associated with COVID-19 vaccine hesitancy via increased endorsement of COVID-19 conspiratorial beliefs. Findings also demonstrated that increased levels of ethnic identity strengthen the association between experiences of racial discrimination and COVID-19 conspiratorial beliefs. In contrast, increased levels of social support weakened the association between cumulative experiences of racial discrimination and COVID conspiratorial beliefs. Taken together, these results suggest that racial discrimination may promote conspiratorial beliefs which undermine Black American men's willingness to be vaccinated. Future interventions aimed towards promoting vaccine uptake among Black American men may benefit from the inclusion of targeted efforts to rebuild cultural trust and increase social support.

A Study on Community needs, perceptions and demand regarding the use of the health services during COVID-19 pandemic in district Kathua, J and K

Introduction

The impact of the COVID-19 pandemic on essential health services is a source of great concern. Health gains made during the last 2-3 decades have been halted due to shifting of resources to fight the COVID-19 pandemic.

Aim and Objective

This study was conducted to identify community needs, demands, and perceptions regarding the effectiveness of using health services during the pandemic.

Methodology

This was a qualitative study which was conducted through focus group discussions. The participants comprised of three groups: community leaders, healthcare providers, and field workers. Discussion among the participants was conducted using the standardized World Health Organization community assessment tool.

Result

In our study, it was reported that most of the essential health services were disrupted due to COVID-19 pandemic. The barriers to accessing essential health services have been exacerbated and the provision of community-based services is effected due to this. In regard to COVID-19 vaccination also, there remain individuals who are reluctant to be vaccinated.

Conclusion

Our study shows that the community faced barriers in accessing and using health services during the pandemic. To ensure the public's access to health services and strengthen healthcare preparedness strategies like health budget allocation, manpower, infrastructure, trainings, integration with primary healthcare, etc., need to be carried out during and after the pandemic. Thus, participation and inter-sectoral coordination across levels are required to overcome these barriers.

Novel COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students: a scoping review

Medical students are likely to be exposed to COVID-19 patients so achieving high vaccination coverage rates for this group of healthcare workers is important, as is their potential as vaccination role models. The aim of this scoping review was to evaluate the current literature to determine the rates of COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students. Systematic searches of the Medline Ovid, Embase, PubMed, and Education Resources Information Centre (ERIC) online databases was conducted for relevant articles with keywords: 'COVID-19', 'vaccine hesitancy & acceptance' and 'medical students'. Articles were included for review if they reported the rates of vaccine hesitancy and acceptance, and associated factors, amongst medical students. Of the 258 articles identified, 52 met the inclusion criteria and underwent full-text review. Rates of vaccine hesitancy ranged from 5.4-86.7%, with generally positive attitudes towards COVID-19 vaccination. The main factors associated with vaccine hesitancy were concerns about the safety and efficacy of vaccines due to their accelerated development, being a pre-clinical medical student, and low perceived personal risk of COVID-19 infection. Inconsistencies were found for the influence of gender on attitudes towards vaccinations. Previous vaccination behaviours were predictive of willingness to receive the COVID-19 vaccine. Knowledge about COVID-19 vaccinations and their importance was found to be deficient amongst vaccine hesitant medical students. Generally, medical students express low levels of vaccine hesitancy. However, due to the variability in the factors associated with vaccine hesitancy across different populations and the dynamic and contextual nature of hesitancy, it is recommended that vaccination intent and associated attitudes are monitored on a longitudinal basis. It is important to map vaccine hesitancy at a local level to allow medical schools to develop strategies to encourage vaccination specific to their school's needs.

Identifying Mental Health Literacy as a Key Predictor of COVID-19 Vaccination Acceptance among American Indian/Alaska Native/Native American People

BACKGROUND

This study examines how health literacy and mental health literacy associate with the willingness to receive a COVID-19 vaccination among American Indian/Alaska Native/Native American (AI/AN) people.

METHODS

The data were collected with an online Qualtrics survey in February 2021 (n = 563). A purposive snowball sampling strategy was used by sending recruitment flyers to colleagues and organizations who work with AI/AN communities to share with appropriate potential respondents. We performed linear regression analyses examining the relationships between the willingness to receive a COVID-19 vaccination and socio-demographic characteristics such as age, gender, education, health literacy, mental health literacy, self-rated physical and mental health status, worry about getting COVID-19, perceived COVID-19 susceptibility, and perceived COVID-19 severity.

RESULTS

Mental health literacy and health literacy predicted 30.90% and 4.65% of the variance (R2adjusted) in the willingness to receive a COVID-19 vaccine, respectively. After holding the self-rated physical/mental health status, worry about getting COVID-19, perceived susceptibility, perceived severity, health literacy, and socio-demographics constant, mental health literacy was still a strong predictor (b = 0.03, p < 0.001) for the willingness to receive a COVID-19 vaccine (model R2adjusted = 40.14%).

CONCLUSIONS

We identified mental health literacy as a substantial factor associated with the willingness to receive a COVID-19 vaccination among AI/AN respondents.

COVID-19 vaccine hesitancy worldwide and its associated factors: a systematic review and meta-analysis

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has taken a toll on humans, and the development of effective vaccines has been a promising tool to end the pandemic. However, for a vaccination program to be successful, a considerable proportion of the community must be vaccinated. Hence, public acceptance of coronavirus disease 2019 (COVID-19) vaccines has become the key to controlling the pandemic. Recent studies have shown vaccine hesitancy increasing over time. This systematic review aims to evaluate the COVID-19 vaccine hesitancy rate and related factors in different communities.

Method

A comprehensive search was performed in MEDLINE (via PubMed), Scopus, and Web of Science from January 1, 2019 to January 31, 2022. All relevant descriptive and observational studies (cross-sectional and longitudinal) on vaccine hesitancy and acceptance were included in this systematic review. In the meta-analysis, odds ratio (OR) was used to assess the effects of population characteristics on vaccine hesitancy, and event rate (acceptance rate) was the effect measure for overall acceptance. Publication bias was assessed using the funnel plot, Egger's test, and trim-and-fill methods.

Result

A total of 135 out of 6,417 studies were included after screening. A meta-analysis of 114 studies, including 849,911 participants, showed an overall acceptance rate of 63.1%. In addition, men, married individuals, educated people, those with a history of flu vaccination, those with higher income levels, those with comorbidities, and people living in urban areas were less hesitant.

Conclusion

Increasing public awareness of the importance of COVID-19 vaccines in overcoming the pandemic is crucial. Being men, living in an urban region, being married or educated, having a history of influenza vaccination, having a higher level of income status, and having a history of comorbidities are associated with higher COVID-19 vaccine acceptance.

Global prevalence of COVID-19-induced acute respiratory distress syndrome: systematic review and meta-analysis

BACKGROUND

Acute respiratory distress syndrome (ARDS) is potentially a fatal form of respiratory failure among COVID-19 patients. Globally, there are inconsistent findings regarding ARDS among COVID-19 patients. Therefore, this study aimed to estimate the pooled prevalence of COVID-19-induced ARDS among COVID-19 patients worldwide.

METHODS

To retrieve relevant studies, the authors searched Embase, MEDLINE, PubMed, Web of Science, Cochrane Library, Google, and Google Scholar using a combination of search terms. The search was conducted for articles published from December 2019 to September 2022. Articles were searched and screened by title (ti), abstract (ab), and full-text (ft) by two reviewers independently. The quality of each included article was assessed using the Newcastle-Ottawa Assessment Scale. Data were entered into Microsoft Word and exported to Stata version 14 for analysis. Heterogeneity was detected using the Cochrane Q statistics and I-square (I2). Then the sources of variations were identified by subgroup and meta-regression analysis. A random effect meta-analysis model was used. The publication bias was detected using the graphic asymmetry test of the funnel plot and/or Egger's test (p value < 0.05). To treat the potential publication bias, trim and fill analysis were computed. The protocol has been registered in an international database, the Prospective Register of Systematic Reviews (PROSPERO) with reference number: CRD42023438277.

RESULTS

A total of 794 studies worldwide were screened for their eligibility. Of these 11 studies with 2845 participants were included in this systematic review and meta-analysis. The overall pooled prevalence of COVID-19-induced ARDS in the world was found to be 32.2% (95%CI = 27.70-41.73%), I2 = 97.3%, and p value < 0.001).

CONCLUSION

The pooled prevalence of COVID-19-induced ARDS was found to be high. The virus remains a global burden because its genetic causes are constantly changing or it mutated throughout the pandemic to emerge a new strain of infection. Therefore, interventions such as massive vaccination, early case detection, screening, isolation, and treatment of the cases need to be implemented to tackle its severity.

Barriers to COVID-19 vaccine uptake: classification and the role of Health Literacy and Media Literacy

Background

Vaccination is one of the most influential and cost-effective health interventions for preventing and reducing COVID-19 diseases. Unfortunately, the majority of the world's population is deprived of vaccination. Health Literacy (HL) and Media Literacy (ML) are essential to the COVID-19 vaccination. The present study investigates the barriers to COVID-19 vaccine uptake, focusing on classification and the roles of HL and ML.

Methods

A cross-sectional study was conducted among people 18-65 years old in Sarab City, located in East Azerbaijan, Iran, between September to October 2020. Multistage cluster sampling was employed to recruit 298 people from Health Care Services Centers (HCCs).

Results

The results of this research demonstrated that about 32.6% of participants reported that they have fully injected COVID-19 vaccines. Also, HL was positively associated with ML (r = 0.214, p < 0.05). Barriers of COVID-19 vaccine uptake were classified into personal, interpersonal, group and organizational, society and decision-making factors. Besides, barriers to the COVID-19 vaccine were significantly correlated with HL (r = -0.298, p < 0.05) and ML (r = 0.266, p < 0.05). Additionally, in the hierarchical regression model, demographic characteristics accounted for 8.2% of the variation in barriers to the COVID-19 vaccine (F = 4.34; p = 0.001), that monthly income (ß = -0.237; p < 0.05) and marriage statues (ß = 0.131; p < 0.05) were statistically associated with low barriers. HL as predictor variables explained an additional 14.4% of variation in barriers of COVID-19 vaccine (F = 53.84; p < 0.001) and ML explained an extra 9.2% of the variation (F = 38.83; p < 0.001). In total, demographic characteristics, HL dimensions and ML were able to explain 31.8% of the variation in barriers to COVID-19 vaccine.

Conclusions

According to the findings, various strategies are needed to increase the COVID-19 vaccination uptake. This is due to the fact that barriers to COVID-19 vaccination uptake are multifactorial. These facts can help health policymakers and healthcare providers design media-based interventions to reduce barriers to COVID-19 vaccination uptake among adults. Enhancing vaccine HL and ML for adults and improving vaccine confidence are of high priority.

Unpacking COVID-19 Vaccine Attitudes: Exploring Hesitancy and Acceptance Among Undergraduate Students in Bangladesh

BACKGROUND

Vaccine hesitancy is a significant global health concern, and mass vaccination is essential in preventing the spread of COVID-19. Undergraduate students need to be prioritized for vaccination as they continue their academic curriculum physically. However, limited research explores vaccine hesitancy and acceptance among undergraduate students in Bangladesh. Therefore, this study evaluated vaccine hesitancy and acceptance among this population.

METHOD

A web-based cross-sectional study was conducted between May and June 2021 using a structured questionnaire to assess COVID-19 vaccine hesitancy and acceptance among undergraduate students in Bangladesh. The Oxford Covid-19 Vaccine Hesitancy Scale was used to measure vaccine hesitancy. The study used convenient sampling.

RESULT

Across the country, 334 undergraduate students participated in this study on COVID-19 vaccine acceptance, with a mean age of 22.4 years. Most participants were male and unmarried, most having spent four years at university. 89.52% of participants would accept a COVID-19 vaccine if it were suggested by educational institutions or available, while 4.49% refused to receive the COVID-19 vaccine. Participants showed low levels of vaccine hesitancy, with a mean score of 10.77 on the Oxford COVID-19 Vaccine Hesitancy Scale. Most participants had a positive attitude towards receiving the vaccine, with the majority wanting to get it as soon as it becomes available. No association was found between vaccine acceptance and participants' background characteristics.

CONCLUSION

Our study found a high level of vaccine acceptance among undergraduate students in Bangladesh, indicating that this group can be vaccinated quickly, significantly accelerating vaccination goals. However, further large-scale studies are recommended among vulnerable groups, including school and college students, to ensure vaccine preparedness.

COVID-19 Vaccine Acceptance Among Pregnant, Lactating, and Nonpregnant Women of Reproductive Age in Turkey: A Cross-Sectional Analytical Study

OBJECTIVE

This study aims to identify the rates of coronavirus disease 2019 (COVID-19) vaccine acceptance, the reasons for receiving and not receiving the vaccine, and the associated factors among pregnant, lactating, and nonpregnant women of reproductive age.

METHODS

This cross-sectional and analytical study was conducted online in Turkey, at the end of the fourth wave of the COVID-19 pandemic, between February and May 2022. A total of 658 women (230; 35% pregnant) (187; 28.4% lactating) (241; 36.6% nonpregnant) women of reproductive age participated in the study.

RESULTS

Vaccine acceptance rates were found to be 91.7% in nonpregnant women of reproductive age, 77% in lactating women, and 59% in pregnant women (P < 0.05). The highest rate of vaccine hesitancy was observed in pregnant women (31.3%), and vaccine rejection rate was the highest in lactating women (10.2%). Pregnancy (odds ratio [OR] = 3.98; confidence interval [CI] = 1.13-14.10), and the breastfeeding period (OR = 3.84; CI = 1.15-12.78), increased vaccine hesitancy approximately four times.

CONCLUSIONS

Lack of knowledge about and confidence in the COVID-19 vaccine is still one of the barriers to vaccine acceptance today. Health-care providers (HCPs) should provide effective counseling to pregnant, lactating, and nonpregnant reproductive-aged women based on current information and guidelines.

Health literacy and COVID-19 vaccine acceptance worldwide: A systematic review

Objective

Health literacy helps an individual to have the capacity to obtain, process, and understand basic health information to make appropriate health decisions. This study aimed to review the association between health literacy and COVID-19 vaccine acceptance.

Method

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses steps. Databases including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of health literacy and COVID-19 vaccine acceptance until August 1, 2022.

Result

In this review, 1348 articles were retrieved. Finally, 13 articles were included in the review after the removal of duplicates that did not meet our inclusion criteria. In all, 10 articles showed that health literacy was significantly associated with COVID-19 vaccine acceptance. This review also showed that positive perception of the vaccine, vaccine hesitancy, adverse reaction from vaccines, residence, socioeconomic status, level of education, younger age, being a health worker, and positive belief have associations with health literacy and COVID-19 vaccine acceptance. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance.

Conclusion

This systematic review provides comprehensive evidence on health literacy and COVID-19 vaccine acceptance globally. There was significant heterogeneity in the study population and measurement tools used for health literacy and COVID-19 vaccine acceptance. Most studies reported that health literacy is significantly associated with COVID-19 vaccine acceptance. Therefore, investing in health literacy using different vaccine promotion strategies may improve COVID-19 vaccine acceptance and health decision-making to decrease the impact of the COVID-19 pandemic.

Understanding Factors Contributing to Vaccine Hesitancy in a Large Metropolitan Area

Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be 27 billion dollars per year in the US alone. To investigate the association between demographic variables and knowledge, attitudes, and behaviours related to vaccination, a survey-based cross-sectional study was conducted with 1163 individuals. Three models were used to perform a multiple linear regression analysis. In Model I, knowledge about vaccinations was found to be associated with smoking habits, education, and marital status. In Model II, attitudes towards vaccinations were significantly associated with sex, smoking habits, education, marital status, and knowledge. In Model III, behaviours related to vaccination were associated with sex, smoking habits, having children, knowledge, and attitudes. One potential solution to improve behaviours related to vaccinations in the general population is to implement specific public health programs, which can be a cost-effective intervention. This study provides valuable insights into the determinants of knowledge, attitudes, and behaviours related to vaccinations in the general population.

An assessment on the knowledge and attitudes of university students concerning adult immunization and COVID-19 vaccine in Turkey

There is ongoing concern about vaccine hesitancy amongst young adults in Turkey. In October 2021 just 53% of 18-25-year olds were fully vaccinated. This study aimed to assess the knowledge and attitudes of university students concerning adult immunization, COVID-19 vaccine, and COVID-19 vaccine literacy to better understand why it is difficult to encourage young adults to be vaccinated. This cross-sectional study was conducted with 307 university students that included socio-demographic characteristics, knowledge of adult immunization, attitudes toward COVID-19 vaccination, and vaccine literacy. The data were collected using a socio-demographic characteristics form, a knowledge form for adult immunization, the attitudes toward the COVID-19 vaccine scale, and the COVID-19 vaccine literacy scale. While more than half of the students (52.8%) had a low level of knowledge about adult immunization, half percent of the students (50.5%) stated that they did not know anything about adult vaccination. Twenty-six and half percent of the students stated that they weren't vaccinated because they were afraid of the side effects of the vaccines for adults. The difference between the student's level of knowledge about adult immunization and their mean scores on the attitudes toward the COVID-19 vaccine scale was not statistically significant (p > 0.05); whereas, the difference between their level of knowledge about adult immunization and their mean scores of the COVID-19 vaccine literacy scale was statistically significant (p < 0.05). There were low levels of vaccine literacy amongst Turkish university students and more than half of the students reported that they did not know and twenty-six percent of students (26 %) of the students were fearful of vaccine side effects. Students outside of the faculty of health had a low level of knowledge about vaccines. Examining and improving vaccine literacy amongst university students could lead to improved compliance with vaccination programs for both COVID-19 and other adult vaccines that are important for community health and well-being.

Knowledge, beliefs and hesitancy among medical and non-medical university students toward COVID-19 vaccination in Punjab, Pakistan

This study assessed the knowledge, beliefs, and hesitancy toward COVID-19 vaccination among medical (MS) and nonmedical students (NMS) in Punjab, Pakistan. An online cross-sectional survey was conducted by enrolling 624 MS and 476 NMS in the largest province of Pakistan, i.e., Punjab. Chi-square tests were used to determine significant frequency distributions, and logistic regression to determine associations. The majority of students, males and females, were between 18-25 years of age and had good self-reported health. MS demonstrated adequate knowledge and positive beliefs about COVID-19. Fewer MS were indecisive about the vaccination; nonetheless, overall, 71.5% of MS and 78.2% of NMS were willing to receive the vaccine. A greater number of MS students were concerned about vaccine safety or side effects. A greater number of NMS demonstrated misconceptions about the COVID-19 vaccine - its effect on fertility and alterations in genomic DNA. The binary logistics regression exhibited a significant association between students' knowledge in the medical sciences (OR;1.53,p = 0.002) and area of residence (OR;1.60,p = 0.008). Compared to NMS, MS had a better understanding of the COVID-19 vaccine and were concerned about the acceptability of the vaccine, although NMS had misconceptions about the COVID-19 vaccine. Knowledge was significantly associated with the field of study.

The Social Ecological Model: A Framework for Understanding COVID-19 Vaccine Uptake among Healthcare Workers-A Scoping Review

Vaccination plays a crucial role in combating the global COVID-19 pandemic. Immunizing all healthcare workers (HCWs) is essential for increasing vaccine confidence and acceptance within the general population. Understanding the factors that hinder or facilitate vaccine uptake among HCWs is of utmost importance, considering they are among the first to be vaccinated. This review follows Arksey and O'Malley's five-stage methodological framework. We searched PubMed, Web of Science, ProQuest, WorldCat Discovery, and Google Scholar for peer-reviewed articles published from 2020 to 2023. A descriptive analysis and narrative synthesis approach were employed to collect and synthesize data. Using the social-ecological model as a framework, the literature was categorized into themes at the intrapersonal, interpersonal, organizational, community, and policy levels. We reviewed a total of fifty-three published academic articles, with the majority of studies conducted in Ethiopia and Nigeria. The intention for vaccine uptake resulted in an unsatisfactory (52%) overall uptake rate among HCWs. Individual-level determinants associated with vaccine uptake included being male, middle-aged, being a physician, having a higher level of education, and having a chronic illness. This review identified significant barriers at each level, such as safety concerns, perceived scientific uncertainty, vaccine ineffectiveness, lack of trust in stakeholders, and religious beliefs. Additionally, we identified facilitators at each level, with the most common factors promoting intention to uptake being the desire to protect oneself and others and a high perceived susceptibility to contracting COVID-19. This review highlights the existence of significant barriers to vaccine uptake on the African continent. Given that HCWs play a crucial role in guiding the public's vaccination decisions, it is imperative to prioritize education and training efforts about the safety and effectiveness of COVID-19 vaccines.

Barriers and facilitators to COVID-19 vaccine uptake among Australian health professional students during the pandemic: a nationwide study

Using a cross-sectional online survey we investigated knowledge, attitudes, and risk perception about COVID-19 vaccination and identified factors influencing vaccine uptake among Australian health professional students from October 2021 to January 2022. We analysed data from 1114 health professional students from 17 Australian universities. Most participants were enrolled in nursing programs (n = 958, 86.8%), and 91.6% (n = 858) of the participants received COVID-19 vaccination. Approximately 27% believed COVID-19 was no more serious than seasonal influenza and that they had a low risk of acquiring COVID-19. Nearly 20% disagreed that COVID-19 vaccines in Australia were safe and perceived they were at higher-risk of acquiring COVID infection than the general population. Higher-risk perception viewing vaccination as their professional responsibility, and vaccine mandate strongly predicted vaccination behaviour. Participants consider COVID-19 information from health professionals, government websites, and World Health Organization as the most trusted information sources. The findings highlight that healthcare decision-makers and university administrators need to monitor students' hesitancy with vaccination to improve students' promotion of the vaccination to the general population.

Barriers and Intention to Get Vaccinated for COVID-19 and Associated Factors Among Adults in Southwest Ethiopia: A Theory of Planned Behavior Approach

Background

Different vaccines have been approved for use against coronavirus disease and distributed globally in different regions. Efforts should be made on the vaccination to control the spread and impacts of the coronavirus pandemic. However, the general population's attitudes and intention to uptake coronavirus disease 2019 (COVID-19) vaccinations were poor.

Objective

This study aimed to assess the barriers to and intention to be vaccinated against COVID-19 and the associated factors among adults in the Jimma zone, Ethiopia.

Methods

A community-based cross-sectional study with multistage sampling was conducted with 621 participants from 16 April to 17 May 2022. Multivariable logistic regression was used to identify factors associated with the outcome of interest. Statistical p-value ≤0.05 was set at p ≤ 0.05. Qualitative data were supplemented with quantitative results.

Results

The majority of the study participants (382 [61.5%]) intended to uptake the COVID-19 vaccine. In this study, travel history (Adjusted Odds Ratio (AOR) = 2.18, 95% CI 1.23-3.87), vaccination history (AOR = 2.64, 95% CI 1.69-4.12), perceptions of infection prevention for COVID-19 (AOR = 1.97, 95% CI 1.28-3.03), subjective norm (AOR = 2.27, 95% CI 1.52-3.39), and perceived behavioral control (PBC) (AOR = 2.30, 95% CI 1.55-3.41) were significantly associated with the intention to be vaccinated against COVID-19.

Conclusion

More than half of the adult participants intended to be vaccinated against COVID-19. The study participant's traveling history, vaccination history, perception of infection prevention for COVID-19, subjective norms, and Perceived Behavioral Control were significantly associated with the intention to be vaccinated.

Concerns, perceived risk, and hesitancy on COVID-19 vaccine: a qualitative exploration among university students living in the West Bank

The current study aimed to explore Palestinian university students' perceptions and concerns about COVID-19 vaccination hesitancy. Our sample comprised 50 university students selected using snowball sampling techniques from Palestinian universities in the West Bank, Palestine. Thematic content analysis was conducted to identify the main themes of semi-structured interviews with students. The results of the thematic content analysis yielded four main themes: Students' perceptions and concerns on COVID-19 vaccinations, perceived risks of vaccination, experiences related to vaccination, and causes of vaccination hesitancy. Participants expressed concerns and doubts about the vaccine's safety, showing high hesitancy and scepticism; they also reported different causes for COVID-19 vaccination hesitancy in the Palestinian context, such as the lack of confidence in vaccines, false beliefs about vaccines, and peculiar political instability and conflict of the Palestinian territories enduring a military occupation undermining the health system's capacity to respond to the COVID-19 outbreak appropriately. Health authorities and policymakers are urgently called to invest in and potentiate awareness campaigns to change the diffuse people's stereotypes related to the COVID-19 vaccine in the Palestinian territories.

COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review

Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.

Hesitancy toward vaccination against COVID-19: A scoping review of prevalence and associated factors in the Arab world

Despite widespread availability of vaccines against SARS-CoV-2 virus, the cause of Coronavirus Disease 2019 (COVID-19), its uptake in many Arab countries is relatively low. This literature review aimed to scope evidence on COVID-19 vaccine hesitancy (VH) in the Arab world. A total of 134 articles reporting prevalence of COVID-19 VH and associated factors, conducted in any of the 22 Arab League countries, were reviewed. COVID-19 VH prevalence ranged from 5.4% to 83.0%. Female gender, young age, low education level and lack of previous influenza vaccine uptake were most commonly reported to be associated with COVID-19 VH. The most-reported personal concerns contributing toward VH were related to the rapid development, safety and side effects of vaccine, as well as an overall lack of trust in government policies toward pandemic control and widespread conspiracy theories. Tailored interventions to enable the distribution of trusted information and enhance public acceptance of immunization are warranted.

COVID-19 vaccination intention among nursing, medical, and dental students: A systematic review and meta-regression analysis

The introduction of the COVID-19 vaccine amidst the pandemic has heralded a paradigm shift. Healthcare students in nursing, medicine, and dentistry must have positive attitudes owing to their future role in vaccine recommendations to the public and patients. This meta-regression analysis assessed the differences in COVID-19 vaccination intention (VI) of nursing, medical, and dental students. Medline/PubMed, EMBASE, CINAHL, Cochrane Library, and Korean MBASE were searched for eligible studies. Quality was assessed by the Joanna Briggs Institute's quality appraisal. Forty-one studies were included in the final analysis, and the estimation of pooled prevalence (68%) and relevant factors were assessed. Dental students were found to have the lowest VI (57%), which significantly (p = .018) differed from that of nursing students (64%). Countries in South-East Asia and those with high income levels were found to have high VI. Therefore, global vaccine programs for healthcare students should be prepared considering their geographical and economic status.

Vaccination as a Significant Factor Influencing the Psychoemotional State of Medical Students During the Sars-Cov-2 Pandemic: An International Aspect

Background

The rapid spread of SARS-COV-2, characterized by its severe course in the absence of effective specific treatment for this infection, may become a significant risk factor for psycho-emotional disorders' emergence during this pandemic. One of the vulnerable groups in the current situation are first-year medical students, whose problems associated with an unfavorable sanitary-epidemiological situation and an increased infection risk are compounded by the difficulties of adapting to specific professional environments. In this situation, along with strict adherence to nonspecific prevention methods, the mass student SARS-COV-2 vaccination acquires particular importance.

Objective

To compare the attitudes of first-year medical students in Russia and Azerbaijan toward SARS-COV-2 immunization and to assess the vaccination impact on the student's psycho-emotional state during the SARS-COV-2 pandemic.

Materials and Methods

The study involved 594 first-year students at the Moscow and Baku branches of Sechenov University. The Google Forms platform was used to conduct an anonymous sociological survey. To compare the psychoemotional state of vaccinated freshmen and non-vaccinated students, we used the State-Trait Anxiety Inventory, STAI, to assess reactive anxiety and the Beck Depression Inventory test - to diagnose depressive symptoms. The online survey was conducted during the fourth wave of coronavirus infection. WHO official sources were used to analyze the current epidemiological SARS-COV-2 situation during the study data provided by the Russian Federal Service on Customers' Rights Protection and Human Well-Being Surveillance and JHU CSSE. Statistical analysis was carried out using RStudio.

Results

The study results showed that vaccination coverage of first-year students at the Moscow branch of Sechenov University during the fourth wave of the SARS-COV-2 pandemic was 42,9±5,13%, at the Baku branch - 69,6±5,86%. The lack of reliable information about anticovid vaccines, indicated by a third of all respondents, may largely determine the motivated participation in the vaccination SARS-COV-2 campaign. The role of medical school in imparting knowledge about active SARS-COV-2 immunization to medical students was found to be insignificant. It was shown that the percentage of students willing to recommend SARS-COV-2 vaccination to the people around them and thereby contribute to increasing collective immunity level significantly depends on the percentage of students vaccinated. It was proved that vaccinated students were characterized by significantly greater psychological stability regardless of their study place.

Conclusion

Vaccination is not only a good preventive measure against the infection spread but also a significant factor in stabilizing the psycho-emotional state of first-year students, which significantly affects the quality of their educational process and its effectiveness.

COVID-19 Vaccine Acceptance, Attitude, Hesitancy, and Its Associated Factors among Wolaita Sodo University Students: A Mixed-Method Study

Background

Countries in the world have been experiencing the ongoing impact and spread of the coronavirus disease (COVID-19) virus pandemic. The health and financial burden of the pandemic has prompted the need for timely and effective vaccination to be considered as the best strategy for controlling disease transmission. However, vaccine acceptability remains an area of concern in developing countries like Ethiopia.

Objective

To assess attitude, hesitancy in the COVID-19 vaccine acceptance, and associated factors among health science students at Wolaita Sodo University.

Methods

A triangulated mixed-method study was conducted. Quantitative data were entered into SPSS Windows version 25 for analysis, and the qualitative data were transcribed using open code version 4.3. A binary logistic regression model was used to establish the association between dependent and independent variables. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the strengths of the association. Thematic approach was used for qualitative data analysis.

Results

A total of 352 students participated in this study. Having family members who were infected with COVID-19, information about COVID-19 vaccine, the need for a vaccine with the level of concern, intention to take COVID-19 vaccine, and academic year were strongly associated with vaccine acceptability. Graduating class and other senior students were about 4 and 2 times more likely to accept vaccination as compared to freshman-year students (AOR = 4.128; 95% CI: 1.351-12.610;P = 0.012) and (AOR = 2.195; 95% CI: 1.182-4.077; P value = 0.013), respectively. Even if 67% of students had a good attitude towards the vaccine, 56% of the students hesitated to take the vaccine.

Conclusion

The majority of respondents had a constructive attitude towards the COVID-19 vaccine, and only a few of them were vaccinated against the COVID-19 virus. It is of utmost importance to design an evidence-based strategy to increase the uptake of vaccination for healthcare students and other nonhealth science students in universities.

Egyptian hemodialysis patients' willingness to receive the COVID-19 vaccine booster dose: a multicenter survey

BACKGROUND

Health authorities have struggled to increase vaccination uptake since the COVID-19 vaccines became available. However, there have been increasing concerns about declining immunity after the initial COVID-19 vaccination with the emergence of new variants. Booster doses were implemented as a complementary policy to increase protection against COVID-19. Egyptian hemodialysis (HD) patients have shown a high rate of hesitancy to COVID-19 primary vaccination, yet their willingness to receive booster doses is unknown. This study aimed to assess COVID-19 vaccine booster hesitancy and its associated factors in Egyptian HD patients.

METHODS

A face-to-face interview was conducted with closed-ended questionnaires distributed to healthcare workers in seven Egyptian HD centers, mainly located in three Egyptian governorates, between the 7th of  March and the 7th of April 2022.

RESULTS

Among 691 chronic HD patients, 49.3% (n = 341) were willing to take the booster dose. The main reason for booster hesitancy was the opinion that a booster dose is unnecessary (n = 83, 44.9%). Booster vaccine hesitancy was associated with female gender, younger age, being single, Alexandria and urban residency, the use of a tunneled dialysis catheter, not being fully vaccinated against COVID-19. Odds of booster hesitancy were higher among participants who did not receive full COVID-19 vaccination and among those who were not planning to take the influenza vaccine (10.8 and 4.2, respectively).

CONCLUSION

COVID-19 booster-dose hesitancy among HD patients in Egypt represents a major concern, is associated with vaccine hesitancy with respect to other vaccines and emphasizes the need to develop effective strategies to increase vaccine uptake.

The Prevalence of COVID-19 Vaccine Hesitancy Among the Black Asian Ethnic Minority in New South Wales, Australia

INTRODUCTION

Vaccination provides a cost-effective approach to controlling the COVID-19 pandemic. The success of vaccination depends on global preparedness and acceptance of the new vaccines, and this is threatened by vaccine hesitancy worldwide. This study aimed to measure the prevalence of COVID-19 vaccine hesitancy, attitudes, and contributing factors in the Black Asian Ethnic Minority (BAME) of New South Wales (NSW), Australia.  Aim: This study aimed to measure the prevalence of COVID-19 vaccine hesitancy and identify contributing factors leading to vaccine hesitancy in the Black Asian and Ethnic Minority (BAME) in NSW.

METHOD

A cross-sectional study was conducted among the BAME community in NSW; over 12 weeks, from January 3^rd, 2022, to March 28^th, 2022. The study used the pre-existing previously known 5Cs model (confidence, constraints, complacency, calculation, and collective responsibility) to assess reasons for hesitancy. The questionnaire was distributed in English using social media platforms: Facebook and WhatsApp.

RESULTS

The study received 101 respondents over 18 years from all states in Australia from BAME communities, males and females, with different educational levels, employment sectors, marital statuses, co-existing chronic medical conditions, previous COVID-19 infection status, and COVID-19 vaccine received. Of these, 56 respondents were from NSW. Our findings revealed a high prevalence of COVID-19 vaccine hesitancy among the BAME community in NSW, with 72.8% of respondents demonstrating hesitancy/reluctance due to various attitudes identified by the 5Cs model. Despite this high hesitancy, 98.2% of the participants had received at least one to three vaccine doses.

CONCLUSION

 Even in populations with high vaccine uptake, it is still essential to address vaccine hesitancy and provide ongoing education about the importance of vaccination, particularly as new variants of COVID-19 continue to emerge and the need for booster shots may arise. This can help ensure continued protection against the virus and prevent future outbreaks.

Vaccine Hesitancy Among Parents and Its Determinants During the Era of COVID-19 in Taif City, Saudi Arabia

Background Vaccine hesitancy is a growing concern worldwide, particularly during the COVID-19 pandemic. The aim was to investigate vaccine hesitancy and its determinants among parents in Taif, Saudi Arabia. Methods A cross-sectional study was conducted among parents using a validated and reliable questionnaire, the parent attitudes about childhood vaccines (PACV). Parents of children aged (two months to seven years) attending primary health care centers (PHCC) outpatient clinics were selected using a stratified sampling technique and interviewed to fill out the pre-structured questionnaire. Result The study included 301 parents, with 41.2% between the ages of 30-39 years and 25.2%% between 40-49 years. Mothers constituted 69.1% of the respondents. The most common sources of information regarding vaccinations were the doctor (34.9%), the internet (27.9%), and social media (16.6%). COVID-19 influenced the beliefs of more than half (52.5%) of parents regarding the importance of vaccinations. The median PACV score for vaccination hesitancy was 23.3/100, interquartile range (IQR) (13.3-33.3). The highest hesitation was among the age group of 30-39 years old (21.6%) and those whose beliefs were not influenced by the COVID-19 pandemic (16.1% vs. 5.7%) (p-value=0.003). The study found a significant difference in vaccine hesitancy rates between the different sources of information (p-value <0.001); parents who got their information about vaccinations from social media were more likely to be hesitant about vaccinations (40%). Concerns about side effects (93.8%), thinking that vaccines are not safe (84.4%), and thinking that fewer vaccines are needed (78.1%) were the top three factors influencing vaccine hesitancy. Conclusion This study urges promoting vaccine uptake through healthcare providers and combating vaccine misinformation on social media. Additionally, addressing safety concerns and misconceptions about vaccine necessity, and focusing on first-time parents, younger parents, and those with lower socioeconomic status are recommended strategies to improve vaccine uptake rates.

Determinants of COVID Vaccination Willingness among Health and Non-Health Studies Students: A Cross-Sectional Study

Students, as a relatively health-informed population group, may still have limitations in health literacy, which is a concern as students take increasing responsibility for their health and make independent health decisions. The aim of this study was to evaluate the overall attitudes towards COVID vaccination among university students and to investigate various factors contributing to vaccination willingness among health and non-health studies students. A total of 752 students from the University of Split were included in this cross-sectional study and completed a questionnaire that consisted of three sections: socio-demographic data, health status information, and information on vaccination against COVID-19. Results show that the majority of students of health and natural sciences were willing to be vaccinated, but the majority of students of social sciences were not (p < 0.001). Students who used credible sources of information had a more significant proportion of those willing to be vaccinated and the majority of students who used less credible sources (79%) or did not think about it (68.8%) were unwilling to be vaccinated (p < 0.001). Multiple binary logistic regression modeling shows that female gender, younger age, studying social sciences, negative opinion about the need to reintroduce lockdown and the effectiveness of epidemiological measures, and usage of less credible sources of information were the most important factors contributing to increased vaccination hesitancy. Therefore, improving health literacy and restoring trust in relevant institutions can be critical in health promotion and COVID-19 prevention.

Seroprevalence of SARS-CoV-2 immunoglobulin G antibody during COVID-19 pandemic in Fayoum District, Egypt: a community-based pilot survey

Introduction

controlling the worldwide pandemic, coronavirus disease (COVID-19), could be impossible due to the hesitancy about the available vaccines and the difficulty to implement strict restrictions. Little information is available about herd immunity in the highly vulnerable region of North East Africa, Egypt. The objective of this study was to assess the seroprevalence of SARS-CoV-2 during the pandemic in one of the highly vulnerable populations in Egypt, the Fayoum district of Fayoum Governorate. Additionally, to assess the predictive value of symptoms and other associated risk factors towards a positive COVID-19 test.

Methods

in this cross-sectional community-based pilot study, immunoglobulin G (IgG) antibodies that are specific for the SARS-CoV-2 spike (S1-RBD) protein were tested during the period from February 2021 to July 2021.

Results

out of 155 participants, 60.6% were SARS-CoV-2 seropositive. Out of symptomatic and asymptomatic individuals, 76.5% and 56.2% were seropositive, respectively. Surprisingly, only one individual had received the COVID-19 vaccine. Previous history of COVID-19; such as symptoms and gender are statistically significant predictors of high seroconversion independent of age, comorbidities, and level of education.

Conclusion

this study which disclosed unexpectedly high SARS-CoV-2 seroconversion among the Egyptians, might provide a clear insight into COVID-19 transmission patterns and state of immunity. Further study with a larger sample size on a large scale is required to represent the whole local population.

Reasons for not getting COVID-19 vaccine in Ardabil, a Northwestern province in Iran: Based on an ecological approach

BACKGROUND

Understanding the reasons for not getting the COVID-19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated.

METHODS AND MATERIAL

This study was conducted from October to December 2021 on 426 participants who had not received the COVID-19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy-making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment.

RESULTS

A significant difference was found regarding gender between likely and not likely groups (P = 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738-0.942), P for trend = 0.003; model 1: OR = 0.820 (CI: 0.724-0.930), P for trend = 0.002; model 2: OR = 0.799 (CI: 0.703-0.909), P for trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783-0.948), P for trend = 0.002; model 1: OR = 0.864 (CI: 0.784-0.952, P for trend = 0.003; model 2:OR = 0.862 (CI: 0.781-0.951, P for trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy-making (P > 0.05).

CONCLUSIONS

We found that a high score of "interpersonal" and "group and organization" factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.